Taipei Times: People have in recent years come to realize the threat posed by new infectious diseases, especially after the SARS outbreak. What is your evaluation of the various disease threats of the past year?
Su Ih-jen (蘇益仁): There was nothing special or different about the course of disease transmission last year and this year -- it's just that the prevention of infectious diseases was not really considered that important in previous years. The development of the mass media and the increased efficiency of transportation have probably had the effect of bringing infectious diseases to light. In the past, it was possible for an epidemic to occur in China, bringing about the deaths of many people, while people in other countries knew nothing about it.
Also, the fact that living standards are improving has changed how people view diseases. You can't just shrug off the deaths of a small number of people as unimportant. Now, thousands of chickens are culled because a few people die. You just can't say: `Two people died -- so what?'
Because of new human rights concepts and the evolving value of human life, disease control is now the government's responsibility. In the past, death or disease prevention was a doctor's or a patient's own problem, but now it is part of the package of responsibilities the government must take on.
TT: What kind of policymaking mechanism should the CDC adopt in light of the SARS experience?
Su: Scientific research and evidence should be used to support health policies. The process of formulating policy should be very much like solving a scientific problem. There has to be solid data to provide evidence for a policy decision.
The CDC's manual outlining its SARS prevention strategy and what measures to take, which we refer to as `The Bible,' began as just a draft document. The draft included policies that for the first time took into account the circumstances under which influenza and SARS would be closely linked. It also included an extensive vaccination program.
After the CDC had finally settled on a complete version of the policies, we had to work with local health authorities to see if the policies were plausible and what had to be revised. The SARS policies went through many revisions before being completed in November.
The CDC's policymaking reflects the spirit of science in seeking different ways to solve a problem.
TT: What is the main contribution you've made to the CDC so far?
Su: I think my main contribution is the philosophy that I impressed upon the CDC -- that the scientific spirit must form part of its policymaking process. Solving problems is the central spirit of science. Just as I already mentioned, the policymaking mechanism should involve research and the procurement of solid data. `Knowledge is power.'
This also makes pre-emptive policies possible, instead of planning after the fact. For example, the CDC vaccinated 8,000 farm workers last October in anticipation of a possible bird flu outbreak. We also bought supplies of Tamiflu, an anti-viral medication, early on last year. Policies and strategy have to be in place before something actually happens.
TT: Before becoming CDC director, you were mostly involved in academic research. How does that differ from being a government official, and what challenges have you encountered?
Su: The main lesson I learned as a government official is to keep an open mind to all voices of criticism. You really need to be able to take criticism from all angles in order to formulate the policy that will be best for all members of society. You have to open your mind to different ways of attaining a goal. A lot of times it is insecurity that prevents change. As a policymaker the need to find a solution should and can override your ego.
TT: How has policymaking proved to be different from scientific research?
Su: There are no absolutes in policymaking. You just have to arrive at a point of compromise that will best serve the needs of society. This is a skill and an art.
With science, it's either yes or no. In addition, society is in an evolutionary process, and it takes time for policies to take effect. You can't expect things to work 100 percent immediately.
TT: You mentioned plans to resign last month, but ended up deciding to stay. What were your motivations and how long do you plan on staying on as CDC director?
Su: I see my decision to stay or leave as a struggle between social responsibility and true interest. Originally I wanted to leave after the SARS episode had been brought under control. At the time I felt that the CDC was functioning pretty well and that I was just performing maintenance more than anything else.
I feel that I should give something back to society, but after 20 years of research, my work is at its most mature point. The curiosity and dreams that lie behind my research are my true driving forces. In addition, research is more fundamental and would benefit people beyond the borders of Taiwan.
I think the presidential elections will be a good excuse for me to leave. Not everyone gets the chances that I got, and I consider myself lucky.
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