On November 4, many Americans will go to the polls to vote in the midterm elections. And like all election seasons, issues threatening public health are chief among this nation’s top concerns.
In researching for this post, I came up with a fairly long “short-list” of pressing public health issues – women’s health and contraception, states that have not expanded Medicaid, food insecurity, domestic violence, immigration, climate change, tobacco control – to name a few. Each of these issues is socially and politically complicated, nuanced, and frankly not new. We will be fighting these issues this year, in four years and sadly in eight and twelve.
Still, three issues stand out from the pack:
Antibiotic Use in Livestock and the Rise of Superbugs
Dwindling Federal Funds Allocated for Medical Research
These issues are distinguishable from those on the short list because they are largely born out of poor legislation and weak exercise of regulatory authority, consequently rendering each issue ripe for control through our legislative process.
Voting at the ballot box in 2014 at the local, state and federal level will have a direct impact on the success or failure of any initiative to address each of these issues. Electing public servants who are committed to using their power in office to serve public health is an achievable goal. They just need your vote. Antibiotic Use in Livestock and the Rise of Superbugs
Scientists around the world have provided strong evidence that antibiotic use in food-producing animals can have a negative impact on public health.
As this blog has reported, here (FDA issues guidance for the use of antibiotics in livestock), here (7 things you can and should do to stop the spread of antibiotic resistant superbugs ) and here (6 things the US Government can and should do to stop the spread of antibiotic resistant superbugs)the rise of antibiotic resistance has been a challenge for many years, but the imminence of the threat has never been greater.
For over five decades, livestock producers have been using antibiotics to induce growth and raise animals in filthy crowded cages at the expense of human health. Today, it is widely accepted that these practices contribute to the growing epidemic of antimicrobial resistance. Last year, 23,000 people died from antibiotic resistant infections and 2 million more fell ill.
Last week, President Obama issued an executive order establishing a Presidential Advisory Council comprised of nongovernmental expert advisers and an interagency task force to write a five-year national strategy plan to combat antimicrobial resistance. The President, in collaboration with the National Institutes of Health, also established a $20 million prize for the development of new diagnostic tools to help identify bacterial infections quickly and efficiently and help track the spread of highly resistant bacterial infections.
Dr. Eric Lander, co-chairman of the President’s Council of Advisers on Science and Technology explained that “[antibiotic resistance] has been a problem that’s been brewing for decades, this is now an [issue] that… I think we’re all aware requires very serious, coordinated action [w]hat’s new here is a real federal focus on this.”
Without congressional attention and support, however, the reach of President Obama’s “federal focus” will be seriously limited. Who sits in office after the 2014 midterm elections will directly impact whether the President’s plan gets the funding and attention it requires. In the last two years, both the House (H.R.1150) (H.R. 820) and Senate (S.1256) (S. 895) introduced bills addressing the growing threat of antibiotic resistance resulting from the overuse of antibiotics in livestock. Each of the bills is currently stalled in committee. Without the right leadership, both bills are likely to die there.
The more Congressional leadership that cares about these issues the better.
To let potential candidates know that this issue is important to you, use this tool to find your candidate. Tweet them and ask: Can I count on your support to stop superbugs by ending the overuse of antibiotics on factory farms?
Across the board, funding for medical research is on the decline. After adjusting for inflation, NIH funding today is 25 percent less than it was in 2003. Diminishing funds are bad for public health and bad for our economy. In 2011, NIH investment supported 432,000 jobs and generated $62.13 billion in economic activity (2012, NIH’s Role in Sustaining the U.S. Economy).
At the same time, we learned that this nation cares about medical research. We saw the entire nation generously open their wallets in support of a little known disease and raise over $100 million, more than two times the amount of funding NIH allocated for ALS research in 2014 (ALS #icebucketchallenge).
Out of any of the public health issues to consider in 2014, funding biomedical research is arguably the most obvious and the least contentious. But funding is directly tied to what our elected officials in Congress appropriate to the NIH.
As Mary Woolley, President of Research!America, the nation’s largest not-for-profit public education and advocacy alliance working to make research to improve health a higher national priority, explained in her weekly advocacy blog:
“Using social media this election season to ask candidates to take a stand on the importance or lack of importance they assign to medical progress is a different challenge than pouring freezing cold water over your head and/or writing a check to the ALS Association. Both are ways to speak out about the importance of fighting back against diseases instead of standing down, as Congress appears to be doing. Contact your candidates and tell them what you think. Don’t wait; seize this teachable moment; make a phone call; show up at a town hall meeting; use social media to connect to candidates. Tap our list of candidates’ Twitter handles to easily direct a tweet to their attention.”
Here’s a suggested tweet: Do you support medical research and promise to restore necessary funding to the NIH?
Use this tool to find candidates in your district. Give them a call or send them an email and let them know that your vote rests on their commitment to to support more funding for NIH.
The gun control debate has been particularly polarizing in this election cycle. Recent gun-related tragedies and attempts to respond with legislation and have fueled passions across a spectrum bookended by gun control advocates and those championing the second amendment as their birthright to gun ownership.
The discipline of public health applies a different, distinctly more rational approach to regulating gun ownership. “Public healthis ‘the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals.’” On a daily basis, our individual behaviors are legally bound by what is best for the greater community. As drivers we are legally required to procure a government issued license. As parents we are legally bound (in most cases) to vaccinate our children against highly contagious diseases. As business owners we are prohibited from polluting our waterways with toxic waste. Each of these laws is intently designed to protect the public health.
Why do we distinguish gun ownership? Why as a society do we protect the individual’s right to own a gun at the expense of another person’s safety? Second Amendment arguments supporting gun ownership are muted when the issue is understood in the context of what is the best legislation our leaders can enact to protect the public health.
In this election cycle, vote for a candidate who understands the implication of gun violence on the public’s health. Changing American psychology towards gun ownership needs to start with our elected officials. Last year, members of Congress blocked the nomination of a new surgeon general because of his position for a ban on assault rifles. Really?
Whether you are voting in the 2014 midterm elections at the local, state or federal level, vote to save lives by choosing a candidate supporting responsible gun ownership. The group, Everytown for Gun Safety put together a resource rich website to help inform your decision about which candidates hold good positions on gun safety.
Want to know whether your candidate advocates sensible gun policies? See here.
Call your Senator. Americans for Responsible Solutions provides a direct dial option and a script you can use to let your representative know that you want them to vote for sensible gun control laws. Let them know your vote is contingent upon your representative’s support of sensible gun legislation.
Be part of the solution. This November, support these vital public health initiatives by using your voice to influence those representing issues important to you.
The views reflected in this expert column are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.