Global Health Chronicles

Dr. William H. Foege

David J. Sencer CDC Museum, Global Health Chronicles
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2:40 - Background and Education

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Partial Transcript: Can you tell us about your childhood and early years?

Segment Synopsis: Dr. Foege shares his experiences growing up and how his sister and a hip injury inadvertently got him interested in medical school and global health as well as a professor who introduced him to the EIS.

Keywords: A. Schweitzer; B. Strunk; global health; hip injury; medical school; minister; older sister; R. Ravenholt

Subjects: Colville, Washington; Epidemic Intelligence Service [EIS]; Pacific Lutheran University

6:01 - EIS/smallpox

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Partial Transcript: What did you end up doing in the EIS?

Segment Synopsis: Dr. Foege recalls how one of his first EIS investigations was a suspected case of smallpox which led him to India where as a substitute Peace Corps physician saw real smallpox cases.

Keywords: C. Dixon; chickenpox; D. A. Henderson; D. Millar; herpes; measles; medical student; thrush

Subjects: Epidemic Intelligence Service [EIS]; India; New Mexico; Peace Corps; smallpox

9:40 - Smallpox eradication

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Partial Transcript: Were they at CDC heading up different part of the organization?

Segment Synopsis: Dr. Foege recalls his time as a consultant for the smallpox eradication program in West and Central Africa, the fact that this is a cause-and-effect world, that nothing is done without a coalition and every public health decision is based on a political decision.

Keywords: A. Langmuir; cause-and-effect world; coalition; D. Millar; D.A. Henderson; politics; smallpox eradication; T. Weller; tropical public health

Subjects: Central Africa; EIS; Epidemiology; Harvard University; Nigeria; West Africa

18:52 - Directorship and reorganization of CDC

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Partial Transcript: Can you tell us a little bit about the motivation for this reorganization and describe the early years of this reorganization and some of the challenges?

Segment Synopsis: Dr. Foege explains the reasoning behind why CDC reorganized in the late 1970s and some of the challenges they faced.

Keywords: B. Bumpers; centers; chronic disease; D. Bumpers; D. Millar; environmental; infectious disease; management; occupational diseases; reorganization; W. Dowdle

Subjects: Arkansas; Centers for Disease Control and Prevention (U.S.); epidemiologists; laboratorians; red book committee; statisticians

25:31 - Early years of the AIDS epidemic

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Partial Transcript: What was the initial thinking about this disease at the highest level of the agency, and what was your response in terms of mobilizing a team?

Segment Synopsis: Dr. Foege talks about how CDC responded by putting together an investigation, how the investigation quickly adapted as new the realizations and transmission routes were identified and when the announcement came about the identification of the virus.

Keywords: blood screening; blood transfusion; cancer; D. Francis; E. Brandt; epidemiology; Factor VIII; first cases; gay community; H. Jaffe; immune system; J. Curran; Los Angeles; M. Heckler; P. Wiesner; plasma; R. Gallo; researchers, clinicians; vaccine; virus

Subjects: Africa; AIDS [acquired immunodeficiency syndrome]; blood bank industry; CDC; hemophilia; Kaposi’s sarcoma; Morbidity and Mortality Weekly Report [MMWR]; Mt. Sinai Medical Center; Nobel prize; Sexually Transmitted Disease [STD] program

35:04 - AIDS in Africa

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Partial Transcript: Science did eventually take care of this problem.

Segment Synopsis: Dr. Foege describes how a coalition of leaders from governments. technology and drug companies worked together to improve and control the spread of AIDS in Africa, to improve the human condition.

Keywords: B. Gates; coalition; G. Macdonald; H. Gayle; heterosexual; human condition; J. Carter; J. Curran; Mectizan; newborns; orphans; R. Gilmartin; S. Berkley; sexual partners; Y. K. Museveni

Subjects: Africa; AIDS in Africa; Botswana; Global AIDS; HIV [human immunodeficiency virus]; Merck Drug Company; Microsoft; pregnant women; Rockefeller Foundation; Task Force for Child Survival; Uganda

45:35 - Persuasion and personal style

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Partial Transcript: Do you listen a lot?

Segment Synopsis: Smallpox Eradication Program; Nigeria; USAIDS [United States Agency for International Development];

Keywords: A. Young; Enugu; G. Wills; leader; learning; personal relationships; R. Perot; rapport; trust; Washington D. C.

Subjects: Nigeria; Smallpox Eradication Program; USAIDS [United States Agency for International Development]

53:35 - Political environment at the beginning of AIDS Epidemic

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Partial Transcript: Can you tell us about some of your efforts to draw the federal government’s attention to this disease and to get funding to address it?

Segment Synopsis: Dr. Foege explains the political environment during the early day of the AIDS epidemic, the creation of PEPFAR, how having C. Everett Koop helped and why public health needs politicians but public health should not yield to politics.

Keywords: abortion; abstinence; C. E. Koop; condoms; E. Brandt; G. W. Bush; H. Clinton; hate mail; incorporate politicians; infant formula; N. Reagan; political environment; R. Schweiker; treatment; W. Dowdle; W. Watson; White House

Subjects: CDC; Food and Drug Administration [FDA]; MMWR; PEPFAR [Presidents Emergency Plan for AIDS Relief] World Health Assembly; Reye syndrome; Surgeon General; U. S. delegate; U.S. Federal Government

66:58 - Insights on CDC’s response to the AIDS Epidemic

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Partial Transcript: What did we do best, and what could we have done better?

Segment Synopsis: Dr. Foege is most proud of the science CDC did in the early days of AIDS epidemic, how current EIS applicants now include sociologists and anthropologists for the insight into culture, was surprised by the size and speed of the outbreak and how a few foundations helped with more funding for research.

Keywords: anthropologists, sociologists; coalitions; culture; D. Brandling-Bennett; development; epidemic; outbreak; power; S. Berkley; Science; sex lives; speed; spread; woman

Subjects: Africa; AIDS; Canada; Gates Foundation; Gay community; NIH; PEPFAR; Rockefeller Foundation; Thailand

73:58 - Coalitions and politics

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Partial Transcript: Or can you comment at all about that?

Segment Synopsis: Dr. Foege explains that collations may be messy but sometimes they provide an avenue that the organizations can’t find themselves, and how politics actually gave us our public immunization program,

Keywords: American children; D. Bumpers; D. Eisenhower; different rules; H. Mahler; H. Nakajima; immunization; J. Grant; J. Helms; L. Hill; non-coalitions messy; O. Hobby; polio eradication; politicians; R. Henderson; T. Francis

Subjects: AIDS; HEW [Department of Health, Education and Welfare]; Rockefeller Foundation; Task Force for Child Survival; UNDP [United Nations Development Program]; UNICEF [United Nations Children’s Fund]; WHO [World Health Organization]; World Bank