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June 28, 2007

One on One: GSPH Dean Donald S. Burke

As dean of a public health school, Donald S. Burke fights the common perception that academia and field work are incompatible.

“The apparent tension between what kind of things you do in academia versus applied research, in some ways, that’s a false dichotomy,” Burke said in a recent interview. “I don’t subscribe to that at all. I think you can do really good stuff in both areas at the same time. That’s the ‘sweet spot’ where you want to be.”

A Cleveland native, Burke, who was recruited from the Johns Hopkins Bloomberg School of Public Health, wears a number of hats in addition to being dean of Pitt’s Graduate School of Public Health (GSPH), a post he filled last September.

Burke also directs Pitt’s new Center for Vaccine Research; serves as associate vice chancellor for global health, a newly created position in the Office of the Senior Vice Chancellor for Health Sciences, and is the inaugural holder of the UPMC-Jonas Salk Chair in Global Health.

As GSPH dean, Burke has academic oversight of the school’s more than 550 students, 150-plus primary faculty members and some 475 staff members in seven departments.

As director of the Center for Vaccine Research, which is housed in the Biomedical Science Tower 3, Burke oversees a regional biocontainment laboratory and is responsible for building a program that will develop, test, evaluate and produce vaccines against existing and emerging agents that have potential to cause harm to large populations as well as those that could be weaponized.

In his role of associate vice chancellor for global health, he coordinates the University’s varied global health activities. He is developing international research and education programs, with an emphasis on programs targeted to improve the health of poor and underserved populations.

“I don’t get a moment’s sleep. That’s the price,” Burke joked. “The management side of this is still a bit of a trick. I’m working harder than I ever have in my life. But I had been warned before I came to Pitt that there were potential problems between institutions at the University, as there are within any large university. So I had quite consciously decided to take these positions because it would allow me to operate within different institutions and at different levels in the University as a way to personally break down some of the barriers, and so far that’s worked okay.”

Burke recently talked with University Times staff writer Peter Hart about his first year as dean of GSPH and discussed what’s on his agenda for the future.


UNIVERSITY TIMES: As someone who came from outside the University, what are your general impressions of GSPH?

BURKE: One thing I am impressed by is how strong a research organization the school is. We’re third in the country among public health schools in NIH (National Institutes of Health) funding, and depending on how you calculate the total faculty headcount, we may well be first in the country in per-faculty research dollars from NIH, well ahead of Harvard and Hopkins and Columbia and our other competition.

One of the consequences of that is that we also are getting a pretty good return on our indirect costs, and that allows us some flexibility. And not only do we get more dollars in indirect costs per faculty, but we get more dollars in indirect costs per square foot in University-owned buildings compared to all the other schools at Pitt.

When you look at how we as a school of public health are nationally, or how we as a school in the University are, we have this wonderful research productivity that arguably is the best in the country and best in the University compared to other schools. When I look to see what is unique about us, it’s both those spheres.


Do you see subfields or subdisciplines emerging in public health that would affect your programmatic plans?

There are three areas that I want to foster. One is emerging infectious diseases. That fits very well with the Center for Vaccine Research, but I’m also talking about within our school of public health. I want to have new hires in that area.

One of my interests for many years is can we do better about predicting where the new diseases come from and preventing them, rather than waiting for them to erupt and trying to react to them.

In my personal research agenda I spent quite a bit of time in Africa studying cross-species transmissions and trying to decide how these viruses move from animal populations into humans. That’s the field side of things.

But I think there’s a disciplinary area to be developed in prediction and prevention. It’s almost at the ecology interface: You need to understand where are the viruses lurking in nature that could potentially erupt as new emergencies, and that means studying the animal populations in which they’re being transmitted, studying viruses that are not human viruses now, but could be.

Whether it’s AIDS or SARS (severe acute respiratory syndrome) or influenza, what they have in common is that they’re all in animal reservoirs, they all made the jump to humans probably because the animals were meat sources. So humans intentionally came in contact with the animals in the process of getting food ready to eat. This process is likely to occur again, so there are themes to explore.

We need to think about where the next epidemic is going to come from. And even though there’s a lot of uncertainty about that, my sense is we’re getting better and better at understanding the underlying processes.

A second area I want to promote is what I call computation in public health. It sounds pretty dry, and I’ve got to come up with a better marketing name, but there are tons of data coming out on the human genome and microbial genome and also, importantly, on human social networks, large data sets on who moves where, how you represent social networks and how information moves in populations, all of which are really important issues in public health.

I’ve done a fair amount of work on modeling and simulating infectious disease and I’ve been impressed how useful models have been in thinking through problems and in the development and evaluation of policies.

The best example is that we’ve made some computational simulations of epidemic flu in southeast Asia. We basically got all the data on population densities and represented all 80 million people as separate individuals, put them into households according to what we knew the household size and distribution was, put them into the workplace, put them into schools depending on age distributions, so we built a little society of people moving around in the computer that represented people in Thailand and southeast Asia, and then introduced influenza into that population using what we believed to be reasonable transmission parameters, and then traced how it moved.

And we looked at the differences if we treat the cases, or give prophylaxes to family members, or if we close the schools, and so forth.

You trial-and-error things, but you do it in silicon and not in reality, so you get to think through some of these problems by creating social simulations of contact processes, looking at who would infect whom. Then you can test out these strategies ahead of time.

On the basis of our models, the World Health Organization decided what the size of the stockpile of the influenza antiviral would be — 3 million — because our model said that would be the upper limit of what would be required.

Necessarily, to do this right requires a truly interdisciplinary activity. You need people who have strong computer skills, sociologic skills, epidemiologic skills, behavioral science skills.

Pittsburgh is wonderful place to try to bring that about with Carnegie Mellon and the universities that are here, the medical center, the strengths in engineering; a lot of the components are here.

I’ve got some money to launch a program in this. I can’t tell the faculty what to do, and it’s not my style anyway, but I can offer my vision and say here are some resources and if you think this is something you want to do, then I’ll be happy to try to help you move in that direction.

The third area is global health. This will take more time, because this involves getting a take on how the University sees its role in the international climate today.

If I had to compare us to other top 10 national universities in the health sciences, I would say we don’t have as much of an international footprint as the others do.

There may be historical reasons for that, but I think there are a lot of strengths that we can apply to the international arena and at the same time there are opportunities for the University in academics and research and financially that we should be looking at.

The international emphasis, so far, has tended to be more Euro-centric, and more focused on security and NATO and that kind of thing. What’s gone on so far in promoting international training has been the study abroad programs where you’re sending kids to learn how the other half lives, or groups that have had interest in giving students international experience.

That’s really not what I think about when I’m talking about international health. You need to establish long-term research relationships that can take easily 10 years to mature, where you’re actually working jointly on problem-solving.

I think what we’re going to do, although it’s still in the formative stages, is to make some modest investments in infrastructure in a couple key places around the world where we think there’s going to be strong partnerships with a medical and public health presence in those countries.

This is not the kind of thing you do as a drop-in, parachute kind of research. These have to been seen as long-term mature investments. You have to be diplomatic, but it’s really a philosophical question of how you view what it is you’re doing.

Global health is a Pitt-wide question and it’s longer term. I am being a little more cautious as I approach this issue. The other ones I’m pushing forward on: in emerging diseases and computation. Those are things I know about.


So is the global health initiative a major challenge?

Yes, but that’s okay. This is not a bad time for Pitt to be asking those questions. Given the enormous strengths in the Health Sciences, I really do believe there are real opportunities for us to make a difference in the world, and given that the stature of Pitt is increasing, this is a good time for Pitt to be looking at the next decade and saying where do we want to be 10 years from now.


How would you characterize GSPH’s relationship with UPMC?

The Graduate School of Public Health has not been an integral component with UPMC the way some of the other Health Sciences (schools) have been: With the UPP (University of Pittsburgh Physicians Practice Plan) and the School of Medicine, they’re hand-in-glove.

But times are changing, and the way medicine is being done there is this increased interest in prevention and what you can do about cost savings, and how you can reach out to the uninsured, and a lot of the things that are more fundamentally public health questions than they are traditional medical school questions, although, obviously, school of medicine questions are still very important.

When UPMC Health Plan had its retreat last year, I went along to spend some time with them and get a sense of what they do. They do wonderful work, and a lot of stuff they focus on in the plan is how do we get our people healthy, how do we prevent obesity, how do we prevent smoking, how do we treat our diabetics. These are very much bread-and-butter public health issues, so for us to be on the same campus, and not to take advantage of these synergies I think is something we need to pay more attention to.

I’ve been impressed with the health plan and particularly how big its membership is, as one of the largest plans in the country. If we’re looking for a place to test out strategies that could have national impact, this is a probably the right place to look. So I’m excited about that kind of stuff.


Are there other areas where GSPH will try to build or reinforce ties?

I’m just beginning to put some of these together as I get the lay of the land, but a good example of that, which I’m quite happy about, is our initiative for preventing and reducing smoking in the county and in Pennsylvania.

This seems to be an area that we could be helpful, but rather than to jump in and tell Allegheny County: “Here are the programs we need to do jointly,” I thought we should organize ourselves as a University first. I formed a steering committee from seven or eight departments across the University and we invited people from the county and the state with the message that it’s our job to help them in whatever way we can, not as researchers per se, but what can we do to fill in gaps in information or to evaluate information, that is, do the things that academics do: epidemiological statistics, or evaluation of health impacts or cost-benefit analyses.

I knew in general we wanted to strengthen our relationships in the areas of applied public health in Allegheny County and in the state. There are multiple reasons for doing that. One is a very parochial concern that I want us as a school to be seen as an important player in these areas, and I’d like to develop closer relationships with the state. Right now, it is exceedingly cumbersome for us to work with the state, and we need to find ways to expedite that. It’s in their interest to do that, too.

Here we are, one of the premier research institutions of public health in the country, and the state has lots of public health problems, not just smoking but influenza epidemiology, hepatitis vaccination, obesity, the epidemic of violence in the cities, you name it. We have people working on all those things.

I like the image of a university as being an activist and involved in problem-solving as well as in the research, theoretical and academic components.


Parran and Crabtree halls are in for a $40 million renovation under plans recently announced by Pitt. Will that affect research output for a time?

I don’t expect there to be any financial slowdown. There will be some dislocations, but we already have a number of our resources off-site at 19 sites.

There are two kinds of rental space: In one, it makes perfectly good sense to actually be out in the community where you’re doing your studies, and the other where there’s space pressure, where you actually need more space and you take it anywhere you can get it. We have both kinds; it’s about half and half. We have a fair number of people I’d rather have here [in Parran Hall] if we could.


Are the faculty nervous about the renovations?

Sure, of course. They should be. This is a major renovation while you’re occupying the building. We’re looking at four or five years for this. The question is how to maximize the space we have.

So far, we’ve got some tentative plans and cost estimates. Part of the challenge is: Are there creative ways to improve the lab space and overall space, and are there ways we can squeeze out some more square footage with add-ons here and there? We’ve got some places on the side of the building that we might add on, and on the top.

I’m a bit concerned that, although $40 million sounds like a lot of money, for a building that has not had a significant renovation since Crabtree was added 40 years ago, we have to replace virtually all the utilities, all the HVAC, all the electrical, all the mechanical, and there’s asbestos on top of that.

Particularly in the Parran building, which was built at a time when the floor-to-ceiling height was less than 11 feet, to try to put adequate ventilation in for modern laboratory spaces is a challenge — it will be tight. This building is not meant for modern laboratories.

Because of the difficulty in putting in utilities within the building, we might do it on the outside, like the Chevron Science Center. In the process of doing that, we may be able to create a new facade and gain a little more space. My concern is we’ll have very little money left over for what might be considered programmatic space.


Has the University’s multi-million dollar commitment to the school’s renovations helped GSPH’s fundraising efforts?

We have not structured fundraising around the renovations. I would very much like to raise additional funds for the building, whether that means establishing a separate fund, or asking for support for a particular laboratory or support for a new lobby through naming rights. Those are possibilities.

I’ve also been personally active in fundraising. The people you meet generally are pretty smart people, and our influential alums are influential because they’ve got talents and goals that make them interesting and successful people. So I don’t see fundraising as all that onerous.

One of the rules of fundraising, particularly with individuals, is that it takes multiple contacts: It takes a relationship. You can’t expect to just knock on a door, even if it’s an alum or someone who has an association with the University, and expect to get a large donation. They have to believe it’s worthwhile.

We have a development officer, but since I came here we’ve been without a director of external relations. I’m hoping pretty soon we’ll be hitting on all cylinders, and determining what our primary targets are for fundraising.


The school’s enrollment has been rising steadily. Is GSPH still in an expansion mode?

For this fall, we just passed last year’s number. One thing that happened this year is that most of the schools of public health got together on a joint online application system. But because the systems are changed everything was a bit slower this year, so I was nervous, because we were behind last year. But we’re not overtly trying to increase our enrollment by more than a few percent. We’ve had a substantial increase over the last few years: Since 2001 our enrollment has increased 32 percent.


Has anything surprised you during your first year at Pitt?

I would make the observation that I think I’m still in my honeymoon phase. So far, I won’t say I’ve been surprised, but pleased and gratified that people have been pretty good about doing what they said they would do, and promises that were made to me have been kept. I have no serious complaints about anybody welshing on the original agreements.

A year’s only a year, but so far, so good.

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