EP131 Lessons in Global Health Leadership with Dr. Michael Merson

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EP131 Lessons in Global Health Leadership with Dr. Michael Merson

Aman: Folks, welcome back to another episode of the I AM GPH podcast. Today, we're very excited to have an inspiring figure in the field of public health. To me, at least, after doing all this research. Dr. Michael Merson. He's currently the Interim Chair and Clinical Professor of the Department of Global and Environmental Health. From his impactful work at the World Health Organization within diarrheal diseases, acute respiratory infections, and AIDS, to his numerous contributions in academia, Dr. Merson's journey is a story of dedication and insight that continues to shape the world of global health. He served in an advisory capacity for UNAIDS, WHO, the Global Fund to Fight AIDS, and so many more, including the World Economic Forum, Bill and Melinda Gates Foundation, and I can keep going. He also has two honorary degrees and is a member of the National Academy of Medicine. Dr. Michael Merson, we're so excited to have you on the I AM GPH podcast. Welcome. 

Michael: Thank you. Thank you for those kind words. 

Aman: They're all very true. And I'm very excited to hear…You know, we've been talking right now since before the interview started, and I'm so curious to know. Where did this journey start? It's such a prestigious– you have had so many prestigious leadership roles. What was the day one of your journey? How did this even begin? A lot of people watching this podcast are students that are graduating undergrad, graduate, some people watching it are midway through their journey. How did your journey begin? 

Michael: Well, I was influenced, initially, by my grandfather, who was a physician, used to hang out in his office a lot when I was a young kid. He was a cardiologist. And then went on to medical school after college. And in my junior year to senior year summer of medical school, I had an opportunity – this would've been 1965 – an opportunity to go to Nepal to work in a USAID program on family planning that was working with the Nepal Family Planning Association. And in that experience, which was two months, I really saw for the first time the poverty and challenges that people had in a country like Nepal, particularly women in reproductive age. Had a chance to work in the family planning program, had a chance to go up into the hillside, into the mountains in Nepal and see people in rural areas and all the challenges they had. That really impressed me. And I was also impressed that there was two things. First, that so much of the health problems that people had was so much a result of their life. Of poverty, of lack of water, lack of food. That it made me see health in a very broad sense. And secondly, that with simple approaches, we could do quite a bit in terms of prevention and in treatment. And that really has got me, I think, launched into a life of public health and global health. 

Aman: How did it evolve after that trip? So where did it start? So you come back from Nepal, and then what are you telling yourself in that moment? This is where I wanna take it. 

Michael: Well, first I had to complete my medical training, and so I finished med school, did my internship, what they called internship residency. And at that time, I had an opportunity during my residency to spend a couple of months on a ship called the Hope Ship that, at that time, was docked in Northeast Brazil. So that gave me a second experience in a different part of the world. Also an area with a lot of poverty, a lot of, particularly, children that died at a young age. And so that was another experience that got me really committed to trying to work with poorer populations. Also, during my training, I went to med school in Brooklyn and I did my residency in East Baltimore. These were poor populations also. And I realized that the challenges in public health and global health were everywhere. This was exciting for me. I enjoyed practicing medicine, but I was more stimulated by the opportunities to do something about prevention and coming up with simple ways of treatment. Then there was a military obligation that I had to serve, and in my case, it was during the Vietnam War. And all physicians were drafted. And I had the opportunity, as part of my draft, was to go to the Center for Disease Control into what's called the US Public Health Service. And I served there for two years in a diarrheal disease program there. And had the opportunity there to also learn about diarrheal diseases, not just in this country, but also abroad. And also, to help in development of a new technology called oral rehydration therapy. In those days – this is now in the early '70s – we treated diarrheal disease intravenously, particularly in kids. Now, we learned in around that time that you could successfully treat most cases orally and that simplified treatment greatly, and also feed a child so they wouldn't get malnourished. This became an area of expertise for me as a result of that. And after my service at CDC, I moved to Bangladesh to Dhaka where there was a laboratory there called the Cholera Research Laboratory. It's now called the International Center for Diarrheal Disease Research, Bangladesh, ICDDRB, but at that time, it was a US-based cholera research lab that had been set up by the military to learn about treatment, particularly of cholera. And I spent two years there, mostly treating patients, and also doing research on cholera and on childhood diarrhea with a good deal of focus on oral hydration therapy. When I was there – this was now in 1978 – one day, a very prominent Indian physician, microbiologist also, walked into my office in Dhaka and asked me if I'd like to come to WHO. I was shocked. He said, yeah, please come. I've heard about some of the work you've been doing here. Come for a couple of years and help us start a global program that would promote the use of oral rehydration therapy around the world and reduce the number of deaths, which at the time, was 5 million. Reduce it greatly by getting rehydration treatment to the field using oral rehydration packets. 'Cause intravenous therapy was far more complicated to administer. So there I went from my training to living in Bangladesh, exposure and more in Northeast Brazil. And then working in Bangladesh for a couple years, and suddenly finding myself, at a fairly young age, working in the World Health Organization. 

Aman: I can't believe this has only been a little over a decade, from going to Nepal to you going to the World Health Organization. It's admirable to see how that journey transformed you and you kept evolving and going to new places and getting different experiences. Since we're gonna be talking about the World Health Organization a lot, I get a sense that most people have an idea. It's a big organization. We all know that. But what exactly is the World Health Organization? What do they do? 

Michael: We'll call it WHO 'cause it's easier, but WHO was established like many UN organizations after the Second World War. And it's a UN specialized agency, which means that it's part of the UN, but it's a little bit apart from the UN in New York. It has its own governing structure, its own executive board, has the World Health Assembly, and it exists and was set up primarily to provide advice to all countries, but particularly low- and middle-income countries, regarding health and health matters. And it's very big, like many other UN agencies, it's located in Geneva. It has six regional offices and it has country offices, and most of its staff and funding today is more in the field than in headquarters, although it has a fairly large headquarter staff, which primarily provides technical advice to countries in many different areas. 

Aman: Okay. That's clear on what it does. Does it still do that to this day? Or has it evolved into so much more? 

Michael: Well, the UN in general has become more political. And of course, WHO has had its challenges with some of the pandemics that have recently occurred. But it's pretty much still the same as it was when it was created. One of the differences now is that there are many other UN organizations and many other international agencies that work in health, because the problems are huge, and WHO cannot, by any means, do all that needs to be done. And so a lot of the work in WHO now, more so than when I was there, is very much around coordination and trying to bring a common approach to global health problems. 

Aman: I understand. So, you know, the physician approached you in your office in Dhaka, and then you went to the WHO. And I remember when reading about it, you worked on different projects over there, different kinds of diseases. How do you decide your area of focus? I know you were working with the oral hydration therapy that came in. Did it evolve for you? Do you choose your own path over there or do you get assigned a project? 

Michael: A combination. Both. In my case, when I went there in 1978, I spent 12 years there working in diarrheal disease building up a global program, so that we were able to help. By 1990, almost every low- and middle-income country set up a diarrheal program, set up proper treatment, deal a lot with prevention of diarrheal disease, hand washing, safe food, breastfeeding, which was very important. The last two years when I ran that program, some research had discovered that it was also a way to simplify treatment of pneumonia, which was the second leading cause of death in young children after diarrheal disease. Talking about children less than five years of age. And so, the director general said to me, asked me if I would take on that program as well. Because a lot of the approaches we were using, a lot of the technical approaches, a lot of the management approaches, was related. We were dealing with two, now, the most common diseases that children got, which were diarrheal disease and pneumonia. So there was a common approach to training healthcare workers, managing health systems, setting up programs for surveillance, for evaluation. So I agreed to take that on. So my last few years of running that program, the diarrheal program, I was also starting to build up a program in acute respiratory infections. And both of these became at the heart of, at the time, of primary healthcare, which had been launched in 1978 through a meeting in Alma-Ata. A very significant meaning convened by WHO and UNICEF focusing on communities and helping communities build up systems for prevention and for treatment of common illnesses. Then in 1990, my life shifted quite a bit. At the time, we were dealing with the first decade of the AIDS pandemic. Now that started in 1981, but the first 10 years of that pandemic was mostly infection. Some disease, but the interval between infection and disease was usually between seven and 10 years. But what happened in 1990 is the direct WHO launched its-- although the virus was discovered in 1981, WHO didn't launch its program to deal with AIDS until 1986, and that program grew very rapidly and with a lot of resources. 'Cause there was a lot of fear of AIDS and that it was spreading very quickly around the world, and at that time, there was no treatment. Unfortunately, being infected was a death sentence. And this led to a lot of discrimination, a lot of denial. These were tough times. In 1990, the very charismatic director of that program, in WHO, Jonathan Mann resigned over a dispute with the director general. And the director general called me one day and asked me if I would fill in for Dr. Mann. I was, at that time, the most senior American in WHO and asked me if I would help to find a new director. I didn't know much at that time about AIDS. So I took over that program in an interim capacity for a few months. And, yeah, at that time, the director general asked me if I would move from the Diarrhea and Respiratory Infection Program and direct the AIDS program. That was a real challenge for me. I had not worked in that area. And there was a lot of emotion and a lot of human rights issues. And it was a tough thing for me to take on, but I agreed to do it, and I ran that program from 1990 until 1995 when I left WHO. That program had-- it was much bigger than the diarrhea program. When I took it on, it had about 500 people in that program. It was by far the largest program WHO had ever launched. And it had about 250 people working in Geneva and about 200, 250 people working in the field in about 120 countries. Now, the pandemic was most severe in Africa, but it was slowly spreading during the period I was directing it, to Latin America, to Asia, and really became a global pandemic. By far, the most serious pandemic the world had seen since the influenza pandemic in 1918. And because it was spread through mostly sexual contact, injecting drug use, these were illicit behaviors. And as I mentioned earlier, there was a lot of stigma, discrimination, and denial, and it made tough to get countries to be open about their problem and to build programs that they needed to build. What accelerated that was, as we moved through the '90s, more and more people were dying of AIDS. Because that long incubation period was coming to reality. And so that was the program I ran between '90 and '95. And then I left WHO, finally to come back to the States. 

Aman: I feel like I was transported into… wow. Oh, my. You know, the question that kept coming up for me while you were mentioning that was running a program. And there might be some people watching this whose dream might be to run a program, where some of them have no idea what running a program, leading a program is like. What is that whole journey like? What's a day in the life? 

Michael: Well, I think it depends a little bit on the program, but some of the most important parts of running a program in WHO, and could be many places is really being a good manager. Knowing how to manage operations, manage people, raise funds, and learning how to be a good leader. And these are things that one should be learning initially, you learn about them in school, but then, you know, you have to gain experience to know how to do it well. That's a lot of what you do. Now, technical advice is important, and you need to get people around you that know the technical things you don't know, and you need to count on them to give you that advice. So it's a complex task of running a big program. The AIDS program, there were 500 people.When I ran the diarrhea program, we had a hundred people. So 500 staff's a large staff, around the world. Now remember, in those days, we didn't have email, we didn't have cell phones. So, you know, I was running these programs with fax and the regular we didn't have mobile phones, so we were just using the regular telephone. So the communication was different. We had air travel, but not with all the kind of air travel, the distances that planes go now and the frequency that we have today, we didn't have then. So there were quite a few challenges.

Aman: I'm fascinated by this. So let's move to 1995. You come back to the States. What happens then? 

Michael: Well, I had decided, at that point in my life, that I had had enormous opportunity. And it wasn't planned. But what I really felt next I wanted to do in my life was to help the next generation of, now we're calling it global health leaders, to be involved in education and training and try to have an impact on future generations in the field of global health. And so that's what drove me to come back. And I had never worked in academia since I had left my training at Hopkins, but I thought that my experience would be of value if I could convey it into an academic institution. And I was very fortunate to have been offered a deanship at the Yale School of Public Health, and so that's where I went in 1995 to take on that position. It was a change, both of course, living abroad and coming back to the States, and also moving from a UN system to an academic institution with different culture, different way of making decisions. And like when I had moved to the UN, this was a an interesting transition for me, but it allowed me to start into an academic part of my life, which I really enjoyed. 

Aman: So where did you start in academia then? How did that journey begin then?

Michael: Well, I was dean of the Public Health School at Yale, so I had to learn what were the main ways one could successfully run a public health school. 

Aman: Oh, okay. 

Michael: And you learn very quickly that your most important currency is your faculty.  Interesting. And helping to have your faculty thrive and help them do what they want to do. That helps to attract good students. You want to have strong educational programs, so you need faculty that both want to do research and want to teach. You need to raise resources, because in today's academic world, tuitions don't pay the whole cost. So you need to help raise funds, and you need to work with your alumni to get them to feel part of what you're trying to do to build a school. It was a relatively new public health school, and that was interesting. There had been a school there, they had offered an MPH program, but it was in the School of Medicine. And I was able to help bring the school out of the school of medicine to become an independent school. And so that was, for me, another great challenge. But the main enjoyment I had was in meeting young students and helping them grow and plan their careers in public health and in global health. I also took it on myself to write what was really the first textbook of global health as part of helping to convey the knowledge and experience I had gained abroad for the 18, 20 years I lived abroad. 

Aman: How does one even write this entire book? 

Michael: Oh, I didn't write it myself. I worked with a publisher, a very good publisher of textbooks. And we found the top people to write different chapters. I wrote a few myself. And I tried to anticipate what were the main topics that students of global health would learn and tried to include that in chapters in the textbook. It was wonderful. I was new back in the States. I met a lot of very exciting people. And we did four editions over 20 years, but I think we've come to the end of that now. There are plenty of other textbooks. 

Aman: How lovely. That's really cool. So was that the thing that formed the curriculum at Yale for you? Or how did you decide that?

Michael: No, the school had a curriculum already, and I didn't have to do much about that. And it was a very strong curriculum. I was mostly engaged, of course, in trying to make the school more global. and trying to recruit some new faculty. I also was able to get a grant. I had never gotten a grant before from NIH. And I applied and got what's called a center grant to set up really what was the first AIDS center. There were many centers of AIDS by that time, but there hadn't been an AIDS center that had dealt with global issues. Most of it, naturally, understandably, it focused on the problem in the United States, which was quite serious until we had antiretrovirals, which came about around, well, discovery was in '96, and they became available a couple years later. But in the low- and middle-income countries, these drugs were very expensive at that time and were not affordable outside the rich countries. It wasn't until the year 2000 when there was a lot of activism around AIDS and human rights and the price of drugs, where the price dramatically came down. Pharmaceutical industry was under great pressure, thank God, to bring the price down and make it available to everyone. And it was around 2000 that that happened. I was able to run an AIDS center that focused on the problems of prevention and treatment for AIDS in low- and middle-income countries when I was at Yale. So, although I was primarily a dean running the school, I also had my own research center, which was built on a lot of the experiences I had had running the AIDS program in WHO.

Aman: How lovely. It seems like academia and these organizations are big organizations, and they are big systems in place, but they serve a different purpose. Did you notice similarities? Or the environment and the goals were perhaps different?

Michael: Well, it's true. They are different. In a UN organization...Simple way to say it-- you use the term "we" a lot. It's a common group of people working in the organization that speak. Whatever you're doing, you're doing on behalf of the organization. And, of course, you have to use your own judgment, your own skills, your own knowledge. But you are working as a multilateral, it's called, for a multilateral institution. And so you don't come in with any particular bias, you try to give the best information you can to the people that really need it. In academia, you have a little bit of a, in some ways, similar approach in that you're working for the common good in a public health school. You want to get knowledge that anyone can use. But as I mentioned, the main currency you have is your faculty, and you get rewarded in academia for scholarship, and of course for teaching, and for practice. So we cover all three areas in academia. We try to help our faculty be highly successful in discovery or in implementation science. We work to get our faculty provided the tools they need to be good teachers of students. And then of course we take opportunities for practice, both to make a difference in the world. Usually, it can be domestically, it could be internationally, both the faculty, and of course, for the students who really want those opportunities. So it's very much based on the individuals at the school and you don't necessarily think of the world at large quite as much. 

Aman: It's fascinating. I mean, you know what I love about hearing about this entire journey? There's different way points that got you there. You know, there were these indicators and you went into that direction, then you went into that direction. And I'd like to transition into this mentorship section. And for people that are discovering their life, who they are currently, where do you look for leading indicators in an industry? What was your process like? You mentioned it briefly, "Oh, I was invited here, and then this opened up, and then that opened up." How do you know that I'm gonna go in that direction or this is what I want to do? 

Michael: Well, one doesn't always know right away, okay? My feeling about this is for students who often want to know what should they do or how do they find their way, which I think is what you're asking me. Well, first, you have to get a sense of what your strengths are. What are your strengths as an individual? What do you do well? Where have you found in your life you can make a difference or you can be helpful? I think that's important. And then you have to feel passionate about what you're going to do. You'll be much better at what you're gonna do if you really want to do it. So there's understanding your own competencies and your own advantages, but then also caring enough about something that you really want to do. And it doesn't matter what it is. It's something that you care about. And then I think you can't think you're gonna know right away. Many people try things. They work, they don't work. Fine, move on to the next one, okay? We don't all have the answers right away. And sometimes we have to do 2, 3, 4 things before, "Yeah, that's it. That's what I really want to do." And that's normal. And no reason to be worried about it. Of course, little anxiety is normal, but I think we have to not be afraid of failure. Failure, or maybe not failure so much as it just doesn't feel right. It's not something I really want to keep going. That's okay. You're gonna live a lot of years, right? So, I think we sometimes feel we got to know the answer right away. Now, of course, there are decision points. If you're gonna go to medical school, you better know you're gonna go, right? And I mean, so just to take that example. But you can do a lot of things in health today and not go to medical school. So I think that there's no magic answer to this. The other thing I'd mention, which I tell students, is get some experience. And when I say get some experience, I always feel you should get go-on-the-ground experience. So, people will come up to me, students will come up, "I wanna work in WHO." Well, okay, when you get more gray hair, maybe and that's fine. But start, go to the field, go to a country that you care about, go to a region that you care about. Maybe you have a language that you like. You speak French, you speak Spanish. Go to a Spanish speaking country. Learn the culture. Be part of the people. Anyone that's really effective at a global level, most people I know started off at a local level and got some really good local experience. I mentioned I had worked in Bangladesh, I had worked in Nepal, I had worked in Brazil. That made a huge difference 'cause I had spent, you know, four or five years total of my life in the field. And so I could understand a lot of what people went through, the suffering, the challenges, what were the determinants of their health. It wasn't just paper for me that I read in the classroom. And so I always appeal to students, at least public health students, global health students, go to the field and get some experience first. Don't go right to WHO where they'll ask you to write a paper or do some xeroxing. That's not the best way to start. I think that's the other part. So that's what I would say. Go with your passion, go with your skills, take some risk. And in most cases, go to the community, start in the field, and see what it's like to get your hands dirty.

Aman: I was interacting with a YouTuber the other day, a YouTube creator who was successful, and I said, "How do people become successful on YouTube? What's the way to find it?" It's very similar to what you mentioned. He used this term called, you have to "niche down" to blow up. So we start local and then we go global. We have to start somewhere, find our niche. And that's passions, as you mentioned, things that excite us, what do we care about, how do we go there, and then that will help us take it to a global scale.

Michael: Right. I don't think my formula is unique to global health, but I think it works in many areas.

Aman: Absolutely. I mean, it resonated. It resonated hearing that. Let's talk a little bit about, you know, behaviors, habits, the vital skills that are needed for succeeding in this world. What are some things that stand out to you? 

Michael: Well, I think we often, in public health, global health, I think we often rightfully say, "Well, you need to have technical knowledge." And I don't doubt that. I mean, I think if you're working in an area, you need to know the fundamental technical information. Keep up with it, know where to get it if you don't have it. That's important. But what I have found over the years is what's really important. Most successful programs in our field  have been managed well. So learning the principles of management, setting targets, picking the activities that will reach those targets, knowing how to evaluate them, knowing how to supervise staff. All of these are critical management skills, which I have found often make a difference between a good program and a not so good program. You can have all the technical knowledge in the world, but if you can't apply it in a solid management way, you're gonna have problems. Now, sometimes they're problems that are terribly difficult to control. Look at our experience with COVID. But I think, you know, you get a political dimension to it and that complicates things. But in general, I think learning the basic principles of management, knowing how to apply knowledge, and also leadership. What makes a good leader? The first thing that makes a good leader is you gotta listen. And a lot of people don't listen. They just talk. And I think it's not easy. It's not easy. And also understanding culture. What is the way to work in an Arab population versus working in a Latin American, Hispanic population? It's quite different. Not that there's good or bad, it's just different. And one has to respect the culture and know the culture and what words to use, how to approach people. That's the other part of being a successful manager in global or global public health. It's critical. So those are the things that I've learned over the years are as important as a technical knowledge.

Aman: If we could go back to your early days, right? Where if you go back to, say, your 20-year-old self.

Michael: Right. 

Aman: What would be some advice about professional and personal fulfillment? If you could go back and talk to yourself, what would you be telling yourself right now? 

Michael: You mean, if I had to start again?

Aman: Yeah. 

Michael: Well, I think I would do what I just told you I would do. I'd figure out where I had strength, I'd figure out what really interested me. I, for example, although I had very good training in medicine, I found it much more exciting to deal with prevention, to deal with operational programs than I did in treating individual patients. It's not that I couldn't treat patients or didn't like treating patients, I just really like seeing the bigger picture and seeing what we could do on a population level, at a community level, to make a difference in the world. That, for me, was a critical decision point. And I recognize that by going through med school and realizing that through these other experiences I had abroad, that that's what really made me excited. And, you know, I think that's why it's been, I think for me, very critical in my career path. 

Aman: I mean, I can talk to you forever. I'm really loving everything you've mentioned this entire journey. Let's end on this one question we ask most of our guests, and it's the magic wand question. I know you have transitioned in multiple diseases, multiple paradigms, different areas of public health. But right now, in your world, if there's a public health crisis that you had a magic wand to... You know, it disappears. What would that be in your world?

Michael: Today? 

Aman: Today. Yeah. 

Michael: That's a tough one. You know, I've been teaching here at NYU. I came to NYU a few years ago to help teach the core foundations course. The introductory course in global health. And it's the largest concentration of students, and we now are a department. It's really grown. We're called the School of Global Public Health, so global health is obviously one of our key components of the school. We live in New York where there's a lot of organizations to work with. We have a very diverse faculty, very diverse student body. And I love talking to the students about what they think after they take the courses. What do they think are the most important? Because that tells me something about what they're thinking. And the last three years, I get the same answer every time. It's not pandemics, even though we were in the middle of COVID. It was climate change. 

Aman: Wow. 

Michael: Every year, every time the last three years, every class I asked, "What do you see as the global health crisis above all else?" I was delighted to see this, because the future of climate change depends on young people. My generation, we messed up. We missed the boat and we messed up. And the generation after me, same. It's really up to today's young people that have to make a difference with climate change. Look at the fires going on now in Canada. Certainly in Hawaii. Look at the enormous problems in California just this week. Go on TV today. You can't get in and out of Palm Springs. I mean, the roads are washed out from the rains that they've had. When did the West Coast have a tropical storm, particularly in the summer? And we can go on and on about the climate issues and other consequences for health. We have more famine today because of climate change in parts of the world. 1 billion people are short of food now, and at least 20% have acute malnutrition. All of these problems are related to climate change. Even the pandemic. We know that today, we see that the pandemics are occurring because the animal-human interface is much more. We see mosquitoes and other vectors living in places they never lived before 'cause of higher temperature. So you name the health problem, so much of it today is related to climate change. So if I could go back in time, I wish we would've dealt with climate change 30 years ago when we were warned. Actually, even 40, 50 years ago, we were warned we had to deal with this. We had to deal with fossil fuels. We had to deal with alternative sources of energy. Now we're at the point where if we don't, we're gonna really face some more serious problems. We are at a critical point right now with climate change. Now, you might say, is that really a global health problem? Well, one of the reasons we neglected it in global health is we saw it as an environment problem. We didn't appreciate the consequences that high-temperature climate, the storms that we have, would impact on our health. And we sure see that now. And so for me, if I could wind the clock back, that's the clock I would wind. 

Aman: That answer was fantastic. I did not expect that. 

Michael: That's okay.

Aman: And even hearing that from students for the past three years- 

Michael: Absolutely. 

Aman: It's fascinating. Especially during pandemic time and transition. We're in 2023 now. Who knows someone's watching this.

Michael: Well, they thought-- I mean, I think most students thought-- "Yeah, the pandemic's terrible. Don't get me wrong. I can't go out of my house. I can't have the life I wanted to have." And that was awful for everyone, right? I mean, I'm not diminishing that at all. I spent a lot of my time dealing, in a lot of ways, with COVID. But I think if you'd look down what's coming, people thought the pandemic would eventually pass. Like, what's happened, we built up a lot of immunity, a lot of people got vaccinated, the strain, thank goodness, mutated to a less virulent strain. Hopefully it stays that way. We're gonna continue to have COVID and we're gonna continue to have pandemics, but a lot of the possibilities of future pandemics are related to climate change. So that is what I think is our main focus now. And, as I say, we're coming pretty close to the deadline of whether we're gonna be able to change what could be in front of us.

Aman: That was a very, I wouldn't say heavy ending, but surprising. So I'd love to end on a note where… Let's leave something for the next generation of public- 

Michael: Well, I would say, on a positive note,

Aman: Yes. 

Michael: Let's take a positive note. There's an enormous amount of innovation in front of us now. Diagnostics, preventive tools, treatment that didn't exist even a decade ago. Look how fast we made a COVID vaccine. So there's great opportunities today. There's digital technology, which is simplifying a lot about how we can prevent illness and diagnose illness and treat illness. So for me, there's never been a more exciting time to come into global health. Because yes, there are great challenges ahead of us, but there's also great opportunities to do something about them. And no matter what you pick as an area, we can find a path that's an exciting one. And that's why I've enjoyed helping here at NYU to build a school. And why I think we're certainly on the forefront of being a leader in the country in this area, and being in New York, having a dean very supportive of what we're doing. And as I said, we have "Global" in the name of the school. So I think the positive note is that we can make a difference and we should make a difference from the opportunities that we have. 

Aman: Absolutely. Dr. Mike Merson, such a delight talking to you. This was an absolute delight. Thank you for sharing your insights. 

Michael: Thank you very much. 

Aman: All right, folks, that was an awesome, awesome episode. Let us know what you thought of it. We'll have everything in the description and see you in the next one.