Ambassador Deborah Birx on Creating an AIDS-Free World

The Strategerist
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Guest. Today's Ambassador Large Deborah burks who serves as the global AIDS coordinator in the US Special Representative for global health diplomacy diplomacy and in this role she heads up far the US president's emergency plan for AIDS Relief Dr Burks. Thank you so much for spending the time with us today happy to be here and our expert co host is the esteemed colleague who's Mitch the Executive Director at the Bush Institute Holly. Thank you for spending this so Dr Burks we. We we really WanNa talk to you about the incredible work that pep far is doing and has done but we've been extremely lucky to have so many great guests with leadership journeys that are just incredible on the on the strategic since we want to talk about your leadership journey a little bit to start and so early on I understand you're you you actually started off as a physician in the US military in the US army. Yes I was yes. How did that start off your career well. That's a great question so so I actually paid for my own medical school. It's why I went to Penn State Hershey on my parents and I paid but I ended up meeting someone in College Canary them my first year of medical school and I didn't realize he had taken the army scholarship and so he was actually active duty Army when he finished so in order under for me to be with him because it's not like they let you just come in and be a co resident so his residency was at Walter Reed so I joined the military military so I could be in an internal medicine residency with him otherwise I would have never seen him and what kind of what kind of did you learn from your from your standing. The military freising up to colonel. I believe you have to read was really an amazing place to trade it was at that time every complicated case from all all over the world came to Walter Reed. It didn't matter if you were retired in Europe or you were active duty and Thailand if anything befell someone or there was a very very complicated illnesses they came to Walter Reed and so we would have araks medical Arabic's coming in three and four times a week and as residents so you would bring all those patients in an exam in them so it was a we saw the most complicated infectious diseases is to the most complicated cancers do it was just it was amazing experience and we had really terrific professors we call them. Attending who were over at the research institute who would come over to Walter Reed Hospital to attend and so it was very easy for me. Pass my internal medicine boards 'cause I had actually seen everything that was on the board because it was really an amazing training experience so given that you initially really only joined the military because of your husband and you were when you went to medical school did that change your path in terms of. Do you think you would have been the head of PEP far today. If you hadn't gone the military route I definitely nervous angle angle because the military I think they spent so much time on leadership training so it didn't matter that I was a physician from the military standpoint you were just a captain didn't or you're just a major or lieutenant colonel and you were just a colonel and you had to be able to lead troops and so we had the same trainings and the same leadership trainings things as all the line officers at the time you could imagine you're busy with medicine and you're taking care of patients and then you're having to do all of this command and General Israel Staff School and Leadership Training and at the time I was like I'm never going to use this because when you're in their twenties as you think all of this stuff is really natural very or you think it's intuitive but it leadership is not intuitive and I think that trainings at the military the discipline that the military brings to sequential leadership training. I think is quite unique. I think it's why many businesses have tried to copy it the end it's really comprehensive so I had to learn acquisition and budgets and so all of the terminology that used in government. It's all normal to me because all that acronyms we had to train on. Even though I was in medicine I really had to learn all the other pieces different there you went to from your from the military you went to the Department of Defense on the civilian side now dow. You skipped a little bit of a step so it was very very interesting. I was in. I was actually in pep far. At the time I soon as President Bush announced pep far are at the state of the Union. I had already been working in Africa for about five or six years. I was doing research and it really bothered me that I was doing very significant. HIV Vaccine Research but the community around me was dying so when President Bush announced this I flew back from from Kenya and waited outside of Joe O'Neill's house for almost a week in February to get a meeting with him and of course everybody knows is my powerpoint this time I went in like one hundred eighty slides and tell he agreed to let people are to let the army awesome be part of have far. I was not leaving his office and so I think I war him down by my powerpoint and I came into pep far as the critical community compassionate program that surrounded our research in both Uganda Kenya and Tanzania and then later Cameroon and Nigeria and it was that unbelievable ability to bring your high tech laboratory Ori Piece to serving the public that it was so intriguing so I got into pep far as on the side and then people ask me to apply for the CDC we see position in two thousand and five and so I went through the regular civilian application process got selected which I was very much shocked by uh-huh and my commanding general at that time my surgeon general general scumacher said I really we want them to understand the military and CDC doesn't really have a lot of experience with military members. Would you go down there on active duty for two years so they could see uh that the military is just like them and you know we can work together seamlessly so I did and then the war started and so I ended up being an active duty longer than I had anticipated but eventually I became the civilian down at CDC and so it was a it it was a very crooked pathway into my office visit you tell the story there. We have one hundred eighty point powerpoint deck where did good where did that passion for. HIV and AIDS really start to form for you. So I had just finished my fellowship. I had finished internal medicine. I was doing immunology. I wanted immunology really do research on how the immune system works. I was working on primary and secondary condemn. You note efficiencies similar to like the boy in the bubble who didn't have T. cells. I worked with B. Cell immunodeficiencies. Tesol immunodeficiencies and I got called old in one thousand nine hundred eighty two about individuals. I'm dying at Walter Reed soldiers young soldiers dying from a mysterious serious immune immune dysfunction and so came into HIV not knowing it was HIV. We didn't know that it was. HIV until nineteen eighteen eighty five so from eighty to eighty five. I worked side by side with the Infectious Disease Team while we tried to save these soldiers and we couldn't and I think it was so profoundly I think what you're trained in medicine and the eighties and you've got all this high tech stuff and ability to diagnose everything when you naughtily could make a diagnosis didn't know what the problem was and you didn't know how to treat it. It was devastating. It was incredibly humbling and I they really and the shocking thing to me was all of my patients who were dying. We're worried about me because I was so upset that I couldn't can do anything to help. They died with such courage and such willingness to try different things realizing that may not help them but it helped the person person behind them. I just never saw that level of altruism in the midst of just death and despair from the patients themselves and so so I think like for the last I guess thirty seven years. I've just really thirty plus even more than that. We're not it really been focused on doing everything we can to not only save lives but change the course of the epidemic so that the future feature for the world could be imagined as age as AIDS free so. Let's talk a little bit about pet far and the progress we've made. It's been then going since two thousand and three for sixteen years so what's happened in the six juniors. It's been really I would say. It's probably everything that that I've ever done. It's been an enormous privilege. I think because of two reasons one it was like a moonshot. I mean when President Bush Bush announced this there weren't sophisticated labs in sub Saharan Africa which was bearing the brunt of the disease where one a- and in four adults were already infected. Children hundreds of thousands millions of children's didn't have parents anymore. It was really this unbelievable translation translation of what you believe America stands for as we will take our best and our brightest and everything that we know and use that to change the future for others and I think being able to translate. US Taxpayer dollars through this initiative has been the most extraordinary piece of work take anyone could be involved in and I think that is such a big responsibility but it's also an amazing really representation of what we stay on for it and it's not just I think what's been always exciting to me. It was never just about the money it was ensuring that that money continue new to us the best science and the best evidence to do what you could do remarkably for people and making sure that you're bringing that best signs. It's the same science that we have here in the United States and Europe to the people who need it the most around the globe. There's not very many programs as a lot of programs. That will say oh well. You can't really do that there. Because of these ten reasons this program said Oh nope. We're GONNA do everything that we're doing here. There and we're just GonNa make it happen and I think ah boldness that the president brought to this. I think people don't realize it wasn't just the boldness and the money it was the fact that he decided to create an entirely different structure for foreign assistance. I think people still have trouble understanding how brilliant that was the way it was positioned at the State Department the way it brought all the agencies together the way it made the State Department as the coordinator but but not actually Benny parts of implementation so that you could maintain accountability separate from any of these single agencies understanding that anyone agency would be conflicted. Ah trying to oversee another agency if they were actually doing the work

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