Commencement 2014: Dean Julio Frenk address

May 29, 2014

Welcome remarks

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

It is a true honor to be among the first to congratulate you as you move from being Harvard School of Public Health students to becoming Harvard School of Public Health alumni.

Congratulations, too, to your families, friends, teachers, mentors, and others gathered here—to all of you who have helped to make this day possible.

At a gala dinner this fall celebrating our School’s 100th anniversary, the rock star and activist Bono sent us a birthday message, where he spoke of “Ubuntu”—a word used in Southern Africa to express the idea that our lives are interconnected and interdependent. Those of you who loved and supported this year’s graduates—you embody Ubuntu. This day of triumph belongs to you as well.

The Class of 2014 is remarkable in its diversity as well as in its accomplishments—about which I will have more to say shortly. But your differences are far outweighed by what you share. Each one of you has made substantial sacrifices in terms of time, money, and foregone opportunities to arrive where you are today. You have done so because you are profoundly committed to making the world a better, healthier place, both now and in the future, both here and around the globe. You are driven not by personal gain but by a desire to help others, especially the most vulnerable.

In these ways, you are the rightful successors to the generations of Harvard School of Public Health students who have gone before you. Passion, talent, vision—these are hallmarks of our School’s alumni throughout time and space.

Still, there is one way in which those of you receiving your degrees today are unique—and will always have a special place in this School’s history. All 537 of you share the distinction of graduating during our 100th year.

You come from all over the world, including 63 countries and 43 states plus the District of Columbia in the United States. Fifty-eight percent of you are women—a welcome change from our first class when that number stood at 0%—and one more reason to be optimistic about the future of public health.

The degrees you are receiving reflect your wide-ranging goals and interests—33 Doctors of Philosophy, 56 Doctors of Science, 264 Masters of Public Health, 176 Masters of Science, and 8 Masters of Arts.

And yet—for all this wonderful diversity—every one of you is, and will always be, a member of Harvard School of Public Health’s Centennial graduating class.

It was on May 19, 1914—almost exactly 100 years ago—that the Harvard-MIT School for Health Officers, as the School was then known, voted to award the Certificate in Public Health to its first five candidates.

On the eve of World War I, those earliest alumni took their places in a burgeoning public health movement that was quickly transforming the globe with discoveries relating to sanitation, bacteriology, and the emergence of the new field of scientific epidemiology. They became part of an undertaking that would lead to dramatic improvements in human wellbeing, including a 30-year increase in life expectancy during the 20th century. Twenty-five of these 30 extra years are generally credited to public health advances, many of which evolved out of work done at this School.

When the legendary anti-apartheid leader Nelson Mandela died last December at the age of 95, President Obama had this to say: “Nelson Mandela reminds us that it always seems impossible until it is done.”

It always seems impossible until it is done.

This was true of dismantling the system of apartheid—and it strikes me as equally true of our work over the past century on the frontlines of public health. We make the impossible possible. It’s in our DNA. It’s simply what we do.

Consider that for most of human history—up to and including my generation—it was virtually impossible even to imagine a world without smallpox, which some experts believe killed more people over the centuries than all other infectious diseases combined. And yet, in 1979, a scientific commission certified that smallpox had been eradicated, the first disease to have been eliminated on a global scale through deliberate human action. Among the key players in this historic campaign was Harvard School of Public Health alumnus Bill Foege, then director of the U.S. Centers for Disease Control and Prevention. This position is now held by Dr. Tom Frieden, today’s commencement speaker.

Consider, too, that just 30 years ago HIV/AIDS was considered an automatic death sentence. Today, thanks to massive efforts at this School and elsewhere, it is increasingly treated as a chronic condition. Anti-retroviral medications are reaching millions of infected individuals around the world and—even more remarkably—government and civil-society leaders are aspiring to set the stage for an AIDS-free generation.

Consider that toxic air pollution was once seen as a necessary byproduct of industrialization. Today, thanks to this School’s groundbreaking research on particulate matter, air around the world is far cleaner than many would have thought possible. Our research prompted revolutionary revisions to the U.S. Clean Air Act—with hundreds of thousands of lives saved as a result—and continues to drive efforts to combat life-threatening pollution around the world.

And consider that the utopian goal of universal health coverage is increasingly becoming a global reality. It was our Professor Bill Hsiao who spearheaded the pilot studies for China’s innovative low-cost insurance system, which now covers almost 100% of that country’s 800 million rural peasants, making it by far the largest expansion of health insurance in human history over such a period of time. In the United States many of our faculty, especially in health policy and management, have played roles in the evolution of the U.S. Affordable Care Act, which despite a bumpy rollout has resulted in more than 8 million people enrolling for health coverage.

Many of you have already embarked on that lifelong mission of making the impossible possible—a commitment you share with some 13,000 living alumni of this School.

Such enormous potential to do good makes it all the more devastating when a young life is cut short. Last September saw the tragic death of 33-year-old Elif Yavuz, a malaria specialist who had received her doctorate from our School only four months earlier. Just weeks away from giving birth to her first child, Elif and her partner were among 69 people killed in a terrorist attack on a Kenyan shopping mall. At the time, Elif was working for the Clinton Foundation in Tanzania as a vaccine researcher, advancing the mission to which she dedicated her far too-short life.

As we mourn the senseless loss of this bright light, let us use it as an inspiration to recommit to doing all we can to create a better healthier world.

I cannot imagine a group more well-equipped to tackle this challenge—and make the impossible possible. Already, you are devising new health technologies, seeking to prevent and cure deadly diseases, launching new ideas and new initiatives. For many of you, the fact that you are here today at all is itself a testament to your capacity to overcome seemingly impossible obstacles. This is why student financial aid has long been at the very top of this School’s funding priorities, helping us fulfill our goals of diversity and equal access.

To be sure, it’s not always comfortable being a person committed to what others see as an impossible goal— something I can attest to from first-hand experience.

Back when I became Mexico’s Minister of Health, my single most important goal—the thing I quickly became most passionate about—was expanding health coverage to all of our citizens. Of course, I knew this was ambitious—very ambitious—as we were talking about coverage for some 50 million people, most of them poor. Still, it never occurred to me that it was impossible. I just got to work.

And then, through someone’s indiscretion, an email from a very high-ranking person in the Ministry of Health wound up in my hands. It said, in essence, “The Minister has lost his marbles. How does he think he can insure those 50 million people?”

This was a very competent technical person, and I didn’t want to fire him—even if he did think I was losing my mind. Instead, I called him to my office and I said: “Look, it’s come to my attention that you’ve been questioning my sanity, so let me tell you why I’m not crazy.”

I’m proud to say that nine years later, the universal coverage program known as Seguro Popular is firmly ensconced in Mexico—and it now covers some fifty-eight million people, my colleague’s doubts notwithstanding.

Of course, skepticism is a small price to pay for what we seek to accomplish—which is nothing less than changing the world. Today, in this second decade of the 21st century, we face both enormous dangers—and enormous opportunities. Never has there been a greater need for visionary public health leaders committed to making the impossible possible. Never has there been a greater need for you—for all that you are and all you will become.

As the School moves into its second century, we face four urgent global health threats, and while the challenges are great, the path forward is clear:

First, we must commit to defeating killer diseases and pandemics—both those with which we are all too familiar, and those that have yet to emerge. Infectious diseases are a moving target, as we have been reminded all too recently by the alarming resurgence of polio that prompted the World Health Organization to declare an international health emergency earlier this month. We are also seeing an emerging tsunami of non-communicable diseases around the world—cancer, diabetes, heart disease, and mental health problems prominent among them.

Second, we must commit to combating harmful physical and social environments—places made toxic due to factors ranging from violence to air and water pollution. These include dangers such as smoking and poor diet that result from a combination of personal choice and the larger social context that makes it harder or easier to make healthy choices.

Third, we must commit to addressing poverty and humanitarian crises—desperate situations that lead inevitably to human suffering, including death, disease, and other devastating outcomes. The Class of 1914 completed their studies just months before the outbreak of World War I, with its staggering death toll in the tens of millions. Today, with conflicts flaring around the world, I again urge you—the Class of 2014—to do everything in your power to build a safer, healthier world.

Fourth, we must commit to repairing and replacing health systems that are failing the people they purport to serve. This is the larger context for every other goal. Simply put, we cannot ensure the public’s health without well-performing health systems that achieve the best possible health outcomes while respecting the dignity of persons and protecting them from financial hardship.

Addressing these four urgent threats is an immense undertaking—and it’s easy to understand why some might consider it impossible. And yet, we know from experience that the best definition of impossible is “not yet.”

Last month, we held our third annual Fellowship Celebration to honor those whose generosity makes it possible for so many of our students to attend this School. Our student speaker Calvin Kagan, who receives his MPH today, talked about this School as a place where the exceptional is normal. He talked about how the experience of being at HSPH—of being surrounded by truly remarkable classmates, faculty, and resources—has expanded his sense of what he is capable of doing himself. How goals that would have seemed impossible before now seem entirely possible. This experience is at the heart of Harvard School of Public Health.

As our newest alumni—as our Centennial class—you now take your historic place in a long line of women and men committed to pushing forward the frontiers of public health. At the same time, you also join our vibrant alumni network—a community with an awe-inspiring track record for making the impossible possible.

I like to paraphrase a profound notion by the German philosopher Arthur Schopenhauer: “Health may not be everything, but without health there is nothing.” I truly believe that there is no work more important than the work that you have prepared for during your time with us. Health is the necessary foundation for all other social goods. Health comes first. Health always comes first.

This is the last time that all of you are likely to be in one place. Your interests, goals, and commitments—personal as well as professional—will carry you around the world. Your path will be yours alone, with its unique challenges and gifts. But even as your lives move in vastly different directions, you always will be bound to us and to each other by virtue of your membership in this Centennial class.

This School’s earliest graduates were part of a public health movement that left a legacy from which we continue to benefit today. I have no doubt that 100 years from now, someone standing where I am now could say the same of you. I have no doubt that you too will leave a legacy of impossible goals come true.


Closing remarks

Before concluding this ceremony, I would like to take a moment to honor Associate Dean for Student Services Stan Hudson, who is retiring after 18 years of service to this School. Stan has played an important role in so many of our lives, as well as in the lives of thousands of our alumni. We are tremendously grateful for his many contributions and wish him all good things as he—like all of you—embarks on a new life chapter.

And now, I would like to ask all graduates to rise.

As a sign of your entry into the company of learned women and men, you may now move your mortar board tassels from right to left.

This moment marks the end of our Centennial Academic Year—and the beginning of your life as a graduate of Harvard School of Public Health. May it be filled with wonder, joy, and satisfaction as you use your talents and education to make the world a healthier place. I have no doubt that each of you will find your own way of making the impossible possible.

Congratulations to all of you—and best wishes for the journey!

Office of Communications

Additional Coverage

Centennial closing symposium
Award winners
Commencement Eve Celebration photo gallery
‘Make the impossible possible,’ graduates told
Commencement 2014 photo gallery
Commencement 2014 slideshow
Student speaker Jacqueline Murdoch address
Alumni Association President Anthony Dias address