Michael H Merson
Michael Howard Merson
Interim Chair of the Department of Social and Behavioral Sciences
Clinical Professor of Global and Environmental Health
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Professional overview
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Michael Merson is Interim Chair of the Department of Social and Behavioral Sciences and a Clinical Professor of Global and Environmental Health at NYU. He also the William Joklik Emeritus Professor of Medicine and Global Health at Duke University, where he served as the founding director of the Duke Global Health Institute and as Vice President and Vice Provost for Global Affairs. His current research is focused on policy issues related to the response to pandemics, evaluating the rollout of Paxlovid in low-income countries and on ways to regain trust in public health.
Prior to NYU, he joined the faculty at Yale University as its first Dean of Public Health. Before entering academia, between 1980 and 1995, Dr. Merson served as director of the World Health Organization (WHO) programs on Diarrheal Diseases and Acute Respiratory Infections, and subsequently the WHO Global Program on AIDS. He has authored over 150 articles, is the senior editor of a leading global health textbook “Global Health: Disease, Programs, Systems, and Policies” and lead author of The AIDS Pandemic: Searching for a Global Response on the history of the global response to AIDS. He has served in advisory capacities for UNAIDS, WHO, the Global Fund to Fight AIDS, TB and Malaria, World Bank, World Economic Forum, Bill & Melinda Gates Foundation, and was an advisor to various private sector entities on the COVID-19 pandemic. He has two honorary degrees and is a member of the National Academy of Medicine.
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Education
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B.A., 1966, cum laude, Amherst College, Amherst, MassachusettsM.D., 1970, summa cum laude, SUNY, Health Sciences Center at Brooklyn, New York
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Honors and awards
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Consortium of Universities for Global Health (CUGH) Distinguished Leadership Award (2018)Duke Medical Alumni Association Distinguished Faculty Award (2017)Master Teacher Award in Preventive Medicine, Downstate Medical Center (2010)Outstanding Contribution to the Campaign Against HIV/AIDS, Russian Association Against AIDS (2000)Connecticut Health Commissioner’s AIDS Leadership Award (1998)Connecticut Health Commissioner’s AIDS Leadership Award (1997)Frank Babbott Alumni Award (1995)Surgeon General's Exemplary Service Medal (1993)Commendation Medal, US Public Health Service; (1986)Arthur S. Flemming Award for Outstanding Federal Service (1983)Commendation Medal, US Public Health Service (1975)
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Publications
Publications
A summary of the literature on global hearing impairment : Current status and priorities for action
AbstractTucci, D. L., Merson, M. H., & Wilson, B. S. (n.d.).Publication year
2010Journal title
Otology and NeurotologyVolume
31Issue
1Page(s)
31-41AbstractBackground: Hearing loss (HL) and deafness are global issues that affect at least 278 million people worldwide. Two thirds of the people who have HL worldwide live in developing countries. Importantly, it is estimated that 50% of this HL can be prevented. In developing countries, funding for prevention, early detection, and rehabilitative programs is severely limited, and therefore, agencies must compete against priorities to treat life-threatening, pandemic diseases such as human immunodeficiency virus, malaria, and tuberculosis. Delays in diagnosis are common, and social attitudes, local customs, and cultural bias are contributing factors. Objective: The purpose of this review is to gain an understanding of the prevalence of HL in the developing world and to focus attention on the growing need for both prevention and effective treatment programs. A second goal is to use this information to suggest priorities and approaches to address these problems worldwide. Data Sources: The data were compiled from a review of the literature on the global impacts of hearing impairment and recently published reports on the prevalence and cause of hearing impairment in developing nations. Conclusion:: The high prevalence of HL in the developing world is due to a variety of factors, including lack of widespread comprehensive immunization programs and other medical care, and inadequate funds for intervention once HL is identified. International organizations, governments, and nongovernment organizations have many opportunities to prevent and treat HL through cost-effective means.Results of the NIMH collaborative HIV/Sexually transmitted disease prevention trial of a community popular opinion leader intervention
AbstractNIMH Collaborative HIV/STD Prevention Trial Group, A., Caceres, C. F., Celentano, D. D., Coates, T. J., Hartwell, T. D., Kasprzyk, D., Kelly, J. A., Kozlov, A. P., Pequegnat, W., Rotheram-Borus, M. J., Solomon, S., Woelk, G., Wu, Z., Dyatlov, R., Ganesh, A. K., Li, L., Sivaram, S., Somlai, A. M., Benotsch, E. G., … Lawrence, J. S. (n.d.).Publication year
2010Journal title
Journal of Acquired Immune Deficiency SyndromesVolume
54Issue
2Page(s)
204-214AbstractOBJECTIVE: To determine whether community populations in community popular opinion leader intervention venues showed greater reductions in sexual risk practices and lower HIV/sexually transmitted disease (STD) incidence than those in comparison venues. METHODS: A 5-country group-randomized trial, conducted from 2002 to 2007, enrolled cohorts from 20 to 40 venues in each country. Venues, matched within country on sexual risk and other factors, were randomly assigned within matched pairs to the community popular opinion leader intervention or an AIDS education comparison. All participants had access to condoms and were assessed with repeated in-depth sexual behavior interviews, STD/HIV testing and treatment, and HIV/STD risk-reduction counseling. Sexual behavior change and HIV/STD incidence were measured over 2 years. RESULTS: Both intervention and comparison conditions showed declines of approximately 33% in risk behavior prevalence and had comparable diseases incidence within and across countries. CONCLUSIONS: The community-level intervention did not produce greater behavioral risk and disease incidence reduction than the comparison condition, perhaps due to the intensive prevention services received by all participants during the assessment. Repeated detailed self-review of risk behavior practices coupled with HIV/STD testing, treatment, HIV risk-reduction counseling, and condom access can themselves substantially change behavior and disease acquisition.The role of academic health science systems in the transformation of medicine
AbstractDzau, V. J., Ackerly, D. C., Sutton-Wallace, P., Merson, M. H., Williams, R. S., Krishnan, K. R., Taber, R. C., & Califf, R. M. (n.d.).Publication year
2010Journal title
The LancetVolume
375Issue
9718Page(s)
949-953Abstract~Diagnosis of Acute HIV infection in Connecticut
AbstractDubrow, R., Sikkema, K. J., Mayer, K. H., Bruce, R. D., Julian, P., Rodriguez, I., Beckwith, C., Roome, A., Dunne, D., Boeving, A., Kidder, T. J., Jenkins, H., Dobson, M., Becker, J., & Merson, M. H. (n.d.).Publication year
2009Journal title
Connecticut medicineVolume
73Issue
6Page(s)
325-331AbstractAcute HIV infection (AHI) is the earliest stage of HIV disease, when plasma HIV viremia, but not HIV antibodies, can be detected. Acute HIV infection often presents as a nonspecific viral syndrome. However, its diagnosis, which enables linkage to early medical care and limits further HIV transmission, is seldom made. We describe the experience of Yale's Center for Interdisciplinary Research on AIDS with AHI diagnosis in Connecticut, as a participating center in the National Institute of Mental Health Multisite AHI Study. We sought to identify AHI cases by clinical referrals and by screening for AHI at two substance abuse care facilities and an STD clinic. We identified one case by referral and one through screening of 590 persons. Screening for AHI is feasible and probably cost effective. Primary care providers should include AHI in the differential diagnosis when patients present with a nonspecific viral syndrome.Identifying acute HIV infection in Rhode Island.
AbstractBeckwith, C. G., Cornwall, A. H., Dubrow, R., Chapin, K., Ducharme, R., Rodriguez, I., Velasquez, L., Merson, M. H., Sikkema, K. J., & Mayer, K. (n.d.).Publication year
2009Journal title
Medicine and health, Rhode IslandVolume
92Issue
7Page(s)
231-233Abstract~Strategies used in the detection of Acute/early HIV infections. The NIMH multisite acute HIV infection study : I
AbstractKerndt, P. R., Dubrow, R., Aynalem, G., Mayer, K. H., Beckwith, C., Remien, R. H., Truong, H. H., Uniyal, A., Chien, M., Brooks, R. A., Vigil, O. R., Steward, W. T., Merson, M. H., Rotheram-Borus, M. J., & Morin, S. F. (n.d.).Publication year
2009Journal title
AIDS and BehaviorVolume
13Issue
6Page(s)
1037-1045AbstractAcute/early HIV infection plays a critical role in onward HIV transmission. Detection of HIV infections during this period provides an important early opportunity to offer interventions which may prevent further transmission. In six US cities, persons with acute/early HIV infection were identified using either HIV RNA testing of pooled sera from persons screened HIV antibody negative or through clinical referral of persons with acute or early infections. Fifty-one cases were identified and 34 (68%) were enrolled into the study; 28 (82%) were acute infections and 6 (18%) were early infections. Of those enrolled, 13 (38%) were identified through HIV pooled testing of 7,633 HIV antibody negative sera and 21 (62%) through referral. Both strategies identified cases that would have been missed under current HIV testing and counseling protocols. Efforts to identify newly infected persons should target specific populations and geographic areas based on knowledge of the local epidemiology of incident infections.Towards a common definition of global health
AbstractKoplan, J. P., Bond, T. C., Merson, M. H., Reddy, K. S., Rodriguez, M. H., Sewankambo, N. K., & Wasserheit, J. N. (n.d.).Publication year
2009Journal title
The LancetVolume
373Issue
9679Page(s)
1993-1995Abstract~A global partnership in medical education between Duke University and the National University of Singapore
AbstractWilliams, R. S., Casey, P. J., Kamei, R. K., Buckley, E. G., Soo, K. C., Merson, M. H., Krishnan, R. K., & Dzau, V. J. (n.d.).Publication year
2008Journal title
Academic MedicineVolume
83Issue
2Page(s)
122-127AbstractDuke University and the National University of Singapore (NUS) have partnered to launch a new medical school that brings the American style of postbaccalaureate medical education to Asia. The new institution, called the Duke-NUS Graduate Medical School (GMS) and located in Singapore adjacent to the Singapore General Hospital, admitted its inaugural class of students representing citizens of seven nations in August 2007. The project represents an investment of more than $350 million from three ministries of the Singapore government, and a commitment on Duke's part to provide senior leadership and recruit faculty from Duke, from other international locales, and from within Singapore itself. Graduating students who complete the four-year Duke curriculum will receive an MD degree awarded jointly by Duke and NUS, thereby distinguishing this school from medical education in most Asian institutions that award an MBBS degree after a five-year period of study that follows directly from secondary school. The emphasis of the Duke-NUS GMS is to prepare physician-scientists for academic careers, with plans for 20% of each class to complete a combined MD/PhD degree. This article describes events leading up to this partnership and details of the relationship, including curriculum, organizational structure, milestones, and goals.Combination HIV prevention
AbstractMerson, M. H., Padian, N., Coates, T. J., Gupta, G. R., Bertozzi, S. M., Piot, P., Mane, P., Bartos, M., & for the Lancet HIV Prevention Series authors, the L. (n.d.).Publication year
2008Journal title
The LancetVolume
372Issue
9652Page(s)
1805-1806Abstract~Government-NGO collaboration and sustainability of orphans and vulnerable children projects in southern Africa
AbstractRosenberg, A., Hartwig, K., & Merson, M. H. (n.d.).Publication year
2008Journal title
Evaluation and Program PlanningVolume
31Issue
1Page(s)
51-60AbstractGiven current donor attention to orphans and children made vulnerable by HIV/AIDS, and the need for a new framework that recognizes the complementary roles of nations and non-governmental organizations (NGOs), this analysis reviews NGO-operated community-based orphans and vulnerable children (OVC) projects in Botswana, Lesotho, Namibia, South Africa, and Swaziland. There has been a lack of attention within the field of evaluation to inter-organizational relationships, specifically those with government agencies, as a factor in sustainability. We analyzed evaluations of nine OVC projects funded by the Bristol-Myers Squibb Foundation for the influence of government-NGO collaboration on project sustainability. For eight of the nine projects, evaluations provided evidence of the importance of the government partnership for sustainability. Government collaboration was important in projects designed to help families access government grants, initiate community-based solutions, and advocate for OVC rights through legislation. Government partnerships were also critical to the sustainability of two projects involved in placing children in foster care, but these showed signs of tension with government partners. In addition to the more common factors associated with sustainability, such as organizational characteristics, donors and NGOs should concentrate on developing strong partnerships with local and national government agencies for the sustainability of their projects.The global health and diagnostic (flow) cytometry - Breakthroughs in HIV and tuberculosis
AbstractMerson, M. H., & Denny, T. N. (n.d.).Publication year
2008Journal title
Cytometry Part B - Clinical CytometryVolume
74Issue
SUPPL. 1Page(s)
S4-S5Abstract~The history and challenge of HIV prevention
AbstractMerson, M. H., O'Malley, J., Serwadda, D., & Apisuk, C. (n.d.).Publication year
2008Journal title
The LancetVolume
372Issue
9637Page(s)
475-488AbstractThe HIV/AIDS pandemic has become part of the contemporary global landscape. Few predicted its effect on mortality and morbidity or its devastating social and economic consequences, particularly in sub-Saharan Africa. Successful responses have addressed sensitive social factors surrounding HIV prevention, such as sexual behaviour, drug use, and gender equalities, countered stigma and discrimination, and mobilised affected communities; but such responses have been few and far between. Only in recent years has the international response to HIV prevention gathered momentum, mainly due to the availability of treatment with antiretroviral drugs, the recognition that the pandemic has both development and security implications, and a substantial increase in financial resources brought about by new funders and funding mechanisms. We now require an urgent and revitalised global movement for HIV prevention that supports a combination of behavioural, structural, and biomedical approaches and is based on scientifically derived evidence and the wisdom and ownership of communities.A social cognitive model of health for HIV-positive adults receiving care in India
AbstractTarakeshwar, N., Srikrishnan, A. K., Johnson, S., Vasu, C., Solomon, S., Merson, M. H., & Sikkema, K. (n.d.).Publication year
2007Journal title
AIDS and BehaviorVolume
11Issue
3Page(s)
491-504AbstractIn-depth interviews were conducted with 50 HIV-positive adults (23 women, 27 men) with access to care at a non-governmental organization in Chennai, India to gain a broad understanding of how they managed their HIV infection. Using a Social Cognitive Model of Health, we identified factors within the model's three domains-Personal, Environmental, and Behavioral-that are applicable to this socio-cultural context. The Personal domain's factors were a positive self-concept, family-focused goals, and treatment optimism; the Environmental domain comprised family-based support, treatment availability, access and quality, and HIV stigma and discrimination; and the Behavior domain's factors were medication adherence and health habits, sexual behavior, and social relationships and emotional well-being. Significant differences for many of the factors within the three domains were observed across married men and women, widowed women, unmarried men, and female sex workers. Implications for an enhanced intervention for HIV-infected individuals in similar treatment settings are discussed.HIV and drug use in Eurasia
AbstractHeimer, R., Booth, R. E., Irwin, K., & Merson, M. H. (n.d.).Publication year
2007Page(s)
141-163AbstractThe twin epidemics of drug addiction and HIV simultaneously emerged in the Eurasia region in the late 1990s. Both were unanticipated by health establishments. Failure to act slowed the collection of detailed data and effective responses. In this chapter, we report on our observations and on those of our colleagues. To provide a proper sense of the problem created by the slow response of most of the governments in the region, this chapter combines a description of our experiences with the limited data available from scholarly sources.Living with HIV infection : Perceptions of patients with access to care at a non-governmental organization in Chennai, India
AbstractTarakeshwar, N., Krishnan, A. K., Johnson, S., Solomon, S., Sikkema, K., & Merson, M. H. (n.d.).Publication year
2006Journal title
Culture, Health and SexualityVolume
8Issue
5Page(s)
407-421AbstractThrough interviews, we examined explanatory frameworks of living with HIV infection among 50 HIV-positive individuals (23 women, 27 men) receiving care at a non-governmental organization in Chennai, India. Results were analysed according to three sets of issues, all of which were found to differ by gender: causal beliefs about HIV, impact of HIV, and care/treatment of HIV. HIV-positive participants attributed their infection to biological, moral and social causes, and the physical, financial and relationship dimensions of their lives were impacted upon by the infection. Furthermore, HIV-related stigma evoked fears about isolation and discrimination. Regarding care/treatment, men were most usually first initiated into the healthcare system while women often entered as a consequence of their partner's condition. Non-adherence to medication was reported by 32% of the participants due to financial constraints or side-effects. Although all participants were hopeful about a cure for HIV, women were less positive than men about treatment. Results highlight the importance of a gender-sensitive approach to HIV care, nuanced to accommodate an individual's gender, marital status and social background.The HIV-AIDS pandemic at 25 - The global response
AbstractMerson, M. H. (n.d.).Publication year
2006Journal title
New England Journal of MedicineVolume
354Issue
23Page(s)
2414-2417Abstract~Uganda's HIV/AIDS epidemic : Guest editorial
AbstractMerson, M. H. (n.d.).Publication year
2006Journal title
AIDS and BehaviorVolume
10Issue
4Page(s)
333-334Abstract~Unprotected intercourse for extra money among commercial sex workers in Kinshasa, Democratic Republic of Congo
AbstractMerson, M. H., Ntumbanzondo, M., Dubrow, R., Niccolai, L. M., Mwandagalirwa, K., & Merson, M. H. (n.d.).Publication year
2006Journal title
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIVVolume
18Issue
7Page(s)
777-785AbstractThis study assessed the extent and correlates of the practice of engaging in unprotected intercourse for extra money among commercial sex workers (CSWs) in Kinshasa, Democratic Republic of the Congo. We conducted a cross-sectional survey using a structured, interviewer-administered questionnaire among a convenience sample of 136 CSWs. More than one-quarter of CSWs (26.5%) engaged in unprotected intercourse for extra money. These CSWs charged about 3.5 times more for unprotected intercourse than for protected intercourse. Multivariate logistic regression showed that CSWs who engaged in unprotected intercourse for extra money were significantly more likely to live or work in non-downtown (lower socioeconomic) areas of Kinshasa (odds ratio [OR]=3.07), to have at least one child less than six years of age (OR=2.95), and to know other CSWs who engaged in the same practice (OR=9.38). We hypothesize that desperate socioeconomic conditions combined with peer/social norms drive the practice of engaging in unprotected intercourse for extra money. Additional circumstances under which Kinshasa CSWs engaged in unprotected intercourse included intercourse with clients who tore their condoms to increase sexual pleasure (58.8% of CSWs), episodes of condom failure (56.8% of CSWs), and unprotected intercourse with regular noncommercial partners (only 5.3% of CSWs with noncommercial partners always used condoms with these partners).Improving home-based care in Southern Africa : An analysis of project evaluations
AbstractRosenberg, A., Mabude, Z., Hartwig, K., Rooholamini, S., Oracca-Tetteh, D., & Merson, M. H. (n.d.).Publication year
2005Journal title
Southern African Journal of HIV MedicineIssue
19Page(s)
30-36AbstractWe describe lessons learned from independent evaluations of nine home-based care (HBC) projects in Lesotho, South Africa and Swaziland. Projects were funded through Bristol-Myers Squibb's Secure the Future (STF) initiative and evaluated through the STF Monitoring and Evaluation Unit (MEU) at Yale University. The objectives of this study were to: ■ Assess the management capacity of the HBC organisations reviewed, concentrating on monitoring and supervision mechanisms. ■ identify innovations in responding to the challenges of delivering care in resource-poor settings, and ■ explore the nature of linkages between HBC projects and governments. Specific strategies to assure quality are discussed, as are policy changes necessary to provide system-wide improvements in quality and the integration of HBC. These are particularly important as governments seek ways to use existing resources to make antiretroviral (ARV) roll-outs successful.Global health and university patents
AbstractKapczynski, A., Crone, E. T., & Merson, M. H. (n.d.).Publication year
2003Journal title
ScienceVolume
301Issue
5640Page(s)
1629Abstract~Allocating HIV-prevention resources : Balancing efficiency and equity
AbstractKaplan, E. H., & Merson, M. H. (n.d.).Publication year
2002Journal title
American journal of public healthVolume
92Issue
12Page(s)
1905-1907AbstractThe primary goal of HIV prevention is to prevent as many infections as possible. This requires allocating HIV-prevention resources according to cost-effectiveness principles: those activities that prevent more infections per dollar are favored over those that prevent fewer. This is not current practice in the United States, where prevention resources from the federal government to the states flow in proportion to reported AIDS cases. Although such allocations might be considered equitable, more infections could be prevented for the same expenditures were cost-effectiveness principles invoked. The downside of pure cost-effective allocations is that they violate common norms of equity. In this article, we argue for a middle ground that promotes both equity and efficiency in allocating federal HIV-prevention resources.Estimating the cost of unmet HIV-prevention needs in the United States
AbstractHoltgrave, D. R., Pinkerton, S. D., & Merson, M. H. (n.d.).Publication year
2002Journal title
American journal of preventive medicineVolume
23Issue
1Page(s)
7-12AbstractBackground: Although new HIV infection cases have dropped from over 160,000 per year in the mid-1980s to 40,000 per year in the 1990s, HIV incidence has been relatively unchanged for a decade. This number of annual incident infections suggests that substantial, unmet HIV-prevention needs continue to fuel the HIV epidemic in the United States. Objectives: This study estimates the cost of addressing the unmet HIV-prevention needs in the United States and establishes a performance standard by estimating the number of HIV infections that would have to be prevented in order for these programs to be considered cost saving to society. Methods: Standard methods of cost and threshold analysis were employed in this study. Interventions needed to address unmet behavioral risks include services to reduce sexual risk of HIV infection, services to provide access to sterile syringes for people who cannot stop injecting drugs, HIV counseling and testing, and intensive preventive services to help HIV-seropositive people avoid transmitting the virus to others. Results: If brief interventions are utilized to address sexual behavior risk, the total program cost (over and above current resource levels) is just over $817 million; and if more expensive multisession, small-group interventions are used, the costs increase to over $1.85 billion. However, even the higher-cost program has a threshold of only 12,000 infections that must be prevented in order for the program to be considered a cost saving to society. Conclusions: Addressing the remaining unmet HIV-preventive needs in the United States will require a substantial commitment of resources. However, even a greatly expanded HIV-preventive program in the United States could pay for itself through savings in averted medical care costs.Overcoming barriers to collaboration between basic behavioral scientists and public health scientists in research on mental disorders
AbstractMuehrer, P. R., Salovey, P., Afifi, A. A., Coyne, J. C., Kring, A. M., Merson, M. H., Prohaska, T. R., & Rozensky, R. H. (n.d.).Publication year
2002Journal title
Journal of Clinical Psychology in Medical SettingsVolume
9Issue
4Page(s)
253-265AbstractThe behavioral and public health sciences both have a long and rich history supporting basic, translational, and applied research aimed at improving human lives and reducing human suffering. Through the complementary expertise of these disciplines, investigators have contributed to significant, worldwide improvements in mental and physical health. Further gains can be achieved through collaborative research among scientists in these 2 fields. Unfortunately, there are a number of barriers to such collaboration originating in different intellectual traditions, research methods, and the structure and values of academia. We identify these barriers and potential strategies for overcoming them. Several areas for future collaborative research appear promising, especially comorbid mental and physical disorders, adherence to interventions, stigma, and emotional processes. Theory-guided preventive interventions may represent especially fertile areas of collaborative effort.Mission now possible for AIDS fund
AbstractHale, P., Makgoba, M. W., Merson, M. H., Quinn, T. C., Richman, D. D., Vella, S., Wabwire-Mangen, F., Wain-Hobson, S., & Weiss, R. A. (n.d.).Publication year
2001Journal title
NatureVolume
412Issue
6844Page(s)
271-272Abstract~Success hinges on support for treatment
AbstractHale, P., Makgoba, M. W., Merson, M. H., Quinn, T. C., Richman, D. D., Vella, S., Wabwire-Mangen, F., Wain-Hobson, S., & Weiss, R. A. (n.d.).Publication year
2001Journal title
NatureVolume
412Issue
6844Page(s)
272Abstract~