Biden failed us on public health. Harris must do better.

We have been living with Covid-19 for almost five years. Anyone who has read my articles in

know that I think the Biden administration’s response to the virus is terrible. The administration is essentially washing its hands of any guilt, except that it has launched a lackluster vaccination campaign within a year or so. Many commentators, from David Wallace-Wells (many of whom New York Times From colleagues who most downplayed the pandemic to editors of major medical journals, it was pointed out that we had buried Covid in our memory and refused to learn from the lessons it showed us, even in the face of potential threats such as H5N1 (bird flu).

Even if you leave Covid aside, the picture is not much rosier. In terms of life expectancy, we lag behind our peer countries and are in a group with Albania, Panama and Chile.

Kamala Harris needs to try harder, and while a few weeks ago I was in a depression wondering how I could resist the next Trump administration, I now have cautious hope that she will have the chance to do so in January.

Where to start? The first step should be a “moon flight,” a “Marshall Plan,” or whatever you want to call it, for our public health infrastructure. The Centers for Disease Control and Prevention almost always gets shortchanged on federal funding, and since much of the CDC’s money goes to local health departments, our cities and towns suffer. It’s hard to believe, but even after the worst pandemic in a century, Congress had the gall to claw back hundreds of millions from the CDC in recent budget deals, hampering efforts against even old enemies like syphilis, which is on the rise in the United States. We have a crumbling public health infrastructure across the country that needs to be fixed.

If we continue to ignore this crisis, Americans will continue to be sicker and die earlier than many people in much poorer countries. No amount of medical care will fundamentally solve the American dilemma: Many of the factors that cause health risks and consequences operate beyond the level of the individual patient, in the so-called social determinants of health. Only a committed, well-funded public health system can address these problems.

Next, we must address the scourge of political interference in public health. At the height of the AIDS epidemic, many of us helped fend off ideologues like Jesse Helms and others who opposed HIV prevention efforts. During Covid-19, we took up the fight against the Trump administration’s nonsense about hydroxychloroquine and herd immunity. Yet, shockingly, the Biden administration maintained the pattern of political interference.

Biden’s team has backed away from its original plans for a robust, comprehensive plan to combat SARS-CoV-2 when it realized it was politically easier to simply “claim victory” and declare mission accomplished. The blame for this lies squarely with the political players in the West Wing like Ron Klain and Jeff Zients, and the con artists in my own profession who gave them the opportunity to do so. Public health took a back seat to political machinations, and the CDC and other health agencies were put on a short leash by the White House on everything from testing to access to vaccines.

One way to protect public health from political influence is to make the CDC an independent agency. Soheil Shah of Brigham and Women’s Hospital and Howard Forman of Yale argued for this in the Journal of the American Medical Association at the beginning of the Covid pandemic, and Harris should consider that path.

There are many other proposals to improve the health of all Americans that should be the focus of a Harris-Waltz administration.

It was encouraging to see the campaign foreground the importance of the “care economy.” It is impossible to care for ourselves if we cannot care for those we love. Harris understands the need for basic things to survive—housing, access to food, childcare and elder care. These are all part of the “social determinants of health,” and real investment in these areas will have a massive impact on people’s lives. In fact, the Boston Consulting Group has suggested that ignoring the “care crisis” is also economic madness, as it “puts $290 billion of GDP at risk in 2030 and beyond, equivalent to the entire GDP of the state of Connecticut.” But Harris has an uphill battle ahead, with experts like David Brooks of The New York Times calls their proposals “economically illiterate” and fellow news reporter Reid Epstein calls the campaign politically superficial, as if it doesn’t address fundamental policy issues. We need them on these issues from day one.

Harris has wisely ignored the chattering classes over the past month and made her own decisions based on her own vision and instincts. Forward, as her campaign slogan goes. I am optimistic that a Harris administration might be able to take bold new steps to secure the public health of all Americans for generations to come. Now we all need to get them to “do it,” even once they (hopefully) move into the White House. We need to harness the energy and enthusiasm many of us are feeling now and save it for the months and years to come. Because the changes needed are not in Kamala Harris and Tim Walz’s hands—they are in our hands.