Imagine Magazine - Johns Hopkins - January/February 2009 - (Page 6)

in my own words Fixing the System Rajeev Venkayya, M.D. Director of Global Health Delivery Bill & Melinda Gates Foundation As a physician, Rajeev Venkayya focused on the pulmonary system and how it integrates with other systems in the body. At the White House, he emphasized the need for an effective and coordinated public health system in the 2005 National Strategy for Pandemic Influenza and the 2006 Implementation Plan. Now at the Gates Foundation, Dr. Venkayya is working to build and strengthen systems that will bring lifesaving products—including a malaria vaccine in the next few years—to people in developing countries. From One to Many When I was practicing pulmonary and critical care medicine, I started thinking about ways to address one of the problems I saw every day in the asthma clinic: lack of education. Because people didn’t know how or when to use their inhalers or what types of things to avoid in their environment, their asthma ended up being much worse than it had to be. I pulled together a team and created an educational video about asthma, which I posted on the web for free. It’s had a massive audience around the world. Instrument of Change I realized that one way to extend my impact to populations of people is to influence the way health policies are formulated in government. I applied to the White House Fellows Program, which assigns people from different professional backgrounds to a cabinet secretary or another senior person in government to learn policy and leadership skills. The idea is that when you go back to your profession after that year, you will use those skills to become a leader in your field and give back to society. At the end of my fellowship, I heard about a position at the White House working on bioterrorism defense. While that may seem far removed from pulmonary and critical care medicine, the reality is that to prepare and protect the population against a bioterrorism agent, you need to first protect the population against day-to-day, naturally occurring threats like influenza, food poisoning, or asthma. 6 imagine If you don’t have an effective public health system and medical system, you’re not going to be able to protect the population during a bioterrorism event. I saw the need to make the whole system function more effectively and flexibly so it would be ready for whatever comes our way, whether it’s something nature sends us or something somebody does deliberately. It Takes a Village Typically, when we think about how to respond to health problems, we think about doctors and nurses. But if you have a really big health problem like an influenza pandemic, it will involve not just healthcare workers but everybody in the community. It affects people who work in the power plant, who work in the schools, who drive buses. Unless you have a plan that engages these different parts of the community, things will fall apart. Think about Hurricane Katrina and the impact of the cell phone towers going down, or of not getting gas into New Orleans. You can have people ready to work and do good things, but if they can’t communicate with each other or be transported to the parts of the community that need them, you don’t have a response at all. We need to take a systems view of problems like these. We have to engage all the right parties to come up with a comprehensive solution. Progress without Perfection I strongly believe that the perfect is the enemy of the good. There is an understandable desire to come up with the perfect solution. In medicine and public health, it would be coming up with the medicine or vaccine that has no side effects, or creating a system to immediately get a drug or vaccine to every single person who needs it. There are no such perfect solutions. Sometimes the way forward is to come up with the best solution you can—even if it’s only going to tackle 60 percent of the problem—to begin to make progress while you refine the approach. In preparing for a bioterrorism January/February 009

Table of Contents for the Digital Edition of Imagine Magazine - Johns Hopkins - January/February 2009

Imagine Magazine - John Hopkins - January/February 2009
Contents
Letters
Big Problems
In My Own Words
Witness to a Pandemic
An Ounce of Prevention
Of Math and Measles
Predicting the Next Pandemic
Medicine, Medicine Everywhere
Food Matters
Looking for a Challenge? Try Summer College!
CTY: The Real Deal
Hot Topic
Selected Opportunities & Resources
Off the Shelf
Word Wise
Middle Ground
One Step Ahead
Exploring Career Options
Planning Ahead for College
Students Review
Creative Minds Imagine
Sudoku
Knossos Games

Imagine Magazine - Johns Hopkins - January/February 2009