DR. STEFANO BERTOZZI began his service as dean of at the UC Berkeley School of Public Health in September 2013, succeeding Dean Emeritus Stephen Shortell. Previously Bertozzi was at the Bill & Melinda Gates Foundation, where he directed the HIV program and led a team that managed the foundation’s portfolio of grants in HIV vaccine development, biomedical prevention research, diagnostics, and strategies for introduction and scaling-up of interventions. He serves on the scientific advisory boards for the President’s Emergency Plan for AIDS Relief, the National Institute of Health’s Office of AIDS Research, and the World Health Organization’s HIV Program.
Prior to joining the Gates Foundation, Bertozzi worked at the Mexican National Institute of Public Health as director of its Center for Evaluation Research and Surveys. He has also held positions with UNAIDS and the World Bank and was the last person to lead the WHO Global Program on AIDS before it metamorphed into UNAIDS. He holds a bachelor’s degree in biology and a PhD in health policy and management from the Massachusetts Institute of Technology. He earned his medical degree at UC San Diego, and trained in internal medicine at UC San Francisco.
Stephen Shortell: Stef, let me officially welcome you to Berkeley. On behalf of our faculty, staff, students—all of our community—we’re absolutely delighted you’re here.
Stefano Bertozzi: Thanks, Steve.
Shortell: Let me start by asking, what attracted you to become dean at Berkeley? You had a key leadership position at Gates and you’ve done a lot of fantastic things in your career. What was the attraction to this particular position at this point in time?
Bertozzi: It starts with the extraordinary environment. The Bay Area—Berkeley in particular—is just a fabulous place to be. The School of Public Health is housed within the finest public university in the world. That is very exciting because of the growing need to bring other disciplines and expertise into the rapidly changing world of public health. People naturally think of the overlap between medicine and public health, but here we can highlight the huge shared mission with other parts of the University: humanities, social sciences, physical sciences, other professional schools and the Lawrence Berkeley Labs. And that’s an amazing opportunity.
I was also drawn to this amazing school. It’s one of the world’s top schools of public health. It has extraordinary faculty. I think there are many things that you should be extremely proud of during your leadership, but I’d say that perhaps the most important is the people that you’ve managed to recruit while you’ve been dean. My impression is that the people that you’ve brought in over the last eleven years are really transforming this place and bringing new and different depths to the faculty. The reputation of the School and the University attracts extraordinary students and I’ve already seen that in our undergraduate major, in our graduate students, and in our fellows and postdocs.
“I think there’s no question the strength of this school is its faculty, and I’ve been very fortunate and privileged to be able to recruit twenty-one of them over the years, and they’re just outstanding.”
– Stephen Shortell
Shortell: Yes, we’re fortunate, being at Berkeley, that we’re able to draw on the resources of the entire campus and able to contribute to those as well. And I think there’s no question the strength of this school is its faculty, and I’ve been very fortunate and privileged to be able to recruit twenty-one of them over the years, and they’re just outstanding. And when I go elsewhere, to schools and other kinds of forums, the first thing they talk about in regards to our school is our faculty.
Let me ask you another question: From your vantage point, what do you see as the major public health problems that we need to address? As you look externally, what are your initial thoughts on how to position the School even more so to address the challenges of this century?
Bertozzi: Well, as you know, I have much more experience in the global sphere than I do in the domestic sphere. But some of the global challenges are also very relevant domestically. So I would say that health inequity and health disparities are not only global problems. Of the high-income countries, the United States has the greatest amount of health disparity.
We are far less equal in terms of health status than we should be given our resources, and that’s even more astonishing given the extraordinary amount of money that we spend. You would think that with the amount of money that we spend, we would not only have the best mean and median health status in the world—we deserve it for the money we spend—but also that we would have far less health disparity,and we have neither of those. Another challenge I see is the persistence of the traditional diseases of developing countries and poverty with the overlap of what some people historically called the diseases of wealth, or more privileged, and among them obesity, diabetes, and hypertension.
Shortell: It’s double jeopardy.
“We share health problems with Mexico and will change the health of both populations faster if we collaborate on developing solutions.”
– Stefano Bertozzi
Bertozzi: As an example, Mexico has perhaps the world’s worst epidemic of diabetes and competes with the U.S. to be the most obese country. We share health problems with Mexico and will change the health of both populations faster if we collaborate on developing solutions. These will certainly require innovation in many overlapping areas of public health: technology development, behavior change, and community engagement to name a few.
I had also been working extensively with the Gates Foundation in China, and you can’t do that without every day being aware of the extraordinary environmental challenges and their relationship to health. In poorer settings, the indoor environment is also a very big determinant of health. The School is looked to for its expertise on a broad spectrum of issues related to the environment and health, an area I look forward to learning more about.
Shortell: I think we are also learning from developing countries and low-resource settings about more efficient and effective ways that we can deliver health care services in our own country. Community health workers are one example. They are used heavily, as you know, in Africa and even Asia, and we’re beginning to transport these innovations back into our system here, because we have to learn how to deliver care in lower-cost settings using different kinds of health professionals.
I also want to ask, what are your preliminary thoughts in terms of your short-term goals or ambitions for the School, and then anything longer term as well?
Bertozzi: I do need some time to get to know the School better. It’s already clear to me that there is no need to push the reset button; we need to build on the School’s prodigious strengths—which means I need to better understand what those strengths are. It’s also very clear to me that Berkeley is a shared-governance, shared-leadership environment. I need to understand the aspirations of the faculty, staff, and students, and then help to coalesce those around common goals.
There are exciting things happening that will need further nurturing. The online program is just one of those. This is an extremely exciting time in the world of virtual education. The School can have an enormous global impact in terms of development of human resources because we can use these new tools to do at-scale things we could previously only do in small groups. I’m not worried that there is competition between the physically present, bricks-and-mortar, people-to-people interactive environment and the virtual environment, because I believe that each will strengthen the other. We will bring the virtual into the bricks-and-mortar and we will increasingly capture the richness of the physical world in the virtual one.
Bertozzi: I met with the Public Health Alumni Association, and I’m excited about the idea of working with them to strengthen the connection between the skills and knowledge that our students obtain on campus and the work environment we’re preparing them for. Our alumni are in a broad spectrum of work environments, and they can serve as representatives of the labor force for our students.
I also think that the transition from your leadership to mine occurs at a time when Berkeley is transitioning an enormous amount of its administrative infrastructure and staff support. So I think one of my top priorities is working with the staff and with the faculty and the students to help that transition to be as non-disruptive as possible, and in a way that makes people satisfied in their work.
“I certainly recognize that fundraising is not a short-term game. These are relationships you build for years, and often decades.”
Shortell: I think that’s very important to recognize. The campus wide changes will have a significant impact on all of us—faculty, staff, and students—and we all need to work on helping to implement these changes as effectively and constructively as possible.
Bertozzi: Another thing that’s worth mentioning is a project that you’ve agreed to help me with, and I expect to work together with you and others on, and that’s the as-yet unfinished project of getting a building for the School.
Shortell: I’m sorry I left you that one. That was one thing on my punch list I had hoped to get done but did not. But you will be the hero!
Bertozzi: Well, I’d like to think that we will be heroes together.
Shortell: Yes, collectively we will all be, because it will take a team to do it.
Bertozzi: Not only will it take a team, but I certainly recognize that fundraising is not a short-term game. These are relationships you build for years, and often decades. And so it’s a question of working with the groundwork and the platforms that you’ve built to get us over that finish line, and I know that I can count on your support.
Shortell: Absolutely, and you have my commitment and time on that.
Let me switch gears a little bit. One of the ways I used to think about this job is in three buckets. One of these is the internal/within the School bucket, which we’ve talked about some already. Then there’s the cross-campus relationships bucket, which, at a place like Berkeley, can take a lot of time. It’s a very academically entrepreneurial campus. And I think that’s largely good, but it means there’s ten, fifteen ideas a day that crop up. Some suck your energy and go nowhere; some are the ones that pay off. And then the third bucket is the external bucket. Fundraising is the big part of that, but there’s also accrediting bodies, various other forums, the external reputation of the School, and related considerations.
So as you think about those three buckets, it would be interesting to hear your thoughts—you’ve talked a little bit about some of them already—on how you see those playing out for yourself, particularly this first year, as you get your feet on the ground.
Bertozzi: Well, I think we’ve spoken about the internal stuff and some of the challenges and opportunities. In the short term, managing the administrative transition is going to be a very high priority internally. I think that any change in leadership is an opportunity to say, let’s take stock of where we are, let’s think about where we’d like to be ten years from now, and let’s start a path for getting there.
With respect to the rest of the campus, I need to learn a lot more about that. What is really encouraging to me is that my initial interaction with different parts of the campus has been not only very welcoming, but eager to strengthen collaborations. I’ve met with many of the deans and it’s clear there are lots of exciting things to explore.
With respect to the broader community, you had mentioned fundraising. I would say that another important part of the broader community is that we want to influence policy in public health—we want to do that locally, we want to do that in the state, we want to do that nationally, we want to do it globally—and becoming more purposeful in strengthening our ability to have that policy impact is something that is a long-term process. The School already does a lot in these arenas, but I think that schools of public health generally need to develop a greater sense of accountability for the impact that we have on health policies, and ultimately, on the health of the population.
Virtually everybody who enters public health practice or the academy does so because they want to have an impact on the health of the population, and we need to continuously question how we can have greater impact. If we’re training people less than optimally for today’s health challenges, we need to modify our training. If we are researching less important problems in terms of ultimate impact then, over time, we need to focus on the most important problems.
Shortell: We can’t afford to sub-optimize; we can’t afford to not address the biggest challenges. That’s what we’re aiming for. That’s what we have to make sure that we continue to support our faculty, staff, and students to do, absolutely.
Bertozzi: It seems to me that our academic incentive systems should have more positive incentives for working on problems that will have greater impact. And we should figure out how to do that. It’s obviously not an issue just for the School—it’s an issue for the profession.
Shortell: Exactly right. In a way, I think we have an advantage at Berkeley, because the culture here is such, you can study anything you want, you just better be damn good. The University’s not going to restrict us in our decisions. And team-based science is growing here as well. There is a growing recognition on campus as they review and work with our faculty that team science is what public health is about. You need multiple disciplines to deal with these problems. So this is something I have found has been really reinforcing in terms of what we’re trying to do here.
Bertozzi: One of the casualties of the current reward system is that it differentially rewards individual effort. If we are trying to tackle very big problems, they’re unlikely to be addressable by an individual faculty member.
Shortell: Exactly, and it often takes time. In many cases, you’ve got to collect primary data, it may take three or four years before the publications are going to bubble up.
“Just as there is increasing discussion about ‘big science’ that requires new forms of collaboration, we need to have a dialogue about ‘big public health.”
– Stefano Bertozzi
Bertozzi: I think you’re exactly right. In many ways, the Human Genome Project was a “line in the sand” project that created a new way of working and a new way of recognizing intellectual contribution, and a new way of a shared collective approach to something. Just as there is increasing discussion about “big science” that requires new forms of collaboration, we need to have a dialogue about “big public health.”
Shortell: One last question, for today at least: Tell us a little bit about any hobbies you have, your family life, what you like to do when you’re not working. What would you like to share with us?
Bertozzi: Because we’ve lived in lots of places, I have my childhood, or actually my great-grandfather’s childhood home in Italy that is still in the family—and my father was the only member of his family that left Italy. So we still have strong connections back there. I was born in a place called Cortina d’Ampezzo—it’s where the 1956 Winter Olympics were held—and I still have family there, and my grandfather’s family came from Piedmont, or Piemonte in Italian. So our old family farmhouse is about a third of the way from Milan to Torino.
We lived eleven years in Mexico, and my kids grew up there. So we built a house in Mexico when were down there, and we get down there as often as we can. It’s in Cuernavaca near the National Institute of Public Health.
And here in the U.S., what we really like to do is get outdoors. We’ve been in Seattle for the past four years, and I have to say the western side of this continent is hard to beat for extraordinary natural spaces. Last summer we spent a week up at the Georgia Strait, which is in British Columbia, about as far north as you can go in Puget Sound, and it was just spectacular. You sit and watch the bald eagles fish in front of you. It’s just an amazing place.
Shortell: And so is Berkeley! We are all fortunate to be living in a very beautiful part of the world. I know I speak for all of us in the School that you will have our full support as you lead us to ever greater opportunities to improve the public’s health.
Bertozzi: Thanks so much, Steve. I have felt that support since my my first visit to campus. It is an honor to be able to join this team.