A microbiologist and global health doctor
Peter Piot talks about the Ebola virus, HIV, and global health challenges
Peter Piot is a microbiologist and global health doctor. He co-discovered the Ebola virus in 1976, two years after graduating from medical school. He has also researched HIV. Piot is director of the London School of Hygiene and Tropical Medicine. He was the first director of the United Nations’ AIDs programme (UNAIDS) and has been under secretary general of the United Nations and president of the International AIDS Society. He received his medical degree from the University of Ghent in Belgium in 1974, and a PhD in microbiology from the University of Antwerp in 1980.
Why did you choose to pursue a career in medicine?
I started out in engineering because I was interested in mathematics, science, and technology, but my main interest is the combination of people, science, and society, which all come together in medicine. I also wanted the opportunity to see the world and work in other countries, and a medical degree is like a passport to the world.
Why did you choose infectious diseases as your specialty?
Firstly, because of a professor who was very inspiring, and because I was fascinated by the interactions between microbes and man. Secondly, there was my growing interest in the tropics where infectious diseases were still the main cause of mortality. I did a PhD in microbiology to learn more about these fascinating microorganisms and pathogens.
What inspired your transition to global health?
The term “global health” didn’t even exist when I graduated in 1974, but I always had a keen interest in helping developing countries. I come from a village near where Father Damian, a local saint in Belgium who dealt with leprosy, had lived. I often went to his museum and that inspired me.
I stopped seeing patients in 1994 when I moved to UNAIDS. The transition from clinical work wasn’t easy. It would have been irresponsible to combine the two, but I still have a lot of interaction with people as part of my work, and ensure that I have frequent contact with people living with HIV so I can understand what their problems are. When you see a patient, you help that individual, and that’s the essence of medicine, but in the global health work I did, you know you are potentially helping millions of people. It’s about job satisfaction and the desire to make a difference.
What has been your greatest achievement?
Unveiling the big heterosexual epidemic of HIV in Africa. Discovering the Ebola virus was also quite exciting. The achievement I rank as top is putting AIDS on the world’s agenda. When I started work at UNAIDS there was no money; AIDS was not visible. I was able to bring this major health issue to the top of the world’s agenda, the first time any health problem had such prominence. Secondly, negotiating a lower price for antiretroviral drugs so that now eight million people in low and middle income countries are on antiretroviral therapy, compared with 200 000 10 years ago. To have brought people with HIV to the table, ensuring they are respected and can play a role and have their voices heard. This contributes to a much more effective response.
What has been your greatest challenge?
Politics and institutional resistance—it’s not enough to have the science and the technological solutions, it’s equally important to ensure the decision makers are on board. It’s never finished. In Russia HIV prevalence is increasing and the driver is injecting drug use. Still the government refuses to implement evidence based interventions such as needle exchange and harm reduction.
Do you have any regrets about your choice of career?
I never planned my career. I often find when I speak with students that they have planned out their career and the rest of their lives. I would say to these people: it never works out that way and is usually a guarantee for a boring life, and you also miss lots of opportunities. I’ve always tried to be prepared for what comes next.
What do you hope to achieve as director of the London School of Hygiene and Tropical Medicine?
We need to continue to work on the unfinished agenda of infectious diseases: HIV, malaria, and maternal mortality; and the new agenda that’s emerging in global health of chronic diseases: diabetes, obesity, cardiovascular disease, and mental health. That’s an area that we are developing because these are no longer problems only for the wealthy; it’s affecting the poor everywhere. India will soon have the highest number of obese people and of undernourished people in one country.
How can students contribute most effectively to improving global health?
The best idea is to connect with non-governmental organisations and charities of all kinds to see whether you can acquire real life experience. It doesn’t matter which specialty you’re going into, from general practice to anaesthesia to infectious diseases; the global health needs are everywhere and demand for good quality doctors is high. I also think it is useful to connect with fellow students in low and middle-income countries. Today, with Facebook and social networking it’s easy to be part of this developing international community of people interested in global health.
Do you have any advice for people with an interest in pursuing global health as a career?
I think it’s good to have another specialty before going into global health, but there is some additional training required. Also acquire as much experience as possible during electives and holidays.
What do you think will be the major global health challenges of the future?
Firstly, the unfinished agenda: polio is still there, it has to be eliminated, and we still have 300 000 women dying while giving birth every year—that’s unacceptable. AIDS is not over, and in contrast to what you might hear the end of AIDS is not in sight by any means. But the new challenges for the future will be the non-communicable diseases. Better prevention is going to be a huge challenge. How can we make sure that there is societal commitment to change the way we’re living, in terms of food, food production, and exercise? The solutions for the problem are nearly all beyond the medical sphere.
I also think we should globalise medical education in the United Kingdom and Europe so that it takes into account the world that exists outside the NHS.Emma Rourke, Clegg Scholar, BMJ
Correspondence to: firstname.lastname@example.org
Competing interests: None declared.
Provenance and peer review: commissioned; not externally peer reviewed.
Cite this as: Student BMJ 2013;21:f3275