In May, Senator Frist co-led a conference at CSIS entitled U.S.-Russian Global Health Collaboration. Given the outcome of discussion at the conference, the Senator produced this Op-Ed recently published in Foreign Policy.

What the Doctor Orders

The United States and Russia face strikingly similar health-care challenges -- providing a rare opportunity to strengthen their bilateral relationship.

BY WILLIAM H. FRIST | SEPTEMBER 11, 2009

On Wednesday night, U.S. President Barack Obama made a historic address to a joint session of Congress on the issue of health-care coverage and affordability. It is the banner issue of his first year in office, and Washington's top domestic priority. At the same time, nearly 5,000 miles away, in Moscow, legislators are undergoing a strikingly similar process to reform their health-care delivery system. Given the importance of the U.S.-Russia relationship and the similarity of the challenges confronting us, our two countries have a historic opportunity to expand our health collaboration and, in so doing, improve our diplomatic ties.

Thankfully, this process is already underway. At a summit in early July, Obama and Russian President Dmitry Medvedev announced a memorandum of understanding to expand cooperation on public health and medical sciences. The meeting also produced an agreement for Secretary of State Hillary Clinton and her Russian counterpart, Foreign Minister Sergei Lavrov, to co-chair a forthcoming bilateral commission on health collaborations.

But both countries can and should continue to do more. In May, Dr. Nikolai Gerasimenko -- vice chair of the Duma's Committee on Health Protection -- and I hosted a daylong discussion on the topic at the Center for Strategic and International Studies. Our objective was to generate a blueprint for a future strategic collaboration on health. The conference revealed a strong desire to build genuine partnerships around health on the basis of two key challenges.

The first is national demographics. Both Russia and the United States grapple with rapidly aging populations, with all that implies for the provision of health care and social services. Russia's problems are compounded by alarmingly high middle-aged male mortality and birthrates that are too low to sustain the current size of the population. Demographic regression, the Russian delegates emphasized, is the top health-policy priority. In each of our societies, efforts to encourage healthier lifestyles -- in diet, and alcohol and tobacco use -- will reduce chronic disorders, extend lives, and make for a healthier next generation.

The second challenge is the pressing need for health-care reform. Both of our countries struggle to balance the competing imperatives of high quality, equity in access and affordability, and containment of health-care costs. We are each in the midst of a historic effort to reform our health systems, bring about greater efficiencies in complex federal systems, and produce better health outcomes as a return on substantial investments.

Our dialogue also identified five choice opportunities that I hope will inform the next steps by the United States and Russia in building health cooperation.

First, there is much to be learned from each other with respect to lowering health risks associated with tobacco and alcohol use, especially among young people, including through public-education strategies and community engagement.

Second, in the face of the H1N1 pandemic flu threat, there is much we can do to improve surveillance and data use to bring about better global detection and response to emerging infectious disease threats. Even at the height of the Cold War, the Soviet Union and the United States worked together to create vaccines. Our countries could certainly benefit from such collaboration today.

Third, we should launch an annual U.S.-Russia forum on the reform of national health systems, with a special focus on financing, cost controls, and evaluation. Comparative effectiveness research across national boundaries is a vitally important undertaking. In particular, a U.S.-Russian initiative could include joint exploration of innovative approaches such as e-health and electronic medical records.

Fourth, we should engage in a discussion on how to best leverage our mutual efforts to support global health programs in those countries most affected by infectious diseases such as HIV, tuberculosis, and malaria. The Obama administration recently committed to billions in donations in this area, and Russia is emerging as a significant global health donor as well. Thus, the time is right for our two countries to more closely collaborate.

Lastly, substantial ongoing joint research, institutional twinning and professional exchanges could be expanded. This includes research and research training in alcohol abuse and related disorders, cardiovascular disease, cancer, and tuberculosis. These efforts could be broadened to encompass chronic-disease prevention and management and national health-care reform as well.

Health collaboration is a surprisingly powerful foreign-policy tool and one where U.S. and Russian interests converge. Expanded communication and cooperation will build on a history of collaboration that survived periods of acute strain. There is active interest in both our societies -- among universities, medical schools, research institutions, and private businesses, as well as key government agencies -- in joining such an enterprise.

I urge Secretary Clinton and Foreign Minister Lavrov to commission in the coming months a joint organizing committee charged with prioritizing issues, laying down a timetable, and agreeing upon some early concrete products. It could prove a vital platform for the health of our countries and the health of our bilateral relationship.

William H. Frist, M.D., is a former two-term U.S. senator from Tennessee and was the U.S. Senate majority leader from 2003 to 2007. He is a member of the Center for Strategic and International Studies' board of trustees.

Healthier beginnings

What the world can learn from Pittsburgh

Monday, September 14, 2009

By Bill Frist

When world leaders chart a course toward a more prosperous future at next week's G-20 summit, Pittsburgh can inspire in more ways than one.

The city built on steel has renewed its shine as a center for research and technology and become a model for economic comeback. When this recession recedes, Pittsburgh is poised to jump far ahead of cities where "rust belt" still rings true.

But progress is not measured solely in economic terms. Presidents and prime ministers should note a different kind of progress that Pittsburgh pursued and achieved in the years it was still building its first boom. This kind of progress has yet to reach many parts of the planet, but, in the interests of all, must.

Sustainable recovery and long-term economic growth depend on improving the well-being of the world's most vulnerable people and ensuring they, too, participate in recovery. To that end, improving the health of children and mothers is fundamental.

In 1920, Pittsburgh had the worst recorded infant mortality rate of any large U.S. city. Some of the oldest residents of Pittsburgh today started life with the same odds of reaching their first birthday as newborns in Somalia do now. One in nine babies died.

Several other cities also had dismal records, but Pittsburgh's last-place ranking prompted the federal government to make a case study of the city. After World War I, the United States had recognized that resilience and continued growth depended on healthy babies who would grow into strong, productive adults.

In "Infant Mortality in Pittsburgh," the Children's Bureau of the U.S. Department of Labor recorded diarrhea and pneumonia as the most-common infections killing babies in Pittsburgh. Remarkably, despite decades of medical advances and low-cost, easy-to-administer treatments, this still holds true in the developing world.

The study also noted that nearly half of Pittsburgh's infant deaths occurred in the first month of life from prenatal or birth-related causes. Today, this remains by far the most dangerous month of life in poor countries. Nearly 4 million newborns die every year, half on the day they're born.

In analyzing Pittsburgh nearly 90 years ago, the Children's Bureau wrote that most newborn deaths had already been "clearly demonstrated" to be "largely preventable." Yet, the kind of basic health services and practices that Pittsburgh subsequently embraced are still lacking in many countries today.

For More CLICK HERE: PITTSBURGH POST-GAZETTE

The end of August has brought with it an amplified reminder of the cultural divide between America and Tanzania. The sighting of the first crescent of the new moon signified the beginning of Ramadan and because Tanzania has a sizable Muslim population the effects are quite noticeable. Ramadan is a Muslim holy month meant to cleanse the soul and express repentance for all the sins committed during the rest of the year. Muslims must, amongst other things, fast from dawn to dusk everyday for the duration of the holy month. The goal is to be pure in thought and deed, which means Muslims give up behaviors that are thought to be sinful, negative, or distracting from spiritual introspection and closeness to God. Less orthodox Muslims who usually don't are now wearing traditional Muslim clothing and in many parts of the city where there are concentrated Muslim populations you will find restaurants closed during the day and open late into the night. In Zanzibar, where something like 98% of the population is Muslim you can be fined if caught eating publicly during daylight. The most orthodox Muslims are so strict about fasting that they spit on the ground all day to avoid consuming their own saliva.
t's not all that easy to get to Xi'an, in the heart of China, when you are in Beijing or Shanghai, but since we have a day, we are off to see one of the great wonders of the world - one that man built 2,300 years ago but just discovered during my adult lifetime.

Situated geographically in north central China, Xi'an is ranked among the great historic centers of the world. From its early role in Chinese civilization as the center for the first empire from which "Qin" (I pronounce "chin") gave the West the concept of "China," this gateway to the fabled Silk Road also was the largest and most cosmopolitan city on earth during the golden ages of the Han and the Tang.

Commentary: Ted Kennedy's death a loss for mankind

By Bill Frist
Special to CNN

Editor's note: Bill Frist is the former Republican majority leader of the U.S. Senate and a professor of medicine and business at Vanderbilt University.

(CNN) -- The telephone rang in the deep hours of a dark night after a heavy day for our family.

My mother, affectionately known as Dodie, had passed away just a few hours after my father had passed, the two dying of independent causes.

The call -- the first that my wife, Karyn, and I had received from any of our friends or Senate colleagues -- was from Ted and Vicki Kennedy. That is caring and that is love.

Imagine being in Nantucket with your non-sailing sons with Ted, the master of the sea, skippering his beloved wooden sailboat over from Hyannis, asking the boys to jump aboard so he could take them on a harbor cruise and tell them a bit about why his brother John so dearly loved the United States of America.

He focused time and energy on the young and the importance their lives will play in meeting the challenges of today and tomorrow.

You see, in our lives Ted Kennedy was more than the legislative lion of the Senate.

He was the young senator I first met as a college intern in 1972 as he patiently found the time to lay out the fundamentals of universal health care to our summer class.

He was the proud stepdad who with Vicki beat Karyn and me to every afternoon high school baseball game while our sons played side by side.

And he was the masterful legislative colleague who never sacrificed his liberal principles standing for the everyday person as we joined each other on the health committee as respective co-chairmen to write and pass bills on health care disparities among the poor, emerging infectious diseases such as HIV and avian flu, and preparing the nation and the world to fight bioterrorism.

His death is a loss not just for Massachusetts and the Senate, but for all of mankind.

The opinions expressed in this commentary are solely those of Bill Frist.

August 26,2009

Today Karyn and I feel the deep loss of a personal friend.  In our lives Ted Kennedy was more than the legislative lion of the Senate.  He was the proud sailor who introduced our sons to the spiritual element of sailing on his beloved wooden sailboat in Nantucket, the young senator I first met as a college intern in 1972 as he patiently found the time to lay out the fundamentals of universal health care to our summer class,  the proud step-dad who with Vicki beat Karyn and me to every afternoon high school baseball game while our sons played side by side, and the masterful legislative colleague who never sacrificed his liberal principles standing for the everyday person as we joined  each other on the health committee in writing and passing bills on health care disparities among the poor, emerging infectious diseases like HIV and avian flu, and preparing the nation and the world to fight bioterrorism.    His death is a loss not just for Massachusetts and the Senate, but for all of mankind.   

 --Senator William H. Frist, M.D.

Met this morning with the Minister of Health. The last time I was at the ministry we met just down the hall from the minister's office. That was in 2003, and SARS had struck just the month before. Allegedly the Chinese government has hidden the problem from its people and the world, but as the outbreak grew, the news exploded, and no longer could the government contain the news. I was openly critical that day in our public meeting, representing the U.S. and world opinion. Though my remarks had nothing directly to do with what was about to occur, the minister just hours later was summarily fired, a sign of recognition that China would officially change its secretive policy of minimizing the ongoing impact of SARS. And the epidemic rapidly spread throughout China, Asia, and Canada, paralyzing travel and tourism, killing hundreds, and greatly diminishing economic growth for the next year of Asia and Canada.
From Big Kenny Interview: The First Trip -- Impressions of Akon, SUDAN 2007

Love Everybody has helped with the facilitation of the Konyok School for Girls in Akon, Sudan. The school currently has 550+ students enrolled. Love Everybody's goal is to instill hope, strength, and excellence to all students who attend so they can prosper in life. Their motto: "Highlight the good, inspire greatness, and encourage mutual responsibility for the betterment of humankind. -- Love Everybody." Member of the Tennessee Global Health Coalition.

August 26, 2009

So, two years ago; October of 2007, my wife and I and several friends from the organization My Sister's Keeper from Boston and Dr. David Marks and Walt Ratterman from Sun Energy Power decided we were going to get together and go into the country of Sudan. We went there and visited this village, which is basically a refugee camp right in southern Sudan, about 50 kilometers from the line of demarcation between there and Darfur. So this is an area that people had fled into that had been pushed off of their land. Like farmers. My dad's a farmer, and I guess that's why it hits with me.
As much as I hate to say it, my time in South Africa has now come and gone. Calandra Miller and I safely arrived back on American soil at 7:30 AM on August 6, 2009. At the time, I could not say the same for our luggage, which remained (safely) in Johannesburg, South Africa.

The last couple of weeks spent in South Africa were bittersweet, to say the least. I was looking forward to coming home and seeing my family and friends once again, but at the same time I was having to say goodbye to many good friends and, what I consider to be, family back in South Africa. The volunteer girls, Betty, Eva, and Engelinah treated us to some milkshakes as a going away present. This was a distinct honor to me, because what we might take for granted in the United States, they had to budget for weeks in advance. We also spent some time celebrating with Stefan and his family, the Wiids (the family who hosted me in their cottage during my stay in SA), and Pastor Dave Garton and his wife Gail (who run the rehab program that Project HOPE is partnering with). In the midst of our imminent departure, I took some time to reflect on what I was doing and had done since arriving in South Africa.
August 24, 2009

Today, after meeting all day with health reformers in China, it is clear that partnerships with U.S. academic institutions are important to build capacity and institutional support here.

At Peking University, Dr. Ke Yang, Executive Vice President of Peking University (PKU), enthusiastically described the great results of a Duke-Peking University two-week global health diploma program with the School of Public Health.

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