PROFILES IN TROPICAL MEDICINE AND HYGIENE AND GLOBAL HEALTH

ASTMH website Editor Jonathan Mayer, PhD, provides unique insights into the work and lives of recent award winners.

Tina Rosenberg: She Writes! She Travels! She Sings Jazz Standards!
At the 59th Annual Meeting in December 2010, Pulitzer Prize-winning journalist Tina Rosenberg was awarded the ASTMH Communications Award for her National Geographic magazine article, “The Burden of Thirst,” about members of an Ethiopian village for whom the daily task of fetching water to drink is a way of life. In this interview, she talks about her exciting career, from how she got her start in journalism to her proudest accomplishments to date to her love for a (fictional) detective named Arkady Renko. 

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How did you originally get into your field?
My field is journalism, and I came about it the old-fashioned way.  It was my family business. My grandfather, Philip Sandler, was a journalist for a whole series of Yiddish lefty newspapers in New York. When he died in 1979, he was the city editor of the Jewish Daily Forward. He used to take me into the building frequently; I loved looking at the linotype machine. So I have always been interested in journalism and writing.  

From a true journalist’s point of view, how have tropical medicine and research changed over the course of your career?
I can only answer the question of how journalistic coverage of tropical medicine and research has changed over the course of my career. My impression is that we have gotten a lot more sophisticated about the political factors affecting what is researched and how that research is applied. For example, it was accepted wisdom in the late 1990s that third-world countries simply could not provide antiretroviral treatment to people with AIDS. It was too expensive. Adherence was too difficult.  

Now we know that both these problems are man-made, and both are solvable. 
Antiretroviral therapy has dropped from $12,000 a year to about $100. There was no act of God that decreed the price had to be that high. It was simply a product of the political power of the pharmaceutical industry. On the adherence front, I think we assumed that comfortable patients would be the only ones able to take their medicines regularly, and now we know that this is far from the case–in fact, in many poor settings adherence is better than in rich countries. The myth of rich-country exceptionalism has been busted. 

Tell us how you would explain your research/work to a casual acquaintance at a party?
I like to write about issues that are generally undercovered in the news media. I spent much of my career writing about very difficult problems, and now tend to focus on highlighting solutions to them. Public health is a very difficult problem, but there are also important and exciting stories out there that show what is being done.

What are the three most important accomplishments of your career?
In terms of public health, I would cite two stories in The New York Times magazine. One was my article on Brazil’s program to provide AIDS treatment to everyone who required it.  It ran on January 28, 2001, and was important in the debate about whether poor countries could do universal ARVs. I think it helped make the case for the establishment of the Global Fund. A second article in The New York Times magazine, which ran on April 11, 2004, made the case for considering DDT for indoor residual spraying in the fight against malaria. At the time I wrote, no wealthy country would finance the use of DDT in poor countries, but this changed shortly after. 

I hope that my third accomplishment in writing about public health is my new book, Join the Club: How Peer Pressure Can Transform the World. It is a book about the positive uses of peer pressure—in defeating dictators, fighting terrorism, university education and other fields. But many of the stories in it are about public health. I make the case that appeals based on providing information or inducing fear are less effective than those that encourage people to change their behavior by giving them a new peer group to identify with and hold them accountable. One example of this is DOTS, and I make a case for extending the idea of peer health buddies far beyond tuberculosis in poor countries to chronic diseases and conditions all over. I think this could have real resonance in American health care as we struggle with the problem of adherence and try to bring down costs while making people healthier.

What are your favorite activities outside of work?
I have three small children, so I have very few activities outside of work and family. But I do like to sing. I have sung in choirs and in small bands, but now I am pretty much limited to singing jazz standards to my kids as lullabies every night. 

What is the last film/movie that you have seen?
I did get to watch "The Social Network" on Netflix while folding laundry last week. 

Do you have a favorite country for your work? Where?
This may not apply to public health, but I always love writing about Chile, where I lived for five years. Chile is a country that does so many things right. 

What is your favorite parasite? Vector? Book?
I have never been asked about my favorite parasite and vector before. I have to say I am partial to the classics:  the malaria parasite and good old anopheles mosquito.

My favorite book is Eichmann in Jerusalem, by Hannah Arendt.  

Are you optimistic about the future of tropical medicine? Why?
Very much so. I see a very strong increase in research but just as important, in the availability of public health interventions for those who need them. If I have to choose the most important reasons, it would be that new money from the Global Fund and the Gates Foundation has helped solve the market failure issues.

What are you reading for pleasure?
I recently re-read Martin Cruz Smith’s series of novels starring my favorite detective, Arkady Renko.     

What is the last good film that you saw?
"The Social Network" was terrific.  I’m a fan of Aaron Sorkin.   

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