The Biostatistics Department would like to take the opportunity to honor Professor Marcello Pagano who will be retiring from the Department this year. It is difficult to know where to start, in part because in interviews Pagano would rather that you focus just about anywhere else than on himself!
Marcello Pagano began his educational path in the United States at the University of Florida, where he received a master’s degree, and later continued on to Johns Hopkins University, where he received a PhD, both degrees in the field of statistics. He arrived at Harvard University in the Summer of 1978 at the tail end of the “Great Buffalo Migration,” which started in 1977 when Marvin Zelen transitioned with a team of seven from SUNY, Buffalo, to Harvard. This move instantly grew the Department of Biostatistics at the School of Public Health and the Biostatistics Division at the Dana-Farber (then Sidney Farber) Institute in scale and capacity.
Marvin’s team had received from the National Institutes of Health one of the first DEC 20 computers, which was introduced to the world in 1977 and filled an entire air-conditioned room. This workhorse linked several groups (at the Farber, the Brook House down the street, and Frontier Science back in Buffalo) that together formed the statistics center for several clinical trials groups, which still exist to this day. Cumbersome as it was when compared with current computing power, the DEC 20 played a pivotal role in that it made it possible to implement and manage high-quality randomized clinical trials in all their stages, from the design of the protocol for study to trial execution, data collection, statistical analysis, and reporting.
Marcello devoted himself to developing algorithms and code to perform calculations associated with analyzing these trials, including the development of DASH (Data Analysis System at Harvard) with Anne T. Hunt (ScD 1984). Closely related to this effort, he oversaw the operation of this computer, as well as serving as head of the HSPH computing facility. During this time, Marcello also led members of the Biostatistics department in developing the concept of ABC, or Applied Biomedical Computing, a forerunner of data science. They were way ahead of their time, and though some were antagonistic to the role of computers in the discipline, the excitement for the myriad possibilities of computing was infectious. Computers were recognized as increasingly necessary in tackling problems that required the analysis of immense quantities of data with speed and accuracy and for allowing the graphic communication of results. At the Farber, Marcello began to work on cancer research and, through this experience, realized how computerized technologies could revolutionize the public’s understanding of data and its real-world significance. It hit him in the first week: a “7” became more than a statistic once the quantity of data was collated, sorted, and interpreted to represent a group or population. It was the number of months that a patient survived after a lung cancer diagnosis. That weighty revelation convinced him of the value of the team’s work.
Exploring the role of disease surveillance continued to be a theme in Marcello’s research, and computing played a pivotal role in his work on surveillance during the HIV/AIDS epidemic. Victor De Gruttola, who had completed his ScD at Harvard in 1986 and had joined the department the following year, shared with colleagues both his apprehension and his urgency to understand and address the epidemic using statistical approaches. Victor, Marcello, and Samantha MaWhinney (ScD 1991) then collaborated on a project to develop a surveillance system for HIV/AIDS incidence in New York, using back calculation to estimate the number of HIV-infected from the number of current cases to present a more accurate representation of the disease to an anxious public. Marcello later went on to explore other aspects of HIV surveillance, as evidenced in the theses of Rino Bellocco (ScD 1998), Aaron Foster (ScD 2000), and Dionne Graham (PhD 2005), and in collaborations with postdocs Xin Ming Tu and Eugene Litvak on estimating the prevalence of HIV using pooled samples and monitoring HIV drug resistance.
As part of the expansion of the doctoral program under Marvin Zelen, Marcello initiated the AIDS training grant in 1998 with colleague Susan Ellenberg (also a Harvard undergraduate) who was at NIAID at the time. This program, which continues to this day, has supported about one hundred and twenty students and postdocs over more than twenty-five years. Along with his work on HIV/AIDS, Marcello also developed methods to understand the dynamics and transmission of tuberculosis, allowing researchers to target spatial drivers of TB, provide robust estimates of the burden of childhood TB, and inform decision-making to reduce transmission.
In addition to research, Marcello’s core work since his arrival at the School has been, of course, teaching. He inherited the introductory biostatistics course Biostat 201, one of the oldest taught at the School and required for an MPH. The first year was a disaster, as he remembers it, with only a month to prepare, a huge enrollment, and no proven TAs. But slowly, over the next ten to eleven years and with the help of head TAs Paul Catalano (ScD 1991) and, for a number of years, Kimberlee Gavreau (ScD 1992), the course evolved and expanded. Indeed, Marcello was awarded the school’s teaching prize for the 1989-90 academic year and student-body citations for teaching in ’91, ’94, and ’95. In partnership with Kimberlee, the notes from the new class were compiled to form the foundation for a book, Principles of Biostatistics, which was published in 1993, with a second edition to follow in 2000. The third edition was published in 2022, with the addition of a third author Heather Mattie (PhD 2017), and it incorporates a sizable computing component. The textbook continues to be seminal in the field, used in courses not only at Harvard but also in programs all over the world. To date, the book has been translated into six languages other than English.
When considering Marcello’s impact on the department, all this foundational history arises, but what comes to the forefront is his persistent role in shaping the Biostatistics community. This commitment has been demonstrated in multiple ways: through the long-lasting friendships and professional collaborations he has formed with students, to his efforts to open the community to new and diverse members, to the way he has made teaching a means of empowerment.
Marcello’s relationships with his mentees have reflected a reciprocal exchange of ideas and interests that have not only shaped students’ paths but also affected the direction and focus of Marcello’s own research. This is particularly true in the areas of surveillance and monitoring and evaluation, where his collaboration with Bethany Hedt-Gauthier (PhD 2008) led to several publications on methods to improve the ability to infer unbiased findings from surveillance data and to support ongoing health program monitoring using techniques such as lot quality assurance sampling. It was also reflected in his mentorship of Laura Forsberg White (PhD 2006), whose thesis work focused on biosurveillance and estimating epidemic parameters; Justin Manjourides (PhD 2009), who developed methods to more efficiently monitor TB dynamics; and Natalie Exner Dean (PhD 2014), whose research involved surveillance of HIV incidence and drug resistance. Like many of his former students, these more recent mentees went on to become respected faculty members at their institutions; in the cases of Bethany, Laura, Justin, and Natalie, at Harvard Medical School, Boston University, Northeastern University, and Emory University, respectively.
Marcello’s service efforts have also been pivotal for the biostatistics community, helping to open up the School’s department to a wider and more diverse population. As chair of the department from 1995 to 1996 and as a faculty member, he has been instrumental in developing entry points for faculty and students from underserved backgrounds to enter the Biostatistics community. In part, he has done so by calling attention to the issue of under-representation. In 2022, Marcello co-published with Biostatistics alumna Melody Goodman (PhD 2006), currently Vice Dean for Research and Professor of Biostatistics at the NYU School of Global Public Health, and recent graduate Jemar Bather (PhD 2023) a study entitled Racial and Ethnic Diversity Among Students, Graduates, and Faculty in Biostatistics and Epidemiology, 2010-2020, which was a follow-up to a study in 2020 that reviewed changes in the racial and ethnic composition of public health students, graduates, and faculty among Association of Schools and Programs of Public Health (ASPPH)–member institutions.
A further contribution has been through the tireless support of Equity, Diversity, Inclusion, and Belonging initiatives within both the department and the school as a whole. In 2015, under Marcello’s mentorship, Octavious Smiley (PhD 2023) and Alex Ocampo (PhD 2020) introduced the StatStart program, which opened up the department to underserved high school students in Boston while also helping graduate students develop their teaching skills. StatStart exposes young people to the power of statistics and shows them different possibilities for the future. Marcello has also served as a tireless leader of the Summer Program in Biostatistics and Computational Biology, initiated by Louise Ryan in 1993 and then continued by Rebecca Betensky, currently professor of biostatistics and chair of the department of biostatistics at New York University’s School of Global Public Health, who was PI of the program for five years. The program has served as an invaluable pipeline for underrepresented minorities, facilitating entry into the Harvard Biostatistics masters and PhD programs and other graduate research communities. Additionally, Marcello, together with Betty Johnson, former Assistant Dean for Faculty and Staff Diversity, Development and Leadership, worked with former Dean Michelle Williams to found the Donald Hopkins Program. Currently housed in the Office of Diversity and Inclusion, the Hopkins fellowship prepares students from underrepresented communities for doctoral study, increasing diversity among students pursuing PhD degrees in biostatistics, epidemiology, and global health and population at the Harvard T.H. Chan School. The program is designed to enhance the quality of the scholars’ educational experience by affording them the opportunity to take doctoral-level courses while pursuing a funded master’s degree, interact with current doctoral students, and attend professional-development workshops on topics such as building self-confidence, improving writing and research skills, self-care, and time management.
Marcello also pursued his passion for promoting quantitative thinking worldwide by establishing, with Rino Bellocco and subsequently Marco Bonetti, the Summer School on Modern Methods in Biostatistics and Epidemiology. Since 1997, the school has met annually in Italy, first in Sicily and then in Treviso, except for two years during the COVID epidemic. Further, Marcello demonstrated his philosophy of empowering others by serving as director of the John L. McGoldrick Fellowship in Biostatistics in AIDS Research. The fellowship, established in 2009 through a generous gift from its eponymous benefactor, had a mission to improve human capacity within SubSaharan Africa to combat HIV/AIDS and related diseases by better equipping fellows with tools to use upon their return to their country of residence. In its first iteration, from 2009 to 2014, the program brought fellows to Harvard for intensive medium-term training (typically four to six months). A recently famous fellow is Sikhulile Moyo, who helped alert the world to the highly contagious SARS-CoV-2 Omicron variant in 2021. In 2017, Marcello worked to expand the reach of the fellowship by working first with Sarah Anoke (PhD 2017) and then Elysia Larson (ScD 2018, Global Health and Population), along with the ARISE Network, to develop modules to train faculty from research institutions in sub-Saharan Africa (SSA) to offer quantitative methods courses at their home institutions—essentially teaching trainers to teach. In 2019, the program was modified to offer training at one of the participating universities in SSA, the University of Rwanda. This course has since been offered at five additional institutions and has reached more than one hundred students. The course that afforded maximal exposure was Marcello’s Health in Numbers: Quantitative Methods in Clinical & Public Health Research, offered in 2012 by HarvardX in partnership with the online course provider edX. Marcello taught this course together with epidemiologist Francis Cook (ScD 1983, Epidemiology). It was one of the first two online courses offered by HarvardX and was watched by approximately 75,000 students.
It is fair to say that Marcello Pagano has been a guiding force in the department for forty-five years, shaping the emerging field of biostatistics and its relationship with computing, applying statistical methods in contexts and to diseases that afflict particularly vulnerable populations, and nurturing a generation of diverse practitioners that are shaping the tone and tenor of the field. Although Marcello warns about the forces of inertia in academia and is skeptical of his own impact in exerting lasting change, his network of mentees, students, and collaborators stand as a testament to the years of progress he has brought to the department and the discipline of biostatistics. The collective impact of his work and the work of his students is and will continue to be transformative, pushing the department and the field to expand its boundaries and better reflect the diversity of the public it serves.
