COVID-19 has taught us a great deal about public health—not least of all its importance to us as we age. But amidst the obvious lessons about treatment and prevention, there are also important lessons to learn about unlikely areas where sustained support is essential. At the American Geriatrics Society (AGS), we have been hard at work not only identifying those arenas but also ensuring they receive the recognition they deserve.
Earlier this summer, for example, the AGS joined organizations across health care, international development, and science in speaking out against the Trump Administration's move to withdraw the United States from the World Health Organization (WHO) (AGS, 2020a).
Simply put: The WHO is vital to who we are—and who we can become—as we age. At a time when so many hard-won victories for creating age-friendly communities and health are jeopardized by crises like the COVID-19 pandemic, we need to stand indivisible and support international cooperation, which is critical to high-quality, person-centered care for us all.
As the United Nations agency responsible for public health, the WHO has played a key role in improving health, safety, and independence for us all as we age (WHO, n.d.a). Founded after World War II, the WHO employs >7,000 workers spread across 150 offices that alert the world to threats, fighting diseases, developing policy, and improving access to care, including for older adults (WHO, n.d.a).
The WHO has dedicated this decade (2020–2030) to healthy aging, bringing governments, civil society, international agencies, professionals, academia, the media, and the private sector together for 10 years of “concerted, catalytic, and collaborative action to improve the lives of older people, their families, and the communities in which they live” (WHO, n.d.b, para. 1). In years past, the WHO also has been instrumental in ensuring that the needs of older people are factored into sustainable development plans, and that priorities such as increased longevity and chronic disease management remain at the forefront of health and care (WHO, 2015).
In 2019, the United States contributed more than $550 million to the WHO, whose biennial budget exceeded $6 billion in 2018–2019 (AGS, 2020a; WHO, 2020). Eliminating that funding jeopardizes health in the United States and abroad, as American investment powers the WHO to ensure the health and safety of the public worldwide by:
responding to outbreaks and health crises;
addressing vaccine-preventable diseases;
responding to HIV and hepatitis;
promoting treatment and prevention for tuberculosis;
developing country health emergency preparedness and international health regulations;
orchestrating infectious hazard management;
powering emergency operations in health settings;
propelling reproductive, maternal, newborn, child, and adolescent health; and
ensuring access to medicines and health technologies (WHO, n.d.c).
In our interconnected world, withdrawing from the WHO will risk the health of older adults worldwide, including here at home in the United States.
In a similar vein, the AGS also expressed concern this summer that a new process for sharing COVID-19 data risks fragile progress in our hard-fought national response to the pandemic (AGS, 2020b). We were particularly concerned that the new process, which changed the role of the Centers for Disease Control and Prevention (CDC), did not provide public access to data at a time when the agency's impartial expertise has never been needed more (AGS, 2020b).
As a Society, we strongly believe the CDC is still best positioned to collect, analyze, and act on health data as we support age-friendly care in the face of pandemics. So instead of removing the country's premier health protection agency from the equation, we believe we should focus on building the infrastructure it needs to remain “first among equals” leading local, state, and other national partners in ending COVID-19.
At issue is the Trump Administration's order that hospitals and laboratories send data on patients with coronavirus straight to the Department of Health and Human Services (HHS), instead of the CDC and its National Health Safety Network (NHSN) (AGS, 2020b). At the AGS and elsewhere across health care, the change raised questions about the quality and utility of data analysis, with several experts worrying that the move could result in less transparent data, especially as the CDC's protocols are built around long-standing safeguards, such as those included in the Health Insurance Portability and Accountability Act (HIPAA) (AGS, 2020b).
Although the NHSN certainly can be modernized with bipartisan collaboration, geriatrics experts like those here at the AGS reiterated the network's critical role—and that of the CDC, by extension—in addressing many other serious infectious diseases (AGS, 2020b).
Such a sudden change in data collection coupled with previously collected data disappearing from and then being restored to the CDC website raises serious concerns that there is no plan to provide access to COVID-19 data in real-time for states, researchers, and the public. Again: We need more—not less—collaboration and transparency if we are to protect health, safety, and independence for us all as we age. And that means we need to strengthen the framework we already have at the CDC—just as we also need to strengthen the response we offer nationally and internationally in supporting our health, safety, and independence across health spans and lifespans.
Annette Medina-Walpole, MD, AGSF
President, American Geriatrics Society