Helene Gayle on Fighting Global Disease

I grew up in Buffalo, N.Y., the middle child of five children. We were very fortunate to be raised in a family that put a high value on giving back to the community. My mother was a social worker, very much focused on helping people and helping communities. My father was a small businessman. They were both very active in their churches. On Sundays my father would often take us to visit the sick and the shut-ins, particularly elderly people. Both parents gave a real example of doing whatever you could to try to make people's lives better.

When I was 12 years old, I was hit by a car as I was crossing the street on my bicycle. I was hospitalized for three months and then in traction at home for another three months. I had to learn to rely on my own resources perhaps more than you normally do at that age.

Shortly after that, my parents got divorced. My mother had chronic mental illness that manifested itself more acutely at different points in time. The marriage and my father's support probably kept her from having more frequent and severe crises than was the case after their divorce. The combination of a divorce and losing my father's support was a turning point. Our lives became less stable, and my mother's mental illness become a more constant and dominant factor. She was hospitalized multiple times, and we lived with different relatives at different times. Throughout it all, my father went to great lengths to stay engaged with us and served as a stable force and source of emotional support. I think the experiences we went through with my mother gave us resiliency and self-reliance.

I went into medicine because in keeping with the values my parents had instilled in us, I wanted a profession that allowed me to give back. When I was doing my residency training in pediatrics in an inner-city hospital, I saw so many children who showed up in the emergency room at night for non emergency care because they didn't have insurance to pay for regular health care. I realized that many of the things my patients were facing really were linked to broader issues. If I really wanted to have an impact and keep that child out of the emergency room, I had to look at other ways of helping tackle the underlying issues.

As I was thinking about options to pursue after residency, I thought of the Centers for Disease Control. I had heard about their training program in epidemiology when I was at Johns Hopkins getting my master's in public health while in medical school. CDC is the premier public-health agency in this country and around the world. I went to CDC, loved it and felt it was a match for me. I stayed with CDC for 20 years.

One of my early assignments was doing nutrition assessments in drought-affected areas in West Africa that were at risk for food shortage and famine. Everywhere I went, people pooled together their best meals to make sure that I, as a visitor who was coming to help them, was treated with the greatest amount of kindness, even if they weren't going to be able to get a meal themselves. That generosity of spirit cemented my commitment to finding ways to work internationally. I then went on to do much of the rest of my career at CDC in HIV, both domestically and internationally.

The Gates Foundation recruited me in 2001 because they were starting to put a big focus on global-health issues and HIV and wanted somebody with depth of experience in this area. At that time, the Gates Foundation was very small. The whole global-health team was 10 people. Now they have a talented team of almost 300 people.

I was intrigued by the opportunity to lead CARE, because it seemed like an opportunity to pull together the different strands of my life. I think my career has been one of going from the individual to the societal to the mega societal. This was full circle back to what brought me into medicine to begin with—wanting to address social inequity. We work on everything from health, education, water and microfinance to emergencies and conflicts, agriculture and climate change—the whole bucket of things that affect people living in extreme poverty. We put a special focus on empowering women and girls, because we believe they hold the key to long-lasting social change in communities.

I feel very fortunate to be here. You reach a point in life where you know you may have more years behind you than ahead of you. I want to know that I'm using each day in ways that are meaningful to me. I want to feel that each day is better than the day before and that I'm happy to be waking up and have the opportunity to do the things I do. And when I no longer feel that, I'll do something else.