Politics has no place in federal Public Health Service

THE ISSUE A former surgeon general said that Bush administration officials tried to weaken or suppress important public health reports.

STIFLING by the Bush administration of health reports by the surgeon general should prompt Congress to make the office more independent. Allowing politics to trump science in the Public Health Service is tantamount to letting politicians operate on the patient.

Former Surgeon General Richard Carmona, who left office when his four-year term expired a year ago, told the Senate Health Committee earlier this month that the administration would not allow him to speak or issue reports about stem cells, emergency contraception, sex education or prison, mental and global health issues.

A report on global health, which has been suppressed since its completion in draft form in May 2006, "covered all of the contemporary issues of public health, from environmental health through infectious disease transmission," Jerrold M. Michael, a former assistant surgeon general, told the Washington Post. Michael, who worked on the report, was dean of the University of Hawaii School of Public Health for 20 years before his departure in 1992.

Past surgeons general from the Clinton and elder Bush administrations have said they were discouraged from issuing reports that conflicted with the administrations' positions, but did so anyway. Carmona had no such authority.

"The reality is that the nation's doctor has been marginalized and relegated to a position with no independent budget and with supervisors who are political appointees with partisan agendas," Carmona testified. "Anything that doesn't fit with political appointees' ideological, theological or political agenda is ignored, marginalized or simply buried."

Carmona did not name the officials who told him to put political considerations over science in his testimony, but said he would provide the names to the committee privately. The New York Times reported that former top health officials said that one likely political operative was physician Cristina V. Beato, a former deputy assistant secretary and acting assistant secretary for health who was Carmona's boss from 2003 to 2005.

The official who blocked publication of the global health report was identified by the Washington Post as William R. Steiger, head of the Office of Global Health Affairs in the Department of Health and Human Services. Steiger is a godson of former President George H.W. Bush but has no background in medicine or public health.

In June 2006 a Steiger aide sent an e-mail saying the report on global health should not be made public. In a written statement to the Post last week, Steiger said the report's publication was delayed because of "sloppy work, poor analysis and lack of scientific rigor."

Eight agencies in the Public Health Service, including the Food and Drug Administration and the Centers for Disease Control and Prevention, used to report to the surgeon general. Now, along with Hawaii-born interim Surgeon General Kenneth Moritsugu, they report to the secretary of health and human services. The old system should be reinstated to remove politics from science.