Bill Foege, an epidemiologist and former CDC Director and global health advisor to the Bill and Melinda Gates Foundation, was awarded the Presidential Medal of Honor in May 2012. President Obama called the medal “the highest civilian honor this country can bestow”. In pointing out what is special about the honor, the President added, “Every one of today’s honorees is blessed with an extraordinary amount of talent.  All of them are driven.  But, yes, we could fill this room many times over with people who are talented and driven.  What sets these men and women apart is the incredible impact they have had on so many people -- not in short, blinding bursts, but steadily, over the course of a lifetime.”

Comments About Foege

In introducing the honorees which included familiar names such as Bob Dylan and John Glenn, the President offered these observations about Bill Foege. “In the 1960s, more than 2 million people died from smallpox every year.  Just over a decade later, that number was zero -- 2 million to zero, thanks, in part, to Dr. Bill Foege.  As a young medical missionary working in Nigeria, Bill helped develop a vaccination strategy that would later be used to eliminate smallpox from the face of the Earth.  And when that war was won, he moved on to other diseases, always trying to figure out what works.  In one remote Nigerian village, after vaccinating 2,000 people in a single day, Bill asked the local chief how he had gotten so many people to show up.  And the chief explained that he had told everyone to come see -- to ‘come to the village and see the tallest man in the world.’  Today, that world owes that really tall man a great debt of gratitude.”

Citation

Prior to awarding the medal, a military aide read the following citation:   A distinguished physician and epidemiologist, Bill Foege helped lead a campaign to eradicate smallpox that stands among medicine’s greatest success stories.  At the Centers for Disease Control and Prevention, the Carter Center, and the Bill and Melinda Gates Foundation, he has taken on humanity’s most intractable public health challenges from infectious diseases to child survival and development.  Bill Foege has driven decades of progress to safeguard the well-being of all, and he has inspired a generation of leaders in the fight for a healthier world.

Interview

At the time of the award, Foege was interviewed by a reporter for APHA and its public health newswire. In this interview, Foege was asked to list some of the most important lessons learned in how to implement successful public health interventions, a topic which is of broad interest to the epidemiology community. Among the lessons cited by Foege were:

1) Good results are never an accident. “It requires someone formulating a future in their mind, defining that future with enough clarity for others to follow, and then the usual management steps of setting objectives, developing strategies, and monitoring progress. Good managers are the key to success.

2) Seek the truth even when it hurts. He added, “Corrections in the program can only come with knowing the truth.

3) Every activity requires a coalition. He added, “the real leaders in public health will never be defined by a title but rather by the ability to get a group to be productive in achieving an objective.”

Other notable comments made in the interview include those on child health, global health, and public health as follows:

Child Health.

While the number of child deaths under the age of 5 has been reduced markedly in my lifetime, it is still disheartening that millions will still die this year of preventable problems. Each of those deaths is an indictment of a world more concerned with accumulating wealth and power than in providing better chances for all children.

But certainly the major threat to the health of children is poverty. We all benefit from poverty in the sense that the poor subsidize the cost of our food, clothes, housing and even computers. Poverty is the slavery of the 21st century and we need public health people to play a lead in correcting this devastating inequity that cheapens all of our gains.

Global Health

 The interest in global health has mushroomed. Every school now has a large cadre of students interested in global health. When the history is finally written, I believe it will be clear that the tipping point for global health occurred in about the year 2000 because of Melinda and Bill Gates. Because of them, there are research, delivery and organizational approaches to global health that did not exist when I became interested. It would be so much fun to be starting over in the field today!

Advice For New Public Health Professionals

Public health requires every occupation and skill imaginable, so it is possible to follow a passion and still be involved in public health.

Second, attempt to be a generalist and specialist simultaneously. A generalist to understand as much as possible about how the world works, what are the problems and solutions, and how do the various sectors of science, the humanities, government, business, religion, etc. interact. Then find what you enjoy, develop it and have a special skill to contribute now that you know how it contributes to the whole. Avoid the kind of blind specialization that precludes seeing where it fits into the whole.

Third, read history so it becomes clear this is a cause-and-effect world. Public health advances are not made by fatalists.

Finally, develop tenacity and an optimistic outlook. It doesn’t mean that everything will always work out or that you won’t suffer. But pessimism seems to be designed to force you to suffer before the fact!