Taking Risks to Reduce Global Health Inequities

RICHMOND, Va.—Speaking to students and professionals at the Medical College of Virginia on Feb. 17, the president of the Bill & Melinda Gates Foundation’s Global Health Program emphasized the need for a courageous, enterprising approach to global health in the 21st century.
Dr. Tadataka Yamada, who completed his residency at MCV in the 1970s, currently leads the Gates Foundation’s efforts to develop and deliver effective, affordable health tools to counteract diseases that burden the world’s poor. Malaria, AIDS, tuberculosis and malnutrition are among the diseases targeted by the Gates Foundation’s research and grants.
“The battle against suffering, misery and death is a very real one -- one that requires tremendous focus and commitment,” said Yamada.
He said that a motivated, visionary work force will be necessary to drive the technological innovation essential to achieving equity in global health. We are fortunate, he said, to live in an era where global health issues spark the interest of many college and medical school graduates.
Two MCV students who attended Yamada’s lecture, Radha Chirumamilla and Sahar Lotfi-Emran, said they hope to join the global health work force and perhaps work abroad one day. Both students expressed interest in expanding research on the infectious diseases that affect impoverished nations.
According to Yamada, successful medical research and innovation require risk-taking.
“Safe bets will not give us a new HIV vaccine,” he said. 
To illustrate the importance of taking research risks, he described the March of Dimes’ decision in the 1940s to invest in the development of a polio vaccine rather than in health services for victims of the disease. While it was an unpopular decision at the time, it led to the development of a sustainable solution to a major health challenge.
Yamada said that, in addition to being sustainable, global health solutions must be marketable.  In his opinion, pharmaceutical companies, governments, foundations and NGOs all have a role to play in marketing campaigns for global health initiatives. 
He said the greatest challenge for any global health program is to get people in developing countries to adopt health tools and services on their own accord. 
“If you tell a child ‘You have to take this medicine,’ he won’t do it,” Yamada said. “But if you present the medicine as something delicious and sweet, he might actually get excited about it and take it on his own.”
Yamada has worn many hats over the course his medical career. Prior to joining the Gates Foundation in 2006, he was chairman of research and development for pharmaceutical giant GlaxoSmithKline. He also served as chairman of the Department of Internal Medicine and physician-in-chief at the University of Michigan, and, before that, as an investigator in the U.S. Army Medical Research Institute of Infectious Diseases.
Yamada has published over 150 medical manuscripts and a textbook on his area of expertise: gastroenterology.
Students, doctors and professors who attended Yamada’s lecture and are familiar with his work agreed that he sets a commendable example of scholarship and innovation in the medical field.
Dr. Jay Kuemmerle, a gastroenterologist at MCV, described his colleague and mentor as a “thought leader and dynamic force.”
Dr. Alvin Zfass, who taught Yamada at MCV and has kept in touch with him ever since, remarked that Yamada “always had a prepared mind.” Zfass said he has long admired his former student’s ability to think outside the box with regard to medical research and development.
“He doesn’t let his work get stale,” said Zfass.