Dr. Ashish Jha: For public health leaders, ‘expertise plus humanity’ is key to success

A prominent global voice on COVID-19 and the new dean of the Brown University School of Public Health, Dr. Jha weighs in on lessons from the pandemic and how educators can best train future leaders in health and medicine.

PROVIDENCE, R.I. [Brown University] — With COVID-19 impacting communities across the world, 2020 has been a volatile year for medical and public health professionals — undoubtedly an interesting, challenging time to lead a global health institute. Or to take the helm of a public health school at a major research university.

Dr. Ashish K. Jha has done both — culminating a successful term as faculty director of the Harvard Global Health Institute to become the next dean of the Brown University School of Public Health on Sept. 1.

The accomplished physician, health policy researcher and global health advocate has also advised mayors, governors and members of Congress on pandemic response; offered advice to academic leaders at Brown and other schools on plans for 2020-21 operations; and contributed his expertise to the public through near daily appearances with local, national and global news outlets.

Twice a week, he’s also walking the streets of Providence with students, faculty and staff from the Brown community — appropriately masked and social-distanced — learning on the fly about the University, its host city and the individuals who will be his colleagues for the years to come. 

One month into his tenure as dean, Jha shared insights on what brought him to Brown, what the COVID-19 pandemic will teach future public health professionals about leadership, and why Brown’s School of Public Health is poised to become a global leader in research and education.

Q: Before we frame everything through the lens of COVID-19, tell us why you chose to come to Brown.

Public health is a field that does best when it is truly multidisciplinary — the problems we're trying to solve don't always lend themselves perfectly to any single discipline. There are many disciplines that are very, very important — economics, sociology, anthropology, humanities. But if you look at public health through any one lens, you do not see the complexity of the whole thing.

What I got excited about when I learned about the Brown University School of Public Health was — obviously it's a great school, but also one established within the broader context of the University. Brown is a place more inherently multidisciplinary in its structure and culture than almost any other university I've encountered. That struck me as the right environment to grow a public health school and see it flourish in tackling the big issues.

Q: Brown announced your appointment on Feb. 26, 2020 — what understanding did you have then that COVID-19 would impact the U.S. to the degree that it has?

By the end of January, we were aware that this virus was within our shores. But I felt confident that we were going to take a really effective set of public health steps to manage the disease. I even wrote that I thought America's response was going to be quite good — we have great public health agencies, and we have the CDC.

By late February, I was concerned because I expected to see a series of actions by the federal government that I wasn't seeing. I could not believe that our country had wasted six weeks and not prepared. I assumed that preparations were happening, testing was being built out — that our country was getting ready and that somehow I was just missing it.

It was right around that announcement that it dawned on me that we, as a nation — and really the federal government — had missed an incredible opportunity. I went from concerned to downright distressed as it became clear that we were about to get hit pretty hard.

"As a school, can look toward a future that is going to be extremely bright. This is already a very, very good school, and I think it's going to become one of the leading public health schools in the country, if not the world."

Dr. Ashish K. Jha Dean, Brown University School of Public Health
Jha Tweet
 

Q: If we look forward a decade, what will be the most significant lessons learned? How might our national approach to public health look different?

We have to acknowledge first and foremost how devastating our inadequate response to this pandemic has been. More than 200,000 Americans have died. It has had very large effects on our economy. And we're nowhere near done — we have a long way to go with more infections and economic damage to come.

If we decide that we're going to take all of that seriously — and how could we not take it seriously? — then there is a set of lessons about investing in preparedness, in surveillance systems, in laboratories, in a public health workforce, in data infrastructure. And of course investing much more in the science around diseases, outbreaks and vaccines.

That's what a normal functioning country would do. I'm hopeful that this is what our nation will do, so we'll be far better prepared. But I've become more humble about my own ability to predict how our nation is going to respond. Most public health experts believe this is what we need to do, and I'm certainly going to do my best to make the case. The question is whether we can impress this upon our political leaders.

Q: What is your reaction to the anti-science rhetoric that feels like it's dominating headlines?

The anti-science movement has been growing for some time. We saw it with climate change. We saw it with vaccines. But those were pockets and did not represent large segments of the population. The vast majority of Americans, I think, tended to trust science and go with the scientific consensus.

What you've seen here is a very concerted effort to create misinformation and disinformation. This is not just people waking up one morning and saying, “I'm anti-science.” The anti-science crowd actually tends to believe that what they're saying is scientifically accurate. I am very sympathetic to the majority of those people who have been inundated with misinformation that has come at them, not randomly. These are concerted efforts by foreign governments, by organizations within our own country to misinform the public.

The scientific community, I think, has been caught flat-footed. At times, I've been caught flat-footed. I think we need to really think about how we communicate more effectively in the future so that we can combat the virus and not also have to combat misinformation at the same time.

Q: What has the pandemic taught us about how to best educate future health professionals?

One lesson is simply the incredible value of expertise. This pandemic, like other health challenges, raises very complex technical problems. How does the virus spread? That requires a lot of technical know-how to figure out. Or what is the R0 of the virus? That requires very sophisticated modeling. [Editor’s Note: “R0” or “R-naught” is a mathematical indicator of how contagious an infectious disease is.]

But at the same time, technical skills are not enough — they won't tell you which communities might be hit hardest. Or where we should implement testing so that we can identify and help people. How do longstanding social problems manifest themselves in the middle of a pandemic? Technical skills won't teach you that.

We need to consider how we give people enough depth to be technical experts, but also enough breadth that they can see the connections to other fields. People talk about the idea of being a “T” — professionals should have broad but relatively shallow knowledge across a range of fields, but also one area of deep knowledge. Most public health schools haven’t done education that way. We have to look at our educational agenda and ask whether we are effectively training leaders in this way.

Q: After this year, what advice do you have for aspiring public health professionals?

Everybody needs to know something about public health. If you're going to go be a Wall Street financier or a lawyer, you should know basics about public health. If there were a much broader set of Americans who had knowledge about the basics of public health, it would be enormously useful. So part of our job is not just to educate public health professionals, but to educate the broader global public on the basics of public health.

Of course, for people interested in a career in public health, I would have said a year ago that this is a great time to learn. I don't think I have to make the case now that it's a great time. The world is aware of the importance of public health. This moment is an extraordinary opportunity to learn and train.

Q: Is there a leader who has inspired you in this last year? Somebody you would suggest that emerging public health professionals seek to emulate?

The easy, but very true answer — for me and everybody else in America — is Dr. Tony Fauci, who spoke with us here at Brown in the summer. We can all learn from him. Tony Fauci has deep expertise in infectious diseases — he can go toe-to-toe with anybody on immunology and on viruses. But he is also deeply human. He communicates with people out of respect. He does not use his expertise to look down on people who understand less. In fact, he uses science to build other people up. That is the model of scientific engagement that we all need to emulate. There's no shortcut for expertise, but expertise is not enough. Expertise plus humanity is what makes you effective as a scientist and as a public health leader.

Q: You've advised leaders in K-12 schools and colleges and universities across the nation. What is your assessment of the approach that Brown has taken to operating during this academic year?

Brown has taken as evidence-based an approach as any school there is — and I don't just say that because I’ve now joined the University. Since May or June, I’ve consistently argued for de-densification, social distancing, mask-wearing, a testing program that is proactive and aggressive. All the things that Brown is doing. Brown is not the only institution, but it's one of the few places I know of that has been truly data-driven.

But of course, none of this is a guarantee that it's going to work. We're still learning about the virus. There's still a large component of human behavior. But if we can be effective in communicating with our students and staff and faculty about personal behavior change, then we have a pretty good shot. At the end of the day, that's what we can do — if we're not able to keep our university open, I want to know that we did everything by the book, by the best scientific evidence we had. And we're doing that.

"There's no shortcut for expertise, but expertise is not enough. Expertise plus humanity is what makes you effective as a scientist and as a public health leader. "

Dr. Ashish K. Jha Dean, Brown University School of Public Health
Dr. Ashish K. Jha
 

Q: You’re a public health scholar, physician, academic leader and a prominent voice nationally. How are you prioritizing your time as you begin your tenure as dean?

My short-term priorities are twofold. One is to try to be as helpful as possible on a national and a local scale in working with leaders — members of Congress, governors and mayors — with their COVID response. I feel that is an important part of what a public health leader should do. A lot of places are really struggling and to the extent that we can play a helpful role, it helps all of us.

The second is a set of specific responsibilities to the School of Public Health. I'm not somebody who walks in and says, “All right, here are the five things we're going to do.” I want to learn what we're doing well. I want to learn where the challenges are. I'm spending quite a bit of time with students, faculty and staff. And, of course, I have ideas about where I think the school ought to go and opportunities for us, which I'm sharing and vetting.

My hope is that over the next three to six months, we can make progress as a nation. We're going to live differently, but the things that we love and value in our lives — the arts and indoor gatherings, being able to spend time with friends and family — I do think much of that will be back in 2021. And we, as a school, can look toward a future that is going to be extremely bright. This is already a very, very good school, and I think it's going to become one of the leading public health schools in the country, if not the world. That's the opportunity in front of us. Figuring out how to get there is going to take a collective effort.

Q: What have you learned about the School of Public Health that positions it to be such a leader?

I've been really impressed by the entrepreneurial nature of the faculty. That bodes well for an environment that is going to change. The priorities of the National Institutes of Health two years from now, for instance, will not look like the priorities of two years ago. There may be many changes in our federal priorities and with a lot of entrepreneurial people, I think are well-poised to manage that change.

Second, there is a commitment among our faculty, staff and students towards greater equity. Let's just call it what it is — problems of deep systemic racism in our country have come to the forefront in a way that those of us who are not Black, who are not Latino, have not paid as much attention as we need to. As a country, we’re confronting that. Within the School of Public Health community, I see a willingness to do the hard work, to take chances, to not keep doing what we've been doing, but to try new things. That's a very fertile ground.