‘Heart disease is the Number one cause of premature death globally’

Dr. Tom Frieden is the President and Chief Executive, of Resolve To Save Lives, an international NGO. In this interview with CHIJIOKE IREMEKA, he spoke on the efforts of the organisation to combat heart diseases and other heart-related ailments.

BEFORE we talk about Resolve To Save Lives and its activities in Nigeria, could you share with us your background, who is Dr. Tom Frieden?
I currently serve as the President and CEO of Resolve to Save Lives, and formerly worked as the director of the US Centers for Disease Control and Prevention where I led the CDC response against the Ebola epidemic. I also worked as Health Commissioner of New York City, helping prevent deaths from smoking, and spurred national and global action on better epidemiologic understanding and control of public health problems, including HIV, tobacco control, nutrition, and the integration of health care and public health.

While working with WHO in India, I helped support the Indian tuberculosis control programme to improve diagnosis and treatment rapidly, saving at least 3 million lives. When I’m not working, I enjoy spending time with family, reading and staying physically active.

What’s the idea behind Resolve To Save Lives, what informed the decision to set up the NGO?
Resolve to Save Lives is a global public health non-profit organisation with the goal to prevent 100 million deaths from heart disease and make the world safer from epidemics. We are committed to saving lives from these preventable causes by partnering with the government and civil society to implement scalable, proven strategies.

Your organisation recently partnered with the Nigeria Centre for Disease Control (NCDC) and the African Field Epidemiology Network (AFENET) to set up the Revolving Outbreak Investigation Fund (ROIF). Can you tell us a bit more about this initiative?
The Revolving Outbreak Investigation Fund (ROIF) was founded through a partnership of the NCDC, the African Field Epidemiology Network (AFENET) and Resolve to Save Lives (RTSL). Before the ROIF was established, the NCDC faced challenges in rapidly acquiring emergency funds during health emergencies, due to issues with contracting, legislation, staffing and the transfer of funds.

This led to delays in the deployment of disease detectives, which increased the risk of disease spread and the chance someone could die from a new health threat. The three organisations worked together to develop procedures for rapid funding, determine qualifying events and approval chains, and report on how the funds helped the response. 

How has the ROIF impacted the activities of the NCDC, could you shed more light on the achievements so far?
The speed with which a rapid response team is deployed is critical in controlling outbreaks and preventing regional and national health systems from becoming overwhelmed. After the ROIF was established, the median time from the verification of an infectious disease threat to initiating the deployment of a rapid response team dropped from six days to two days.

Unlike other forms of funding, ROIF’s structure is flexible, so the NCDC was able to use its financial and technical resources immediately to respond quickly to COVID-19 when it first emerged and help prevent the explosion of cases that took place in other countries. The innovation of the ROIF serves as a model that other countries and partners can adopt to support life-saving strategies in outbreak response.

How can the Nigerian government and private sector participants adopt the ROIF model for the health sector?
Resolve to Save Lives is using the ROIF programme in Nigeria as a model and applying lessons learned to improve funding for and effectiveness of outbreak response globally. Early, rapid and flexible funding for outbreak investigations and responses is not always readily available and yet is crucial to saving lives and preventing outbreaks from becoming epidemics.

The ROIF approach is a recommended intervention in the WHO IHR Benchmark document for countries to develop mechanisms that rapidly receive and distribute funds to public health emergencies. Having ROIF already operational means Nigeria is a step ahead.

To sustain this gain, the national government should create a similar budget line in their annual budgets to complement the ROIF programme. Additionally, private actors should dedicate a proportion of their annual Corporate Social Responsibility (CSR) funding to the existing ROIF programme. Dangote Foundation and MTN Nigeria have previously contributed to the ROIF program.

Lassa fever continues to be on the rise in Nigeria, despite efforts to curb its spread. The country is also battling Monkeypox. From your experience, what more should the Nigerian government do to curtail the spread of these diseases?
Every time there’s an outbreak, we should look carefully at what were the delays in detection, reporting and response. Even with an optimal response, the new variant of Monkeypox would have been difficult to contain, and it’s clear that many aspects of the response in many countries could have been better.

Improving public health takes time and sustained funding. This is why the global target, 7-1-7, is so important: The goal is that every outbreak would be identified within 7 days of emergence, reported in one, and all essential control measures in place within 7 days. I’m excited that the Nigerian government is working to implement this target alongside partners.

RTSL’s focus areas appear to be pandemics and cardiovascular health. Any rationale on why you are focused on these aspects of health issues?

These are two areas in which life or death hangs in the balance. When we started Resolve to Save Lives, the goal was to save as many lives as possible — working to combat heart disease and supporting epidemic preparedness are the two key areas that we believe it is possible to have an impact.

Heart disease is the number one cause of premature death in the world; high blood pressure alone kills more people worldwide than all usual infectious diseases combined.

Very few organisations work in cardiovascular health and fewer work across prevention and treatment. There is a tremendous amount of work to be done— with limited political attention and global health funding.

Resolve to Save Lives is positioned to help countries to fill this gap and save 100 million lives in the next 30 years, by reducing global sodium intake, helping countries eliminate trans fat, and supporting the control of high blood pressure.

Every country needs to be able to find, stop and prevent epidemics. But many are not adequately prepared, as demonstrated by the COVID-19 pandemic, recent Monkeypox outbreaks and other emerging diseases. COVID-19 revealed preparedness gaps on a global scale and the terrible danger that comes with leaving these gaps unchecked.

Both heart disease and epidemic prevention are serious public health issues in Nigeria. Right now, 11 per cent of all deaths in the country are from cardiovascular disease, with as much as an estimated 30 per cent of the adult population suffering from high blood pressure and a projected 1,300 deaths in the country from coronary heart disease each year directly linked to trans fat consumption. The country has made significant progress in addressing the gaps in preparedness.