Commencement 2012: Dean Julio Frenk’s Address

May 24, 2012 – Welcome Remarks

Dear graduating students, family members, and friends; distinguished members of the faculty and members of the entire Harvard School of Public Health community:

It is my immense honor and pleasure to be here today to preside over this important rite of passage for the Class of 2012. Congratulations to our graduating students. Congratulations also to your family, friends, teachers, and mentors who have all been supporting you emotionally—and perhaps even financially—on this important journey.

A few weeks ago you probably could not imagine getting to this point, with so many papers and projects and tests to complete. But all of that is behind you now.  Savor this moment, if only for a short time. And then it is my hope that you will go out with your new-found knowledge and produce powerful ideas that will create a healthier world for us all.

This year’s graduating class comes from 57 different countries, represented by the national flags displayed along this tent. In addition, our U.S. graduates come from 34 states, plus the District of Columbia.

The Graduating Class of 2012 is comprised of 515 accomplished individuals upon whom President Drew Faust has conferred an impressive array of degrees: 25 Doctors of Philosophy, 1 Doctor of Public Health, 53 Doctors of Science, 272 Masters of Public Health, 153 Masters of Science, and 11 Masters of Arts. Sixty-one percent of this year’s class are women.

This is my fourth commencement ceremony as dean. Each year I am even more impressed with the talent, intellect, compassion, and diversity of our graduating students.

We have students graduating today who during their time here have worked with faculty to develop research that has been published in prestigious journals ranging from the New England Journal of Medicine to the Annals of Surgery.

Graduates sitting before me today have spent their time at HSPH working with international non-governmental organizations and UN agencies to assess the cost-effectiveness of new strategies to prevent and treat child malnutrition. You have researched the quality of cervical cancer screening and hepatitis C care among the homeless in Boston. You have studied the relationship between arsenic in drinking water in Bangladesh, a person’s genetic makeup, and their risk of developing type 2 diabetes. You have completed the first study ever done to determine the prevalence of drug resistant TB among people with HIV in Nigeria, work that will lead better care of TB-infected patients in the future.

These are but a few of the accomplishments of the people we are here to congratulate and celebrate today.

In thinking about what I would say at this commencement, I came across a quote from Sheryl Sandberg, the chief operating office of Facebook, which I would like to share with you:

“Don’t let your fears overwhelm your desire. Let the barriers you face—and there will be barriers—be external, not internal. Fortune does favor the bold, and I promise that you will never know what you’re capable of unless you try.”

I suspect some of you are wondering: why is the Dean of Harvard School of Public Health quoting a business person at Commencement? Shouldn’t he be quoting Einstein or Pasteur, or even Plato?

The students who selected today’s commencement speaker can probably surmise why I quote a businessperson at today’s commencement ceremony. Our commencement speaker, Gerald Chan, is a graduate of Harvard School of Public Health who has pursued what many would consider a bold, non-traditional career path since earning his degree. That path has taken him from a promising career in academia to private business as an entrepreneur and innovator—and now Gerald is coming back to academia, at least part-time, to teach and mentor students here at HSPH. Wherever his career path has taken him, Gerald has worked in the service of improving people’s health.

What we see today in the career paths of Gerald, and increasing numbers of people like him, is what I call career plasticity…a refusal to let those barriers that Sheryl Sandberg talks about get in the way of achieving great things.

The tightly-defined career paths where a student goes to Harvard School of Public Health and then pursues a career in academia or the public sector, or, alternatively, goes to Harvard Business School and pursues a career solely in the private sector—those are no longer the only routes to personal and professional achievement.

The old career rigidity is melting away due to the power of connectivity and the global nature of the world we live in. Barriers are dropping between countries at an amazing rate. A growing number of people are interconnected. The world’s economies are all interdependent, as the financial collapse of 2008 has taught us in painful fashion. And as those of us in the field of public health know, even the longest intercontinental flight is now quicker than the shortest incubation period of most known pathogens—so a person infected with a deadly virus can get on a plane without symptoms and arrive a half-day later at the other end of the world, only to fall ill, having spread that virus to another continent in a few short hours.

The last few years have also taught us that no government—even that of the wealthiest nation—can afford to pay for all of the scientific research and public health programs that we require to keep people healthy. As a result, it is vital that we have people educated in science and public health who see opportunities where others see barriers—who are comfortable moving easily between the worlds of government, business, civil society, and academia, to improve people’s health.

At this Commencement 2012 ceremony, it is worth considering for a moment not only how far you have come, but also how far the field of public health has come and where we hope you, as its future leaders, will take it.

There are very few areas of human endeavor that have experienced more change in the last 100 years than health. But because these changes are not cataclysmic, we can lose sight of them. I invite everyone here today to think back in your mind to about the time you were born, or your parents were born—not to the Middle Ages, but fairly recently. And think about what things were like.

Smallpox was still killing millions of people in the middle of the 20th century. Today, thanks to a dedicated group of public health professionals, including an HSPH alum by the name of Bill Foege, a system of worldwide vaccination was developed. Smallpox has been eradicated.

In the 1940s and 1950s there were just a handful of useful drugs and vaccines. The first mass-produced antibiotics had only come on the scene a few years earlier.

There were millions of people around the globe who had died of polio or who were suffering its long-term effects, and a polio vaccine had just been developed. Now, thanks to vaccines made possible by the discoveries of an HSPH faculty member, the Nobel laureate Thomas Weller, polio exists in only a handful of countries around the globe, and eradication appears as a real possibility.

Think how much things have changed since the 1960s, or even later. People were smoking everywhere in the 1960s. Now smoking in the U.S. and increasingly in other countries around the world is prohibited in public places, and the rates of lung cancer attributable to smoking have declined as a result.

When AIDS was first identified in the early 1980s, it was a nearly uniform death sentence—and people didn’t know where it came from or how it spread. Today, while it is still a scourge in many poor countries, particularly those in Africa, thanks to efforts by people here at HSPH and elsewhere we understand how the disease spreads and have major efforts underway to prevent it. New drugs and systems for distributing those drugs over the past couple of decades are helping to make AIDS a chronic disease that, in many circumstances,  people can live with, rather than die from.

Today infectious diseases like AIDS, TB, and malaria remain as major threats in the poorest countries. But as people are living longer, they are also experiencing diseases previously prevalent mostly in rich countries— diabetes, heart disease, cancers, mental illness. We are, in effect, victims of our own successes. It is a double-whammy, potentially, for fragile health systems in developing economies. And the dual burden of infectious diseases and non-communicable diseases threatens to overwhelm those countries’ health systems, and their economies.

Here in the U.S. the biggest threat to the economy, conceivably, is healthcare costs. They are spiraling higher because of the growth in chronic diseases like diabetes, heart disease, and cancers—many of which are tied to obesity, smoking, and other unhealthy lifestyles. Those costs are rising also because our health care systems are inefficient, and we focus so much money on treating disease rather than on keeping people well.

The causes of disease and illness in the 21st century also come from our environment—both the physical and the social environment. Yet our society frequently gives little credit to the role investments in decreasing air pollution, preventing violence, or providing a better education to our children will have on improving people’s health.

For the past nearly 100 years, we at Harvard School of Public Health have made fundamental contributions to improving people’s lives. These discoveries and improvements are an important legacy that Harvard School of Public Health provides to future generations. But perhaps our most important legacy is educating and mentoring outstanding students like you.

You are an immensely talented and accomplished group of students.

I am proud of the contributions made by our community of public health leaders—faculty and students alike— over the past 100 years and today. While I do not know how, precisely, you will improve the quality of people’s lives around the world in the years ahead, I have no doubt that you are destined to do great things.  You have a passion for serving your fellow human beings. You burn with a mission to pursue knowledge and ideas that will empower millions of people to lead healthier lives in the years ahead. And you have the generosity of spirit to be outstanding colleagues and mentors to the public health students who will follow you in the years ahead.

In your time here you have shared ideas—and overcome barriers. And now it is time to seek your own paths.

As Ralph Waldo Emerson said:

“Do not go where the path may lead; go instead where there is no path…and leave a trail.”

Congratulations!

Closing Remarks

As we near the end of this Commencement Ceremony, I want to thank Gerald Chan for his inspired remarks. I hope you—and all of us—accept his challenge to pursue both ideas and ideals to improve people’s health, whether it be through careers in government, non-profit organizations, academia, or in the private sector.

When I first met Gerald, we found that an element we had in common was that we both had great mentors. I believe Gerald would be the first to admit that he would not have been as successful as he is today if he had not had a great mentor in Professor Jack Little.

My mentor’s name was Avedis Donabedian who, among many other virtues, was an HSPH graduate—just like you are as of today. In fact, I believe that many of you will be called upon to be leaders—but your roles as mentors will be one of the most important tasks you will take on in your careers.

In our age of mass education and productivity-driven workplaces, the mentor has become something of an endangered species. Yet a mentor plays an irreplaceable role: He or she sows in your mind and in your soul the seeds that will nourish intellect and spirit for the rest of your life. This is what Avedis Donabedian gave me.

There is a certain geneology to mentorship. During his time as a student here, Avedis had benefitted from a warm mentoring relationship with a faculty member by the name of Franz Goldmann. I benefitted from Avedis’ mentorship and, I hope, have subsequently mentored others. And now I am back at HSPH, calling on each of you at this Commencement to consider how you can mentor others in the years ahead.

As you leave this ceremony today, my wish is that all of you will go on to emulate the guides and mentors you have encountered throughout your lives, including the time you were here at HSPH. Those mentors may have been faculty or administrators—they may in fact have been fellow students. For some of you, a parent may have also been your most important mentor. Whatever professional roles you may find yourself occupying in the years ahead, you will need colleagues and mentors to help and sustain you. I hope that you will have the generosity of spirit to be a mentor to others, as well.

You have received the best education that we know how to deliver—but we know that we can always do more, better. In 2013, we will be celebrating the centennial of the first professional education program in public health at an American university—the Harvard-MIT School for Health Officers, the direct precursor of the Harvard School of Public Health. In preparation for that Centennial, we are taking a comprehensive view of our educational strategy.

For example, Harvard and MIT recently announced an exciting new initiative called EdX to expand our ability to provide online education, thereby enhancing the educational experience for our students.

This year we created the Center for Public Health Leadership at HSPH, and many of you have benefited from the programs it is offering to promote leadership competencies.

We have just heard from our Commencement speaker, who is an accomplished leader, and our student speaker, who I have no doubt will be a future leader. Today, and yesterday at our student awards ceremony, we have celebrated leadership—and having the courage to pursue one’s own path.

This is why we have decided to establish what we are calling the “Leadership Incubator for Strengthening Health Systems” here at Harvard School of Public Health. Its purpose is to encourage lifelong leadership development in public health, starting with promising leaders such as you and continuing through the entire life cycle.

Today I have a very special announcement. Our School has received a major gift from a generous anonymous benefactor to help fund the first component of the Leadership Incubator. This is the largest gift to support education ever made to Harvard School of Public Health. It demonstrates how important this donor believes educational innovation is to the future of our world. As its central component, this gift will enable our faculty to redesign the Doctor of Public Health degree in order to orient it towards the development of the competencies required for high-level policy analysis and problem-solving leadership. Through pedagogical innovation, the new program will empower the future leaders that health systems all around the world, including the United States, require to better meet the complex challenges of our times.

Just as our School led the way as the first in public health graduate education nearly 100 years ago, this gift will enable us to continue as the leading school of public health—first in time, first in quality, and first in capacity to shape the future.

As we look at these and other ways to improve the way we teach, inevitably we will be incorporating the use of online learning, case-based teaching, and a host of other pedagogical approaches. But what will never be abandoned are the timeless values of personal relationships among students, and the mentorships between faculty and students. These will continue to be the most important way all of us learn from each other.

In a few minutes you will leave this graduation ceremony, anxious to get started on the next phase of your careers. But remember: learning, and developing your skills as leaders, are lifelong pursuits.

We hope that you will return here often—whenever you need advice, consultation, mentoring. Become active in your alumni association and find ways through it that you can mentor the students who will follow you here. Stay in contact with those among your fellow students and faculty who have inspired you. No matter how far you travel in the days, months and years ahead, we are as close as the alumni community on our website.

During my opening remarks I asked you to consider a question: How will health improve over the next 25-50 years, and what will you do to lead that revolution? What will you do to make this world a healthier place in the years ahead?

Some of you came to Harvard School of Public Health because you were doctors in emergency rooms seeing patients who never would have been there if they had better preventive care or access to less expensive care than in an emergency room. Others of you came because you had a commitment to underserved, underrepresented people in the U.S. and around the world. You came because you want to create better ways to help people avoid a potential pandemic or a chronic disease like diabetes or stroke. You came because you want to understand a scientific mystery that underlies the transmission of an illness like malaria or Chagas disease or AIDS, or that causes an environmental toxin to trigger asthma or cancer. You came because you wanted to translate some of the vast knowledge that we already have about how to prevent and treat disease…to find ways for policy makers to use that knowledge to design better health systems…and for people to use that knowledge to lead healthier everyday lives.

I can hardly wait to see what you achieve, and how people’s health is improved around the world as a result of your efforts.

As my mentor Avedis Donabedian once said: “The world of ideas and the world of action are not separate as some would have us think, but inseparable parts of each other. Ideas, in particular, are the truly potent forces that shape the tangible world.”

Not one day goes by when I do not benefit from the many ideas that my mentor sowed in my mind and in my soul. I hope that we have sowed a few ideas in your minds and a few ideals in your souls…and that they will inspire you to transform the lives and health of people around the world in the years ahead.

Congratulations!