From the Bench to the Bank: Q&A with Dr. Debrework Zewdie

Dr. Debrework Zewdie


Throughout her career, Dr. Debrework Zewdie has created and led HIV/AIDS programs with a global reach. As Director of the World Bank’s Global HIV/AIDS Program, she developed the Bank’s Multi-Country AIDS Program that committed one billion dollars to the global AIDS response. She has also served as Deputy Executive Director/COO at the Global Fund to Fight AIDS, Malaria, and Tuberculosis and was a founding UNAIDS Global Coordinator. A native of Ethiopia, Dr. Zewdie has a PhD in clinical immunology from the University of London. She is currently a Menschel Senior Leadership Fellow at the Harvard T.H. Chan School of Public Health.

Dr. Zewdie sat down with Martha Henry, HAI’s Director of Communications, to answer a few questions.

HAI: When you began your career as a clinical immunologist in Ethiopia, how did you think your work life would play out?

Dr. Debrework Zewdie: When I finished my first degree in Ethiopia, I joined the National Research Institute of Health. I was working with a British immunologist. The idea was for him to mentor me and then for me to replace him. I was very happy working on the bench. I stared with sexually transmitted diseases. Then AIDS came. It was both depressing and exciting. There was a lot to be done, so I never thought I would leave the lab.

How did you make the switch from being a research scientist to being in more of a management/leadership position?

Dr. Debrework Zewdie,
Dr. Debrework Zewdie, photo by Emily Cuccarese, Harvard Chan

The Minister of Health had been in Geneva at a World Health Organization (WHO) meeting [about HIV/AIDS]. He came back and asked me to form a task force. I said, “Why? We don’t have anything here.” He said, “We need to be prepared.” We formed a task force and I chaired it. In less than a year, we identified the first case in [in Ethiopia]. This was 1986.

The National AIDS Control program was established. One day I was called to the Minister’s office. He told me that I should lead the program. I said, “No, I love my lab. I’m a bench scientist, not a bureaucrat.” He gave me a few days to think about it.

My boss at the Institute had also been my professor. He said, “Listen, I don’t think you’ll make that much difference as a bench scientist in a developing country. If you take this position, you will be able to do both your research and to help. You’ll make a difference if you go into policy and strategy.” So I said okay.

You’ve held top leadership positions in multinational organizations such as the World Bank, the Global Fund, and UNAIDS. How do you set priorities with limited resources?

 Resources will always be limited, time is always limited, so having a clear agenda is important. What’s the most important thing to do first and why? Where can you put your money and resources to prevent the most new infections? What is going to give you the most impact? Knowing the data, the evidence, and what will give you, not the quickest answer, but value for the money.

Who are the leaders in HIV/AIDS you’ve admired most throughout your career?

Jonathan Mann, who was the global program director for AIDS at the WHO. It was an inspiration to listen to him. You could see how committed he was. I think I heard the words “global solidarity” from him first and that has stayed with the AIDS movement. And then later, Peter Piot [Founding Executive Director of UNAIDS]. And, of course, Max [Essex].

How important is it to have a mentor?

It’s very important. And it’s very important to have a good boss who can see your potential and help you grow. I was very lucky. I had both.

Of all the contributions that you’ve made, which are you most proud of?

The $1 Billion Project at the World Bank. This was at a time when there was no Global Fund, no PEPFAR [President’s Emergency Plan for AIDS Relief]. We were preaching to countries that they should have a national program, yet not a single country had the resources to scale-up to a national level. So for the Bank to come up with a billion dollars and say to most of these sub-Saharan and Caribbean countries, we are here until you build sustainable capacity, that was the biggest achievement.

If you had to give a commencement address is just a few sentences, what would you tell graduates?

I would tell them to make the most out of the knowledge that you get at this school. You need to arm yourselves with the best knowledge, the best evidence. Then go out to do good.

How did HIV/AIDS change Africa’s relation to the rest of the world?

Tremendously. Although development aid has been there for a long time, the global solidarity I mentioned earlier is something that we saw in HIV/AIDS. It wasn’t just a matter of giving money or of experts going from the north to the south to do their own research. You see total commitment. That’s very different.

What do you think is most difficult for people in America to grasp about AIDS in Africa?

Dr. Debrework Zewdie
Dr. Debrework Zewdie

I’m not sure if the American public, except the people who work on AIDS or are in academic institutions, knows the significance of the problem in sub-Saharan Africa and why it’s important that the whole world rallies behind this. It’s not just an African problem.

Most people in the U.S. think that the U.S. gives a lot of money for development aid which they need here themselves. But then if you ask them if the U.S. should give money, they’ll say yes. If you ask how much, they’ll say not more than ten percent. The U.S. gives less then one percent. So that knowledge is not there.

I think that people in general are compassionate. We have to show people that giving is not from us, the rich, to them, the poor. It’s a global community. And a disease such as AIDS or Ebola is a global problem.

Do you think we’ll see an end to the AIDS epidemic in your lifetime?

I don’t think so.

In your children’s lifetime?

Yes.

Click here to watch Dr. Debrework Zewdie’s video interview in the Harvard T.H. Chan School of Public Health Voices in Leadership series.