HJNO Jan/Feb 2026

Health Department — we haven’t changed. We have not changed our stance on vac- cines and the importance of preventative care for Louisianians, particularly whether it’s childhood or seasonal vaccinations and referring to the evidence base for that. We said that before the last two years, and we’ll continue to say that. And again, if we can be that mouthpiece for the state while there has been some ideologic changes in mes- saging, we’re happy to do that, but I want Louisianians to know that the state health department by and large on the ground is working very hard to protect the health of Louisianians. Editor Great answer, by the way. A Louisiana congressman recently referred to the New Orleans Health Department as a “soon-to-be writhing band of sorcerers” and argued that your department should be federally defunded. What do you think he meant by that? Avegno Good question. I had to Google that because I wasn’t sure if it was code for something or a reference to a book or a movie. And I have yet to find out exactly what it means. But look, I’ll tell you this: I and my team, largely me, which I’m happy to take the slings and arrows, was called every name in the book during COVID, every name you can imagine to my face, via email, leaving messages at my office. We don’t take it too personally. We have pretty thick skin. And every criticism is an opportunity to say, “Okay, are we doing this right? Is there something that we’ve missed?” And to make sure that, no, we’re actually on the right track. Again, I will go back to my training as an ER doctor. I’ve been called every name in the book by patients and their families because when people are confused, afraid, uncer- tain about whatever’s going on, whether it’s a pandemic, whether it’s the news I’ve just given them in the emergency department, you get an emotional response and you just have to sort of accept that. We stand on our work, we’re very proud of it. It’s very rigorous. When we decide to do an initiative or a program, we do it because we have done extensive research into what problem is it solving; why it’s the best use of resources. We also, through our Community Health Improvement Plan, work with hundreds of community partners to figure out what should we be working on?And how should we be doing it? And how can we share that work and the outcome? It’s not just the New Orleans Health Department waving our flag all by ourselves; everything we do has incredible community support and buy-in. If it didn’t, we wouldn’t be doing it. If you want to be mad at us or me as the direc- tor, that’s fine, but it’s really the whole com- munity that has decided to come together and do whatever you’re mad about. Happy to help explain that to anybody who might think we’re sorcerers. Editor You put your wand down and talk to them. Avegno Yeah, right. Editor Louisiana’s first surgeon general, Ralph Abraham, MD, just got promoted to the number two position at CDC. What was your initial reaction to that? Avegno Well, it’s no secret that Dr. Abraham and RFK Jr. had been close colleagues, possibly friends — I don’t know — since before either of them were in positions of health leadership. And it seems pretty standard for this new administration to bring in all your friends. And that’s true of any administration. You build your team. I’m just more interested to know what he’ll be doing at the agency. What initiatives is he most interested in? We met several times when he was surgeon general. We had cordial discussions about a variety of topics, including vaccinations. I like to start with where do we agree on things?What are things we agree on?And how can we build a relationship based on those?And then when they disagree, if we have a relationship, then it’s easier to talk to someone about disagreeing. The CDC has been through a tremen- dous upheaval in the last year. Some really, really wonderful individuals left — several of whom I know. They were nothing but dedi- cated public servants. It’s one thing to criti- cize an agency from afar — but now if you’re part of the agency, what is your vision for making it better, building it back? Or what exactly should it be doing? I’m really inter- ested to hear that from him. Editor What do you know of his replacement at LDH? Avegno I think it’s Dr. Evelyn Griffin, a local physician who was appointed by RFK Jr. to the ACIP — the American Committee on Immunization Practice — the committee that’s been voting on COVID vaccine authorization and hep. B again. I believe her most notable views are those aligning with RFK Jr. on limiting vaccine access, so we’ll see. Editor When you look at the city right now, what would be the deepest structural challenge holding New Orleans back from being as healthy as it could be? Avegno Oh, that’s a great question. I think, again, back to the social drivers of health. Our biggest challenges are those of inequality — income inequality, structural inequity, access to just basic resources in order to thrive. We have, in some cases, a 25-year life expectancy difference between neighborhoods that are three miles apart. That’s some pretty foundational challenges. And the way I think that you address those are, number one, to acknowledge social drivers of health as being the way to get better health outcomes and better eco- nomic outcomes. We have fantastic hos- pitals. We have fantastic doctors. We have a robust FQHC [federally qualified health DIALOGUE 12 JAN / FEB 2026 I  HEALTHCARE JOURNAL OF NEW ORLEANS