Putting People First
January 14, 2013鈥擜mbassador Mark Dybul (C鈥�85, M鈥�92, H鈥�08) recently received the 2012 Timothy S. Healy S.J. Award for his outstanding public service in support of humanitarian causes and advancements for the benefit of mankind. Dybul served as the U.S. global AIDS coordinator during the Bush administration and implemented the President鈥檚 Emergency Plan for AIDS Relief (PEPFAR). This year, he was named the executive director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria. He also serves as a distinguished scholar at 鈥檚 . In a recent interview, Dybul explained the need for a more integrated approach to global health policy.
How did you get involved in HIV/AIDS research and work?
When I was at Georgetown, I was a major in , and I had no interest in science. I was working with Father Healy at the time, and I was trying to decide between pursuing a career in philosophy or poetry. I wrote an article about global HIV and AIDS, and it grabbed me in a way I can鈥檛 describe and changed my career path as a result.
How has your study of philosophy and English affected your life and career?
I think those are great starting points for anyone going into anything. Philosophy teaches you how to think effectively and how to work through issues and look at the big picture and still work your way through complex issues. Philosophy is trying to understand the wonder of life in a way our minds can get around it. Poetry makes sure you never lose sight of the wonder of the world. Those are pretty important for science or global health.
PEPFAR was the largest international health initiative focused on a single disease. What are some of the challenges that arise when targeting particular diseases in global health policy?
I think it鈥檚 important to note that PEPFAR did contribute to a lot of different diseases other than HIV. It was specifically focused on HIV because we needed to do that at the time. The problem is that many people in Africa just don鈥檛 have or are at-risk for HIV.
A good example is a pregnant, HIV-positive woman. You could treat her and save her life and prevent the transmission from her to her child, but if she dies in childbirth鈥攚hich women in sub-Saharan Africa have a tenfold higher risk of than in higher-income countries鈥攕he鈥檚 not any better off, her family is not any better off, and her community is not any better off. Taking care of people and taking care of the health of persons鈥攁ll the diseases and health issues that they will have, at least at some basic level鈥攕eems to be a smarter approach. It also seems to be a more cost-effective approach.
With PEPFAR, there was criticism of your results-based approach, what would you say to people who thought the projects were not going to succeed and that these problems are unsolvable?
They were wrong. Right now, we鈥檙e looking at the potential鈥攂ecause of scientific advances鈥攖o completely control HIV. We have the science to completely control malaria. We initiated projects on cervical cancer. We hear the same things we heard back then, 鈥淚t鈥檚 not possible, the systems aren鈥檛 strong enough. There isn鈥檛 enough money.鈥� And we can either continue to listen to those naysayers who raise those issues, which are the exact same issues they raised 10 years ago, or we can get on with the business of saving lives. And we鈥檒l always go with the latter.
What are the current challenges that the global health community faces in fighting HIV and AIDS?
We have the science to control the infection, which means taking the worst pandemic of our time, a modern plague, and converting it to a low-level endemic. That is pretty extraordinary. The challenges are just focusing on public health and utilizing the current science in a way that is effective, and that can be very complicated. I鈥檝e just become the head of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and I think the other challenge is to have all of these global institutions work together to support countries [and] their national health strategies that focus on the health of people.
What work are you looking forward to doing at Global Fund?
The fund is on a very forward-looking trajectory, and the work will be to continue that and to ensure that the original model of partnership鈥攂ilateral [institutions] like PEPFAR and mutilateral institutions鈥攊s in fact supporting countries to achieve their health objectives. And to get the highest value for [our] money and the greatest impact.
For current students who want to help solve global health problems, what issues will they need to address?
That we won鈥檛 know until they get into these positions. We鈥檙e just in this evolution, and it鈥檚 a two steps forward, one step backward [situation]. We鈥檙e just getting out of a 20th-century approach and into a 21st-century approach to global health and development. Our institutions are trying to change to that. Global Fund was created as a 21st-century institution鈥攚hereas for the most part, we鈥檙e trying to cram these 21st-century ideas into 20th-century or even 19th-century institutions. The next generation will have the opportunity to advance that. They will be the ones doing the innovation to push that forward.