AYESHA RASCOE, HOST:
Republicans in Congress jostled with Dr. Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases, during a congressional hearing last week, insinuating he was part of a cover up during the coronavirus pandemic. Here's Senator Rand Paul.
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RAND PAUL: Dr. Fauci, would you like to at least answer this one question for us today and let us know whether or not you've changed your mind on whether or not the benefits of gain-of-function research outweigh the risks?
ANTHONY FAUCI: On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution.
RASCOE: Depending on who you ask, Fauci was either a hero of the coronavirus pandemic or part of a criminal cover-up. Trust in the institutions that protect public health has seen a steep decline since the pandemic. Marianne Udow-Phillips, a lecturer at the School of Public Health at the University of Michigan, joins us now. Welcome to the program.
MARIANNE UDOW-PHILLIPS: It's great to be here.
RASCOE: Can you tell us about the history here? Is this level of distrust really new?
UDOW-PHILLIPS: Well, you know, it really isn't new. Back in the 1830s, there were editorials that were published that were ranting about public health. And if we go back and we look at the flu epidemic in 1918, there were rallies opposing the masking mandates. And, you know, this has always been a controversial topic because public health has police powers, and those come into tension with other values that Americans hold very, very dearly.
RASCOE: Are there things that you think institutions need to approach in a different manner?
UDOW-PHILLIPS: Oh, absolutely. Well, first of all, we learned a tremendous amount from the COVID-19 pandemic. It's really important going forward for our public health leaders to get more training in public communication, more training in how we really explain uncertainty and how things change. And then the last thing I would say is that historically, public health has been enormously underfunded, and we need to fund it at a better level.
RASCOE: I know you talked about communications and how that is one of the lessons from COVID. I guess, can you talk a bit more about that? Because it seems like people really felt like they were misled on mask, or anger about people not being able to be with their families when they were passing away or not being able to be with their grandmother at Thanksgiving and the school closures. There's a real anger about that.
UDOW-PHILLIPS: Yeah. You know, I think it's two things. Part of it is communications. You're absolutely right. Public health leaders need to understand how to better communicate uncertainty and why guidance might change and why, especially in something as fast-moving, where we didn't have a lot of information, as COVID, that the guidance might be different as we get more information.
But there's something else that I think is also really important that I hope we learn from COVID-19, and that is this issue about how we balance different values. Public health has a real priority on saving and protecting lives. But there are other values that are also important. You know, life, liberty and pursuit of happiness, right? Individual choice is a very deep-seated value in our country. And I think one of the things that we have to struggle with a little bit more clearly is how we balance all those different values.
RASCOE: What is the danger of eroding trust in public health institutions and public health officials?
UDOW-PHILLIPS: Well, we see that danger right now, don't we? We see it in this tremendous increase in the number of measles cases in our country. I think we're over 2,000 measles cases, the highest since 1990. And that has real consequences for children and for many others - I mean, to a point where we're seeing people dying as a result of not being vaccinated against the measles. So there are real consequences to a drop in trust in public health and a drop in financial support for public health.
RASCOE: So the MAHA movement, led by Health and Human Services Secretary Robert F. Kennedy Jr. - it may represent, like, a high watermark in mistrust of public health authorities. But are the fears about toxins in the world and in our diets - like, are they valid?
UDOW-PHILLIPS: Yes. They are absolutely valiant. There are many things in the world that are unhealthy for us. And, you know, the areas where the MAHA movement has focused on diet, on ultra-processed foods, on environmental hazards - those are really tremendously legitimate concerns, and it's understandable that people have a lot of anxiety about those kinds of issues. But those issues are really very consistent with the values and the role of public health. Where you find things that are somewhat inconsistent in some of the MAHA movement are with beliefs about things like vaccines and the balancing of public interests and individual freedom with the common good.
RASCOE: Is that an opportunity, then, for people who run public health institutions to find those areas of common concern and maybe work with people in the MAHA movement?
UDOW-PHILLIPS: Oh, absolutely. I think there really are areas of common concern. And I think, actually, there was quite an opportunity, and people really were looking forward to a focus of HHS into areas related to nutrition and related to toxins in the environment, etc. There clearly are opportunities to work together.
RASCOE: That's Marianne Udow-Phillips. She teaches at the School of Public Health at the University of Michigan. Thank you so much for being with us.
UDOW-PHILLIPS: It's been my pleasure. It's such an important topic. Thanks for... Transcript provided by NPR, Copyright NPR.
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