Nick Littlefield

"Political leadership is what is essential to make big, broad progress in health care," Littlefield said at a November 20 lecture in Snyder Auditorium. The event was part of the Public Health Practice Speakers Series sponsored by the Division of Public Health Practice.

A graduate of Harvard College, Littlefield started out practicing trial law and became a prosecutor for the U.S. Attorney’s Office in New York and the Massachusetts Special Anti-Corruption Commission. In 1982, he joined what was then Foley, Hoag and Eliot, where he developed an interest in health care policy, food and drug law, and issues related to education, civil rights, labor and employment.

The pivotal phone call of his career came in 1988, when Sen. Edward Kennedy tapped him to serve as staff director and chief legal counsel for the Senate Committee on Labor and Human Resources. "This was my dream," he said, "and I went for it."

An example of what can be achieved in public service is exemplified by Littlefield’s experience working on what became known as the Ryan White AIDS Care Act, he said. A hemophiliac, White was an affable teenager dying of AIDS after receiving contaminated blood. He became an outspoken symbol of the growing epidemic, one that demonstrated that the disease was not confined to homosexual groups. His fight to attend public school was an early test of the legal system and basic rights in the face of AIDS.

In 1989, Kennedy, assisted by Littlefield and two others on the Senator’s staff, began working to convince Congress to authorize $500 million to fight AIDS. At the time, the disease was poorly understood, rapidly spreading and socially stigmatizing. They asked themselves, "How do we pass a bill about AIDS when people won’t even speak the word?"

They lined up Sen. Orrin Hatch to co-sponsor the bipartisan bill and, with a little help from the actress Elizabeth Taylor, they announced a press conference to introduce the controversial legislation.

"We measured our success that day by the number of cameras that showed up," Littlefield recalled. The press conference drew national media.

A revised version of the bill went to the floor of the House in 1990, but not before White and his mother talked to nearly every Senate member about the need for federal support for AIDS victims, said Littlefield. Congress ultimately provided the $500 million. White, 18, died shortly after the bill passed.

The Ryan White AIDS Care Act has been reauthorized twice, Littlefield said.

Senator Kennedy put his legislative will behind it and, with his staff, put a bill together that now means $2 billion a year for AIDS, said Littlefield.

"That’s the incredible power you can have in a government position if you go for it," he said.

During his time with Kennedy, Littlefield worked on a number of successful health care legislative initiatives, including the Kassebaum-Kennedy Health Insurance Portability and Accountability Act [HIPAA], the Hatch-Kennedy Children’s Health Insurance Act, the Family Medical Leave Act and the Americans with Disabilities Act.

Littlefield encouraged each student in the HSPH audience to find his or her own way toward becoming a political activist for health care policy.

"I know you wouldn’t be in this program if you weren’t committed to making a difference," he said.