Dispatch from the front lines: From Pakistani refugee to APHA chief

Mohammad Akhter, MD, MPH, executive director of the American Public Health Assn., reflects on the traditional, and new, challenges facing our public health system.

By Stephanie Stapleton, AMNews staff. Dec. 17, 2001.

Public Health: Renewed Attention
A six-part series exploring the role of the public health system in the context of our nation's newfound state of alert.

1. From the front lines
2. Recent history
3. Greater expectations
4. The risk-benefit ratio
5. New promises
6. Homeland security

Weeks ago the nation was frozen with fear as anthrax became a household word and other infectious diseases -- smallpox, plague and other scourges usually considered exotic and unlikely -- suddenly emerged as everyday concerns. As a result, the public health system was thrust into the spotlight, and its role as first-line defender against such diseases became clear.

But to public health experts such as Mohammad Akhter, MD, MPH, these events were not a surprise. They have warned for years that a bioterrorist assault was not a matter of if, but when. They repeatedly detailed the shortcomings of the infrastructure and called on the federal government to provide more resources to shore it up.

As executive director of the American Public Health Assn., Dr. Akhter has strong opinions about what needs to happen now to protect against future outbreaks of disease -- whether the result of attack or nature. Some of these opinions are informed by his tenure as a policy adviser at the Dept. of Health and Human Services, or his work as a public health official in Washington, D.C., Illinois and Missouri. But his thoughts are also guided by another set of influences -- early memories of being a refugee in Pakistan, of emigrating to the United States and returning to Pakistan as a medical missionary and public health educator.

He recently sat down with AMNews to share his thoughts on the challenges public health now faces.

Q: Is the public health system really underprepared, and how did it get to this point? [...]