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Remarks at Harvard School of Public Health

I suppose it will be the case for some time that any set of remarks like this has to begin with September 11th and what it means. Barry spoke very powerfully about some aspects of that; the symposium that you just attended reminded us of the unique capacity of Harvard and the Harvard School of Public Health to mobilize expertise on matters of national concern. But it seems to me that there are two other things to be said about the meaning of September 11th and its aftermath.

The first thing I would say is that in a very real sense all of us are now engaged in a struggle over things we took for granted. The idea of progress, of steady human betterment, of the continuation of hope, of the idea of freedom from repression and freedom from dogma, and of the notion of progressive, ordered society — that is what is threatened by what happened on September 11th. And, yes, we will need to meet that threat by increasing our security, by going after those who perpetrated such terrible deeds, and by addressing the conditions that made it possible for something like this to happen.

But the main way we will prevail in the struggle in which we are engaged is to redouble our efforts to be part of things that are larger than ourselves We need to demonstrate that humanity is capable of enormous progress, to demonstrate that the human condition can be made better by strengthening the forces of hope — better not just in rich countries like this one, but better in every country in the world. And that, at root, is the mission of the Harvard School of Public Health.

We have seen something else in the wake of September 11th, as people have debated and grappled and tried to respond to these events. We have seen that the world’s problems at this moment require two different things that often come alone but rarely come together. On the one hand, there has to be compassion, commitment, and rigorous determination. On the other, there has to be careful, hard-headed thought about what works and what does not. We live in a time when the problems the world faces are too serious for compassion alone to be enough if it is not channeled effectively. And if September 11th reminds us of anything, if the statistics that Barry cited remind us of anything, it is that it is not sufficient to be rigorous, hard-headed, and analytical in one’s approach — one has to care, and one has to be committed to the most important things. And what makes this School at Harvard so exciting and important is that the Public Health School is a place of caring, compassion, and commitment — but not of that alone. It is also a place of rigorous analysis, standards, and hard-headedness. And both are necessary if we are going to meet the world’s challenges.

This is something that has always been important to me, but is much more so now. The reason I decided, almost 30 years ago now, to become an economist is that I wanted to work on solving what felt to me the most important problems in the world: poverty, unemployment, helping poor people. But I knew that I didn’t want to just shout and rant about them; I didn’t want to just advocate about them — I wanted to carefully study what worked and what didn’t work. That’s what led me into the field of economics. That’s what’s led many, many different people from different places down that path and others.

That sort of caring and careful analysis is embodied in Harvard’s School of Public Health. And now, more than ever, it is what the world needs. Just think about these facts: Five million people die each year of malaria, AIDS, and tuberculosis. Five times as many Americans have died from infectious diseases as have died in military conflicts in the last 50 years. Take those two facts and then take this fact: between 1975 and 1997, more than 1,200 drugs were licensed. Only 13 were for tropical diseases. Of those 13, five were products of veterinary research, two were modifications of existing medicines, and two were produced for the military. Only four of the 13 reflected the research and development of private companies trying to address those diseases.

If we as people are going to do our part in responding to that challenge, we have to be prepared to act, and to recognize that the challenge cannot be met by the market alone. Countries where average incomes are less than $2 a day are not going to fund basic medical research programs. Drug companies are not going to do the most basic kind of research anyway, since the benefits flow so widely. And they are certainly not going to do applied research where the only market is in countries where the income is only $2 a day.

This is not a problem that’s going to get solved in any one place. Government has its major role. When I was in the government, I was very focused on appropriating funds for the Global Vaccine Initiative, on new tax credits to encourage the development of drugs, an idea that came out of research here at Harvard. God knows the countries affected have a role that they need to play. With $2 income per capita per day, it becomes even more important not to waste that money on corruption, or to allow its diversion.

But I say to you, if any institution in the world is well situated to maximize the contributions to solving that problem, it is the School of Public Health, with unmatched connections throughout the developing world, with an extraordinary scientific capacity, located here in the center of the best bio-medical research community that there has ever been in the history of the world, in the middle of a university whose major mission is to become more open to the rest of the world. It is a very exciting time to be associated with the Harvard School of Public Health because I am convinced that the School is going to accomplish great things in the next 10 years. And I am determined to do everything that I can to help Barry and his colleagues do those things and make progress against what I believe are the largest solvable problems that this planet faces. Thank you very much.