Dr. Ashish Jha on vaccines, climate change, and the future of public health

Since the beginning of the COVID-19 pandemic, Dr. Jha has been a national advocate for effective testing and prevention strategies. Now as the new dean of the rapidly growing School of Public Health, he's bringing together minds from every corner of Brown to tackle the public health crises of today and tomorrow.

Dr. Ashish Jha came to Brown from Harvard where he last served as the faculty director of the Harvard Global Health Institute and dean for global strategy at the Harvard T. H. Chan School of Public Health. An accomplished physician, health policy researcher, and global health advocate, he began his term at Brown on September 1, 2020. He has been featured as an expert on pandemic preparedness in the national media and serves on Rhode Island’s COVID-19 Task Force. In this Q&A, he talks about the need for more strategic pandemic response and the School of Public Health’s future priorities under his leadership.

Why was the Brown School of Public Health well positioned to respond to this crisis?

I think Brown's response has been pretty extraordinary, and good leadership is fundamental to that. What we've seen from President [Christina H.] Paxson is a data-driven, realistic approach to managing the pandemic. What she said early on was that she wanted to get it right, whatever it cost. We had to get the public health measures right, and she was steadfast on that and supportive of all of the measures we put into place. This didn't happen randomly; there was a lot of work that went into it.

What do you expect to see happen in the year ahead as the country works to vaccinate everyone? How can Brown and the School of Public Health help that move forward?

By the time we're into May and June, I think the vast majority of Americans will be vaccinated. While I don’t expect the 2021-22 academic year to be exactly like it was before the pandemic, it can be close to it. We'll have to think about how to manage large indoor gatherings. That's going to be the risky part. 

Personally, I and many others at the School of Public Health have been involved in different aspects of the national response, from setting testing targets and exploring how to address vaccine hesitancy to doing modeling for the state. We've really tried to provide data and evidence to policymakers that can help guide their work. 

When you talk about testing and modeling for the state, were these things that Brown’s public health faculty were involved in already?

There were some members of the school’s faculty who were already in this space. Once the pandemic really got going, more people got involved, but we didn't have a large group who were thinking about pandemics and pandemic response before this happened. One of the things I think we need to invest in is a center that brings together people who are experts in different aspects of pandemics — epidemiologists, biostatisticians, data scientists, economists, and bioethicists — because we have to get through this pandemic, but we also have to begin to prepare for the next one. And there will be future ones. There's no doubt about it. I think Brown is well-poised as a university to work on these issues.

Can you talk about how a center for pandemic preparedness might come together at the Brown School of Public Health? What kind of resources will we need to accomplish that?

Pandemics represent one of the biggest global health challenges. What we need in such a center is people from different backgrounds, different areas of expertise, coming together under one roof to collaborate. You need people who can do advanced modeling, people who are experts in communication and countering misinformation, people who are policy and national security experts. This pandemic has been so devastating that we are going to see a totally different approach in the future. It's not going to be left just for the public health world. It is going to be truly multidisciplinary.

That's what plays to Brown's strengths. Brown's most important strength is its ability to bring people together from across disciplines. It's actually one of the main reasons I decided to come to Brown. Almost all the big public health challenges require that multidisciplinary approach, and Brown is really well-suited to do that.

How do you balance the pandemic work with other public health priorities?

There's a set of things that the School of Public Health does fabulously well, and these things are important with or without the pandemic. Combating substance abuse is one of them. And while you may say this is unrelated to the pandemic, of course, we know the pandemic has worsened substance abuse and addiction. There's great work happening at the school on mindfulness. I think that's another area that actually needs to grow because the mental health effects of this pandemic are so substantial.

But we also have to realize that the world is shifting and that there are these new things that we need to tackle. For many people climate change doesn't feel like the central issue of public health now, but I can promise you in five to ten years, everybody will realize that climate change is probably the biggest public health threat of our times.  

How can you start addressing the effects of climate change on public health at the school?

What we have to do in public health is connect the dots. We have to help people understand that climate change is not just about two- or three-degree temperature changes, which doesn't feel all that relevant to most people. That's not how we're going to feel climate change. We're going to feel it in our health, and there's so little work being done to connect those dots. We're going to see new disease vectors. It’s going to affect the nutrition of our food. We're going to see changes in access to water. Just about every aspect of health is going to change because of climate change. We have to get going on both understanding it and mitigating it.

What we can do at Brown is partner with the Institute at Brown for Environment and Society to create the critical mass we need to lead in this area. Our students have an incredible hunger to work on issues around climate change, but they don't know where to go. I want to create the environment where the next generation of scholars can make progress.

Can you talk a bit more about how the students — from undergraduates to doctoral candidates — contribute to the strength of the School of Public Health?

I have to say, meeting with students has been my favorite part of being here for a couple of reasons. First, they are super talented and smart, but they are also more forward-thinking than most of the faculty and staff are. They see limitless possibilities, and I think they push us. On the issue of climate and health, for instance, I've been evangelizing to public health leaders and public health scholars about the need to focus on it. But our students are ready to go. They feel like this is incredibly obvious and how are we not doing this? So, they are the pull that keeps us moving in the right direction. There's no way we could be a dynamic and impactful school of public health without the students we have. 

What about the need for increased diversity in the public health sphere? What is the school doing to create a more inclusive pipeline of expertise in this area?

One of the things that this pandemic has highlighted is the deep inequities in our society and how systemic racism shapes and affects public health. We all have a part to play in trying to address those inequities. If you look at public health workers, they're pretty diverse. But when you look at the public health leadership, it's almost exclusively white. That means when decisions are being made, even by well-intentioned people, those at the top levels don't always understand what is happening in communities of color. We have to change that. 

In order to shape a more representative public health leadership, we have launched the Health Equity Scholars program at the School of Public Health. It builds on the University’s Brown-Tougaloo Partnership with Tougaloo College in Mississippi. We're bringing in ten students a year who are graduates of historically black colleges or universities. They will have their Master’s of Public Health fully funded, so they don't have to graduate with debt. The idea is to build a diverse cohort that's deeply networked with each other and deeply networked with senior people throughout the country. Dismantling systemic racism and its effects on public health is always going to be a challenge, and it's clear to me that we need to train different people as part of the leadership to effectively tackle these things.

As the School of Public Health continues to grow, it will need expanded and updated physical space. Can you talk about the plans for renovating the recently purchased Packet Building?

We're excited that the University on our behalf purchased the Packet Building, which is literally next door to where the School of Public Health is right now. We actually think we can get the two buildings connected. We want to re-envision what our workspace looks like and how it can bring people together. Most of us under non-pandemic circumstances spend about 90% of our time indoors. But we don't think about the air quality or how the light affects cognition and mood. There’s very good evidence that these things have a real effect on performance and on people's sense of wellbeing. One of the things I want to do with this new building is try to turn it into a physical space that promotes health for the students, for the faculty, and for the staff who are going to be there. That's going to take some time and effort, but I feel like this is an opportunity for us to do that. 

Since the beginning of the BrownTogether campaign, raising support for the School of Public Health has been a top priority. What kind of impact do you think donors can have through philanthropic investment in the school?

It's pretty clear that this is an important public health moment for our country and for the world. I think we have come to realize what happens if we underinvest in public health. There are important new areas from pandemics and climate change to data science that we need to build capacity to address. Our school, and Brown more broadly, is poised to lead in these areas. But to do that, we will require new resources. Right now, there's very little federal funding for climate change work. That work has to be funded through philanthropic support initially. And, as that work begins to have an impact, other funders are going to step in. So much of what needs to happen to tackle the big public health problems in the 21st century is not going to happen without strong philanthropic support. The people who are generous supporters of what Brown is doing now are literally enabling the next generation of public health solutions. That is going to leave the world much healthier and better off than we are right now.