Barry R. Bloom began as dean of the School of Public Health on January 4, coming to Harvard from Albert Einstein College of Medicine, where he was the Weinstock professor of microbiology and immunology and former department chair. A Howard Hughes investigator, Bloom is also a member of the National Academy of Sciences and a longtime leader in the World Health Organization. Editor Robert Neal interviewed Bloom for Focus.
Focus: What are your initial goals as dean of the School of Public Health?
Bloom: The first goal, really, is to increase awareness of the mission of public health both within the Harvard community and, more broadly, among the public.
The overall problem is a lack of public understanding of what we do, what our relationship is to biomedical science, and what our unique aspects are. Some think that we have to create an identity independent of the biomedical research paradigm. I don't share that view. I think that research is a tremendous strength that brings new tools to what we do. In fact, I feel we would do best extending the range of what people think of as biomedical research to include public health.
The major focus of public health is learning how to prevent disease in populations, and the major focus of clinical medicine is learning how to treat disease in individuals. This is a fundamental distinction that is by no means absolute, but it shows a difference in mission and in emphasis.
Within that context, a third of the School does basic biomedical research in some of the same areas as the medical faculty. One of our first recruits since I've been dean is a first-rate molecular cardiologist. So there is a certain amount of overlap. On the other hand, we have these unique aspects of quantitative and social sciences--biostatistics, epidemiology, policy and management, public health practice--that are different and would add value to any medical institution.
A second major goal is to strengthen global health. As of the moment, there's a need to appoint a full-time chair of the Department of Population and International Health and a need to appoint a director for the Center of Population and Development. And that's a big responsibility. The School should be a world leader in global health and of particular value to people in developing countries as a source of knowledge, training, and guidance.
One of the enormous assets of this institution and of our colleagues in the Medical School and the hospitals is the existence of spectacular cohorts of people who've been studied for over 20 years. The most famous of these is Brigham and Women's Nurses' Health Study. From them, we are able to learn enormous amounts about the environmental risks that predispose people to a wide variety of diseases--breast cancer, lung cancer, prostate cancer, asthma, and virtually any other disease that we might choose to look at.
What we're not taking advantage of now is the potential of these cohorts to inform the Human Genome Project, and a major thrust is to recruit a world-class population geneticist to be able to work with our epidemiologists and the clinicians in the Channing Lab, Medical School, and hospitals to determine genetic risks for the diseases that we study in these extraordinary cohort populations.
Are there any other important issues you are addressing early on?
I'll tell you the most important issue that I don't have to address. In this university and elsewhere, there has traditionally been a tension between the school of public health and medical school. During the interview process here, I was asked to see Dr. Martin at the Medical School, whom I take as a friend, a person I have never heard anybody say anything but the nicest and most respectful things about. I walked into Joe's office and sat down, and he said, "How can I be helpful to you in getting you to take the job?"
The expectation I had was that Harvard was a very difficult, very competitive environment, but in the 28 days I've been here, the reality is clearly the opposite. People like Dr. Martin, Dr. Nathan at the Dana-Farber Cancer Institute, and many others have been enormously generous, enormously welcoming, and enormously forthcoming.
In your view, what are today's most significant public health problems?
I think without any question at all, for me, the major problem in health in this country is the disparity between rich and poor, between minorities and majorities, and between racial subsets of the population. In my first speech over the summer to the senior faculty, I set as my highest priority in public health something that almost everybody in this School is concerned with, and that is equity--narrowing that disparity. We have extraordinary programs here devoted to that, those of Tony Earls, Deborah Prothrow-Stith, Marie McCormick, Lisa Berkman, and others.
What are your current international leadership roles?
I have been involved at the World Health Organization for 37 consecutive years in some capacity. The current one is to chair the UN AIDS vaccine advisory committee. I've also been asked to chair a committee that will visit WHO in March and review the role of research within the organization. What is the appropriate role of research vs. other major activities there? It's a question that has never been defined, never really been addressed.
What is your own lab working on now?
My own lab at the moment is working on survival without the lab chief, and they're doing a marvelous job. They're still in New York. They will not come here until probably mid-May. One area of interest is trying to understand something about pathogenesis of TB, which is still the largest cause of death in the world from any single infectious pathogen. The other interest is making vaccines against TB and using BCG [bacillus CalmetteGuérin, a weakened TB strain used for a vaccine] as a vehicle to make recombinant vaccines against other infectious agents. My broader aim is to make my lab accessible to any of the qualified scientists around the complex who have a real interest in TB and to create a center of excellence in TB research.
How do you relax with all this activity?
I don't. Woody Allen has a chapter in one of his books, which I love, on the curriculum, and there's a course called "Stress and How to Achieve It." I have mastered that course. I find this tremendously exciting, and I wouldn't know what to do if I didn't do this.