Donna Shalala, president of the Clinton Foundation, delivered the Commencement address at the Harvard T.H. Chan School of Public Health (SPH) on Thursday, telling graduates, “The history of public health is a story of surprises,” and warning them to “expect the unexpected.” Shalala, who served as secretary of health and human services under President Bill Clinton and then as president of the University of Miami, said significant progress has been made in improving health infrastructure during the last 20 years, but also expressed her concern that policymakers still pay too little attention to issues of public health.
“Not only has public health evolved around the world, from improvements in sanitation, vaccination, and clean air and water, [to] building codes,” Shalala said, “but, for the first time, it has the attention of the world’s leaders because they know it impacts their economies, their security, and their reputations.” Nonetheless, she added, politicians have yet to take adequate action to address public health problems; Shalala argued forcefully that government must “confront the lack of investment in public-health infrastructure in our daily lives and home countries if we want to improve the health and well-being of our citizens—including in the United States.” In her own experience, she went on to say, too often “politicians’ eyes glaze over when you talk about the need for such investments.”
Shalala cautioned that, if more resources are not devoted to public health, the world will always be a step behind threats like Ebola, Zika, and a yellow-fever outbreak that experts believe might soon explode. “Unless the world’s leaders confront the fact that our international public-health infrastructure is too weak to manage outbreaks and emergencies,” she advised, “many of you will spend your careers simply being reactive to the latest public-health crises.” To that end, Shalala lightheartedly suggested that the graduates “write a memo to the next president of the United States” to urge him or her to use the government’s resources “to improve lives.” (Shalala has been a longtime friend of presidential candidate Hillary Clinton; some students were critical of SPH’s decision to invite Shalala for that very reason, fearing that her appearance would be seen as a tacit endorsement by Harvard of Clinton’s campaign.)
Shalala did provide a positive example of the government’s taking action to address a public-health issue: she recounted her experience upon joining the Clinton administration in 1993, when, she said, she was told that one of the administration’s priorities was “getting all the children in the United States immunized on time—that means before they were three years old.” She said that achieving that goal seemed, at the time, nearly impossible, because the nation ranked near the bottom among countries in the region in early immunization. But, Shalala continued, “If the veterinarians in this country can put a system in place to get all the dogs, cats, sheep, goats, and cows vaccinated on time, we can do it for the children of the United States.” The Clinton administration’s vaccination efforts, she said, were largely successful.
The efforts the graduates are undertaking, Shalala said, “are not small tasks.” She urged them to “research, and understand, and manage the next generation of infectious disease and environmental crises; find a way to improve the health and science infrastructure of every place on earth”; and “advocate for wealthier nations not to abandon their financial commitment to poorer nations.” Facing these responsibilities, she said, will be daunting yet rewarding: “The big issues of infrastructure and preparation for emergencies will determine the fate of millions of people,” she said. Nevertheless, she added, “Each of you will get the opportunity to save lives—and enrich them—because you have chosen this great adventure called public health.”
