Since the very beginnings of the AIDS epidemic, hematologist/oncologist and former Harvard professor Richard G. Marlink has been at the forefront of the worldwide fight against the disease, on the ground and in the laboratory. He helped establish the first HIV/AIDS clinic in Boston, founded Botswana’s national AIDS training program, and was among the pioneering scientists in Senegal who discovered the second type of human AIDS virus, HIV-2. With his appointment as the inaugural Henry Rutgers Professor of Global Health and founding director of the new Rutgers Global Health Institute, the university is poised to significantly increase its already substantial impact on the health of populations around the globe. Rutgers Magazine asked Marlink about the greatest health challenges facing the planet and the institute’s plans to address them.

RUTGERS MAGAZINE: How do you define global health?

RICHARD G. MARLINK: Global health really focuses on overcoming the great inequalities that exist in health and health care worldwide, whether in New Jersey or New Caledonia. A university like Rutgers has a three-part mission of education, research, and service. All three are needed to advance the goals of improving access and equity in health around the globe.

RM: December 1 of this year marks the 29th World AIDS Day, which was the first annual acknowledgment of a threat to global health. Is AIDS still a global threat?

RGM: Unfortunately, yes. There are more than 36 million people living with the AIDS virus, with two million new infections occurring each year. About half of those people are on treatment—which is great. But that means that there’s still half that aren’t. So, the cup is half empty.

RM: Why did you want to take on the directorship of the Rutgers Global Health Institute?

RGM: It was a dream opportunity for somebody like me, who was both in the trenches and in the laboratory working on global health. There’s such unbelievable activity in the field of global health at Rutgers, across many different schools. I almost couldn’t say no.

RM: Why is it critical for Americans to address global health?

RGM: The first reason is just a moral imperative: it’s the right thing to do. Second, when a community is under threat of an epidemic such as AIDS, where one in three or four adults are living with a deadly, untreated infection, that creates an unstable society. And third, the planet is connected now more than ever. Epidemics like Ebola, Zika, and influenza travel and can affect all of us.

RM: What are the greatest challenges to global health in terms of communicable and noncommunicable diseases?

RGM: We have the big killers that are already with us: tuberculosis, which kills 1.4 million people a year; AIDS, which kills a million annually; malaria; and childhood diarrhea and childhood infections. Six million children die each year before their fifth birthday, a lot of them because of preventable bacterial infections. And then there is the threat of the next surprise epidemic: When will the next Ebola outbreak happen? When will we have a repeat of the deadly worldwide 1918 influenza pandemic?

Regarding noncommunicable diseases, as countries move out of poverty, they suffer from the plagues that affect us in the West, such as cancer, cardiovascular disease, and diabetes. It reminds me of the early days of AIDS: we have childhood cancers here that are 90 percent curable, and you fly to other countries where the same cancers are 80 to 90 percent deadly.

RM: You’ve said the institute will create local and countrywide health systems around the world, increasing access to health care for severely underserved populations. How will that happen?

RGM: In partnering to scale up AIDS care in developing countries, we learned that if you create a system to take care of a chronic disease like AIDS, you then have a system that can take care of other chronic diseases, using the same staff, laboratories, and clinics.

In my own experience working to improve care, treatment, and prevention for HIV/AIDS, we would create partnerships with governments, universities, and hospitals in Africa. With the host country directing, we would help them build what was needed, whether a clinic, a laboratory, or education and training programs. Our goal is to partner on the ground, drawing on the more than 350 agreements Rutgers has with different countries, universities, and institutions around the world.

RM: You’ve talked about incorporating other disciplines like engineering, business, economics, and the social sciences. What do they have to contribute to global health?

RGM: Health doesn’t just occur in the clinic. If you’re really going to affect health, you have to be involved in all the aspects that affect it: poverty, conflict, environmental issues. 

RM: What has AIDS taught you about global health in general?

RGM: That we’re all the same, worldwide. There really is very little difference between people, and the virus knows that.