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On January 22, the University of California, San Francisco (UCSF), University of California, Berkeley (UC Berkeley), Stanford University (Stanford), and the Bay Area Global Health Alliance co-hosted the Bay Area launch of the Lancet Commission on Investing in Health report, Global Health 2050: The Path to Halving Premature Death by Mid-Century, bringing together Bay Area students, researchers, and other key stakeholders to explore the significant findings of the report, discuss next steps, and highlight the priorities for follow-up studies. 

The report, published in October 2024, outlines how countries can reduce their rates of premature death by 50% by the year 2050. ​​It identifies 15 priority conditions, ranging from infectious diseases and maternal health to non-communicable diseases (NCDs), that account for significant life expectancy disparities. 

“We share universal principles, and we are united in the work of saving lives, improving health, and advancing equity. These principles are not confined by nations, borders, or political movements, and they endure, especially in challenging times.” – Payam Nahid, Executive Director of UCSF IGHS and Alliance Board Member

The launch event was held at a timely moment, as the global health community navigates shifts brought by the new political administration’s directives. Payam Nahid, executive director of UCSF Institute for Global Health Sciences (IGHS) and Alliance board member, delivered a message of optimism amidst the uncertainty, emphasizing the critical importance of collaboration in addressing global health challenges. 

“We share universal principles and we are united in the work of saving lives, improving health, and advancing equity. These principles are not confined by nations, borders, or political movements, and they endure, especially in challenging times,” Nahid said. “This report is not just a vision for the future; it is a call to action for justice and health equity,” he continued, highlighting the report as a framework for inspiring institutions and nations to drive impactful progress in global health over the next 25 years.

Emphasizing the transformative potential of focused health investments, Gavin Yamey, director of the Center for Policy Impact in Global Health at Duke Global Health Institute, introduced the report’s seven key messages:

• The “50 by 50” goal: Countries can achieve a 50% reduction in the probability of premature death (before age 70) by 2050. This target is based on historical evidence, as 37 countries, including seven of the world’s most populous nations, have achieved similar progress in the past. Continued scientific advancements make this goal feasible.
• Focus on 15 Priority Conditions: These conditions account for the majority of life expectancy disparities between the high-performing nations and other regions and include eight infectious and maternal conditions, such as HIV, tuberculosis, and maternal mortality, and  seven NCDs and injuries, such as diabetes, cancer, and road traffic injuries.
• Resetting Universal Health Coverage (UHC): The report argues for a “reset” to UHC, proposing a modular approach, focusing on delivering 19 core modules that target the 15 priority conditions. These modules include interventions like childhood vaccinations, maternal care, and palliative care.
• The “Arrow Mechanism” for Financing Health: A proposed system to publicly finance a focused set of essential medicines, vaccines, and diagnostics for the 15 priority conditions. It includes: redirecting budgets toward these items, centralized pool procurement to ensure availability, and strengthening public and private supply chains.
• Tobacco is Still the New Tobacco: Tobacco use remains the leading avoidable cause of premature death worldwide. Increasing tobacco taxation is deemed the most effective intersectoral policy for achieving the “50 by 50” target.
• Pandemic Preparedness: The risk of another pandemic of Covid-like magnitude is high, with an estimated 20% likelihood within the next 10 years. Public health fundamentals, such as early case isolation, test-and-trace systems, and financial and social support during quarantines, are critical to mitigating deaths while awaiting vaccines.
• Development Assistance for Health: External financial and technical support remains essential, particularly for countries with limited resources. Focus areas include disease control, pandemic preparedness, antimicrobial resistance (AMR), and developing new health technologies.

The report features notable Bay Area representation, with five of its 50 authors hailing from the region. Four of these contributors, including Dean Jamison (UCSF), Stefano Bertozzi (UC Berkeley and former Alliance board member), Shuchi Anand (Stanford), and Justina Seyi-Olajide (Lagos University Teaching Hospital and McGill) joined moderator Michele Barry (Stanford and Alliance board member), to share reflections of the report and explore how its messages can translate into actionable progress across global health.

Anand drew attention to the report’s premature death metrics, noting that a “30% probability of premature death for people under 70” reflects both a substantial challenge and a sign of progress in global health. She conveyed optimism, emphasizing that the report demonstrates advancements as a global health community.

Seyi-Olajide shared insights on reducing premature mortality by 50% by 2050, stressing that “focusing on 15 priority conditions, tailored to local contexts” could make this goal achievable. She underscored the importance of strengthening surgical systems, explaining that “surgery plays a key role in halving premature mortality” and should be prioritized within health systems. 

In thinking about the effects greater degrees of environmental threat and hazardous health exposures will have on NCDs, Anand noted that “chronic conditions are being amplified by climate change,” highlighting the effects that heat stress and lack of access to clean water can have on people with chronic conditions such as diabetes or kidney disease, particularly in lower-resource settings. 

Bertozzi reflected on the role of government intervention, citing the success of Covid-19 vaccine distribution as an example, “The public sector’s role in global health, especially during emergencies, is vital.” Regarding Covid-19 country mortality rankings,  Jamison observed that early in the pandemic, countries with strong public health and social measures, like Japan and China, performed well. However, he noted that the landscape had changed significantly by the end of the emergency period, with the virus’s transmission efficiency increasing and previously effective measures no longer providing the same results.

In thinking about how global health will change given the new administration, Bertozzi noted, “I think we have to play the hand that we’re dealt, not the hand we wish we were dealt. We have to look at opportunities, one of which is the difference between rhetoric and action,” sharing that the U.S. withdrawal from the WHO does not mean that the U.S. will stop collaborating with global efforts that are coordinated by WHO.

Jamison also emphasized that during their work on the commission report, there was a transition where they started to ask, “What are the messages for national governments and for regional organizations?” This indicated a shift in focus from national to regional actors, noting that “the decisions coming out of Washington are less important for countries,” with important actors, like the Africa CDC and WHO’s regional offices, becoming much more dispersed.

Reflecting on the path forward, moderator Neelam Sekhri Feachem (UCSF IGHS) was joined by Mike Reid (PEPFAR), Neha Agarwal (PATH), Thu Do (Gilead Sciences), and Tomás Aragón (California Department of Public Health) to share their thoughts on how to achieve the goal of “50 by 50”.

Reid pointed out how the new administration has been articulating an “America first” vision, so it is important to highlight how investments in global health can benefit both the U.S. and the world. “America’s contributions to global health can have a big impact, not just for Americans, but for people around the world,” he shared. However, he also emphasized the importance of countries taking more ownership of their health programs, especially those that have been traditionally funded by international donors, like PEPFAR. “Countries that have received sustained amounts of donor assistance need to be able to fund and respond to their own health needs,” stressing that strengthening local health systems is crucial for long-term success.

With the advancement of technologies, particularly artificial intelligence (AI), Agarwal shared that we should be cautiously optimistic and noted that leveraging AI has some tangible benefits. “The first fully AI-generated drug target just initiated phase 2 clinical trials,” she said. “AI is helping predict molecular structures and human targets, cutting down development time and costs significantly.” She emphasized that while AI isn’t the solution to everything, it’s proving to be a powerful tool in speeding up research and improving our response to global health challenges.

Do spoke about the importance of delivering innovations to the people who need them the most, especially in low-resource settings. “Most of the progress we’ve made in reducing child mortality has been due to new medical therapies,” she said. “But getting these therapies to the people who need them is just as important as the innovation itself,” stressing that access and delivery are key to making a lasting impact on global health.

In thinking about California, and the broader global health context, Aragón brought attention to the growing mental health challenges. “Mental health issues, whether caused by behavior, substances, or digital misinformation, are a major threat to public health,” he said, urging that addressing these challenges be a priority in public health efforts. He also emphasized that to build trust among communities and combat the effects of misinformation, it is important to be able to answer the four questions communities want to have answered: “Can I believe you? Do you care about me? Can you deliver? Can I count on you?” 

​​Looking toward the future, the panelists agreed that students and young professionals are the “50 by 50 generation” who will be key to driving these forward-thinking solutions. “The most effective solutions won’t be silver bullets. Most progress will come from well-designed partnerships. Young professionals should seek opportunities to work in diverse teams and embrace challenges to their assumptions using nuanced local evidence,” Do advised. 

In closing remarks, Address Mauakowa Malata (Malawi University of Science and Technology) stressed the need for leadership, collaboration, equitable partnerships, and prioritization of ownership and accountability, stating “As we move forward, as we reflect on this publication, we must look at what needs to be done at every level to ensure that 50 by 50 is achievable.”

 

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Speaker Bios

 

Neha Agarwal, Senior Director of Strategy, Office of the President, PATH; Alliance Board Vice Chair

Neha Agarwal is a passionate advocate for global health equity and approaches her work with a strong vision for sustainability, respectful collaborations, innovation, and analytical rigor. She has over 15 years of experience in global health and the life sciences. Agarwal is currently the senior director of strategy, Office of the President, PATH, and formerly global diagnostics program co-director for PATH, where she led a team responsible for improving and ensuring equitable access to essential diagnostic products in resource-limited settings. She held previous global health roles at the Clinton Health Access Initiative (CHAI) and Applied Strategies. Agarwal has focused on bridging partnerships between industry, governments, and the non-profit sector in her various roles. Prior to her transition to global health, Agarwal’s career focused on innovative product development at companies such as Johnson & Johnson and Verinata Health (now Illumina), earning her several patents for lab-on-chip and drug delivery technologies. Agarwal is passionate about utilizing the talent, scientific rigor, and innovative energy of the Bay Area to achieve health equity around the globe. She has several publications, holds four patents, and received her MS in biomedical engineering from Columbia University and her BS in bioengineering from the University of California, Berkeley.

 

Shuchi Anand, Director of the Center for Tubulointerstitial Kidney Disease at Stanford University

Shuchi Anand, MD, MS, is the director of the Center for Tubulointerstitial Kidney Disease at Stanford University. She received her medical degree from Washington University School of Medicine in St. Louis and completed internal medicine training at Brigham and Women’s Hospital (Partners Healthcare, Harvard Medical School) in Boston. She completed a master’s degree in Clinical Epidemiology and a nephrology fellowship at Stanford University School of Medicine. Anand is engaged in clinical research to advance the care of patients with kidney disease living in low-resource settings using practical tools. She has active projects in collaboration with the University of Utah to promote exercise programming for underserved populations, with the Center for Chronic Disease Control in India to study risk factors for kidney disease in South Asians, and with Kandy Hospital Sri Lanka to investigate chronic kidney disease of unknown etiology affecting agricultural communities. During the COVID-19 pandemic, Anand also participated in partnership to elucidate sero-epidemiology, vaccine acceptance and response to vaccination among patients on dialysis. She is part of two NIH consortia focused on improving the health of underserved populations.

 

Tomás Aragón, Director of the California Department of Public Health

Tomás Aragón has served as the director of the California Department of Public Health and the State Public Health Officer since January 4, 2021. Before coming to CDPH, he was the health officer for the City and County of San Francisco and director of the public health division. Aragón has served in public health leadership roles for more than 20 years (communicable disease controller, deputy health officer, health officer, community health and chronic disease epidemiologist), including directing a public health emergency preparedness and response research and training center at the University of California, Berkeley School of Public Health. As CDPH director, striving to embody and promote the universal values of dignity, equity, compassion and humility, he works through collaborative partnerships to mobilize communities and institutions to transform policies and systems towards a culture of equity, antiracism, healing and health for all people and our planet. As the State Public Health Officer, he exercises leadership and legal authority to protect health and prevent disease. Aragón graduated from the University of California, Berkeley (BA, Molecular Biology; DrPH, Epidemiology), Harvard Medical School (MD), Harvard School of Public Health (MPH), and Stanford University (certification in Strategic Decision and Risk Management in Healthcare). He completed his clinical and research training at the University of California, San Francisco (San Francisco General Hospital Primary Care Internal Medicine; Clinical Infectious Diseases; and Traineeship in AIDS Prevention Studies).

 

Michele Barry, Senior Dean for Global Health; Director, Center for Innovation in Global Health, Stanford University; Alliance Board Member

Michele Barry, MD, FACP, is the senior associate dean for global health and director of the Center for Innovation in Global Health at the Stanford School of Medicine. As director of the Yale/Stanford Johnson and Johnson Global Health Scholar Award program, she has sent over 1000 physicians overseas to underserved areas to help strengthen health infrastructure in low-resource settings. As a past president of the American Society of Tropical Medicine and Hygiene, Barry led an educational initiative in tropical medicine and travelers’ health, culminating in diploma courses in tropical medicine both in the U.S. and overseas, as well as a U.S. certification exam. Barry is an elected member of the Institute of Medicine and National Academy of Science and past chair of the Interest Group on Global Health, Infectious Diseases and Microbiology at the IOM. She has been listed as one of the best doctors in America. She serves on the board of directors of the Bill and Melinda Gates-funded Consortium of Universities Involved in Global Health (CUGH), the Foundation of the Advancement of International Education (FAIMER), and the Bay Area Global Health Alliance.

 

Stefano Bertozzi, Former Dean and Professor of Health Policy & Management, University of California, Berkeley School of Public Health

Stefano M. Bertozzi is a former dean and professor of health policy and management at the UC Berkeley School of Public Health. Previously, he directed the HIV and tuberculosis programs at the Bill and Melinda Gates Foundation.  Bertozzi worked at the Mexican National Institute of Public Health as its Center for Evaluation Research and Surveys director. He was the last director of the WHO Global Programme on AIDS and has also held positions with UNAIDS, the World Bank, and the government of the DRC. He is the founding editor-in-chief of Rapid Reviews Infectious Diseases (RRID), an open-access, rapid-review overlay journal for the accelerated curation and peer review of infectious disease-related research. He serves or has served on governance and advisory boards for the Bay Area Global Health Alliance, the Tsinghua Vanke School of Public Health, the Global Virus Network, the East Bay Community Foundation, HopeLab, the Institute for Transformative Technologies, UNICEF, WHO, UNAIDS, the Global Fund to Fight AIDS, Tuberculosis and Malaria, PEPFAR, the NIH, Duke University, the University of Washington, and the AMA. He has advised NGOs and ministries of health and social welfare in Asia, Africa, and Latin America. He is a member of the National Academy of Medicine. 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.

 

Thu Do, Medical Director with Gilead Patient Solutions 

Thu Do is a medical director with Gilead Patient Solutions, a team dedicated to providing access to medicines in low and lower-middle-income countries. Her 10 years in global health have focused on the intersection of how the private and public sectors can increase access to innovations in health care services and commodities. Previously, she was director of global policy and advocacy at Malaria No More, where she led efforts with the U.S. government, international donors and endemic country governments to prioritize and mobilize resources for malaria elimination. Previously, she led the Programs, Policy & Evaluation team for Novartis Social Business, a unit dedicated to increasing the affordability and availability of essential noncommunicable diseases and malaria medicines for low-income patients. She has also worked in the public sector at the U.S. Agency for International Development (USAID) Office on Family Planning and Reproductive Health and at Results for Development in Washington, D.C. on a portfolio to scale Water, Sanitation, and Hygiene (WASH) programs across east Africa and India. Do holds an MPH in Health Policy and a BA in Ethics, Politics & Economics from Yale University. She has published on women-centric perspectives for creating health-functional markets to address the unmet global need for contraception and has led impact evaluations of access-to-medicine initiatives.

 

Neelam Sekhri Feachem, Associate Professor, Epidemiology & Biostatistics, UCSF IGHS

Neelam Sekhri Feachem has over 30 years of experience in health policy, financing, and management of health care systems. She served as health financing and policy advisor at the World Health Organization from 2003 to 2007, where she provided technical and policy guidance to a wide range of countries on health financing, focusing on private and public insurance and methods to complement public financing with private funding instruments. Most recently, Feachem served as senior vice president for global access and alliances at Napo Pharmaceuticals, a biopharmaceutical firm. As founder of The Healthcare Redesign Group Inc. since 1994, Feachem heads a consultancy firm recognized by the San Francisco Business Times as one of the fastest-growing privately held companies in the San Francisco area. She advises governments and international organizations on health reform, financing, and policy. Feachem previously spent 14 years with Kaiser Permanente, holding executive positions in hospital and medical group management, organizational development, and finance. She has served on various Boards, including the Commercial Advisory Board of the British National Health Service, the Working Group on Private Insurance for the Organization for Economic Development and Cooperation (OECD), INMED Partnerships for Children, and the Board of Directors of the Alameda County Medical Center.

 

Dean Jamison, Emeritus Professor, Epidemiology & Biostatistics, UCSF IGHS

Dean T. Jamison is an emeritus professor in the Institute for Global Health Sciences at the University of California, San Francisco. In addition to UCSF, Mr. Jamison has been with UCLA and the University of Washington and served as the T. & G. Angelopoulos Visiting Professor at the Harvard Kennedy School and the Harvard T. H. Chan School of Public Health (2006-2008). Jamison previously worked as a research economist and manager of the World Bank’s Education Policy Division and its Health, Nutrition and Population Division. Jamison was lead author for the Bank’s 1993 World Development Report, Investing in Health. He studied at Stanford (MS, Engineering Science) and Harvard (PhD, Economics, under K.J. Arrow). In 1994, he was elected to membership in the Academy of Medicine of the U.S. National Academies of Science, Engineering and Medicine. He was co-chair with Lawrence H. Summers of The Lancet Commission on Investing in Health (The Lancet, December 2013). Most recently, he led work on the nine-volume Disease Control Priorities series from the World Bank and was the lead author of its synthesizing publication.

 

Address Mauakowa Malata, Vice-Chancellor at the Malawi University of Science and Technology

Address Mauakowa Malata is vice-chancellor at the Malawi University of Science and Technology, the first woman to hold the position of vice chancellor of a public university in Malawi. Malata’s previous positions include: NYU Rory Meyers College of Nursing Courtesy Appointment, October 2023; vice president of the International Confederation of Midwives; president of the Africa Honor Society of Nursing of Sigma Theta Tau International; and principal of Kamuzu College of Nursing where she led efforts to become a World Health Organization Collaborating Centre for Inter-Professional Education and Leadership in 2016. 

Malata has spearheaded the development and implementation of various undergraduate and postgraduate degrees in nursing, midwifery, health, science, innovation, and technology, and she has facilitated capacity building for faculty and other staff in various fields. She is a renowned international speaker, author and editor of multiple journals in health, nursing, midwifery, and health workforce. Malata serves on various international, regional and national boards. She is an advocate for girls’ and women’s empowerment through education. Her research focuses on maternal and newborn health, quality of care, health workforce, innovation, and technology. She is a Virginia Henderson Fellow of Sigma Theta Tau International (STTI), an adjunct professor at Michigan State University, a fellow of the American Academy of Nursing (FAAN), a global health fellow at the University of California San Francisco, and an adjunct professor in the Department of Obstetrics and Gynaecology, Baylor College of Medicine. She was awarded a Doctor Honoris Causa by the University of Oslo in Norway, 2018 ECU Distinguished Alumni and ECU Honorary Award of Doctor of Nursing Honoris Causa, 2019 in Australia. In 2022, she was nominated as one of the Champions for Malawi Vision 2063 under Enabler, Human Capital Development. In 2023, she received the National Outstanding Award (Educational Achievements, Women Change Makers Science and Research) under Pan African Learning and Global Network and Plan Malawi International. Malata was named a recipient of the 2024-2025 UCSF Presidential Chair Award and is a distinguished visiting professor in the UCSF Department of Epidemiology and Biostatistics.

 

Payam Nahid, Executive Director, UCSF IGHS

Payam Nahid, the Haile T. Debas Distinguished Professor of Global Health, serves as the executive director of the UCSF Institute for Global Health Sciences (IGHS). Nahid has over two decades of experience in global health research, specializing in clinical trials and translational research focused on TB and HIV/TB co-infection. He has spearheaded international programs funded by the NIH, CDC, USAID, and BMGF, developing new TB diagnostics and therapeutics. In 2009, he co-founded the Vietnam National TB Programme-UCSF Research Collaboration Unit to promote equitable international research activities. As the senior research advisor for the USAID-funded Supporting, Mobilizing and Accelerating Research for Tuberculosis Elimination (SMART4TB), Nahid directs the consortium’s research strategies. Nahid also directs the UCSF Center for Tuberculosis and oversees the Tuberculosis Research Advancement Center at UCSF and UC Berkeley, which supports TB investigators on both campuses. Nahid has led WHO Task Forces and international practice guidelines. He is an appointed member of the WHO Strategic and Technical Advisory Group on TB (STAG TB) and is a board member of the Bay Area Global Health Alliance.

 

Mike Reid, Chief Science Officer, U.S. Department of State’s Bureau of Global Health Security and Diplomacy (GHSD) – PEPFAR

Mike Reid is chief science officer in the U.S. Department of State’s Bureau of Global Health Security and Diplomacy (GHSD) – PEPFAR. Reid is a practicing infectious disease physician with 15 years of experience in academic global health. He has published over 100 publications, mostly related to HIV, TB, and COVID-19 implementation science research in diverse settings in sub-Saharan Africa.

 

 

Justina Seyi-Olajide, Pediatric Surgeon, Lagos University Teaching Hospital 

Justina Seyi-Olajide is a pediatric surgeon and PhD researcher focused on improving access to safe, high-quality surgical care in low-resource settings. She is the recipient of the 2013 West African College of Surgeons Alinta Nwako Prize for the best graduating trainee in pediatric surgery. She is passionate about global surgery, neonatal surgery, pediatric urology, surgical education, and research. Seyi-Olajide advocates for global surgery, and her work emphasizes strengthening health systems, improving pediatric surgical outcomes, and promoting equity in health care access. She serves as a board member of the Global Initiative for Children’s Surgery, a commissioner on the Lancet Commission on Investing in Health, a project team member for the Pan-African Pediatric Surgery E-learning Programme, and treasurer and technical team member of the Pan-African Surgical Healthcare Forum. She also chairs Nigeria’s National Surgical, Obstetric, Anesthesia, and Nursing Plan Revision Committee and Technical Sub-committee, as well as the DEI Committee of the Association for Academic Global Surgery. Additionally, Seyi-Olajide is a passionate mentor for medical students, trainees and future surgeons, particularly women in medicine. Through roles in national surgical planning and global collaborations, she works to create sustainable, locally driven solutions to improve surgical outcomes worldwide.

 

Gavin Yamey, Director, Center for Policy Impact in Global Health, Duke Global Health Institute

Gavin Yamey, MD, MPH, MA, is the director of the Center for Policy Impact in Global Health based at Duke Global Health Institute (DGHI). The Center is an innovative policy lab that addresses critical challenges in financing and delivering global health. He is the Hymowitz Professor of the Practice of Global Health at DGHI and a professor of the practice of Public Policy at the Duke Sanford School of Public Policy. Yamey is the associate director for policy at DGHI. He is on the core faculty of the Duke Margolis Center for Health Policy and affiliate faculty of Duke Science and Society. He leads the global health track in the Duke Global Policy (DGP) Program in Geneva. He is on the advisory board of the World Food Policy Center at Duke.

He trained in clinical medicine at Oxford University and University College London, medical journalism, and editing at the BMJ and public health at the London School of Hygiene and Tropical Medicine. He was deputy editor of the Western Journal of Medicine, assistant editor at the BMJ, a founding senior editor of PLOS Medicine, and the principal investigator on a $1.1 million grant from the Bill & Melinda Gates Foundation to support the launch of PLOS Neglected Tropical Diseases. In 2009, he was awarded a Kaiser Family Mini-Media Fellowship in Global Health Reporting to examine the barriers to scaling up low-cost, low-tech health tools in Sudan, Uganda, and Kenya. Yamey has served as a commissioner on four previous Lancet commissions: the Lancet Commission on Tuberculosis, the Lancet Commission on Investing in Health, the Lancet Commission on Global Surgery, and the Lancet-SIGHT Commission on Peaceful Societies Through Health and Gender Equality. He chairs the international advisory committee to the Lancet Commission on Global Hearing Loss. He co-chairs the Partnership for Maternal, Newborn and Child Health’s Finance and Economics Working Group. He has been an external advisor to the WHO, TDR, and the Special Program for Research and Training in Tropical Diseases. Dr. Yamey has published extensively on global health, neglected diseases, health policy, and health disparities. He is a frequent commentator on National Public Radio and is a columnist for TIME magazine. He has written widely for popular media, including the Washington Post and USA Today. He has published over 250 articles in peer-reviewed journals. Before joining Duke, Yamey led the Evidence-to-Policy Initiative in the Global Health Group at the University of California, San Francisco (UCSF) and was an Associate Professor of Epidemiology & Biostatistics at the UCSF School of Medicine.