ASF spent last Saturday with Dr. David Satcher — who, in addition to serving as U.S. Surgeon General, also served as Director of the Centers for Disease Control and Prevention (C.D.C.). Today, President Obama announced his pick for the new Director of the C.D.C.: New York City Health Commissioner Dr. Thomas R. Frieden.

As the New York Times reports, Dr. Frieden will face a host of immediate challenges (including deciding whether or not to pursue and deliver a swine flu vaccine). But he’s also expected to tackle longer-term, bigger-picture issues — chief among them health care system reform:

“Health care reform also needs to be on his plate,” said Dr. Jeffrey P. Koplan, who served as the centers’ director from 1998 to 2002. “There is a huge opportunity there to improve public health, and it’s one in which any C.D.C. director will want to be a player.”

Mr. Obama referred to the issue in his announcement: “Dr. Frieden has been a leader in the fight for health care reform, and his experiences confronting public health challenges in our country and abroad will be essential in this new role,” he said.

However Dr. Frieden decides these questions, he is bound to kick up controversy, say those who know him.

“I found he’s willing to challenge the status quo in an effort to make a difference,” said Dennis deLeon, president of the Latino Commission on AIDS in New York City.

The difficulty — and necessity — of fighting to change the status quo in order to eliminate health disparities was a recurring theme at last Saturday’s ASF symposium with Dr. Satcher. And indeed, it seems that Dr. Frieden isn’t afraid to ruffle some high-profile feathers in the interest of improved public health:

Dr. Frieden has a history of focusing on health threats that endanger large numbers of people, sometimes at the expense of more popular causes. This put him in marked opposition to the Bush administration, which spent more than $50 billion on bioterrorism initiatives and paid far less attention to problems like smoking.

Dr. Alfred Sommer, emeritus dean of the Johns Hopkins Bloomberg School of Public Health, who was on the team that recommended Dr. Frieden as New York’s health chief in 2002, recalled interviewing him shortly after the Sept. 11 attacks. Dr. Frieden had flown to New York from India, where he was living and working on tuberculosis control.

Before he left India, he was asked about his top priority, Dr. Sommer said. “Oh, well, that’s easy, Al,” Dr. Sommer recalled him replying. “Tobacco. Tobacco is killing more people, and that’s my top priority.”

“Tom, I don’t disagree that tobacco is a real scourge, but have you heard of 9/11?” Dr. Sommer said he countered.

“Of course I know about that, but bioterrorists are not going to kill more New Yorkers than tobacco is,” Dr. Frieden said.