On the Frontlines of Public Service

Putting Science and Data into Action with CDC Director Dr. Robert Redfield

Contagious Conversations  /  Episode 7: On the Frontlines of Public Service

Talking data, disease and the human condition

Dr. Robert Redfield shares his thoughts on how we can eliminate HIV in the United States by 2030, why opioid disorder is the public health crisis of our time, and what it's like to work with a team that puts science and data into action in the name of public service.



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Below: CDC Director Dr. Robert Redfield travels to the country of Georgia to meet with Georgia’s Director of National Centers for Disease Control and Public Health (NCDC) and other NCDC staff. CDC provides support to NCDC to strengthen laboratory, surveillance and workforce capacity for key public health issues such as hepatitis C virus elimination, measles, rabies and polio eradication.





Claire Stinson: Hello, and welcome to Contagious Conversations. I'm your host, Claire Stinson. Every episode, we'll hear from inspiring leaders and innovators who make the world healthier and safer for us all. Contagious Conversations is brought to you by the CDC Foundation, an independent nonprofit that builds partnerships to help the Centers for Disease Control and Prevention save and improve more lives.

Joining me today is Dr. Robert Redfield, director of the Centers for Disease Control and Prevention and administrator of the Agency for Toxic Substances and Disease Registry. Prior to becoming CDC director, Dr. Redfield had a long and distinguished career in public health, including researching and contributing to the early scientific understanding of HIV, serving as the chief of infectious diseases and vice chair of medicine at the University of Maryland School of Medicine, and serving on the president's advisory council on HIV/AIDS from 2005 to 2009. In this episode, Dr. Redfield shares his career path to becoming the CDC director, his thoughts on how we can eliminate HIV in the United States by 2030, and the importance of CDC's work to protect America from health, safety and security threats. Welcome, Dr. Redfield.

Robert Redfield: Thank you. I'm glad to be here.

Claire Stinson: To get started, I'd like to talk a little bit about your background. Did you always know you wanted to be a physician and a virologist and what led you to this path?

Robert Redfield: Well, both my parents were in science. They were both at NIH. My father died when I was quite young and my mother continued in science. So I always was brought up in a household that had a great love for science. I will say as time went on, I thought that the aspect of science that I was most interested in was actually medicine and the human condition. And really had a perspective that while right now viruses are diseases that we confront, it seemed to me that viruses had the potential, actually, of being harnessed so that they somehow could actually be delivery systems for the medicines of the future. And so I became very interested in virology.

Claire Stinson: And that led to you becoming a physician as well?

Robert Redfield: And it led to me to become a physician. My mother sadly died last year at 96. She used to always pray that her son would become a “real doctor” and for her that was a laboratory physician, a researcher. I enjoyed seeing the fulfillment of what I did more immediately gratified. My father worked on a number of things back in the '50s that really became the underpinnings of much of science 50 years later. You know, he had that ability, so did my mother. I wanted much more immediate fulfillment, so obviously I thought medicine was going to be closer to that and do clinical research in the field of medicine.

Claire Stinson: Well, you certainly contributed a lot to that field.

Robert Redfield: Well, thank you.

Claire Stinson: Over the course of your career, you are credited with making important observations on the transmission of HIV and you have studied the care of people with chronic viral infections. Can you tell me more about that?

Robert Redfield: Well, when I finished my... or when I was in training for my fellowship after internal medicine and infectious disease, it was when the AIDS epidemic just started. It was just reported. And truthfully, a lot of us that got involved in AIDS at the beginning were kind of the new individuals that weren't established. Because I think initially a lot of people didn't understand how important this was. And so that's when I began working and researching on HIV infection – or AIDS at that time. I was very fortunate to have the ability to collaborate with a number of individuals at the NIH in the early years, and as such saw the power of science. I can remember seeing early electron micrographs of the virus that we now knew caused AIDS. I was able to work with collaborators, Bob Gallo and others at the NCI, and be part of that paper that really proved that HIV was the cause of AIDS, and solve that, and work with Sam Broder and others on some of the new therapies, AZT, and then Tony Fauci's group on some of the immunopathogenesis.

So I got to really work with some really good groups and see how science could begin to be impactful and start to change my patients’ lives. And it was really through that work that I began to understand that it wasn't just AIDS. There was actually a very systematic continuum of progressive immune deficiency that if you were very critically evaluating patients you could actually stage them, and then developed one of the early staging systems. It was difficult because some of the observations I made like, at that time were somewhat painful. They actually– first AIDS conference was here in Atlanta, I think back in 1985. And I presented our first paper that if you look critically at people, that I was following, you could see that at that time 93% of them were actually getting sicker. And that was at a time when people would say only 5% of people get AIDS. So it was clear that this was going to be a progressive disease in the majority of individuals in the absence of a scientific solution.

The other thing that was unique is of where I was positioned in my early years. The reason I got involved in AIDS research was that I was responsible for viral diseases that may pose threats to soldiers, sailors, airmen and women. And that was my job, particularly focused on those viruses that could either be blood-borne or sexually transmitted. So obviously as the AIDS epidemic started, it was clear that that may be falling in that category. So that's when I started to work on trying to understand AIDS better. And it was in that time that the military then sent all the patients with AIDS to Walter Reed for me to be the doctor, and I started caring for patients.

Our experience was very different because back in 1984, 85, 86, between 30 and 40 percent of my patients were women and over 50% were married. And that gave me the opportunity to start studying the interrelationship between AIDS if somebody had it and their – their spouse. And that's how we did the early studies to show that the virus was actually a sexually transmitted disease, can be transmitted from men to women, women to men. I was met with a lot of skepticism back in 1985, 86, but those were really some of the things that we did.

Claire Stinson: That's quite an extensive background and you brought all that with you to CDC?

Robert Redfield: Well, it's always been a dream of mine to be able to be at CDC and obviously be the director of CDC. I feel I've trained, you know, my entire life for it. I had a great opportunity to work with CDC in the '70s on a number of areas when I was in my early military career, and of course the AIDS stuff in the early '80s, got to work with CDC a lot. So a lot of respect for the organization. So it was really a great gift when I got the opportunity to be asked if I wanted to be the director.

Claire Stinson: Absolutely. So since coming to CDC, you've laid out three priority areas for the agency. What guided you and your team to these priorities and how is CDC addressing these?

Robert Redfield: Well, I think when you get an opportunity like this, you have to realize... I always tell people my first job in the military at Walter Reed was for 23 years. My second job at University of Maryland was for 22 years. You know I had my fingers crossed, but I don't know if it's in the cards for me to get to stay here for 21 years. And so when you realize you have a job like this, you realize you have a time period of which you can try to make an impact. And you don't really want to do things that the next individual comes in just takes it all apart. So you've got to look at what is doable, what's important.

And as I stepped back and looked at it, there really were three key areas that I felt CDC had a critical role, which was outbreak epidemics, and eliminating disease when science has provided us the tools to do that, and to build an effective platform to protect the American public from the global health threats that we have and make sure domestically we're prepared.

And then in top of that was the recognition, well, what are the core capabilities that an agency needs to do those missions? And it really is remarkable CDC has been as successful as it has, because there's never been earmarking to fund those core capabilities per se. What are they? One of them is data. You know without data, we really are limited. And we don't want data to be historical, we want data to be actually predictive, so that we can predict where we need to intervene. We need to have laboratory capacity that is up-to-date to be able to actually detect the different diseases that we're trying to diagnose and detect. They need to be deployed throughout the States and local and territory and travel groups that we work with around the country. You need a workforce and you need to keep investing in that workforce. So those are the priorities.

You know, within outbreaks: the outbreak of our time, as an infectious disease physician, I didn't think as CDC director I would be focused on a non-infectious outbreak. But it is. It's obviously the drug use disorder, opioid outbreak, that's the public health crisis of our time. Eliminating disease: very proud of President Trump's decision in the State of the Union to launch an initiative to put science in action to bring an end to the AIDS epidemic. I'm sure we'll talk more about that. Obviously the other area that's important to me is that the American public embrace vaccination, that we have the tools to prevent a variety of very serious diseases that many people in today's society haven't seen, so they don't realize how serious the disease is. So those are the two, and then of course the global health security. So those are the major areas I focused.

Claire Stinson: All vital and important topics. And good luck to you, with all of those. As CDC director, we wish you the best.

This year, government health officials put forward an ambitious plan to eliminate HIV in the United States by 2030, as you just mentioned. Why do you believe that's possible and what is the biggest impediment that must be overcome to end this epidemic?

Robert Redfield: Well, one of the things that's so important to me personally, as I mentioned my parents are scientists, is, you know, science is meant to be put into action to improve the human condition. So when you have the science that can improve the human condition, it needs to be used. And the reality is that we have the science to end the AIDS epidemic in the United States. We've had it for some time now. That is, that we know how to diagnose individuals, we know how they treat them now and it's quite straightforward.

When you are treated, you're not only going to improve your life expectancy to near normal, we now know that if your viral load is suppressed, you're not able to transmit to somebody else. We have prevention strategies. Now that we have evidence-based – it's no longer opinion – we know we have evidence-based data to show they work, pre-exposure prophylaxes. If you're at risk for HIV infection, exposed by a means known to transmit, and you take pre-exposure prophylaxis, you're not going to get HIV infected, very low possibility. We have evidence base now, importance of, say, syringe exchange programs.

So these are the elements that we have in our inner fingertips and we just need to actually apply them in a systematic way. This was why President Trump's decision to launch this initiative to reduce new infection by 75% in the next five years and 90% in the next 10 years is no longer an aspirational goal, it's a very pragmatic goal. We have every intention of accomplishing it and getting this mission completed.

Claire Stinson: Well, I love to hear your optimism. It sounds like you are really optimistic about this.

Robert Redfield: Yeah. I would even say it's not optimism, it’s, it’s – this is something that's very doable, and I think we have the right tools, the science I mentioned. We clearly have a number of us that have been this in for a right long time. We're in a position to get this done. I'm very proud, again, I mentioned the president putting this forward. Secretary Azar has made this one of his five now major objectives, pillars of his secretary time. This initiative is not a CDC initiative, it's the entire Department of Health and Human Service initiative. Very proud that we're actually working together, and say as a single organism, under the direction of the Assistant Secretary of Health, NIH, HRSA, CDC, Indian Health Service, to get this done.

One of the things that was remarkable that allowed people to see that this converted itself from an aspirational goal that we put out there where we try to get toward but we're never going to get it, to actually very pragmatical that we're going to accomplish… When we looked at the new infections that occurred in this country, about 40,000 a year, if we did nothing over the next decade, that's another 400,000 infections that we're going to have of HIV. And that, you know, at the average, 2017, healthcare costs were $476,000. You can see that's looking at about 200 billion to a quarter of a trillion dollars in future healthcare costs. But when we looked at where those cases were occurring, it turned out that more than 50% of all the new diagnosis in our country were attributed to only 48 counties, Washington, D.C. and San Juan. So 50 jurisdictions out of the more than 3,000 jurisdictions. When you see that geographic focus, all of a sudden everyone looked at it and said, "Wait a minute, we can actually do this." And of course then leadership said, "Let's get it done."

Claire Stinson: Well, that's amazing. And we look forward to seeing the progress on all of that. Another important topic for CDC and a priority for CDC that you mentioned, is opioid addiction. Opioid addiction and mental health are two issues that you've discussed quite a bit. In your view, where are we making progress on these two issues?

Robert Redfield: Well, I think again, just to emphasize that the drug use disorder led by opioids is the public health crisis of our time. When I, the year I became CDC director, over 70,000 people died from drug overdose. We're making progress, but still we're in the high 60,000s drug overdose. So it's a very, very serious problem. And we've gone through four ways, heroin, prescription drugs, now the fentanyl contamination of our products, and there's a new wave that's starting to emerge in a number of different states as the dominant way, which is methamphetamines. So it’s a comprehensive issue. I think it's important first and foremost that we all recognize drug use disorder for what it is. It's a medical condition, it's not a moral failing. It's not only a medical condition, it's a chronic medical condition. And again, not only is it a chronic medical condition, it's a chronic relapse in medical condition. We need to recognize it for what it is.

We also need to allow individuals to not define themselves by their medical condition. All too often individuals that have drug use disorder have been pushed to be defined by what is viewed by many as a behavioral decision to use drugs, as opposed to the medical condition that it is. And so, like one of the challenges I didn't mention in HIV, the challenge in drug use disorder is that we have to really confront stigma. You know I've been said that stigma is the enemy of public health. It doesn't have a place in public health. We need to sort of bring drug use disorder out, front and open, allow young people to reestablish the joy of who they are despite the fact that they're confronted with a chronic relapse in medical condition.

Claire Stinson: All really interesting points. Where do you feel like we're lagging behind with opioid addiction?

Robert Redfield: Well, I think we're continuing to make progress, as you know. I think, you know, we are trying to educate in a variety of different ways. We're trying to educate providers about the risk of addiction with prescribed opioids for example, and trying to decrease that. We're trying to educate the American public also. One of the areas that we're making progress, we still have much progress to make, is recognizing the importance of prescribing countermeasures for drug overdose, Naloxone. You know, made a lot of progress on that and that's really what's impacting the change and decline in mortality that we've seen, the 5% decline or so. But we're still not where we need to be. I think if you look at high-dose prescribed opioids, we're still seeing co-prescriptions of, say Naloxone, maybe one in 60. We want it to be 60 in 60.

So we really need to continue to increase the awareness that drug overdose happens. It happens with both prescribed and non-prescribed opioids. And we need to make sure all users, whether they're prescribed or non-prescribed, carry and access and their family members have access to Naloxone so that if they do have an overdose, their lives can be saved.

Claire Stinson: Thank you for your candor on that. Sounds like there's a lot of work to be done in this area.

Robert Redfield: Well, yeah, but I will say again, very proud, both President Trump, Secretary Azar, providing leadership on this. This is one of the original four pillars for the secretary to really take on opioid disorder and now the broader drug use disorder. We don't have any intention of not winning this war either. It's just more complicated. We need more scientific tools, unlike the HIV where we have all the tools we need to win, we just have to execute. In this case, we still need more scientific tools. But I know NIH is working hard on them, and industry, private sector, to provide those tools and ultimately science is going to provide solutions. In the meanwhile, we need to execute with the tools that we have to try to save lives and improve the human condition.

Claire Stinson: Sounds like an important public health topic right now.

Robert Redfield: It's very important. It’s – as I say, it is the public health crisis of our time.

Claire Stinson: We'll be right back with Dr. Redfield.

Since this is a show about contagious conversations, we want to hear from you. Each episode we'll ask you a question and this episode's question is, how has the work of CDC impacted your life? Just email info@cdcfoundation.org to answer. That's info@cdcfoundation.org. And if you share your thoughts with us, you'll have the chance to win some CDC Foundation merchandise.

And now, back to our conversation with Dr. Redfield.

So, you've spoken about data, Dr. Redfield. The potential of utilizing data to address a myriad of public health challenges at the local, state, national and international level is something I know is exciting to many public health professionals. What are the challenges to getting the most out of data at the federal level?

Robert Redfield: Well, data is really critical. I mean, it's really the basis for... when we talk about our model of detection, response and prevention, it's all grounded in data. You know? CDC is science-based, but it's data-driven. And for data to be really useful, in my view, it's got to be actionable. For it to be actionable, it's got to be timely. I give one of the situations I reflect on: when I first became CDC director, I got briefed on the extent of the opioid epidemic in the – in the nation, since it's a very important priority for the president, for the secretary, but it's also important for me, and for CDC. When I finished the briefing I asked the subject matter expert what the data was through and they said it was through March of 2015. And I looked at my phone and I said, "But it's April 2018." And they explained to me that I didn't understand all the nuances of how hard it is to get the data from all the jurisdictions to state and get it – the term they use is curated, make sure it's accurate. It just takes time.

And I feel very strongly that data does not need to be historical. We need to use data in public health in real time, but more importantly we need to use it for predictive analysis so we know where – where we need to intervene before public health problems happen. When you look at Scott County – many people realize Scott County where we had an outbreak in Southern Indiana of HIV – when that was all said and done, 5% of the population had HIV. Over 90% of the IV drug users also were coinfected with hepatitis C when that was done. We know from predictive analysis that we've done that there's over 220 counties in this nation that have all the parameters to suggest they're at risk to become the next Scott County. So you want to have data to do that.

When we sit here today, the progress that the administration has made on the opioid situation today, states now get opiate overdose deaths not in two years, but in 48 hours. Okay, so we're making progress. I think we need to modernize our data collection system across the public health infrastructure of our nation, have a very well-integrated data system between not just CDC, but CDC as you know, provides 70% of its resources go out to provide the public health funding of our states, our territories, tribes, and local jurisdictions. We need to all get into an integrated data system that can take advantage of the syndromic surveillance that we did for opioids where you can take electronic medical records and actually have them be the surveillance instrument. We need to get that all modernized.

And so when you say, "What's the obstacle?" The obstacle is to basically get a critical mass of commitment to make the core investment to get that done. It's going to take time, money, and energy to get it done. You got to make sure that the experts are actually doing it, so when you finish building it, you don't end up something that's no longer in date. But this nation will benefit enormously, public health, from a modernization of our public health data systems.

Claire Stinson: You've got some ambitious goals for your time as CDC director. Do you feel like you can accomplish all these goals?

Robert Redfield: Yeah. I think, well, it's not me by myself. I mean, one thing I've learned about the men and women at CDC, if you look at the, you know, here and the contractors, over 23,000 people that are grounded in science and data. But the thing that make them special is they're grounded in service, public service, and then you match that with the public health infrastructure of our states, our local health departments, territories and tribal health departments, I mean, there is a strong structure here. They just need some glue. And one of the most important glues in public health is going to be data.

Claire Stinson: Along those lines, what is the most challenging part of being CDC director?

Robert Redfield: You know, I think… you have to set priorities. But I think I've spent the time to do that. Some people will say, "What about doing this? What about this? Why isn't this a priority over this?" And for example, I have a great commitment to crack diseases, you know obviously diabetes in particular, obesity, these are important, tobacco use disorder. But you've got to focus your energy, you know as you try to solidify some of these programs and, and go where you think you can put science in action to eliminate certain diseases. But you do have to focus. So I think that's the challenge. You've got to focus. And I think my gravestone is going to have my name and it's going to have my dates of life and it's going to have the word “focus.”

So luckily for me, focus has always been central to what I've tried to do – is to pick the one, two, three things that you think you can get done and stick with it, don't get distracted. For some people, I mean, I think there is a challenge that you can get unfocused. But I'm going to stay focused.

Claire Stinson: That's interesting. What would you say is the most rewarding part of being CDC director?

Robert Redfield: Well, the hardest thing for me was I had to give up something, for at least for now, that I love very deeply, and that was being a practicing physician, taking care of patients. Many of them, of my patients, I've cared for from over 20 years, and we went through a time when they thought they had a fatal illness to the now that they can live in their normal lifetime. I miss that human interaction that in a sense I was able to see my own clinical and scientific knowledge be put into action on a daily basis. I enjoy seeing data go into action.

For me, I think the rewarding thing is to see the opportunities where enormously talented individuals here that are really committed to service, to apply their expertise, to really provide solutions to significant public health problems. I mean, every week there's a... every day there's another something, and people are all over it, making sure that they're doing everything they can to keep the American public safe 24/7. I think that interaction of seeing their skills put into action... From a frustrating point of view for some is, you know, 95, 99 percent of what's done here no one ever hears about, because it's the Center of Disease Control and Prevention and no one actually highlights the preventions, you know, when it's prevented. I think most of the people that are here don't need public gratification to know that they made an impact by the activities they've done each day.

Claire Stinson: Sounds like one of the most challenging and rewarding jobs out there. That's really important information and thank you for sharing that. What would you say is the biggest misperception about CDC and its work?

Robert Redfield: Well, I don't think a lot of the American public realizes that CDC really forms the public health infrastructure of our nation. As I mentioned, when we get appropriations from Congress, about 70% of those appropriations actually go out to the state public health departments, the county, the local, tribal, territorial health departments. So… you know, if CDC was not to be funded for example, the funding for the entire public health infrastructure of this country would be devastated. So I don't think a lot of people realize that we are the core of funding public health infrastructure of our nation. I personally believe that public health remains underfunded in this nation. It needs to be expanded. I think, you know, we're at a very exciting time where we're in the transformation from a disease system to a health system and the underpinnings of that health system is going to be public health. So it's the time to expand.

Maybe the other area of people may not know is the real global presence that CDC has. Some people may think it's a domestic organization. CDC has offices in 69 countries around the world. We believe strongly in the perspective that we need to detect threats at their source in order to protect this nation. The Ebola outbreak in the Eastern Congo is a good example of that. People have seen the impact of Zika coming, you know, from other parts of the world to our country. We're still in the midst of – endemic now – West Nile, which if you flash back 20 years ago was an isolated case in a zoo in New York. So I think people don't maybe understand that as much as I think they should. I think those would be the big ones that I would say.

Claire Stinson: That's really interesting and I think I would agree that a lot of people don't understand that CDC does work globally. Why does CDC work globally?

Robert Redfield: Well, I think that's the point I was trying to make is that the key to protecting this nation 24/7 is we need to detect outbreaks at their source. So we need to detect, respond and prevent them at their source. If they don't, then… we're in a global community now. Now some are complicated, like flu, where despite everything we do it's going to go global within 72 hours just because it's how it's transmitted. But it helps us to detect. We have very aggressive surveillance programs all over the world detecting new flus, so we kind of know when and if a new flu is working its way from the bird population in demand that might cause a pandemic and then cause significant morbidity around the world, including the United States. We work very hard to help understand that surveillance system to figure out what the best flu vaccine is.

The same we're doing now with Zika. You can remember not long ago Zika was a high concern that people in this country, particularly in the southern United States. So we have surveillance to make sure we understand where that is. So I think it's really important that we continue to be able to detect and respond and help respond to outbreaks where they are. The issue of global health security is something that this nation is going to need as long as we're a nation. I've always said that health development programs will come and go, but global health security and the ability to detect, respond and prevent global health threats is something this nation is going to need to have that capacity as long as we're a nation.

Obviously, I feel strongly that the core mission of CDC is in that space. We're the tip of the spear for global health security. We need to continue to build that capacity. It's a very important core mission that we have the responsibility for.

Claire Stinson: So along those lines, do you feel like CDC's global role is evolving?

Robert Redfield: I think it's evolving. I mean when you look at CDC's introduction in a bigger way to global, was when the PEPFAR program started. And we're really in a very important program. CDC is a very important contributor to that along with USAID and the Department of Defense. With that, we've you know, expanded our global footprint to meet that. And again, when PEPFAR really started, the underpinnings of it really was a security response, because life expectancy was dropping in many of these countries to below 40. There was a growing youth bulge from parents that had died and children had to raise themselves. There was great potential that the untreated, unchecked AIDS epidemic in Sub-Saharan Africa could become not only an economic security, but a national security concern in those areas.

And that’s been totally turned around by President Bush's program response. And now that's been continued and obviously... but it really has transitioned to a health development program now. It's no longer a security program. We believe the security mission remains, you know, and that's what CDC's continued role is. We're going to continue to try to articulate that that's a core responsibility of this agency, and hopefully that will continue to be invested in. So we'll build that long-term infrastructure to be able to provide this nation the global health security capacity that it needs, as I said, as long as we're a nation.

Claire Stinson: I've heard very, very many times that a health threat anywhere is a health threat to us all.

Robert Redfield: I think you just have to emphasize that. I mean, the CDC's role, as I say, when we're involved around the world, we're not a health development organization. USAID does health development. Okay. We're a health security organization.

Claire Stinson: Really important point. So Dr. Redfield, I know that you have been a proponent of public-private partnerships in your career. In your view, what are some areas of public health where public-private partnerships are helping accomplish key goals?

Robert Redfield: Well, I think it's key that you got to bring different groups together if you want to accomplish things, you know? I'm very hopeful within the president's HIV initiative, for example. I'm hopeful in different jurisdictions that private sector also gets engaged. You know, this is not something that has to have exclusivity to federal engagement in these programs. So I think there's a clear open door for that partnership as we move forward.

I think there's other areas that we need to see the private sector and foundations and others get involved in the area of making sure there's full utilization of preventive vaccines. I mean, I think there could be great partnerships, maybe even more effective partnerships with communication groups around the... you know, that may be at this present time facilitating disinformation. Maybe they can become greater partners in facilitating accurate information.

I think there can be great partnerships that I'd love to see happen in meaningful and in keeping away public health harm from young people, like… tobacco products. I think private sector can become part of the public health team in some of the things they do. I think there's an opportunity where we haven't been that successful, historically, to try to get the food and restaurant industry together to help us a little more on obesity and showing how we can confront maybe some of the eating styles that the American public has that could be modulated. But they're going to be modulated most effectively when there's a partnership. And I will say ultimately, those partnerships are going to be key to what programs are successful, what programs meet their goals to get over the goal line.

Claire Stinson: And at the CDC Foundation, one of our taglines is, together our impact is greater. Would you say that that resonates with public-private partnerships?

Robert Redfield: Very much so. And I think it's also one of the most important partners not to exclude – I was always proud in the President Bush administration, he brought them to the tables – don't underestimate the impact of bringing in the faith community as part of that public health partnership. A lot of times, you know, people don't realize how influential they are as part of this public health partnership. So the private sector, really important, but the faith community, very important. Obviously, the federal government is an important partner. And, you know, foundations like your own are really important because they sometimes can fill gaps in making sure that the program actually works. So I think you're not going to solve any of these problems in the public domain only.

Claire Stinson: We're very proud to support CDC's mission on a daily basis. So Dr. Redfield, you've been at CDC for over a year now, what can you tell me that you've learned about CDC's team?

Robert Redfield: Well, I think I said this before. The one thing that has just been validated is that CDC is science-based. That's ultimately it's strength. It's data-driven. And so its recommendations... I've always said we're not an opinion organization. All right? We're science-based, data-driven. And I think that's why CDC has maintained the credibility that it's had, and I'm confident we'll continue to have, in being able to come up with recommendations that put science and data into action with key recommendations.

The second thing that I learned, I think, or relearned, is that this is an organization full of really committed men and women that are service. This is a service organization. This is not an academic medical center. You know. This is not a pharmaceutical group. This is a public health service organization and the people are here to use their skillsets to serve the public. And nothing gratifies them more when they see they're able to put science and data into action that –  make some recommendation that then they see actually applied, and the end result is the human condition is better.

You know one of the ones I'm hoping to see happen on our watch is to see maternal mortality go down, infant mortality go down. The wonderful thing about an agency like this is you don't just say that you made an impact. You measure. Obviously, the most important one for me personally in the years quite ahead is to see the president's HIV initiative meet its mission sooner even than our expectations that we put out there to get this done, put science into action and show that we can end the HIV epidemic in America and let our nation be a beacon to other countries that then follow and do the same. And then now that we've seen the joy as a nation of putting science into action, let's pick our next target and put science into action and eliminate the next disease that's plaguing the American public, to improve the human condition.

Claire Stinson: We really appreciate your time today. This has been a very thoughtful discussion. Thank you so much for being on Contagious Conversations.

Robert Redfield: Thank you very much.

Claire Stinson: Thanks for listening to Contagious Conversations, produced by the CDC Foundation and available wherever you get your podcasts. Be sure to visit cdcfoundation.org/conversations for show notes and bonus content. And if you like what you just heard, please pass it along to your colleagues and friends, rate the show, leave a review, and tell others. It helps us get the word out. Thanks again for tuning in and join us next time for another episode of Contagious Conversations.