Public Health

Responding to events and comments

March 11, 2008

Last week

Last week was a very sad one for Carolina, particularly for friends and family of Eve Carson, the Carolina Student Body President who was brutally murdered in Chapel Hill. Our minds and hearts cannot comprehend that kind of senseless violence. Yet, here it was in Chapel Hill, robbing her family and this campus of a wonderful young woman who made the world a better place and who had so much promise ahead of her. Violence is a public health issue, and it is important that a number of our faculty, staff and students are working in the area of violence prevention.

Responding to comments

In the past few weeks and months, some people have raised issues about one thing or another in the School. I want to respond. For that reason, this blog will be longer than most. Also, because a blog reaches some people but provides limited options for dialogue, Dave Potenziani and I will schedule some open forums where people can come and talk about what’s on their minds. If anyone has concerns or issues about where the School is headed, I welcome the opportunity to talk with you face-to-face. I have been gratified at the wide support for the gift from Dennis and Joan Gillings but understand that some people may be skeptical or even negative about it. Our options to start new activities and even to expand what we do would be severely curtailed without philanthropy and corporate partnerships. I believe that these relationships can be managed ethically and responsibly.

For the rest of the blog, I will list some of the comments I have heard, usually from only a few people, and then respond.

We are state-supported. Why do we need this gift?
The gift brings an endowment that will generate funds for years to come, and resources to enable this School to do what we do best, solve big public health problems. While North Carolina is generous to its universities, the state budget covers only about 18.3% of our expenditures, and federal funds are falling precipitously. Without successful fund raising from private citizens, foundations and corporations, we could lose our competitive edge. However, we must develop these relationships in an ethical manner with a clear understanding of what the School needs, what we are willing to offer and with which individuals and organizations we want to partner. Last fall, we developed a statement about the latter issue.

Have you “sold” the School for $50M?
Dennis and Joan Gillings made a pledge of $50M to the School of Public Health. It is customary at Carolina and other schools to provide naming opportunities for very substantial gifts. Even before I became dean, the former dean and UNC officials sought a donor who would make a gift large enough to name the school. A gift that is large, even as large as $50M, doesn’t equate to selling the School or to a corporate takeover. Multiple UNC officials, including Chancellor Moeser, reviewed the agreement, and the final agreement was approved by the UNC Board of Trustees. This is a personal gift from Dennis and Joan Gillings. It is not a corporate gift. In September 2008, the School will be named the Gillings School of Global Public Health to recognize their generous gift.

Do you have the right to rename the School?
UNC has well-developed procedures that must be followed when naming is an option for a gift, and we followed the rules. Kenan-Flagler was renamed some years ago; naming negotiations are underway at several other UNC Chapel Hill schools. About 20 percent of all schools of public health (public and private) carry donors’ names. Many others seek such gifts to provide for the financial health of their schools.

Are you using $50M to globalize the School of Public Health?
Funds from the Gillings’ gift will support many initiatives, including but not limited to global health. As we’ve said repeatedly, we are more committed to North Carolina than ever before. In fact, already the gift is paying dividends for North Carolina. For example, we supported a strategic planning process initiated by the Department of Health, under Dr. Leah Devlin’s able leadership. The process will lead to better coordination between hospitals and health departments to improve the health of North Carolinians. Many of the Gillings Innovation Laboratory applications received to date focus on N.C. problems.

Why all this emphasis on global health?
As Leah Devlin has said so well, “We are all global citizens.” Families USA defines global health as “health problems that transcend national borders.” This includes health problems like AIDS, malaria, TB and obesity that have global, political and economic impact. We must pay attention to these global health problems for a variety of reasons that range from the humanitarian to their direct and indirect impact on us. Recently, the Institute of Medicine said that “the failure to engage in the fight to anticipate, prevent and ameliorate global health problems would diminish America’s stature in the realm of health and jeopardize our own health, economy and national security.” (IOM, America’s Vital Interest in Global Health). For more on this topic, see www.familiesusa.org/issues/global-health/matters/.

Paying attention to the world’s health does not make us one bit less committed to North Carolina. Lessons we learn here can be applied elsewhere and vice versa. We expect that a substantial part of our investments from the Gillingses’ gift will be used to solve problems in North Carolina. We are proud to be the top public school of public health. We live here. We have a great responsibility to this state and its citizens.

Have faculty, staff and students been involved?
Faculty and staff were part of developing the plan we proposed to Dennis and Joan Gillings. Faculty members comprise the planning group to operationalize financial literacy by determining core competencies and how they can be met. Faculty members and leaders are a fundamental part of the review process for Gillings Innovation Laboratories and other activities funded by the gift. Several School alumni are members of the Acceleration Advisory Committee. We welcome even more input.

Are corporate interests in the School too strong?
The SPH has a long tradition of our faculty working with different companies. For example, some biostatisticians consult with industry on pharmaceutical trials. They bring their expertise to assure that the best methods are used to analyze trial data. Meanwhile, students often have experiences working on real world problems that really matter. Faculty members in environmental sciences have collaborated with waste management companies and those interested in developing safer water treatment methods. Nutrition faculty members long have worked with various food companies.

I strongly believe that we should avoid dichotomous thinking that corporations are bad, and public health is good. Some corporations are ones with which we would not want to be associated. And while ultimately, publicly traded companies are accountable to stock holders for the bottom line, it often is in their interests to partner with us to achieve shared goals. While public health may not be their raison d’etre, it may be well within their missions to advance the public’s health. Public companies are under more scrutiny than ever before, and doing good can bring multiple benefits. In the New York Times Magazine 3/9/2008, Larry Brilliant, physician epidemiologist and head of philanthropy for Google, made a good observation. “What I did not understand when I was young was that corporations have personalities just like humans do. It is possible for companies to be virtuous.” I agree.

It is easy to say we will not work with tobacco companies. Except for some medicinal purposes, tobacco is a product that when used as intended, kills. But few other products are so clearly evil. People have to eat. By partnering with food companies, we can help to develop safer, healthier products, influence industry to reduce trans fats and make other changes conducive to health. We could create the best water filter in the world. But unless there is a company or organization willing to manufacture it, our impact will be modest at best. A large amount of literature shows that far too many of our innovations sit on shelves, because they lack capacity to scale. Prudent, ethical partnerships can permit us to achieve greater public health impact. I welcome your suggestions about additional ethical sources of support for the School.

One more thing, most partnerships between faculty members and companies are not approved by me. Our faculty members have tremendous freedom to initiate these relationships. Some of you, me included, may not be thrilled about some of these partnerships, but that is part of academic freedom also.

Why are business people members of the Acceleration Advisory Committee?
The AAC is providing advice to Carolina Public Health Solutions. Its members include academics, people from local and state governments and foundations, alumni, and business. (See Acceleration Advisory Committee roster for members.) They are not a policy group as stated in a recent Op Ed article. The School has one policy board – the Public Health Foundation Board. Already, the AAC has given us good ideas about where faculty members might look for additional funding and other useful suggestions. They are not making final decisions about Gillings Innovation Laboratories although some members are providing feedback about certain elements of GIL proposals, e.g. feasibility and potential for scale. Funding decisions will be the result of a robust process that includes input from Chairs and other School leaders, ratings from an outstanding group of reviewers from around the U.S. and discussions between me and Julie MacMillan, Managing Director, Carolina Public Health Solutions. One of the lessons I learned while at the NIH is the value of bringing into organizations people with vastly different knowledge and perspectives. We won’t change the world if we talk only to people like ourselves. I’m committed to keeping this school a vibrant place where many voices are heard. We have a lot to learn from corporate leaders with an interest in public health, and they can learn from us.

That’s all for now, but let’s keep talking

 I am very optimistic about the future of this School. Thanks to the gift from Dennis and Joan Gillings, we have an infusion of resources to enable us to tackle big problems and to achieve greater public health impact. In a period of abrupt decline in federal funding which is likely to be a part of life for many years to come, we now have other alternatives for support. How we manage and develop the gift is a work in progress. We will continue to seek input from many people about priorities and progress. To learn more, go to http://www.sph.unc.edu/accelerate/.

Next week, I will mention some of the plans for September when we will unveil the new name for the School.

Thanks to those of you who have made public and private comments.

If you are on spring break, have a good one.

Happy Monday. Best, Barbara


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The views expressed in this blog are Barbara Rimer’s alone and do not represent the views and policies of The University of North Carolina or the Gillings School.