Last month, I attended the annual meeting of the New Jersey Local Boards of Health Association and the New Jersey Public Health Association, where the former was celebrating its 150th anniversary. At the awards dinner, the accomplishments and dedication of the honorees — spanning academia, local government, and the private sector — inspired me and reminded me that advocacy in public health is not a one-time act. It is a lifelong commitment.
Looking back on my 50-plus years in medicine, academia, public service, and the private sector, I’ve been fortunate to work in many corners of the public health system. Each chapter taught me how health is shaped — by science, policy, organizations, and people. Yet the work I found most meaningful was in government service. Whether as state epidemiologist and deputy commissioner at the New Jersey Department of Health and Senior Services in the early aughts, or later as COVID-19 medical advisor to the commissioner, I learned that progress in public health is never about one person. It requires many people — scientists, health care practitioners, local health officers, legislators, laboratory professionals, and community advocates — working shoulder to shoulder, often with little public attention, and never giving up.
Public health professionals have faced extraordinary challenges in the 21st century: bioterrorism (anthrax), West Nile virus, COVID-19, vaccine shortages, substance abuse, obesity, health inequities, climate-related emergencies, and chronic disease. Each reminds us of a simple truth: the work of public health is never done. While the challenges change, the mission remains the same — protecting health through collaboration, perseverance, innovation, and hard work.
Public health demands planning for the unseen and preparing for the unlikely. The most successful prevention efforts are often invisible to the public, precisely because they prevent or minimize tragedy. That invisibility makes it difficult to sustain the political will — and the financial support — needed to keep our systems strong between crises. In the wake of COVID-19, we have an opportunity and an obligation not to repeat that cycle.
New Jersey’s local health departments form the front line of defense against emerging diseases, environmental hazards, and community health inequities. Yet many are underfunded and overstretched, relying on temporary grants or emergency allocations that disappear once headlines fade. To build a resilient and stable system, we must treat public health as the infrastructure it is. That begins with sustained funding — resources that allow departments to recruit, train, and retain skilled staff; modernize data systems; and sustain programs addressing chronic disease, environmental health, and maternal and child health. Preparedness cannot depend on the next crisis to remind us of its importance.
With the current sustained attack by the federal government on public health infrastructure, we must also invest in coordination across jurisdictions, clear communication channels, and workforce training that enables rapid, effective response. That’s why initiatives like the Northeast Public Health Collaborative and the Governors’ Public Health Alliance are so encouraging. By bringing agencies and leaders together across state and community lines to share expertise, collect and analyze data, strengthen preparedness, and advance evidence-based policies, governments create a stronger, more resilient system for every resident. No state stands alone in protecting public health.
And we must continue to defend the benefits of vaccines and science-based policy. Vaccines remain one of the most powerful and cost-effective tools to prevent illness and death, yet misinformation spreads faster than any virus. Acting Health Commissioner Brown’s recent directive expanding COVID-19 vaccine access was a welcome step, but more could still be done. Governor Josh Shapiro took similar action in Pennsylvania through an executive order formalizing vaccine access and equity measures. With the election over, Governor Murphy has a brief but important window to do the same before leaving office—securing these protections for the future and reinforcing New Jersey’s leadership in public health.
Recent reports highlight how hostility toward science is becoming increasingly organized, with some political leaders and advocacy groups seeking to limit vaccination programs and even question long-established public health measures like water fluoridation. Hostility toward science and evidence-based decision-making has become its own public health threat. Combating it requires strong voices, transparent communication, and the courage to stand by data even when it is unpopular.
Public health professionals know this truth: collaboration saves lives. Countering misinformation, restoring trust, and protecting communities all depend on that collaboration. Every success — from containing outbreaks to reducing smoking rates to improving maternal outcomes — has occurred through partnership. All stakeholders have a duty to continue working together, sharing information, and aligning strategies. That collective strength is what makes New Jersey’s public health system among the nation’s most capable when fully supported.
New Jersey and the country have shown time and again that when we act with unity and persistence, we can meet any challenge. But maintaining that capacity requires us all — professionals, policymakers, and the public alike — to recognize that prevention and preparedness are not luxuries; it is the foundation of our safety and well-being. We must keep raising our voices, building connections, fighting for resources, and advancing public health — for New Jersey, for the region, and for the country.
