Remarks to the Islamic Medical Association of North America

Good evening. As-salaam alaykum. Thank you for that warm introduction, Dr. Ashraf Sufi. I always enjoy speaking to doctors, and I'm delighted to have this chance to speak to an organization that is so committed to exploring and promoting the link between spirituality and healing.

In particular, I would like to thank you for your work to raise cultural sensitivities in health care, such as the needs Muslim women have in accessing care.

I would also like to thank you for your emphasis on protecting the health and well-being of the unborn, the sick, and the dying. Protecting the rights of those individuals is something President Bush, Secretary Leavitt, and I are particularly committed to as well. A few years ago, President Bush signed the Born Alive Infants Protection Act, which ensures that every infant born alive-including an infant who survives an abortion procedure-is considered a person under federal law.

In addition, several federal laws protect doctors and medical students from being pressured by their schools, employers, or accrediting bodies into performing or referring for abortions. If you know people who are facing such pressure, tell them they have rights. I'd like to know about it, too.

So thank you for the compassion you show toward those who most need our help. Now, I'd like to talk a little about how we're working at HHS to spread a spirit of compassion around the world.

One of the greatest strengths of America is the way people of different backgrounds trust each other and contribute to a peaceful and prosperous society. Peoples from all over the world came together and built free and thriving communities. Organizations like the Islamic Medical Association offer similar opportunities for people to come together to work toward solutions to shared problems. We are all here to share ideas, to improve the health of Muslims around the world.

Earlier this week, I took my children to Ellis Island, where my grandfather arrived from Lebanon in 1920. It was a moving experience to hear about the travails of journeys such as his, and to learn more about the intake procedures at Ellis Island. After my grandfather arrived on the docks, an impoverished teenager with almost no money in his pockets and speaking no English, he met an individual in a military uniform. That person possessed the power to admit him or to send him back to poverty and uncertainty. That person was a member of the United States Public Health Service. It amazes me to think that just 85 years after my grandfather went through his six-second physical on Ellis Island, his grandson would be in charge of the Public Health Service. That is the remarkable potential of America-the reason we are all here. And that is our mission-to ensure that opportunity remains open to Americans of all ethnic and religious backgrounds, whether Muslim or Arab.

My friends, as we are all painfully aware, many predominantly Islamic countries are wracked by violence and injustice. And even in the United States, Muslims, and even those who simply appear to be from Islamic or Arab countries, face many challenges.

But whether we live in South Carolina or Saudi Arabia, Louisiana or Lebanon, Iowa or Indonesia, Pennsylvania or Pakistan, all of us can draw on our rich cultures and long histories to come together in meetings like today's to find common purpose and common interests and share our common humanity.

And I believe one of the best ways we can work together and find common ground is by confronting health challenges together. Good medicine and effective public health can be the basis for strong friendships, regardless of other adversities we face.

In the United States, just as we are committed to doing all we can to ensure the health and well-being of all Americans, we are working to help Muslims overcome the health challenges they face:

• About 33% of all refugees we welcome into the United States are Muslim, and our HHS Office of Refugee Resettlement plays a tremendous role in helping them adjust to life in our country through partnerships with religious groups already present within our communities.

• Our HHS Office of Community Service currently has a special outreach initiative directed toward the Muslim-American and Arab-American communities.

• Our HHS Substance Abuse and Mental Health Services Administration, through the Refugee Mental Health Program, provides technical assistance to mainstream and refugee providers throughout the United States, including many Muslim populations.

• SAMHSA has also been studying the mental health of Muslim youth in America, and, in 2002, issued a white paper that has provided valuable information for understanding the needs of Muslim youth and developing programs for them.

• Through our Healthy Start program at our HHS Health Resources and Services Administration, we help pregnant and postpartum women and their infants at risk for infant mortality and other unfortunate outcomes, including large Muslim immigrant populations.

• And we are working to deploy Muslim-American health professionals to Islamic countries around the world.

   

We are also working to offer opportunities for American Muslims to become health professionals. There are a great many Muslim health professionals in the United States, and many of them are leaders in their fields. Many serve in our Department. Let me acknowledge a few:

• Dr. Elias Zerhouni, born in Algeria, is the Director of our HHS National Institutes of Health-the premier biomedical research institution in the world, with a budget of $27 billion.

• Dr. Hamid Jafari, of Pakistani descent, until recently was the Chief of the Global Immunzation Division, in charge of worldwide polio efforts, at our HHS Centers for Disease Control and Prevention's National Immunization Program. We have recently loaned Dr. Jafari to the New Delhi regional office of the World Health Organization, to oversee polio activities in the last critical years of this effort.

• Captain Ali Khan, M.D., is the Acting Deputy Director for Infectious Diseases at our HHS Centers for Disease Control and Prevention, and is of Pakistani descent. He specializes in zoonotic, vector-borne, and enteric diseases. He was on the Louisiana team during the 2005 hurricanes, and was active during the U.S. government's Tsunami response in Indonesia. And on that subject, I would like to commend your organization for your compassion and commitment to assisting the victims of the tsunami and the earthquake in Pakistan.

And when we look around the world at Islamic countries, we realize the United States shares some public health challenges and problems with many of them. The threat of emerging infectious diseases looms over us all. We want healthy families. We all suffer from rising rates of what should be largely preventable chronic diseases such as cancer, heart disease, and diabetes.

Recently, I traveled to Libya and Jordan to see firsthand the health challenges their people face, and to open and continue discussions on how we can help improve the health and well-being of all our peoples. I would like to tell you a bit about my experiences in the region, and then talk about some of the other activities we are working on with other Islamic countries.

My visit to Tripoli, as part of the first high-level U.S. delegation in years, opened up the way for a broad collaboration with the Libyans. Our work together will start with an HHS-funded effort to help Libyans prepare for highly-pathogenic avian influenza and the possibility of a human influenza pandemic. We hope to expand our partnership to include telemedicine, disease surveillance, clinical training, and improving medical specialty standards.

And HHS has a long history of fruitful collaboration with Jordan. Over the course of my travels throughout the Kingdom, I heard about the results of our collaborations with Jordan to make cancer care there state-of-the-art, by helping develop the King Hussein Cancer Center, the only cancer center in the country. The Center now treats patients from at least seven countries in the Middle East. We also talked how we could expand our relationship with the new King Hussein Cancer and Biotechnology Institute, about Jordan's tobacco-cessation plans, and how our Jordanian Field Epidemiology training program is progressing. We also saw the fruits of U.S. support for Jordanian hospitals and primary care infrastructure, funded by the U.S. Agency for International Development. In addition, I also met with the Jordan Interfaith Coexistence Council, and had a long and very interesting discussion with Shaikh Tamimi, the former Chief Islamic Justice and the Grand Mufti of the Kingdom, about the common goals that bind Muslims and Christians in the world. I also had the privilege of visiting the beautiful new King Hussein mosque in Amman and spending time with the Imam there.

Last week, I met with Dr. Samir Abdullah Hassan, the Surgeon General of the Iraqi Armed Forces. Iraq is one of the most war-torn countries in the world right now, but even in the midst of its strife and despite all of the challenges involved, we are finding ways to assist the Iraqi people in developing a robust health care system:

• HHS has a Health Attaché and deputy in the American embassy in Baghdad, where we coordinate all U.S. health investments in training.

• We are planning for the delivery of mental health and substance abuse care in Iraq.

• And we are working with the Iraq Ministry of Health in rebuilding health infrastructure and planning a disease surveillance system.

If you think you have a tough job, think of Dr Samir. I encourage you to support the health of people in Iraq.

And last month, I oversaw the HHS efforts to repatriate around 14,000 Americans affected by the violence in Lebanon. There were Shia and Sunni. There were Orthodox and Maronite. There were businesspeople and tourists. And, working with state, local, and non-profit groups, we provided all of them with medical care, lodging, and assistance with their transportation.

Besides these recent activities, we have embarked on a number of other collaborations with partners in Islamic countries to realize the promise of compassion through health diplomacy:

• For the past twenty years, scientists from our Centers for Disease Control and Prevention have been working with ministries of health around the world to establish field epidemiology and laboratory training programs. In Pakistan, for example, we plan to recruit the first cohort next year. The new epidemiologists will then work with Pakistan's Ministry of Health at the federal, provincial, and district levels to improve the country's disease surveillance and response.

• For the past several years we have been sending scientists from our HHS Centers for Disease Control and Prevention around the world to assist in efforts to stamp out polio. Though we had come close to eradicating the disease, recent increases in outbreaks in largely Islamic communities have shown us that we need to work harder than ever if we are to be successful. I would like to ask your help in three areas of the eradication efforts.

  • I hope those of you who have influence in Islamic countries could implore donors to contribute to the efforts,

  • I ask those of you have influence with religious or secular leaders in Nigeria or India to encourage them to educate their communities on the vital importance and safety of polio vaccination, and

  • And if any of you with expertise in related fields could give technical support, particularly in northern Nigeria, because the word of Muslim experts carries a great deal of influence. Though the greatest hurdles yet remain, I am confident that, with your support, the international efforts to eradicate polio will eventually succeed.

• Our HHS National Institutes of Health is working with Islamic countries on research on such relevant diseases as thalassemia and diabetes, as well as research in the Middle East related to preventable health problems, such as smoking and various forms of trauma. This research in turn will help Muslims and others in America who suffer from thalassemia. We are also planning a workshop to bring together Islamic countries and U.S. experts on the health of newborn infants to study emerging problems that affect the health of our most vulnerable people.

• Our HHS Centers for Disease Control and Prevention is helping to design public health systems that are responsive to the threats emerging infectious diseases pose to all of us, such as the threat of a pandemic caused by avian influenza. We are working with dozens of countries around the world, including predominantly Muslim countries in Africa, the Middle East, and Central and Southeastern Asia, to prepare against the threat of an influenza pandemic. And the United States is providing a total of $334 million to support the global campaign against avian flu, making us the largest donor in the world on this cause.

• Over the past several decades, we have funded over $200 million worth of cooperative health projects in India-a country with one of the largest populations of Muslims-on areas such as HIV and AIDS, polio, tuberculosis, malaria, leprosy, childhood cancers, environmental health, and oral cancers. Our current investment at HHS in India is around $30 million a year, which supports more than 90 research projects.

• And across much of the Islamic world, we are supporting activities such as:

  • Newly created systems to assure the safety of food and drugs across the Middle East;

  • Population-based cancer registries with the Middle Eastern Cancer Consortium, which involves Egypt, Turkey Jordan, the Palestinian Authority, Israel, and Cyprus;

  • Childhood immunizations and safe water programs in Bangladesh; and

  • Tele-health programs in a number of Islamic countries; and

  • A major investment in the largest maternity hospital in Afghanistan-which is saving lives in a place that has among the highest maternal mortality rates anywhere; in one region of Afghanistan, our scientists at the Centers for Disease Control and Prevention recorded the highest maternal mortality rates ever recorded-6,500 maternal deaths per 100,000 live births.

  • In addition, in Afghanistan, in a partnership with LeapFrog Enterprises, the maker of the children's interactive, multimedia educational tool known as the LeapPad, we have developed the Afghan Family Health Books, a new educational tool targeted towards illiterate Afghan women to teach them about good health practices, such as the importance of prenatal care, nutrition, immunizations, and landmine safety. The books are informative, culturally appropriate, easy to use, portable and fun. So far, we have distributed 20,000 of these books, 10,000 each in Dari and Pashto, and we are receiving requests for more.

Those are just some of the activities we are working on with partners in Islamic countries. In addition, while these collaborations help improve peoples' health and well-being, they also help strengthen the robustness of the countries' long-term economic competitiveness. This is because healthy people are the foundation of healthy societies, and healthy societies are critical for healthy economies. Just as successful companies require an adequate customer base, successful restaurants require good food, and successful farms require fertile land, so too do successful societies require healthy people. Quite simply, a healthy population is a precondition for success in building human capital, economic welfare, and a prosperous economy.

And because one of the biggest obstacles standing in the way of improved health in many Islamic countries is the threat of violence, in all that we do, we pray for peace.

Now that I've told you about some of our work overseas, I would like to turn to an area that we are hard at work on here in America that has direct relevance to your role as medical providers, and that is health transparency. Let me explain what I mean by health transparency.

Good care is priceless, but health care is not without costs. And the price of health care-currently $1.9 trillion dollars or 16% of America's G.D.P.-is growing at such an enormous rate that it is beginning to challenge many of the other things we value. One of the most significant reasons for the expanding costs is that right now, there is no way to know exactly what you are going to be charged, or, even worse, if you are even getting the best quality care for the best price. Though we have created one of the best health care systems in the world, it's a very opaque system subject to complicated regulations and restrictions.

Consumers deserve to know the quality and cost of what they are purchasing. And health professionals deserve to be recognized and rewarded for the quality services you provide. That's why one of our latest initiatives at HHS is to make the quality and the cost of health care transparent.

Last week, President Bush signed an Executive Order to empower Americans to find better value and better care by increasing the transparency of our health care system. The Executive Order directs federal agencies that administer or sponsor federal health insurance programs to:

1. Increase transparency in pricing,
2. Increase transparency in quality,
3. Encourage adoption of interoperable health information technology standards, and
4. Provide options that promote quality and efficiency in health care.

The goal of our transparency initiatives is to enable Americans to access basic information about the health care they consume, so that they can become more engaged, savvier purchasers. And as consumers become increasingly savvy and engaged, they expect more choices, more responsibility, and more control in every aspect of their lives. When it comes to health care, educated consumers demand and get higher quality health care at better prices.

And, whether on transparency in health care or on spreading compassion around the world through health diplomacy, I hope you will reach out to me when you see opportunities for collaboration, because I would like to increase our involvement and integration with Muslim communities in the U.S. As I've mentioned, my family comes from Lebanon, so I know what it means to be Arab in this country. I know what it's like to be treated sometimes with suspicion in airports and other public places. But I also know that in the long run, with mutual respect and dialogue, both America and Islamic countries can be places of greater freedom and tolerance. Thank you.