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India too has shaped my life, and my scientific career as an immunologist. When in 1966 my laboratory and another, at HSPH, simultaneously discovered a new class of molecules that regulate how T-cells, macrophages, and other cells communicate with each other, WHO invited me to participate in a small meeting in New Delhi to try to apply this new insight to what was perhaps the most neglected of all infectious diseases: leprosy.

The meeting was an awakening--to the infectious disease problems of a poor developing country, to the fear and stigma associated with a disfiguring disease, and to the enormous opportunity for basic science to shed light on disease processes--and possibly contribute to new interventions to prevent and cure those diseases. At that time, reductionist model systems were in vogue among lab scientists, few of whom were working on actual infectious diseases of the poorest countries. The impact of this first visit to India was also transformative, in that it shifted my research agenda from basic studies of immune mechanisms of model molecules to exploring mechanisms of pathogenesis and immunity in diseases afflicting the world's poor, particularly leprosy, Chagas' disease, and tuberculosis.

A few years later, WHO again sent me to India to teach the first course in the country in my field, immunology. This class, taught over a summer at the All India Institute for Medical Sciences, had 28 students. Together we worked day and night, improvising in ways I had never before imagined. Because cows are sacred in India, the students had to adapt all of our cell cultures to grow in the serum of water buffalo rather than fetal calf serum--and adapt they did. Their energy, enthusiasm, and thirst for knowledge were truly an inspiration.

Albert Einstein, when asked to identify the most important discovery in mathematics, answered: "compound interest." Einstein was right, but there is no compound interest with returns greater than those reaped by educating young people. When in 1997 I returned once again to India for the first International Congress of Immunology to receive the Novartis Award, the impact of this compounding power was abundantly clear: In attendance were 3,000 registered Indian immunologists.

When I became dean, in 1999, I sought a way to give something back to India. While modern India excels in many sciences, it is equally clear that, for a country of a billion people, it has few schools of public health and a tragically underdeveloped public health system. In September of 2000 I was privileged to meet Rajat Gupta, a distinguished Indian expatriate who had accomplished a great deal for India by organizing humanitarian activities within the Indian community in the United States. Gupta, an alumnus of Harvard Business School, was managing director for McKinsey & Company, and a global expert in management. Over breakfast, I made the case that investments in public health would be a great thing for India, particularly for the 600 million in rural areas who had so little access to health care. I would like to believe that that breakfast was transformative for Gupta. He has since become a great global advocate for public health, serving on the boards of the Global Fund for AIDS, Tuberculosis, and Malaria and the Bill & Melinda Gates Foundation.

With Gupta's support, I joined Peter Berman--then director of HSPH's International Health Systems Program, now an adjunct faculty member who heads the World Bank's Health Nutrition and Population team in India--and met with India's health secretary and health minister to advocate for a major investment in public health training. Our concept was a novel one: to create a public-private partnership which, with a business plan developed by Gupta and McKinsey, became a reality this past spring in the form of the Public Health Foundation of India (PHFI). The vision is to create initially two, and ultimately five or six, schools of public health, and a "think tank" that will provide evidence-based information for major health policy decision-making.

Enthusiasm for the concept has been overwhelming. The launch of PHFI two days after the Harvard Alumni Association meeting in New Delhi, included Prime Minister Manmohan Singh and other secretaries and ministers. In signing a memorandum of understanding, Harvard University's then-president, Larry Summers, HSPH, and PHFI pledged to collaborate in the development of training and research programs for India. PHFI has received the enthusiastic support of all the deans of the U.S. Association of Schools of Public Health, who have offered their help in training India's future teachers and trainers. Our challenge now is to raise financial support for the training at Harvard and other schools of public health of India's brightest and most dedicated students, and to foster an environment so challenging and intellectually appealing that they will be motivated to serve their home countries as India's new public health leaders. This is the kind of "compound interest" through which HSPH can truly make a difference.

This issue of the Harvard Public Health Review describes the journeys of many of our faculty and students as they strive to make lasting contributions to public health in Asia. Suffice it to say that it remains a great privilege for many of us at our School to travel along with the leaders and students of China and India, both as passengers and as guides.

Barry R. Bloom, Dean
Joan L. and Julius H. Jacobson II Professor of Public Health
Harvard School of Public Health

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Photo: Rick Freidman


HSPH Special Report:
China and India

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