Interview with Puthiery Va, D.O.- Ready or Not 2026 Report
Dr. Puthiery Va was named Maine Department of Health and Human Services’ Director of the Center for Disease Control and Prevention in August 2023. Before her Maine appointment, she was the Director of the Division of Public Health in Chinle, Arizona, part of the Indian Health Service. Prior to her work with the Indian Health Service, Dr. Va was an Epidemic Intelligence Service Officer with CDC.
TFAH: Maine is among the states placing in this report’s high-performance tier for emergency preparedness. What are the factors that support your state’s preparedness?
Dr. Va: The first thing I want to acknowledge is that our degree of preparedness and our culture of preparedness are a team effort. We would not be in the high-performance category if it weren’t for
my team—and that’s across all divisions: our Office of Readiness and Response, our state Health and Environmental Testing Lab and its ability to surge as needed, our Divisions of Infectious Disease and Disease Surveillance, and the Maine Immunization Programs. Our team thinks innovatively about what’s necessary to maintain a preparedness posture given the challenges of today’s evolving
public health landscape and asks, what do we need to do to continue to strengthen preparedness and response capabilities?
A culture of preparedness is particularly important when things are uncertain. It requires us to weave readiness into everyday public health operations. Anticipating, planning for, and responding to
emergencies becomes a shared mindset rather than a one-time activity. Our ability to respond isn’t just within our Office of Readiness and Response. It requires building a culture of preparedness across all of our teams, including strategies to address communicable and noncommunicable diseases, strengthening environmental health, and ensuring drinking water safety during emergencies.
Another lesson I brought from my prior work in the Indian Health Service, particularly during the COVID-19 pandemic, was the importance of communications and marketing. We have to think about communications and marketing through the lens of preparedness, and not only as a reactive tool. We’ve worked to build ongoing dialogue with the public and with our community partners in a strategic way. There are intentional communications down to the local level. The goal is to build and maintain public trust. When an emergency happens, we want the public to know who the trusted messengers are.
TFAH: In addition to your focus on a culture of preparedness, are there other aspects of preparedness you are continuing to work on?
Dr. Va: Data infrastructure and data modernization are really critical. My team and I understand that it is essential to build systems that best serve the people of Maine and the public health ecosystem. We are working on building a unified data environment so that critical information reaches patients, hospitals, response teams, public health teams, and other key partners quickly and reliably. For example, an integrated data environment will allow us to better understand vaccine coverage and ensure that we can immediately identify vulnerable populations and direct resources where they are most needed. It also supports our communications team in working with trusted messengers to deliver targeted, effective public health messaging to the communities most at risk.
TFAH: The nation’s public health infrastructure experienced many challenges over the past year, from grant terminations to workforce and program cuts. Has the changing federal public health landscape impacted Maine’s emergency preparedness?
Dr. Va: Those who work in public health know change can happen at any time, and we need to be prepared to adapt. That is especially the case in public health preparedness and response.
Uncertainty can present challenges. But here in Maine, we are prepared to meet those challenges to ensure that we can continue to protect public health in our state.
Uncertainty about funding and the anxiety that creates for my teams are my biggest concern. Uncertain funding makes it difficult to plan and difficult to ensure a preparedness posture. An example was the COVID funding clawbacks. The clawbacks were eventually restored, but the upheaval impacted our programs and created lingering uncertainty about future funding. For instance, we’re not
sure whether PHEP [Public Health Emergency Preparedness cooperative agreement] funding will be level-funded or reduced—or whether we’ll have any PHEP funding at all. We just learned we will have funding this year, but what about next year?
Another concern is that when funding is very constrained and very bucketed, it makes it difficult to be nimble and responsive to emerging threats. This is one of the reasons I’m such an advocate
for PHIG [Public Health Infrastructure Grant], because it is disease-agnostic and very flexible, allowing us to strengthen foundational infrastructure and support local partners when they need to surge during a response.
TFAH: Are you concerned about a diminished federal role in public health?
Dr. Va: Yes, diminished federal support does create stress across our programs. But I also want to highlight Maine’s strengths. We have strong state leadership that supports public health emergency preparedness and response. We also have strong state partners—we work very closely with MEMA [Maine Emergency Management Agency], our state districts and counties, and with hospital systems and clinicians. We have a very unified front that enables us to have honest and strategic discussions about how to manage uncertainty together.
TFAH: Many states are experiencing numbers of measles cases that haven’t been seen in decades. How has Maine fared, and what strategies does Maine employ to
address vaccine-preventable disease outbreaks, including measles?
Dr. Va: Maine has strong vaccine policies, so that’s a really good start. It also has a strong culture of vaccine acceptance— another great start. I don’t take these things for granted; they can change over time, so we need to work to make sure we maintain this strong culture. In February of this year, we had our first measles case since 2019. We immediately worked with the families involved to understand where exposures occurred and then used contact tracing to identify close contacts and their vaccination status. The response was a partnership with the case and the community
involved, healthcare providers, and local partners. This helped us contain the outbreak. Unfortunately, the first case did transmit to four additional close contacts who were unvaccinated, but we kept the incidence to five cases. While this situation has been resolved, we are prepared in the event we see more cases. We know there has already been some erosion nationally in vaccination levels due to mistrust, misinformation, and disinformation. We need to make sure we know where Maine’s vulnerable populations are and engage with them in a thoughtful, patient, non-paternalistic way, leveraging trusted partners and sharing evidence-based information. We need to understand where a family is [regarding vaccination], listen, and address their concerns.
TFAH: Maine is a rural state, and you have a larger proportion of older adults than many other states. How does that impact your public health strategies?
Dr. Va: Maine is a rural state, so access to any primary care provider can be difficult for some residents. Building healthcare access in many communities is critical. As an example, our public
health nurses work to bring vaccines to schools. We also recognize that not every child goes to public or private schools, as we have populations who are homeschooled. How do we reach children who are homeschooled and offer them the same [health] services they would be offered in school?
We are also working on increasing vaccine access in pharmacies. An older adult or a family may not have a healthcare provider, but there may be a pharmacy in their community. We want to think strategically about how to increase access to preventive services that help protect everyone.
Maine CDC also works closely with its health system partners. This includes meeting routinely with long-term care facilities, medical leadership, and our pharmacy association to ensure we support vaccine access and efforts to reach vulnerable populations.
TFAH: Weather-related emergencies—from hurricanes to extreme heat—are increasing nationally and are associated with numerous health risks. What’s your biggest concern when it comes to climate-related events?
Dr. Va: I really appreciate this question. I’ve been fortunate to step into my role in Maine with many of the critical foundational elements for addressing the health impacts of weather already in place. One of the governor’s priorities is focused on combatting climate change, and Maine has a Climate Council and a climate plan that includes public health. Public health therefore has a seat at the table when it comes to climate preparedness and response planning. That allows us to help our partners connect the dots between extreme weather and public health and ensure that families, communities, providers, nursing homes, other care facilities, and hospitals are prepared for extreme weather events.
TFAH: Ensuring the public’s health, particularly during emergencies, requires coordination across levels of government and with community-based and private-sector partners. How does your department build and maintain these relationships?
Dr. Va: Public-private partnerships are absolutely central to our team’s success. We meet routinely with partners to discuss priorities and identify opportunities for alignment and further collaboration. These partnerships allow us to be community- and culturally centered and to meet people where they are. They are particularly important in our work with tribal and refugee communities.
TFAH: Anything else you’d like to tell us?
Dr. Va: As we’ve said, public health is definitely a team sport here in Maine. In addition to that, we still have to communicate and coordinate with our federal partners—and we do. It’s critical that we understand changes happening at the federal level so we have enough of a runway to transition and adapt. That degree of ongoing support and dialogue is necessary to mitigate harm. I understand that priorities change and that our federal partners must pivot. If we maintain strong dialogue, we can also pivot in ways that reduce harm.
Maine is also part of the Northeast Public Health Collaborative. The Collaborative’s purpose is to foster regional coordination and information-sharing. Given the resource environment we’ve discussed, we are asking: how can we work together as health departments to operate more efficiently? One example is by working toward consistent vaccine messaging. As vaccine policy shifts,
consistent guidance and messaging will help build vaccine confidence and public trust.
Finally, I want to recognize two volunteer groups that are components of our emergency preparedness and response program: Maine Responds and our Deployable Medical Assistant Strike Teams. These groups speak to the strong sense of community we have in Maine.