You studied history at Yale, international relations at Princeton and public policy at Harvard. When and how did you decide to specialise in global health?
Since childhood, I have wanted to understand better why some people in the world have so much less than others. As I learned later, this inequality and precarity applies to both wealth and health. I started in global health when I began working for Médecins Sans frontières (MSF) in 1999, a few years out of university. At that time, most people in the field came from medicine or public health, not history or politics, and HIV was out of control – very few people outside the US and Europe had access to treatment.
Prior to joining MSF, I had worked briefly with the US Peace Corps on education in rural South Africa, one of the countries hardest hit by HIV/AIDS in the world. I witnessed first-hand the very human consequences of this global crisis in the host-family that welcomed me, and the ripple effects throughout society of the loss of a teacher, parent or child. I began to wonder why some of the medical treatments that were available in the North were not accessible in the South.
Part of the reason was international patent rules that impeded developing countries from accessing low-cost generic versions of HIV medicines. Those patent laws were the product of decades of power disparities between former colonisers and colonised, between public and private interests. Understanding that health is not only a technical issue that depends on biology, but also the outcome of global power dynamics has driven my interest in the field ever since.
Over the last 20 years, the movement for globally-equitable access to HIV treatment has demonstrated how civil society mobilisation could profoundly shape public policy. But it was working in China, where there is limited space for public protest, that I realised how research also had the power to change minds. This experience persuaded me to pursue a PhD.
In 2016, you joined the Graduate Institute after teaching at the Kennedy School of Government and the T.H. Chan School of Public Health at Harvard. Why did you decide to come to Geneva?
As the world’s “global health capital,” Geneva was a place I came often for work. What struck me when I first came to the Graduate Institute was the unique place it occupied as an academic institution within the sea of international policy processes constantly swirling around it. Each time I stood outside Petal 2 catching up on the week’s events, I felt like a kid in a candy store. So many opportunities to hear new ideas, debate big questions, and meet movers and thinkers!
My research was focused on global governance and health, and the Institute’s Global Health Centre was one of a handful of places in the world that approached health as a global political issue. When the opportunity arose to join the Institute – to take a front-row seat as a participant-observer to global governance processes – I jumped at the chance.
You’ve recently been appointed the first Professor of Practice at the Institute. What does this new position represent to you and what does it imply for the Graduate Institute?
It’s a great honour! The Institute created this faculty category a couple years ago, and to me it represents a commitment to strengthening and institutionalising its place in the world of policy and practice.
One of the Institute’s truly unique assets is being embedded in the international community, not only in the realm of ideas and knowledge, but also in the day-to-day, on-the-ground practices of global governance. Founded as a scholarly counterpart to the League of Nations, this special relationship between academia and policy is in the Institute’s DNA.
In academia we continue to struggle with how to protect our intellectual independence and the arms-length vantage point we have on society, without isolating ourselves from it – the perennial ivory tower problem. How can we engage with the world, while retaining the clear-eyed vision to study, understand and explain it?
For me, a Professor of Practice should wrestle productively with this tension, and occupy this sometimes-unsettled, sometimes-unsettling middle ground. A Professor of Practice should build a bridge for the bustling two-way traffic of ideas, research questions and forms of knowledge that can flow when we better connect these two worlds together. One way to do this is by intentionally designing our research to inform, and be informed by, efforts to address real world problems.
Global health has been profoundly impacted by the ongoing COVID-19 pandemic. What do you take away from this crisis?
I suspect we won’t grasp the full global effects of COVID-19 for years to come, so I’ll limit myself to an obvious takeaway: the utter inadequacy of our international arrangements to protect health.
The need for international cooperation has never been clearer – to share information, to ensure access to vaccines, to protect livelihoods – but we keep failing. This is not “just” a health issue. But health has traditionally been a low priority, while economy and security are considered issues of high politics. COVID-19 forced us to see that without health, society cannot function.
My hope is that there will be a fundamental shift in thinking: that political leaders will see the need to invest as much political and financial capital in building a stronger global health system as they have in building military alliances or a globalised economy. Let’s see what they do.