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Tribute to Ted Eickhoff: Infectious disease practitioners as public health advocates
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Ted Eickhoff understood the intersection of public health and the infectious disease practitioner, effectively using his editorial pulpit at Infectious Disease News to promote dialogue and discourse on the rapidly changing circumstances that would dictate public health policy. He recognized the ever-evolving microbial world’s impact on not only the individual patient, but on the community at large, and remained at the forefront, ensuring that infectious disease practitioners received needed information in a timely manner so they could remain staunch public health partners. A profession is traditionally defined by its common body of knowledge. As with the 1910 Flexner Report that proved revolutionary for medical education in the United States, the 1915 Welch-Rose report presented to the General Education Board of the Rockefeller Foundation outlined public health as a profession in which “Unity is to be found rather in the end to be accomplished. ... Public Health is not a single profession in the traditional sense and is best defined by its shared goals rather than its disparate means. Articulating who we are and what we do remains one of our greatest challenges.”
Ted, who died in March at age 86 years, epitomized the critical role infectious disease practitioners play in contributing to the science of public health policy and practice. The infectious disease community has engaged in public health’s history of activism, promoting clean water and sanitation, pasteurization and immunization, which have greatly impacted morbidity and mortality at the domestic and global level. Food safety is yet another area of public health activism, recognizing that it is through food safety efforts and having nutritious and affordable food available that health can be achieved and global security obtained.
But to achieve such objectives, regulations are necessary. Public health regulations are rarely adopted with great fanfare and nods of approval and popularity. Rather, such actions are usually surrounded in controversy, with opposition coming from several different parties, depending on differing agendas. Reliance on a scientific approach, with access to timely surveillance data, is critical to inform public health actions. Infectious disease practitioners have been supportive of a well-functioning public health infrastructure. In many instances, they have integrated their work with local/state and federal public health agencies, supporting a robust disease surveillance system with laboratory diagnostics and a skilled professional staff that understands the need to detect, respond to and prevent disease.
Ted, who served as an Epidemic Intelligence Service officer and collaborated closely with the CDC throughout his career, worked with Bill Foege, a former director of the agency. Bill noted, “There is something better than science, and that is science with a moral compass, science in the service of humanity, science that makes current deeds responsive to future needs.” Such a philosophy inspired Ted throughout his working career, and in turn, Ted inspired so many others who had the privilege of working with him.
Transparency is another critical aspect of public health policy. Ted was cognizant of Jonathan Swift’s advice: “Falsehood flies, and the truth comes limping after it.” Open communication and engagement not only inform policy but generate high levels of compliance and, most importantly, build trust with the community. Ted worked continuously to inspire trust and enhance communication, which was clearly noted in his service as Chief Medical Editor of Infectious Disease News. Ted also recognized the critical need to establish partnerships with a wide array of stakeholders as a necessary element to achieving scientifically sound public health outcomes.
The modern dichotomy of public health is best expressed by Charles Dickens: “It was the best of times, it was the worst of times.” The work of those engaged in public health is to aspire toward the absence of disease. When the system is not working, there is a public outcry, but when it does work, public health efforts go unnoticed and unheard, and face the “U-shaped Curve of Concern.” Investments in public health sparked by the sense of threat lead to declines in disease incidence, thereby reducing the perceived danger and resulting in lower investments, ultimately setting the stage for disease resurgence. Ted warned of such developments in his editorial role, but as we all recognize, public health budgets continue to be slashed despite the ever-evolving threat posed by microbes.
Ted also promoted the One Health initiative, using his editorial role to emphasize the importance of integrating the multiple disciplines working locally, nationally and globally to attain optimal health for people, animals and the environment. In this role, he acknowledged the work of Rudolf Virchow, who in the 1800s proclaimed, “Between animal and human medicine there are no dividing lines — nor should there be.”
The long-term impact of the control of infectious diseases requires access to clean air, water and sanitary facilities; nutritious and healthy food; vaccines, antibiotics and health care. Infectious disease practitioners are good stewards of therapeutics and technology, safeguarding our environment and other lives that share our world. We believe in equity and human rights so that global security may be realized by all. And to achieve this mission, we recall the words of Louis Pasteur: “Science knows no country, because knowledge belongs to humanity, and is the torch which illuminates the world. Science is the highest personification of the nation because that nation will remain the first which carries the furthest the works of thought and intelligence.”
A giant among giants, Ted performed a Herculean task in his many endeavors. Just as we saw the legendary Hercules complete the 12 impossible labors for King Eurystheus, Ted never stopped in his efforts to advocate, promote and educate. We still have menacing beasts on our doorsteps, trampling our efforts to control infectious disease threats, but with the strong legacy Ted has left the infectious disease community, we will be stronger in our efforts to confront the challenging and complex issues that lie ahead.
- References:
- Dickens C. A Tale of Two Cities. New York, NY: Bantam Books;1989.
- Bull Med Libr Assoc. 1951;39:237-223.
- Foege W. Former Director CDC, Dedication Remarks, William H. Foege Building, University of Washington, March 8, 2006.
- Reichman LB. The U-Shaped Curve of Concern. Am Rev Respir Dis. 1991 Oct;144(4);741-742.
- Swift J. The Prose Works of Jonathan Swift: Contributions to “The Tatler,” “The Examiner,” “The Spectator,” and “The Intelligencer.” New York, NY: Palala Press; 2018
- Virchow R. Interrelations of human and veterinary medicine (as quoted in Klauder JV). N Engl J Med 1958, 258:170-177.
- Welch WH, Rose W. Institute of Hygiene, presented to the General Education Board, Rockefeller Foundation, May 27, 1915.
- For more information:
- Kathleen F. Gensheimer, MD, MPH, FIDSA, is a medical officer at the FDA’s Center for Food Safety and Applied Nutrition. She can be reached at Kathleen.Gensheimer@fda.hhs.gov.
Disclosure: Gensheimer reports no relevant financial disclosures.
Disclaimer: The opinions and conclusions expressed in this article are solely the views of the author and do not necessarily reflect those of the FDA.