(bright music)
>> Good afternoon and welcome.
My name is Paul Rothman,
and I'm the Dean of the Medical Faculty
and the CEO here at Johns Hopkins Medicine.
It's my privilege to welcome you today
on this very memorable occasion.
You should be incredibly proud of yourselves.
You've succeeded in one of the country's best
and most rigorous programs,
a true testament of your hard work, resilience and talent.
I could have said this many years,
but this year it's especially true.
Over the past 14 months,
COVID-19 has thrown the world into disarray.
All of you who are graduating today
have shown great flexibility and dedication
in dealing with this extra ordinary situation.
Despite the interruptions and changes
that the pandemic has brought, you've persevered
and completed your training, congratulations.
I also wanna acknowledge the family and friends
who have supported you in innumerable ways
over the past year and really through your entire lives.
All of you have played a key role
in helping our graduates reach this point,
so thank you and congratulations.
You know for our new MDs and PhDs,
masters of art and masters of science,
these degrees open great possibilities for you.
Whether you're moving on to a residency program,
a postdoctoral fellowship, a teaching position,
a job in industry or some other professional stepping stone,
today marks the beginning of an exciting new chapter.
For graduating medical students,
I know you will touch the lives of many patients
through your compassionate care.
For the graduating PhDs,
I know you will unravel complex and important questions
that will help us better understand science
and the mysteries of the body.
As I consider this moment, I'm gonna take a step back,
maybe actually two steps back.
Let's go back over a hundred years to 1918.
Now that was time of another deadly virus ravaged the globe.
Now over 50 million people died
during the influenza of pandemic of 1918.
And at that time, the world's population
was only about a quarter of what it is today,
so 50 million people was a great number of people.
It was an incredibly difficult time for the public,
for patients and for clinicians.
What fascinates me about that event
was what happened afterwards?
You know, the world was transformed.
Know in 1918,
there was no treatment for the disease.
There were no tests for the disease.
We had very little understanding of the disease itself.
We actually didn't know very much about viruses.
In fact, initially flu was thought to be a bacteria
and not a virus.
At the time, no, there was no CDC. there was no WHO,
there was really no organized system of healthcare.
There was no access for physicians,
to physicians for many patients.
In addition, many people saw the illness
as an individual problem
to be solved at the individual level.
But the global scale of that catastrophe made it very clear
that that approach would not work.
The influenza pandemic
of 1918 triggered major changes in the world.
Now many countries developed natural healthcare systems
after that.
The US took a different tact,
we have our insurance space, but in fact,
even with that, we allowed greater access to healthcare
for many, many people,
both in the United States and throughout the world.
Today it's a century later, our healthcare system
is not flawless here or in other places of the world
and we see that taking its ravages today,
but it certainly was a lot better
than it was in 1918.
The 1918 pandemic also spurred scientists
to focus more on tracking patterns
of disease to better understand them
and to control outbreaks.
It stimulated creative research into viruses and vaccines.
Know as the case is much science,
it just takes a long time for science to play out
and to lead the treatments and cures.
There wasn't actually a flu vaccine that was widely used
until the 1940s.
It just took that long to understand how vaccines work
and to produce them at mass scale.
Now, let's take a leap forward, not from 1918,
but let's go to the early 1980s,
that's when I began as a physician
to a different virus that ravaged the world.
I graduated and entered internship in 1984.
At that time, the New York City, San Francisco
and many major cities were ravaged by a different virus
and that was HIV that caused AIDS.
It had a lot of similarities to 1918.
Initially we didn't even know it was a virus
that caused AIDS and when we did,
we had almost no tools to diagnose it.
Now, it was a smaller than the 1918 pandemic,
but it ravaged communities
and it was a very difficult experience.
It was difficult for patients and for their loved ones,
but it was very hard on those physicians
and clinicians nurses who were treating these patients
because we felt helpless.
You know, as a doctor, you wanna help people,
that's why you go into the profession.
But in the early 1980s,
it was just almost nothing we could do
to watch these many very young people die.
But just as it had done six decades early,
the pandemic triggered monumental social
and medical changes.
When AIDS first appeared,
there was an enormous stigma attached to it
both here and around the world.
In this country was seen as a disease of gay men.
In part because of this,
US government and pharmaceutical companies
gave the disease little attention and funding.
Frustrated by this inaction, the gay community responded.
Gay activists organized protests demanding more resources,
more respect and a voice in policies related
to research and treatment.
One of the key leaders
of this movement was the often activists, Larry Kramer.
He founded both the Gay Men's Health Crisis
and the AIDS Coalition to Unleash Power,
better known as Act Up.
Kramer's activism grew out of his sense of injustice
but it also came from the society
to help people like himself who was sick with the disease.
Here's what he had to say
about what motivated him to take action.
He said it was very scary to have death threat living
over your head.
Activism is very sustaining
but I don't view myself as a political person.
I'm just someone who desperately wants to stay alive.
The eighth activism of Kramer
and many others triggered changes.
Research and funding for HIV ramped up significantly.
The process of testing
and proving medicines was streamlined.
So the drugs would get to patients much more quickly
and patients became a larger part
of the discussion and conversation
about how to study and treat AIDS.
And these changes spread far beyond this particular disease
and helped transform the entire research landscape.
It's also important to mention
that AIDS activism has done a long way
to reduce longstanding prejudice
against the LGBTQ community.
The AIDS epidemic triggered other crucial changes too.
Many experts say it played a key role
in the spreading the idea of global health.
For example, since 2003, the US has spent more
than $90 billion to address the global AIDS crisis.
Much of that has gone to fund retroviral treatment
for patients in the developing world.
In 2005, only 2 million people worldwide
were receiving therapy.
Last year that has grown to over 25 million people.
Clearly, as we've seen over the past 15 months,
global health is an idea and a strategy
that has not been perfected yet.
But I think it's fair to say that the road's
a lot farther along than it was 20 or 30 years ago.
The AIDS pandemic has also led to enormous progress
in many areas of science and medicine.
At the beginning of the pandemic,
a positive HIV test was a death sentence.
That's no longer true.
With antiviral treatment,
AIDS has become a chronic disease,
difficult but usually not fatal.
We also have a much better understanding
how to prevent HIV transmission,
both medically and from a social standpoint.
So what do these prior pandemics have to do with today?
More precisely, what do they have to do
with you and your graduation?
We're in the midst of another pandemic.
In the US it seems to be a little bit easy.
There are only about 700 deaths a day right now,
but there's still more than 20,000 a month,
that's still an awful lot of people.
And the pandemic is raging around the world.
You know, as I take this today,
India and Brazil have huge outbreaks.
And so far less than 4%
of the world's population has been vaccinated,
so this is far from over.
As it continues,
this pandemic has already brought monumental medical
and scientific and social change.
For example, we've seen an explosion in telemedicine,
One change that I know things
aren't gonna go away anytime soon.
In addition, Ocala poll found that more
than half of US workers are working remotely.
I think that's another phenomenon
that's here to stay at some level.
I think that's gonna affect how we design offices
but also has effects on inequality
in the future of the cities.
So we'll have tremendous changes in our society.
COVID has also helped to highlight the longstanding issue
our country have with healthcare inequality.
Black and other people of color
are significantly more likely
than others to be infected by the virus and to die from it.
But these problems are apparent in almost every other area
of healthcare, from cancer rates to life expectancy.
The pandemic has just played a crucial role
in amplifying highlighting these urgent issues.
And of course over these 15 months,
there's been tremendous breakthroughs in research.
For three decades,
research had start to develop the technology
and the understanding to develop mRNs vaccines.
And this pandemic has demonstrated how important
and essential that technology is.
Pfizer and Moderna, those vaccines took less
than a year to develop, which is an amazing scientific feat.
But I don't wanna suggest
in any way that this chapter is finished.
I actually think this pandemic will continue
to change our profession, our country,
our world for decades to come.
This is where you come in.
This is your pandemic.
This is your moment.
You're the ones who bring these monumentous
as yet unrealized changes into being.
You're now embarking on a new phase in your career
in your life.
As you journey into the world,
you'll be the ones to make your patients' lives better.
You'll be the ones to make the discoveries
and develop the innovations that will help thousands
or millions of people.
You'll be the ones who accomplish the next great deeds
in science and medicine.
You may end up focusing on COVID or precision medicine
or cancer or social determinants of health,
or one of many many hundreds of other possibilities.
You could focus on AIDS or influenza.
There are so, so many opportunities,
but wherever you focus your energies I hope you think big
and work to bring positive social change
or increase opportunities for those without it
or help people here and all over the world
to live longer and healthier lives.
Or you can do all of these things at once.
With this degree, you're now part of an extraordinary group,
a long tradition of excellence
extending back more than a century.
I couldn't be more excited to see what all
of you will accomplish in your careers.
I have no doubt you'll seize this amazing opportunity.
Congratulations, this is a very,
very special graduation for me.
It is my 13th as a Dean,
but this one's really special for many reasons.
So congratulations to all
of you and good luck with your careers.