© 2022 Courtesy of the White House
In February, 2022, US President Joe Biden appointed global health physician and epidemiologist Raj Panjabi as a Special Assistant to the President and Senior Director for Global Health Security and Biodefense at the White House National Security Council in Washington, DC, which advises Biden on foreign policy and security issues. In this position, Panjabi's presence ensures that global health threats “are considered in discussions of national security and foreign policy, and are not an afterthought”, said Jennifer Kates, Senior Vice President and Director of Global Health and HIV Policy at the Kaiser Family Foundation, Washington, DC. Panjabi's role puts him at the centre of the COVID-19 response, and his priorities include coordinating a global response strategy to fulfil Biden's pledge to vaccinate at least 70% of the world's population. Panjabi also wants to “strengthen the architecture for preventing the next pandemic and prepare to respond to the next pandemic”, he said. On the home front, he said updating the public health infrastructure is crucial “to ensure that the USA is prepared for any biological incident whether that is naturally occurring, accidental, or deliberate”.
Panjabi's journey to the White House began in 1990 nearly 4700 miles away, when his family escaped the violent civil war in Liberia in a military rescue plane going to Sierra Leone. They later settled in the USA. “I still can remember my heart racing and I looked out the hatch and saw hundreds of others who frankly didn't look like me. We were allowed to evacuate but people who were Black Liberians were restrained by soldiers to keep them from being evacuated. That experience for me—being a 9 year old at the time—was formative in the sense that I didn't know why things were wrong but I knew something was morally wrong.” Over a decade later, the terrorist attacks in the USA on Sept 11, 2001 reminded Panjabi of “the violence I had experienced and borne witness to as a child in Liberia”, he continued. “And that made me wonder where extremism and inequities come from”, he said. “Some of the most striking inequities are in health and Liberia was a good example of how deep inequities can run. I decided then that I wanted to dedicate my life to working on trying to close those inequities in health.”
His training in medicine equipped Panjabi to pursue this goal, but it was his work as a volunteer back in Liberia that proved influential. Panjabi earned his medical degree in the USA from the University of North Carolina School of Medicine and trained in internal medicine and as a clinical fellow at Massachusetts General Hospital and Harvard Medical School. He also received a master of public health in epidemiology from Johns Hopkins University. In 2005, he took time off during his studies to return to Liberia and volunteer with the Ministry of Health to help rebuild the country's health-care system. What happened next is what Panjabi considers his “big break”. He was assigned to a hospital deep in the rainforest that had been bombed in the civil war. Half its roof was still missing, there was electricity for only a few hours a day, and no running water. “It was in that hospital where I started seeing patients with HIV”, he said. The hospital had tests to confirm the diagnosis but no treatment, which only doctors could prescribe. “I worked with the health ministry to come up with a new model of health care, which was to hire and train nurses and other front-line clinicians, as well as community health workers to…decentralise HIV treatment.”
That pivotal experience led Panjabi to launch Last Mile Health, a US-based non-profit organisation to “take that very simple idea of a community-based approach to fighting infectious diseases and scale it up”, he said. It started with US$6000 in seed money he and his wife received in lieu of wedding gifts when they were married in 2007. Panjabi eventually became an Assistant Professor at Harvard Medical School's Division of Global Health Equity, under the mentorship of the late Paul Farmer, and Associate Physician at Brigham and Women's Hospital in Boston, MA, USA. For the next 15 years Panjabi divided his time between teaching, caring for patients, and his role as the Chief Executive Officer of Last Mile Health, which now has over 200 staff who work in five African countries to support rural community health workers.
In February, 2021, Biden appointed Panjabi as the US Global Malaria Coordinator for the President's Malaria Initiative (PMI), where he managed a $770 million budget to fight malaria in almost 30 countries. Less than a year later, Biden tapped Panjabi again, this time to become a senior adviser and join the National Security Council. “It seems like a great job for Raj”, said Joseph Rhatigan, Interim Chief of the Division of Global Health Equity at Brigham and Women's Hospital, who recruited Panjabi to work there. “His strength is in implementing health solutions for marginalised communities”, Rhatigan said. “He's very able to navigate complex systems and…he is a patient-centred doctor trying to improve the patient experience and patient health.” Kates added that Panjabi “is highly regarded in the global health community” and “he brings on the ground experience, as well as an incredible depth of experience internationally”.
Since US Congress cut international aid to tackle COVID-19 in April, 2022, it may not be easy for Panjabi to sustain a global response to COVID-19, but he is undaunted. “The health of one is connected to the health of all,” he said. “We need to ensure treatments and vaccines are accessible to people in places like rural Liberia if we are serious about keeping the world safe from infectious diseases.”