In January 2015, Dr. Eric Goosby was appointed by UN Secretary-General Ban Ki-moon as the UN Special Envoy on Tuberculosis (TB). As Special Envoy, Dr. Goosby works to raise the profile of the fight against TB and promote the adoption, financing and implementation of the World Health Organization’s (WHO) global End TB Strategy and its international targets for tuberculosis prevention, care and control. Dr. Goosby himself contracted latent TB while working as a young doctor in San Francisco.
Dr. Goosby has dedicated his professional life to tackling global health diseases, particularly HIV/AIDS and TB. Dr. Goosby’s HIV/AIDS work runs the gamut from treating patients to directing the United States’ largest foreign assistance program – the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). After serving four years in the U.S. State Department as Ambassador-at-Large and U.S. Global AIDS Coordinator, Dr. Goosby returned to the University of California, San Francisco where he is Professor of Medicine and Director, Global Health Delivery and Diplomacy, Global Health Sciences.
While at the State Department, he also led the Office of Global Health Diplomacy, advancing the United States’ global health mission to improve and save lives and foster sustainability through a shared global responsibility. As CEO and Chief Medical Officer of Pangaea Global AIDS Foundation, 2001-2009, he played a key role in the development and implementation of HIV/AIDS national treatment scale-up plans in South Africa, Rwanda, China and the Ukraine. During the Clinton Administration, Dr. Goosby was Director of the Ryan White Care Act at the U.S. Department of Health and Human Services (HHS), and later, served as Deputy Director of the White House National AIDS Policy Office and Director of the Office of HIV/AIDS Policy at HHS.
Like most doctors, I went into the field of medicine to help people. And it is still what drives me today.
Yet, as the years go by, I have become increasingly focused on not only the care people receive, but also how they receive it. As U.S. Global AIDS Coordinator and now UN Special Envoy on Tuberculosis, I have witnessed the dysfunction that occurs when diseases and other medical conditions are put in silos. Patients travel to one clinic for care for one condition and, then, another clinic to be tested or treated for something else. And these clinics are very frequently miles from each other in areas where transportation is limited or non-existent. Moreover, medical records do not follow the patient, making treatment difficult at best.
This problem is not limited to developing nations. It exists in developed countries as well. There are pockets of disparity in the U.S. that lack access to even the most basic care, let alone care for infectious disease like TB and HIV. Moreover, particularly in rural areas, people do not have the means to travel to their closest clinic, which could be many miles away; are unable to find a health care provider who specializes in specific treatment , especially for HIV and when they do, cannot see them on a regular basis for care; and frequently face stigma and discrimination for certain conditions they may have.
We have reached a point where the health community must focus on the critical need to build health care systems that deal with all diseases – infectious and non- communicable alike. We must be advocates for universal health care. The health landscape is demanding a new, more coordinated effort to tackle health care challenges around the world.
It is imperative that those of us working on specific disease investments not become barriers to accessing universal health care. Together, we must move forward to integrate disease and wellness services. We must implement tools and processes to make health systems in every country more responsive and capable of efficiently delivering essential services to the entire population. The necessity for such integrated service delivery is becoming particularly acute as we see a worldwide surge of non-communicable diseases, even as our fight continues against infectious diseases such as AIDS, TB, and malaria continues. Hypertension, diabetes, and coronary heart disease typically occur in older populations, but are now presenting themselves at an alarming rate in much younger populations, particularly in developing countries.
Tuberculosis is the perfect example of how health delivery systems are failing the most vulnerable. A shocking 4,100 people die each day from TB, despite the fact that we have tools that allow us to easily diagnose and treat 97 percent of cases. We have had the ability to diagnose and treat TB for 50 years and we’re still missing one-third of potential patients. It’s inherently a problem of access — inadequate health systems, financial constraints, and social exclusion.
As the UN Special Envoy on TB, I am committed to supporting health service integration as a central tenet for the future of global health and the achievement of universal health care. I welcome others to join me as we build stronger and integrated health systems that improve and save lives around the world.
Jane Coyne is the Director of TB Programs supporting the UN Special Envoy in the development and implementation of the office’s global advocacy strategy. She comes to this role with a deep commitment to tackling tuberculosis developed during her time with MSF / Doctors without Borders.
Ms. Coyne spent ten years with MSF in the field and was also based in Paris overseeing operations in South Sudan, Central African Republic, Kenya, and Georgia. Her background in global health is built upon a foundation of management experience in manufacturing and supply chain integration.
Ms. Coyne has a Masters in Business from the Kellogg School at Northwestern and a BS in Applied Economics from Cornell University.
Amy Lockwood has a background spanning the business, non-profit and academic sectors. Her work often involves deep partnerships with Ministries of Health and health system managers to develop tools and processes, implement programs, and draft policies to improve the quality of and access to health care. As the Chief of Staff at UCSF’s Global Health Sciences, Amy leads strategy, business development, and operations for the AIDS Research Institute and the Institute of Global Health Delivery and Diplomacy. Amy is also pursuing her PhD in Global Health Sciences at UCSF, with a research focus on identifying the components of management and leadership that have the greatest impact on health outcomes.
Mike Reid graduated with a Masters in Political Sciences from Cambridge University, England and received his medical degree from Imperial College, London. He is a board certified infectious disease/HIV specialist and has completed post-graduate medical training in New York and San Francisco.
Prior to joining UCSF, Mike spent several years working in PEPFAR-funded HIV programs in Southern and Eastern Africa. He was lead physician in the University of Pennsylvania’s global health program in Gaborone, Botswana, for three years before moving to San Francisco in 2014.
At UCSF, Mike supports Dr. Goosby’s TB-related work as well as pursuing his own independent research exploring how to optimize delivery of HIV and NCD programs in resource limited settings. He holds a Masters in Public Health, from the University of California, Berkeley.