Building Health Systems from the Ground Up: Reflections on John Nkengasong’s Global Health Leadership

John Nkengasong, Ph.D., former U.S. Global AIDS coordinator and ambassador for the President’s Emergency Plan for AIDS Relief (PEPFAR) and founding director of the Africa Centers for Disease Control (CDC), recently spoke at Georgetown University. He offered students valuable insight into a lived experience behind one of the most influential and self-built public health careers of our time.

Born in Cameroon, Nkengasong’s journey began far from the global stages where he would later help shape responses to pandemics and infectious diseases. He spoke of his early education in Cameroon, where he found his passion for science, followed by his studies in Belgium, where he earned his master’s and Ph.D. degrees. With more than 30 years of experience in virology and public health leadership, his career has been defined by perseverance, innovation, and collaboration.

One of the main themes that stood out in his talk was building from the ground up.

Nkengasong recalled the early days of his scientific career, when he often had to construct his own laboratory environments, culture systems, and research frameworks. He literally created the infrastructure he needed to pursue science while navigating being a husband and father. That same ethos guided his work years later when he founded the Africa CDC, an institution he started with “just a laptop and a small desk.” Today, it stands as the first pan-African public health agency, coordinating responses across a continent of over 1.4 billion people. His story embodies what it means to build institutions grounded in long-term capacity building and local ownership.

Nkengasong’s work with PEPFAR shows his dedication to addressing the HIV/AIDS epidemic. His call for policymakers and the public to “preserve PEPFAR” served as both a defense and a reminder that global health programs succeed when sustained commitment meets moral clarity. Nkengasong also emphasized the importance of collaboration, particularly when responding to public health crises in areas of conflict across Africa. He notes that epidemics do not respect borders or political divisions, and that only through cooperation between governments and communities alike can health systems remain resilient. He shared his experiences on how to build trust and rapport in the communities that remain vulnerable. His reflections on navigating these challenges are as essential to public health as medicine and data.

Looking toward 2030 and the global goal of ending HIV/AIDS as a public health threat, Nkengasong emphasized that the path forward lies in treating vulnerable populations while maintaining treatments for those already infected. His message underscored equity, access, and continued monitoring for future generations.

As a student, I was deeply moved by Nkengasong’s humility and determination. His story illustrates that effective leadership in global health is not born of privilege or proximity to power, but of persistence, collaboration, and vision. From his beginning in Cameroon to leading continental and global health efforts, his life reminds us that innovation starts from the ground up. 

Guneet Kaur (M’26) is a graduate student studying physiology at Georgetown University.