A Conversation with Dr. Mark Dybul: Preparing for the Future of Global Health
By Denna Nazem
On March 19, 2019, Dr. Mark Dybul came to Georgetown as a part of the Conversations in Global Health speaker series. Currently serving as the Faculty Director for the Center for Global Health and Quality at Georgetown University Medical Center, Dr. Dybul has a distinguished career as a global health expert and humanitarian. Dr. Dybul has led many successful initiatives to mitigate, and ultimately end, massive global health crises worldwide.
Most notably, he has served as the Executive Director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria and as the U.S. Global AIDS coordinator, where he oversaw the implementation of The President's Emergency Plan for AIDS Relief (PEPFAR) – a program he also helped start.Dr. Dybul is known for his impact on incredibly successful global health responses, but also for his dedication to rethinking how programs are designed, paid for, and implemented globally. At the center of this fundamental shift, Dr. Dybul argues that, “a paternalistic donor-recipient model is giving way – slowly and stubbornly – to a constellation of partnerships with strong health systems, not the delivery of treatments by rich countries to poor ones, as their raison d’être.”
Throughout our conversation with Dr. Dybul, he further emphasized how the future of global health lies in this reframing. So-called “beneficiary” countries will cease to partner with the United States and other paternalistic Western countries, if global health programs continue their top-down bilateral approaches. Dr. Dybul urges that a successful future will only be possible with partnerships built of listening, support, and a deep mutual cultural understanding.
While it is true that PEPFAR has seen massive success in conjunction with effective antiretroviral drugs, Dr. Dybul pointed out new potential challenges. He laid out the dilemma clearly: “The population in Africa is doubling by 2050, and that doesn’t mean there are going to be more old people – that means that there will be more births. And we know that young people are more at risk for HIV.” He argues that this makes for a dangerous problem because majority of the African youth do not seek health services out. Due to the overwhelming success of PEPFAR, the young population has not been raised with people they know dying due to AIDS each day. The key to beating HIV/AIDS in the future is an emphasis on prevention today. But there is a problem in the system – “there are too many white doctors,” Dr. Dybul says. We need to create programs that meet the youth where they are, with campaigns that matter to them, and from people they know and trust. With a more multidimensional, comprehensive, and ground-up approach, we will have a more promising future in global health.
Denna Nazem (SFS ‘20) is a junior in the Walsh School of Foreign Service, majoring in Science, Technology, and International Affairs with a concentration in Biotechnology and Global Health.
This blog was written by a student in Georgetown’s Conversations in Global Health course, which brings leaders in global health to Georgetown to discuss their careers and work.