ARI SHAPIRO, HOST:
It's been 25 years since measles was officially eliminated from the United States. That's a technical term. In public health, it means measles has not had a steady 12-month spread. Right now, there are measles cases in several states. The biggest number is in west Texas, where two kids have died.
To find out whether the U.S. can get this under control, we called Dr. Caitlin Rivers of the Johns Hopkins Bloomberg School of Public Health. She wrote a book called "Crisis Averted" about the history of public health victories, and I asked her what the U.S. needs to do to avert this crisis.
CAITLIN RIVERS: There are two things we need to see in order to get this crisis under control. One is clear and frequent communication. I think we could be doing better on that front. State and local communities are doing what they can to communicate, but I don't think that the messaging coming out of the federal government has been as clear as it needs to be about the importance of vaccination.
The other thing that concerns me is funding and support for our public health infrastructure. The majority of Americans live in counties that spend less than $150 per year per person on public health. A single outbreak can really blow that budget for the year. And so if we are asking states and locals to take on more responsibility for outbreak control, we need to resource them to do that.
SHAPIRO: From your research on the book, is there a specific example of a public health victory that you think is especially useful here today?
RIVERS: My favorite is the example of the eradication of smallpox, which I think is one of history's and humanity's greatest achievements. Smallpox was an absolute horror. It killed up to a third of people it infected. Survivors were left, often, with lifelong disabilities. And through years of dedicated, boots-on-the-ground, community-by-community efforts to vaccinate, we drove that virus - the smallpox virus - off the face of the Earth, and it has not circulated for 50 years.
And what I love about that story is it really shows what we, as a global community, as a public health community, can accomplish when we set our mind to these big goals and have the funding and the political support to go after them. And, you know, measles, too - we successfully eliminated it, and I would hate to see that take a step backward.
SHAPIRO: You said messaging from the federal government isn't as clear as it needs to be. Of course, HHS Secretary Robert F. Kennedy Jr. has a long history of vaccine skepticism. Earlier this week, he said the MMR vaccine is the most effective way to prevent the spread of measles. Do you think that message did what it needed to do?
RIVERS: I think we need to keep it coming. The information landscape is very fractured. People get their news from all sorts of places. They tune in, they tune out. And so reaching people is really about communicating frequently and clearly. And so I'm really heartened to hear that message from Secretary Kennedy, but I do think it needs to become a pattern or a cadence of that kind of messaging.
SHAPIRO: And on funding, we have seen widespread cuts across the government, including in the public health establishment. Do you think that is going to trickle down to states that need resources to fight measles outbreaks?
RIVERS: Absolutely, and I wouldn't be surprised if it already has. There were cuts to public health programs that directly affected states and local public health governments. They have had to lay off personnel as a direct result of those cuts, and I think we'll continue to see more. And I think as funding declines, we'll see more and more of these preventable outbreaks resurging.
SHAPIRO: Just to return to the question of whether a country is declared to have measles eliminated - if you've got children dying of the disease, if you have regular outbreaks, if you are not doing everything that could be done to fight this disease, why does it matter whether it is officially formally declared to have been eliminated or not?
RIVERS: Well, we care most about what's happening on the ground. So as you know, the fact that there are children who are dying of this preventable infection and there are dozens of people who have been hospitalized, that's really the thing that matters. But elimination status is a reflection or a testament to our ability to control these preventable viruses, and so losing elimination status would be a blow because it signals that something's gone wrong with our public health system.
SHAPIRO: That's Dr. Caitlin Rivers from the Johns Hopkins Bloomberg School of Public Health. Thank you very much.
RIVERS: Thank you. Transcript provided by NPR, Copyright NPR.
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