Research Article: Looking Back at 2017 with ASTMH Past President Patricia Walker: Political Challenges Remind Her that “Optimism is a Moral Imperative”

Date Published: January 10, 2018

Publisher: The American Society of Tropical Medicine and Hygiene

Author(s): unknown.


Partial Text

I think the most significant thing that impacted global health and tropical medicine over the last year was the election of Donald Trump as President. That made us, as a Society, realize the importance of calm, steady advocacy for tropical medicine and global health funding. Things we thought never would be slated for elimination, like the Fogarty International Center, or threatened with drastic cuts, like the NIH and the CDC, showed us that we have a responsibility to be speaking to the public and to our elected leaders about the importance of what we do.

Most of us feel comfortable within our scientific disciplines. We are not trained to be speaking and writing as advocates. On the other hand, as I said in my Presidential Address, I believe we are frontline witnesses to health inequities around the world. We often know that the issue is not a shortage of good science or good clinical options, it’s that we don’t have the political will to solve big problems in global health. I agree with what Paul Farmer said in his keynote address at the Annual Meeting, that many of the problems we experience in global health persist due to insufficient investments and attention, not because we lack scientific insights.

I think from the perspective of the Society, we have taken the lessons we learned from the Ebola and Zika outbreaks and are using them to continue improving how we deal with these kinds of challenges. I think the work by (ASTMH Scientific Program Chair) Dan Bausch is a good example. We have learned from these experiences and must continue to change and adapt. What concerns me is how the political problems of the last year have caused us to divert attention from important issues like preparing for the next disease outbreak.

I really believe that at times like these, optimism is a moral imperative. If you feel you can have any impact on your own future or the future of your patients or your scientific research, you have to be an optimist. You also have to take the long view that solving problems like social justice, equal access to health care, and ridding the world of tropical diseases is not going to happen in your lifetime. But there can be significant incremental change. When we started a clinical practice at HealthPartners Center for International Health in Minnesota 37 years ago, we had to deal with providers who did not know the differential diagnosis for tropical diseases seen in immigrants and were sometimes racist. But when I look back now, I can see that we have come a really long way. It requires balance to continue to have a heightened sense of outrage, yet maintain that long view; it helps me keep my patience today in what are very difficult times.

The Society will need to maintain a strong focus on advocating for global health R&D and for evidence-based decision making on issues that affect global health, like immigration policy. I also think the Society needs to keep working to mentor the next generation of scientists and to make sure our international members feel supported. We now have two elected international members on the Council. That’s not enough, but we are making progress. We are planning a regional meeting in Mali and we want to do more with our digital education work so that our international members, who may not be able to afford to attend trainings, can access educational materials via webinars and other online options.




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