Incoming Secretary-General Wants to Add Value to Members
When the IANPHI Secretariat transitions in 2014 from Finland to its new home in Mexico and France, Dr. Mauricio Hernández Ávila will become the new secretary-general overseeing the operations of IANPHI. The director general of Mexico’s National Institute of Public Health (INSP) brings to his new post more than 30 years of public health experience. He talked with IANPHI World about his path in public health and his vision for IANPHI’s future.
Why did you make public health a career?
I grew up in Mexico City and always had a desire to help other people. I was the first one in my family to go to medical school—my father and brothers were engineers so I was sort of an outcast. My first contact with public health came during my residency in pathology. I was invited in the early 1980s to assist in research about causes of death related to malnutrition in the Nahua Indian populations of the Puebla Highlands. I fell in love with public health and saw its power to change the course of disease and give people a better chance to have healthy lives.
Seeing the impact of our research has given me great satisfaction over the course of my career. For example, when we at the Ministry of Health identified the H1N1 epidemic in 2011 in a very short time, we were able to alert the world, and set a global precedent in terms of surveillance and reporting. In another instance, INSP advocated for a general law to protect non-smokers and for a tax increase on tobacco in Mexico that has resulted in less exposure to second-hand smoke and fewer young people smoking. And we’ve contributed to the design of a very important transectoral policy that makes it clear that we need all agencies—treasury, labor, social development, and others –to change attitudes about obesity.
"Our first step is to listen to our members and stakeholders to find out what they expect or define as added value from our network."
What do you see as the key issues in global health today?
We have three very related threats at the global level that we need to work together to resolve. Social inequity is widening as poverty increases. Globalization has increased security risks posed by infectious diseases and bioterrorism. And an incredible epidemic of chronic disease is affecting all countries.
To address these challenges, we must have an international commitment to global health. Governments should strive to provide universal health coverage and to strengthen health services. We all need to think about resources to attack current epidemics, in particular the chronic disease epidemic. The pharmaceutical industry must be more responsive and responsible and give access to their products in different economic settings. I am convinced that bioterrorism is linked to poverty and injustice; so, to counter bioterrorism we need to think in terms of bringing development to many places in the world to decrease poverty. And we need collaboration to identify infectious disease threats in different countries and to make a safer and more equitable world.
Speaking of international cooperation, you’ve been very active in IANPHI since the outset. You were one of the founding members of IANPHI and your institute, INSP, hosted the annual meeting last year. Why did INSP agree to house the IANPHI Secretariat in partnership with the French Institute for Public Health Surveillance (InVS)?
I have a personal commitment to IANPHI—I was involved in the initial discussions about it as early as 2003. Then after leading research for the H1N1 epidemic in 2011, I had a better understanding of the need for global cooperation to attack important problems and advance public health at the national and international levels. Lessons learned from the influenza pandemic re-shaped my views regarding north-to-south cooperation in terms of capacity building and access to vaccines and medical drugs, and I wanted to bring this expertise to IANPHI. INSP is a mature organization—we just celebrated our 25th anniversary— and we will bring to IANPHI the perspective of a middle-income country with a national institute of public health that has played a leading role in region and the country. With France’s INVS, we can bring to IANPHI a new approach in terms of how institutes can collaborate among themselves and how IANPHI can become a better organization. In short we want to move forward to be a key player in the global health arena.
What do you see as the value of the IANPHI network, and what is your vision for its future?
IANPHI is a very powerful organization. Our network includes key NPHIs that have dealt with epidemics and helped shape public health response in the world – saving many lives. Jeff Koplan dealt with anthrax as director of US CDC; Wang Yu as head of China CDC led the response to the H7N7 epidemic; Reinhard Burger’s team at Germany’s Robert Koch Institute responded to Germany’s E. coli outbreak; and our institute in Mexico was involved with the H1N1 epidemic. IANPHI’s strength is that it brings together these people and many others to share their expertise with the rest of IANPHI’s membership so that we all can be better prepared for the next epidemic.
We can help each other raise standards in our labs and in disease surveillance and health information systems and standardize the work we do. We hope to help NPHIs expand their surveillance systems to include chronic diseases as well as infectious diseases. Through IANPHI, we can share samples and techniques; we can build capacity in countries and strengthen our public health workforce. That’s not happening now as much as we’d like, but that’s what we want to do through the new Secretariat.
I think IANPHI’s previous work has been remarkable—IANPHI is now a consolidated global network, and that’s why IANPHI has such a strong reputation. So it’s a good time to do an introspective analysis and come up with new ideas to move forward.
What do you see as your biggest challenges as secretary general, and what strategies will you implement to overcome those challenges?
Our biggest challenge is to give members and stakeholders added value. We are an organization of extremely heterogeneous members -- from very small NPHIs in Bolivia or Peru to very well developed institutes like US CDC, Public Health Agency of Canada, and InVS. Mozambique may be happy with technology transfer, while CDC may want to enhance surveillance around the world. What will be the added value for national public health institutes in Bangladesh or Mongolia or China or countries on the African continent? We need to do a listening exercise with our members to get their views and opinions on how IANPHI may add value to their everyday work.
We want to help give voice to more members; we want to strengthen their capacity by helping them perform better. So our first step is to listen to our stakeholders inside IANPHI to find out what they expect or would define as added value from our network. At our Annual Meeting in Tanzania, we will have that listening exercise with our members to find out what will make our institutes stronger and our network stronger.
We also need to go outside our organization and meet with WHO and different global health stakeholders as well as potential funders to better understand how they see us and what products we can offer them so they can help fund and support IANPHI. The challenge is to bring more resources to fund our mission.
How do you envision strengthening and expanding the IANPHI network? Are there any countries in particular that you would like to see join IANPHI?We have a commitment to bring in more members and increase IANPHI’s visibility in the international arena. We want more members from the Americas, and INSP will be working on that. We are teaming with InVS because we think having a close partner in Europe will help attract more African and Asian countries to join IANPHI. But the best thing we can do to make IANPHI more attractive to new members is to offer added value.
When the Secretariat moves from Finland to Mexico in January 2014, who else will be working with you to provide support to IANPHI?
We will work closely with IANPHI President Pekka Puska and our two partners, InVS and the Atlanta office. We are fortunate to have INSP staff members who have been very active in issues of global disease surveillance and members of the WHO network. The Secretariat at INSP will be staffed by Senior Deputy Kelly Anne Scoggins, as well as two other support staff to be named later. Three expert advisors— Hugo Lopez-Gatell, Celia Alpuche, and Laura Magaña—will provide technical support, along with Nelly Salgado, who is an INSP global health leader, and Teresa Tellez. From the Secretariat at France’s InVS, Scientific Director Jean-Claude Desenclos and Anne-Catherine Viso, deputy to the director of the Office for Science and Quality Management, will provide scientific support for the annual conference.
And I have to mention that my family is also supportive of my new role. I have two sons who are now in medical school, a son in business, and two young stepdaughters. And my wife, Sophia Charvel, is a public health lawyer; she has created a lot of interest on my side about the importance of law and public health.
Your agenda for IANPHI sounds quite ambitious.
Yes, we know it won’t be easy to move the agenda. To move forward we will need to be creative in our approach to delivering services to our network members and to translate IANPHI actions into results within the global health arena. We definitely need to be willing to change the way we think and work. Networks are incredible creative environments, and IANPHI is certainly a good example.