Tedros Adhanom Ghebreyesus’s Public Health Address

The World Health Organization Director-General delivered the Commencement address to graduates of the Harvard T. H. Chan School of Public Health.

Tedros Adhanom Ghebreyesus
Screenshot by Harvard Magazine

Return to Words to Live By

My warm greetings and congratulations to all 2021 graduates of the Harvard T.H. Chan School of Public Health, to Dean Michelle Williams, and to all faculty, family, and friends. I want to start by thanking Dean Williams and the School of Public Health for the great honor of receiving the Julius B. Richmond Award. I accept this award with a mixture of pride and humility, and a commitment to following Dr Richmond’s example to do everything in my power to improve the health of the world’s people, especially the poorest and most vulnerable. Thank you once again for this great honor.

Let me start with a story. In a military camp, a cook reports to the medical center complaining of fever, a sore throat, and aches and pains. By lunchtime the count has reached more than 100, and more than 500 by the end of the week. Within months, the outbreak erupts into a pandemic that sweeps the globe. There are no vaccines to stop the virus, and no drugs to treat it. Many of its victims are young, cut down in their most productive years. Schools, places of worship, theatres and other public places are closed. And then, as suddenly and inexplicably as it started, the pandemic ends. One third of the world’s population has been infected, including 25 percent of the U.S. population. Fifty million people are dead.

As students of public health, I’m sure you know that this is no future nightmare scenario. This is what happened in the 1918 flu pandemic, more than 100 years ago. The 1918 flu pandemic killed more people than the First World War itself, and yet it was overshadowed by the war, and its lessons were quickly forgotten. I first told this story this way shortly after my election as Director-General in September 2017, when I was invited to speak at Columbia University in New York. I know what you’re thinking: at least it wasn’t Yale. Why did I choose to make my first major speech as Director-General of WHO on this topic? Because people would often ask me, What keeps you awake at night? And I would answer without hesitation, “pandemic flu.” The lessons from 1918 are as relevant now as they were then: that a devastating pandemic can start in any country at any time, and kill millions of people, because we are not prepared. 

 As you know, that is exactly what has happened in the past 17 months. You are the witness. Despite years of reports, warnings, reviews and recommendations, when the pandemic arrived, the world was not ready. I know that for you, as for students all over the world, this has been an incredibly difficult time. To put it simply, it has been a weird year. And my colleagues at WHO call it a crazy year. And it’s true. But as students of public health, for you the past 17 months have also been an incredible education, far beyond any field course or internship. Certainly, there has never been so much interest in public health in my lifetime. When public health officials become celebrities and the general public is talking about variants, herd immunity and reproduction rates, I hope you will agree with me that there is something seriously wrong. You have been living history. And whether you have been taking notes or not, you have gone from theory to praxis. The lessons of this pandemic will stay with you. You are bearing witness. 

In 1850, well before the 1918 pandemic, the architect of American public health, Lemuel Shattuck, wrote the Report of the Sanitary Commission of Massachusetts. And I hope Harvard is still assigning this, because 170 years later, it’s still relevant. The report even had DALYS.  Shattuck called for the improvement of public sanitation, vaccination programs, the control of dangerous products, the establishment of nursing schools and other radical ideas like informing the public. The most expensive of all things, Shattuck wrote, is to do nothing.

More than any generation of public health graduates, you are embarking on your careers at a vital time. You have witnessed first-hand the power of a pandemic. And you should know that it will not be the last one. So let me leave with you three thoughts that I hope might be helpful going forward. They are basic, but they are not easy. Very often, the most basic is the most difficult.

First, learn to listen. This is perhaps the single hardest skill you can learn, and many people never do. It is far too common in the health world to regard others as beneficiaries of your expertise, rather than people who are working every day for their own survival. Remember that the communities you serve often have a lot more to teach you, than you do them. Even when people insult me or get angry with me, I always try to listen to understand the underlying point they are making, and to see if there is something I need to learn, or change or address. 

Second, learn to ask questions. Health does not happen in a vacuum, and that means you have to work across disciplines. Talk to your colleagues at the engineering school, the public policy school, even at the medical school. People do things for a reason, and you know that, even though you may not understand it. So that is why you have to ask. So, don’t forget to be humble, and never forget that there are a lot of things that you don’t know.  

Third, learn to look. Search for examples of what works in countries and communities outside your frame of reference. You will be surprised by the adaptability of public health efforts used in some countries to other parts of the world, or even from one neighborhood to another, or one academic discipline to another. And never be afraid to admit when things don’t work. That, more than ever, is when you have to ask why. That is when you have to search. 

So, my friends, you are getting your degree, but don’t think for a minute that your education has stopped. It has now entered a new chapter, and that chapter is just beginning. You have all worked so hard, and your families have also supported you immensely. And you and your families have so much to be proud of. And your mentors also have so much to be proud of. That you've done it amid the chaos and uncertainty of this past year is testimony to your resilience and commitment, which is exactly what you will need going forward in public health. 

I wish you all every success. And I'm so honored to join you today.

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