Julie Jacobson, MD, DTM&H, has assumed the presidency for 2021. Dr. Jacobson is a global health leader and physician with a lifelong commitment to addressing complex public health problems. She has worked at the CDC and the Bill & Melinda Gates Foundation and currently serves as Managing Partner for the global health non-profit Bridges to Development. She recently sat down with science writer Matthew Davis to discuss the challenge of being ASTMH President in the midst of the COVID-19 pandemic and her priorities for 2021.
What motivated you to run for President of ASTMH and how has your outlook been altered by the pandemic?
When I decided to seek the presidency, the world was quite a different place. We had arrived at this amazing point where we were looking at 2020 as a time when the stopwatch would start on reaching a lot of different global health targets. I wanted to take a bigger role at the Society because we were at such a tipping point and there was so much in the world that was changing. Now we are navigating these issues in a world that has endured significant disruptions.
The challenge we face as a Society and a global community is how to come through this and assemble the pieces we need to keep moving forward and not lose ground. The pandemic has put stresses on the entire world – on families, health systems, on financial and economic frameworks. The Society is feeling these pressures as well.
How will you be approaching your term as President?
The big stressors we are facing as a Society are the three Cs: COVID, climate change and the vestiges of colonialism. These are the acute and chronic challenges that have come to the forefront in 2020. And my goal is to respond to all of these with another three Cs: compassion, culture and courage.
For compassion, it’s about taking time to reflect on what drives us to do this work and the underlying roots of caring for humankind and curiosity that are part of the endeavor of pursuing global health.
For culture, it’s about overcoming the biases we encounter and unconsciously have, emphasizing the need and benefit of inclusion and respect. We need to embrace the different cultures that enrich our Society and find ways to consistently include, honor and celebrate all contributions.
And then we need courage, because 2021 will still be a very challenging year. We will have to find ways to support each other, create a positive environment and contribute to building a stronger, more equitable world.
I also believe ASTMH is not a society that is just an annual meeting and a journal. We are a group that works together year round.
I think embracing some of the virtual platforms that we have been relying on over the last year can contribute to more consistent collaborations among our members. But we need to stay focused on inclusion and respect as we take advantage of the virtual world. The barriers to inclusion in the past could be about something like who gets a plane ticket or travel award. Now it’s time-zone challenges and connectivity. We need to be aware of how we schedule meetings so that we are not excluding people who may be in Australia, Africa or Papua New Guinea.
How do you view the transition to the Biden Administration in Washington and what that will mean for the Society?
The arrival of the new administration in the White House is both an opportunity and a challenge. They will be overwhelmed with competing priorities.
It’s always important to take advantage of a transition to educate new leadership around our global priorities. I also think it’s exciting that we appear to have an opportunity to come back to a place where scientists are respected partners and not feared or seen as an impediment. We have experienced a big breakdown in trust over the last four years. The scientific community now faces a challenge of how to communicate with the public in ways that generate trust and do not generate fear and suspicion.
(the former director of the CDC) has noted that science itself does not come with a moral compass. We have to bring that ourselves. Our Society can be a solid, stable partner for the new administration. We’re the largest global health organization you’ve never heard of. We can tap a lot of different networks to help rebuild trust in science with the help and voice of our members.
What has informed your journey in the world of tropical medicine and global health that has brought you to where you are today—as a leader of a major NGO and President of ASTMH?
In the 1930s my grandfather built a hospital in what is now the Democratic Republic of Congo and worked as a physician in the northwest of the country. So I went into medicine with a desire to work in global health. And when I finished medical school, my graduation present was to visit the hospital he built. But it was very depressing. The political situation had degenerated and the hospital had no supplies. I also ended up responding to the Rwanda refugee crisis that was happening at the time. There were cholera outbreaks and thousands of refugees in need of care and we were trying to deal with this with no water supply for miles.
I thought I was going out in the field to work with patients and do things like deliver babies. But I realized that I was fighting at the wrong end of the battle. If I was going to make a difference, I needed to be working upstream, on public health and preparedness. That is what pushed me to go to work for the CDC and put me on a path that led me to work at the Bill & Melinda Gates Foundation and now start Bridges to Development – focusing on increasing access to innovations and building coalitions that can help deliver sustainable global health equity.
What do you see as the biggest challenges in fighting infectious diseases and other global health threats in a world that will still be battling the pandemic through much of 2021?
At the top of my list right now is misinformation, which was not something you would think about in the past as a global health problem. But there is so much misinformation out there challenging trust in basic health measures. A good example is the anti-vaccination movement. We have come to a point where it can be really difficult for people to figure out if something is true or not, especially when there are influential people who do not see truth as an important value. It’s super important to find our way back to a place where misinformation is not dominating the conversation.
Also, when you look at the way the pandemic has been affecting the economy, the same disruption is happening in all areas of health. Malaria deaths are increasing. Supply chains critical for dealing with problems like TB are being disrupted. Vaccine coverage is down. Neglected Tropical Disease (NTD) programs have not been able to reach communities. We have so much work to do just to get back to baseline. But there is an opportunity to use these disruptions to build back stronger and better. For one thing, we can appreciate the importance of broadening the focus beyond a particular disease and consider the need to support different systems that affect us all. We need to be less insular. It’s no longer enough to say, for example, “I’m just going do malaria.” Every time we reach a community or a patient we need to think holistically of their needs.
How has the pandemic changed the way you work?
For many of us, our work relies on travel and travel has come to a halt. I spent so much time on airplanes that when I traveled, the flight attendants would take note if I was not sitting in my usual place in the plane. But there are ways to make the current situation work to your advantage.
We can all benefit from the strong relationships and partnerships we have formed over the years and find ways to continue to collaborate even under incredibly difficult circumstances.
For example, our team was involved in a grant that was slowly moving through the funding process. And we were eager to get approval because we were ready to hit the ground and get to work. Now, because of the pandemic, we have had time to think through the project, the people, our priorities, and focus more on planning.
So, like a lot of people, we are trying to find a silver lining, which in our case involves using this pause to think about how we can improve our work, how we can do even better.