What is your current job title?

I am an assistant professor and founding faculty at the Herbert Wertheim School of Public Health at the University of California San Diego.

What do you think have been the top three public health challenges in the past 25 years, and why?

Pandemics: Pandemics have brought public health to the forefront of public discourse, especially in light of the COVID-19 pandemic. This crisis has highlighted how inadequately prepared our societies are for such events. Emerging or re-emerging infectious diseases can instantly alter how people live, work, travel, shop, and receive education. Addressing pandemics involves preventing outbreaks, controlling the spread of diseases, and tackling the growing threat of antibiotic resistance.

Chronic and Mental Health Conditions: The rapid integration of technology and social media into our daily lives over the past 20 years has introduced significant mental health challenges. These include rising rates of chronic diseases, depression, eating disorders, anxiety, and substance abuse. Stigma, lack of access to mental health care, and insufficient funding exacerbate these issues, making it crucial to address them comprehensively.

Mass displacement: Mass displacement is a defining yet often neglected issue of our time. Factors such as global inequality, wars, economic hardship, and climate change have increased the scale, scope, and geographic diversity of displacement, making them highly interdependent. Currently, 120 million people worldwide are forcibly displaced from their homes—the highest number on record. Unlike migration, which is a normal human behavior and is, in fact, great for public health, innovation, and society’s prosperity in general, displacement is not and poses a public health catastrophe if not addressed carefully. It leads to generational trauma and cycles of health disparities and societal unrest.

What are your hopes or vision for the future of your profession/field in the next 10 years?

In the next 10 years, I envision significant advancements in the public health field, particularly in research and advocacy. I want to see an increased focus on addressing the multifaceted issue of displacement, recognizing it as a human experience that impacts millions globally. By integrating the perspectives of displaced individuals into our research and advocacy efforts, we can develop more effective and inclusive solutions.

As global challenges such as natural disasters, wars, and climate change intensify, I am optimistic that the scientific community will rise to the occasion. I envision more researchers from other disciplines, such as the arts, engineering, design, political sciences, and others, communicating more with public health researchers to innovate collectively.

Ultimately, my hope is that our collective efforts will lead to a more equitable and resilient world, where public health challenges are met with innovative, compassionate, and effective solutions.

What is your current job title?

I am a professor in the College of Nursing and acting director of the Center for Health Services Research at the University of Kentucky. 

What do you think have been the top three public health challenges in the past 25 years, and why?

The most obvious public health challenge over the past 25 years is the COVID-19 pandemic.  It exposed major deficiencies in the public health surveillance system and the negative consequences of disruptions in health care delivery and education will be felt for years to come.

 A second major public health challenge, which pertains to my own research, is substance abuse. Both drug and alcohol abuse are problems across many areas of the U.S., but many persons encounter barriers to treatment. The strongest predictor of substance use is poor mental health, which also remains under-treated.

A third major public health challenge is the cost of medical care, which continues to crowd out spending on other segments of the economy.

How has your profession/field responded to the changing public health landscape?

I started my career as a faculty member in a School of Medicine, spent most of it in a College of Public Health, and am now in a College of Nursing. I am pleased to see that Schools of Medicine and Nursing have embraced the population health perspective and have integrated many public health competencies into their curricula. For example, I teach courses on the applications of epidemiology to clinical decision-making and population health to students in the Doctor of Nursing Practice (DNP) program at Kentucky.

What are your hopes or vision for the future of your profession/field in the next 10 years?

I would like to see public health and other health professional students learn more about population health ethics, which would include multiple perspectives about balancing health, education, economic, and other individual and societal needs. This would help prepare health professionals to respond to a future pandemic and more thoughtfully inform decisions about the spending on medical and non-medical resources to benefit population health. 

What is your current job title and employer?

I’m currently the CEO of LucidHealth, a national radiology services company providing radiologists to health care systems as well as operating freestanding imaging centers. Prior to this role, I was a health system president responsible for multi-hospital systems, physician practices, and outpatient services. I’ve also been a hospital CEO at three hospitals.

What do you think have been the top 3 public health challenges in the past 25 years, and why?

1. Adequate government funding for health care services. Governments continue to reimburse providers below the cost of care, exacerbating the problem of commercial insurance cross subsidization and premium cost inflation.
2. Uninsured populations that require health care services but cannot access needed services. While the Affordable Care Act attempted to address this, state funding of Medicaid has fallen short.
3. Staff shortages—from nurses and technologists to physicians. Over the past 25 years, there has been pressure on the health care workforce. Unfortunately, this will continue.

How has your profession/field responded to the changing public health landscape?

The bulk of my health care career was serving as the president of large, multi-hospital health care systems. Systems have responded to the challenges by the combination of health care services to provide scale to the operations. Health care systems have also diversified into non-hospital businesses to provide a full spectrum of care and access points for patients.

What are your hopes or vision for the future of your profession/field in the next 10 years?

The profession will need to continue to evolve and embrace alternative models of care in the future. Those models will continue to move out of the hospital setting (as they have for the past 25+ years) and into the outpatient, retail, or home space.

Telemedicine will also continue to be a large part of the future as the shortage of providers will dictate other ways to provide care to patients. Of course, the promise of artificial intelligence will need to be fully realized and appropriately applied to health care services—future leaders will need to be able to discern how that promise benefits patients, employees, and fellow providers.

What is your current job title and employer?

I am the CEO of Cayaba Care, a tech-enabled, value-driven healthcare company focused on delivering wrap-around, culturally informed services to vulnerable populations that have a history of poor maternal outcomes. This includes people covered by Medicaid and commercial insurance, and Black, Brown, and people who have traditionally been underserved. We serve a variety of women and their families and have demonstrated significantly improved outcomes.

What do you think have been the top 3 public health challenges in the past 25 years, and why?

Health care communications and combatting disinformation; maternal health care and health outcomes; and substance use and abuse, particularly the persistence of the opioid epidemic.

How has your profession/field responded to the changing public health landscape?

I have worked hard on expanding insurance coverage when I helped run the Affordable Care Act (ACA) and start up the exchanges during the Obama Administration. I have also been fortunate enough to help run a process that addressed the Zika and Ebola viruses, so I understand what it takes to get major public health crises under control (a lot of smart thinking; fast, data-driven decisions; and a bit of luck). 

I am now working on maternal health, which is another hard problem. I am focused on a simple question: How do we deploy resources to the things that actually make a difference in improving outcomes? These include wrap-around services, social supports, empathy and social connectedness, and addressing social determinants of health.

What are your hopes or vision for the future of your profession/field in the next 10 years?

We have a fragmented media and communications system, so it is harder to get truthful information out to the general public about public health. Public health and health care in general need to work harder to breakthrough. I am hopeful that some of the big problems we face in health care domestically and internationally see smart solutions that are tested and evidence-based begin to take root, and that we as an industry stop chasing the latest shiny objects with empty promises. This work is hard, and we must be able to deliver in substantive and sustainable ways.

What is your current job title?

Regional Emergency Coordinator with the Administration for Strategic Preparedness and Response and a Commander in the Commissioned Corps of the U.S. Public Health Service.

What do you think have been the top three public health challenges in the past 25 years, and why?

1. An aging/retiring workforce with difficulty recruiting and maintaining the next generation of professionals. The lack of a vibrant public health workforce is partially due to people retiring or moving on for various reasons and a lack of qualified candidates. To increase post-graduate opportunities for students, graduate public health programs should encourage students to build their experiences and networks through internships and mentorships while in school.

2.  The COVID-19 pandemic created numerous moral dilemmas and, unfortunately, hostile situations between the public and public health. Inadequately addressing moral dilemmas within the public health workforce may have led to moral distress, moral injury, and burnout. Therefore, the pandemic may have led to an accelerated exodus of public health workers from the profession.

3. The political environment is creating difficult situations for public health workers. With a politically polarized populace, public health workers are currently at a deficit when it comes to trust. Additionally, public health workers, for good or bad, may be seen as the faces of political groups and receive push-back for it. However, public health requires the populace and the public health workforce to continue building a partnership, which enables the social contract to flourish.

Some challenges in this type of environment are communicating timely what is known and unknown about the problem, identifying misinformation/disinformation appropriately, and providing sufficient transparency. Building partnerships and coalitions with the general public can improve trust and mitigate some of these challenges through a deliberative democracy process. Hence, when a crisis occurs, there are trusted coalitions from the populace, private sector, and public health sector who work together in a transparent forum to enhance trust with the public.

What are your hopes or vision for the future of your profession/field in the next 10 years?

1. Recruit and retain a competent public health workforce. Graduate public health programs should develop public health workers who have the experience and capabilities to work in the government (local, state, and federal) and the private sector.
2. Incorporate/embed bioethics into public health to help identify and address moral dilemmas faced by both the public and public health workforce to mitigate negative outcomes.
3. Advocate for risk management, risk communication, and communicating uncertainty to be included in didactic learning for public health students and professionals.

All statements made are my own and are not official or endorsed statements of my employer.

What is your current job title?

President & CEO of Corewell Health, a leading integrated health system.

What do you think have been the top three public health challenges in the past 25 years, and why?

The public health landscape is always changing, but here are a few that come to mind:

Health equity: There are very real inequities when it comes to care. We have inequities in how we are listened to, understood, and cared for. And we need to address those. We need to make health accessible and equitable for all. One of the areas where inequities can be seen is in infant and maternal mortality. Black women are three times more likely to die from a pregnancy-related cause than white women, according to the CDC. And Black newborns are more than twice as likely to die in their first year of life than white newborns, per the Office of Minority Health.

At Corewell Health, we stepped up to combat this issue alongside seven community partners. We invested in an evidence-based Maternal Infant Home Visiting Program and added a community health worker to the model. We call it Strong Beginnings. We serve moms, dads, and babies who have the greatest challenges and needs, connecting families with medical, educational, and social support. We’ve also increased the rates of adequate prenatal care and postpartum visits, and this is improving birth outcomes. The latest data show that the infant mortality rate has been cut in half—while there is still much work to do, this is significant.

COVID-19 pandemic: Around the world, we had to figure out new ways of operating, providing care, and keeping people safe. It brought to light several underlying issues in public health, from health equity to caregiver burnout to violence against health care workers. It also uncovered some of the best in us—the unwavering commitment and compassion to the health of our communities, the collaboration across systems, and the innovation in care and technology, from drive-through testing to curbside vaccinations to virtual primary care to groundbreaking research.

Behavioral health: As we tackle the stigma and complexity of mental health issues, we recognize the steady increase in the incidence of mental health conditions nationwide. The most concerning trend is the alarming rates of mental illness, loneliness, and suicidality, especially in children and adolescents. Mental health affects everyone; however, it disproportionately impacts marginalized communities. The intricate connection between mind and body highlights that mental health and addictions can predispose people to various chronic conditions and thus decrease the ability to live a healthy, high-quality life. It’s our collective responsibility to reduce stigma and inequities in mental health care and prevent every loss of life to mental illness.

What is your current job title and employer?

I am an assistant dean, executive director, founder and Chief Operating Officer; University of Illinois College of Medicine, National Center for Rural Health Professions, the Rural Medical Training Collaborative, and The Daddo Project.

What do you think have been the top 3 public health challenges in the past 25 years, and why?

There have been many public health challenges over the past 25 years—of course, how to effectively address the novel pandemic with COVID-19 is one of the major historical events of our time. Related to this would be how to mediate misinformation on social media and other platforms surrounding health information.

One challenge that I work to address is creating equitable access to quality health care (which would fall into a broader category of addressing systematic and social determinants of health). 

How has your profession/field responded to the changing public health landscape?

I have the privilege to work at the intersection of public health and academic medicine. In my work, we implement strategic innovations around medical education and creating pathways for underserved students to equalize their educational opportunities to become health care professionals in areas similar to where they grew up.

I also work in community engagement, which has helped create research opportunities that are driven by community interest and influence. This type of approach has shown to identify more root cause issues to some of the challenges we face around trust and public health messaging.

I also work with multiple sectors (in education, workforce development, and health care) to come up with new solutions to persistent problems that many underserved people face. One of the strengths of public health is the ability to navigate across sectors to make a difference in policy and programs!

What are your hopes or vision for the future of your profession/field in the next 10 years?

My hope for public health is that we continue to engage students to pursue public health-related fields—to continue the interest and energy in and around the field of public health is incredibly important.

I want public health to also be able to utilize technology and other innovations to support community needs regardless of how affluent that community may be. Public health shines when we work with the communities we serve in equal partnership, and I think the possibilities of improving access to care, reducing or eliminating health disparities, and creating environments where people can optimize their health status are all very achievable through continued innovation and mission-driven work. 

What is your current job title?

Upon earning my PhD in epidemiology and completing my postdoctoral training, I started my own organization, Human Link, a research institute based in the Middle East where I currently work as a managing partner.

I have been conducting research on emerging viral pathogens with a focus on avian influenza, MERS coronavirus, and SARS-CoV-2. Additionally, I have been engaged in projects aimed at developing policies that enhance preparedness and response to emerging zoonotic infectious diseases in the Middle East and Africa.

What do you think have been the top three public health challenges in the past 25 years, and why?

Over the last three decades, emerging viral diseases have caused the most negative impact on public health. As we make progress towards preventing and managing chronic illnesses, we lag behind on our preparedness and capacity to control outbreaks of emerging novel viral diseases.

Additionally, vaccine hesitancy, misinformation, and conflicts led to the resurgence of previously controlled infectious diseases such as polio, measles, and mumps. A third infectious disease threat relates to antimicrobial resistance and the emergence of multi-drug resistant bacteria.

Together, those threats bring public health to an era we thought was long over with very slow progress towards solving those issues. Global capacities to prevent, detect, control, and recover from infectious disease threats are far from where they need to be.

How has your profession/field responded to the changing public health landscape?

Infectious disease researchers have been engaged in finding solutions to those problems and answers to the research and public health questions surrounding those pathogens. For instance, our ability to characterize emerging and re-emerging pathogens shortly after they are detected has significantly improved. Adapting novel technologies for collecting and analyzing field samples has similarly improved with the adaption of, for example, environmental sampling equipment and drones for collecting samples and using genomics and metagenomics for laboratory analysis.

The global infrastructure for developing, testing, manufacturing, and distributing vaccines has benefited from experiences gained over the last decades. Researchers and public health professionals in my field continue to develop and implement the One Health concept [the interconnectedness of people, animals, and the environment] and create evidence-based policies supporting it.

What are your hopes or vision for the future of your profession/field in the next 10 years?

It is imperative that, in the next 10 years, we invest more in field research to enable us to better understand what pathogens are circulating and assess their potential risks to human and animal health. Additionally, we should be working harder to reduce vaccine hesitancy and misinformation while improving our capacity to equitably produce and distribute vaccines. This should be in tandem with work dedicated to making One Health mainstream in public health practice and research.

What is your current job title?

I am the research director for the American Medical Society for Sports Medicine and an associate research professor in the Department of Orthopedics & Rehabilitation at the University of Wisconsin-Madison. 

What do you think have been the top three public health challenges in the past 25 years, and why?

Three issues that come to mind include the growing burden of mental health challenges, the spread of non-communicable disease and its contributing factors (e.g. obesity, substance abuse, diet), and climate change, all of which are relevant personally and professionally.

How has your profession/field responded to the changing public health landscape?

The field of sports medicine strives to improve the health and well-being of active individuals and athletes throughout their lifespans. Sports medicine clinicians rely on a wellness-based model (as opposed to disease-based) and strive to help sedentary populations incorporate exercise and movement into their lives while preventing illness and injury in active individuals and athletes. This approach to health naturally permeates many of the public health challenges we currently face given the significant benefit of physical activity and movement to overall health and well-being.

When COVID-19 hit the U.S., our cardiac researchers immediately began assessing the risk of myocarditis in collegiate athletes—an area of major concern and unknown in the early days of the pandemic. We also looked closely at the drastic mental health and physical activity declines in youth during this time when sports and other activities ground to a halt.

As we learned about and began to comprehend the pervasiveness of abuse in sport, sports medicine leaders initiated the development of needed education and support resources, implemented essential policies for athlete safety, and developed research studies to identify best practices in responding to and preventing instances of interpersonal violence in sport.

In 2020, during an intense time of racial and civil unrest in the U.S., our field began to look critically at our own weaknesses and biases to understand the ways in which health inequities impact the health and well-being of individuals within our circles. We have made great strides in better understanding, drawing attention to, and addressing health inequities within the field through education, policy, and research.

What are your hopes or vision for the future of your profession/field in the next 10 years?

My hope is sports medicine can continue to make meaningful and lasting strides in keeping individuals healthy in body, mind, and spirit. I hope we continue to use research to assess and implement emerging technologies to advance the care we provide. And I hope we continue to focus on making sports medicine for all—by listening to and responding to the needs of vulnerable and marginalized communities.

What is your current job title and employer?

I am a Distinguished Investigator and Associate Director for Science Programs at the Kaiser Permanente Center for Health Research in Portland, Oregon.

What do you think have been the top 3 public health challenges in the past 25 years, and why?

We have seen new pathogens emerge and cause large outbreaks of disease and pandemics. Our disease surveillance methods and systems have not been resourced well enough both within the United States and internationally to comprehensively assess and understand the burden and impact of these new pathogens. We have also seen the resurgence of vaccine preventable diseases, like pertussis and measles, due to rising rates of vaccine refusal and hesitancy.

A second challenge to public health is the rapid and widespread dissemination of mis- and dis-information on social media platforms and a growing distrust of medical experts and public health policymakers and agencies. 

Finally, our rapidly changing climate is impacting health, and we have not dedicated enough resources and attention to investigating this, nor have we adequately prepared to manage and mitigate the health impacts of mega disasters.

How has your profession/field responded to the changing public health landscape?

In my specific field of vaccine safety and effectiveness research, we have been asked to increase the speed of our work to support vaccine implementation and to inform public health recommendations and policies. The COVID-19 pandemic was a huge driver of this need for more rapid scientific evidence, and we responded to this need by building new collaborations, creating new data systems, and developing new methods for analyzing big data rapidly.

What are your hopes or vision for the future of your profession/field in the next 10 years?

I think public health professionals are facing some uncertain, volatile, and challenging times ahead. Throughout the COVID-19 pandemic response, I saw many of my colleagues personally attacked for doing their work, and many talented and thoughtful people burned out and left the field. I hope that we can support each other better professionally and emotionally as we move forward together to face the challenges ahead.

I hope we can find ways to better communicate with the populations we serve and regain some of the trust that has been lost. A future pandemic is a near certainty, and I hope we can learn from our past successes and mistakes to improve our future pandemic responses.

I think we need to recruit and train our best and brightest in public health so the next generation of leaders can approach some of the daunting and complex issues we face with passion and ingenuity.

What is your current job title and employer?

Senior Vice President and Chief Operating Officer – East Division, UnityPoint Health, West Des Moines, Iowa

What do you think have been the top 3 health care administration challenges in the past 25 years, and why? How has your profession/field responded to the changing health care administration landscape?

First, rising health care costs for patients and relatively poor patient outcomes. Health care spending, both per person and as a share of GDP, continues to be far higher in the United States than in other countries with comparable household incomes. The U.S. has the lowest life expectancy at birth, highest rate of people with multiple chronic conditions, highest death rates for avoidable or treatable conditions, the highest maternal and infant mortality, and among the highest suicide rates. Americans see physicians less often than people in most other countries and have the lowest rate of practicing physicians and hospital beds per 1000 population.

Administrators have implemented a variety of operational methods over the past 25 years to address these trends, including health care organization merger to achieve economic scale, standardization of clinical care protocols, and implementation of electronic health records to reduce fragmentation and improve communication.

Next, ongoing shortages of qualified clinical staff and health care workers. Even before the onset of the COVID-19 pandemic, our health care system needed direct patient care staff, especially nurses and physicians. The pandemic has exacerbated already acute staffing problems due in part to stressful work environments, long hours, compassion fatigue, and burnout.

Health care administrators recognize that their team members are the backbone of their organizations and work diligently to take care of their staff and ensure their personal and professional needs are met.

Finally, changes and complexity in health care regulations including government health insurance programs and private insurance resulting in low reimbursement for providers, administrative inefficiencies, and health care access and equity concerns. Our system is fragmented and requires a significant amount of administrative overhead to obtain reimbursement for services. Hard economic times force patients into Medicaid and the aging population is moving more and more patients into Medicare. These programs pay providers the lowest rates relative to private health insurance who also receive pressure from employers not to raise rates.

Health care administrators have found innovative ways to continue to provide access to health care in their communities by keeping their organizations solvent despite the fiscal restraints and regulatory complexities.

What are your hopes or vision for the future of your profession/field in the next 10 years?

Despite the challenges we face as health care administrators and more broadly as a society, I remain optimistic because of the commitment of our team members to make a difference in the health of our patients and our communities. Moreover, every day we hear incredible stories of our team members giving the health care we’d want our loved ones to receive—recognizing the person beyond the patient and connecting in sometimes very simple and often deeply meaningful ways.

It’s my hope that the work we do as health care administrators fosters both the kind of organizational cultures and the improved systems and processes that our team members need to do their best work. As health care administrators, we exist to serve others, and as one of my mentors said many years ago, we do that best as complete players. 

A complete player understands every aspect of the game. They know through a combination of intuition and study that it all matters —every detail, every time. They love what they do, and they work harder every day to get better than the day before, knowing with confidence that their teams were already remarkable the day before.

I’m grateful to be an Iowa MHA program graduate and, now later in my career, for the opportunity to support leaders along their paths.

What is your current job title?

I’m the public health director at Johnson County Public Health in Iowa.

What do you think have been the top three public health challenges in the past 25 years, and why?

I think the top three public health challenges have been political determinants of health, COVID-19, and the success of 20^th-century public health wins.

Let me explain. I didn’t realize how political public health was until I started working in the field. The political decisions on public health issues—whether it’s expanding Medicaid, providing water fluoridation in local municipalities, funding local public health, or investing in walkable communities—all have an impact on health outcomes. There’s a reason your zip code has a bigger impact on your health than your genetic code. However, as public health professionals, we need to do a better job of connecting the dots between legislation and health outcomes so we can encourage more folks to be public health voters.

COVID-19 was obviously one of our greatest challenges, and a specific example of what happens when politics take priority over public health. I think the greatest challenge we saw from COVID-19 was how the public handles uncertainty and changing guidelines during a rapidly evolving situation. [There are also big challenges] from COVID ahead of us. We have no idea what the long-term consequences will be of subsequent infections, and we’ve seen how bad faith actors have used a public health emergency to spread misinformation and disinformation. We’ve seen the public lose trust in the experts, which puts us in a very precarious position for emerging public health threats.

Lastly, we often talk about the top 10 public health wins of the 20th century, but I’m beginning to believe that those wins have also led us into a false sense of security that undermines the necessity of those wins. Some of those wins—like vaccination, safer foods, and family planning —have become politicized as legislators across the country weaken immunization requirements, legalize the sale of raw milk against public health recommendations, and limit access to reproductive care across the country.

With public health successes came a loss of institutional memory. People don’t remember when children suffered from measles and polio, for instance. This is part of the issue of public health being invisible when it works—there isn’t a good understanding of the layer of protection it brings to everyone, so legislation seems restrictive and unnecessary. As a profession, we have to continue to talk about the importance of our work all the time, not just in disasters.

What is your current job title and employer?

I am currently in my third year at Florida International University, the largest Hispanic Serving Institution in the U.S. My position is distinguished university professor and I support the Vice President of Research and Economic Development who is also dean of all the colleges, including Public Health and Medicine. I have been part of the VP’s small team of distinguished university professors who were challenged to envision and create an enterprise to focus on upstream complex systems determinants to improve the health and well-being of southern Florida communities. This challenge was perfect for me since it challenged the broad interdisciplinary knowledge and skills I acquired over a very long career in health and well-being in the private and public sectors nationally and globally.  Our work created and has just launched a Population Health Initiative that supports complex systems research and interventions as cross-college, multi-departmental efforts.

What do you think have been the top 3 public health challenges in the past 25 years, and why?

Florida is a prominent locus of the major public and population challenges we face as a nation. These include climate change, disasters and catastrophic events, space and population dynamics, public health workforce and infrastructure deficiencies, including technology and data management and analytics.

Health as an outcome of complex systems dynamics underscores that these challenges are interdependent, and this interdependency affects sustainable prevention and mitigation approaches. These include approaches to public and population health problems ranging from syndemics to poor coastal resiliency with flooding-related consequences for health, and environmental pollution and physical displacement from wildfires. 

These events have disclosed to the general public what we in public and population health have long been deprived of, i.e., adequate public health resources and authorities, funding, infrastructure, and technology.  

What are your hopes or vision for the future of your profession/field in the next 10 years?

It is often the case that events with adverse catastrophic and widespread impacts on people, communities, and employers catalyzes momentum for action, investments, and change.  There are early attempts at the federal and state levels in this regard, but much more is needed. It is my hope that this will increase and sustain into the future.

What is your current job title and employer?

I’m currently the Senior Vice President, Head of Medicine for Greater China at Boehringer Ingelheim, the world’s largest family-owned pharmaceutical company. We have been transforming lives in health care since 1885. Our 53,500 employees in 130 markets create value through innovation by infusing long-term, sustainable thinking into our Human Pharma and Animal Health units.

Boehringer Ingelheim is a research-driven group of companies dedicated to the discovery, development, manufacture, and marketing of innovative health care products. We work on breakthrough therapies and co-create solutions that help millions of people worldwide live longer, healthier lives. 

What do you think have been the top 3 public health challenges in the past 25 years, and why?

This is a very good question. In 2015, the United Nations proposed the Sustainable Development Goals (SDGs), many of which are closely related to human health.

As the world gradually recovers from the epidemic, it is important to recognize that there are still many challenges to modern public health.

First, the double disease burden of infectious and chronic diseases remains severe. New and emerging infectious diseases remain a major threat to human health. The COVID-19 pandemic is a wake-up call for the whole world. In addition to causing a large number of confirmed and fatal cases, its impact on the economy, society, and health care systems and further excess deaths are equally alarming.

Deaths from the four major chronic diseases (cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, and diabetes) account for around 60% of all deaths worldwide. The SDGs calls for the probability of premature death (death before age 70) from the four major chronic diseases to be reduced by one third by 2030; however, we are still far from achieving this target. Currently, the declining trend in premature deaths has stagnated or even started to increase in many countries, including the United States.

Second, mental health is a major health problem, but there is a lack of public awareness and effective, innovative treatments. The numbers are shocking. Nearly one billion people worldwide are living with a chronic and complex mental illness. It is estimated that 71% of people with mental disorders receive no medical intervention. Over the past 20 years, studies have consistently estimated that nearly half of all people with schizophrenia or bipolar disorder are not receiving treatment for their mental illness at any given time. It’s important to measure how common mental illness is, so we can understand its physical, social, and financial impact. Drug research in the central nervous system (CNS) is incredibly complex and major improvements have been limited. In fact, the development of new treatment options in this area is complicated by many factors, including the stigma surrounding mental health and governmental underfunding.

Finally, there is the issue of drug abuse and drug safety, which is a major challenge and urgently requires further intervention and management. The issue of drug safety can be divided into two aspects, namely, 1) safety in terms of quality, i.e., that the use of medicines does not pose a risk to human health, and 2) safety in terms of quantity, i.e., that the access to medicines largely meets the demand. Monitoring the safety of medicines is an important public health issue for all countries. Access to medicines is critical to achieving optimal patient outcomes. Patient access to novel pharmaceuticals is often limited by regulatory hurdles, high development costs, clinical trial challenges, pricing, and cost-sharing barriers.

Governments and relevant stakeholders should join hands to achieve the goal of integrating health into all policies and to jointly address the major public health challenges of our time.   

How has your profession/field responded to the changing public health landscape?

Our research focuses on cardiovascular and metabolic diseases, oncology, respiratory diseases, immunology, mental health, and retinal diseases. We are identifying challenges and developing solutions in areas where medical and therapeutic needs are still unfulfilled or insufficiently addressed.

Our innovative pipeline represents potential opportunities to address unmet needs in the mental health treatment landscape. One example is iclepertin, an investigational asset that received FDA breakthrough therapy designation and a GlyT1 inhibitor that is proposed to target the brain biology linked with the cognitive symptoms associated with schizophrenia.

The gap in access to novel medicines between China and the developed countries has been a major public health issue in China in the past. As China’s health authorities continue to reform to implement policies supporting new drug development, Boehringer Ingelheim has rapidly adapted its strategy in China and accelerated the pace of innovation. Through two strategic initiatives, “China In” and “China Key,” China has been fully integrated into the global early-stage clinical development projects, and we have achieved several significant innovative milestones, from simultaneous development, filling between China and global, to first approval in China.

Boehringer Ingelheim has always regarded China as an innovation plateau and is committed to making new advances in areas of high unmet medical need, which will change patients’ lives and improve treatment prospects. To realize this ambition, we attach great importance to collaborating with domestic research institutes, pharmaceutical companies, and medical institutions in China, promoting the deep integration of industry, academia, and research institutes, creating a more open and efficient innovation ecosystem, and committing ourselves to providing better health care solutions and bringing first-in-class innovations to patients both in China and around the world.

What are your hopes or vision for the future of your profession/field in the next 10 years?

Innovative medicinal products need to be rewarded fairly at global markets so R&D investment on tackling unmet medical needs becomes sustainable. At the same time, we need to strive for a good balance with patient access to the innovative medicines globally.

By 2035, I hope the new generation of biotechnology and new modalities have the potential to spark a transformative industrial revolution on R&D in the health field to tackle the afore-mentioned top 3 public health challenges and beyond. Through innovation and collaboration with all stakeholders including governments in emerging markets and the under-developed world, patients around the globe can have fair access to innovative medicines.