Tackling the Muddiness of Reality: A Profile of Dr. Jon Simon

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Jon Simon, Director of the Center for Global Health and Development at Boston University

By Shannon Kelleher
BU News Service

As Robert A. Knox Professor at Boston University’s School of Public Health, Chair of International Health, and former director of the Center for Global Health and Development, Jonathon Simon is well versed in finagling with businesses and government agencies alike. But he also has an indelible soft spot for children—Simon often invites faculty members’ kids to play in the conference room during meetings.

Simon’s work centers around improving the health of populations in third world countries, with an emphasis on helping children. But he won’t describe it as pediatrics—his approach to health care is more integrative. “Often it’s not clinical things,” he explains. “Often it’s knowledge things. Moms know when their babes are sick. It’s their ability to act upon that knowledge, and that has to do with family dynamics.” He has found that issues of female empowerment often are central to a mother’s ability to care for her sick children. In cultures that operate under purdah, in which women cannot even leave the house for medical assistance without being accompanied by a man, health care systems must be structured differently to meet families’ needs.

By taking a holistic approach to health care, Simon works to target world health crises at their roots. All too often, the focus in targeting disease remains grounded in the drugs themselves, an approach that Simon believes misses the big picture. This has become clear to him with HIV treatment. When the South African government asked his group what it would cost to begin treating HIV at an earlier stage Simon knew there was more to look at than the cost of HIV therapy itself. He and his team measured costs associated with doctors, nurses, auxiliary training for health care workers, transportation, a working day missed to receive medical treatment— real world elements that are often overlooked. Only after three years of intensive research could they confidently approach the South African government with an answer that accounted for those various actors.

The structure of Simon’s team is crucial to uncovering the complexity behind each seemingly simple question. The Center consists of three groups: clinical sciences, applied economics, and evaluation sciences. The clinical group covers the medical side of things, performing standard trials for, say, antibiotics, while the applied economics group accounts for the complexity of cost. The evaluation sciences group sees if existing programs are working and tries to optimize them when they are not. “One of the interesting aspects of the center is that it’s quite a horizontal structure. It doesn’t feel like a hierarchical organization,” says Dr. Jacob Bor, who works in applied economics to answer questions about HIV treatment in southern Africa.

Dr. Nafisa Halim, a social demographer who researches women’s empowerment and gender equality in public health, admires Simon’s ability to bring people together. After earning her PhD in sociology, Halim knew that she needed to apply her skills to the real world in all its messiness. ““I am from Bangladesh. I saw poverty. I saw the illnesses and diseases firsthand.” When she learned about Simon and the culture he has created in the CGHD, Halim knew she had found a place where her work could have an impact. Halim now works with her colleague Emily Rothman, Associate Professor of the Committee of Health Sciences, to study an intervention in Bangladesh aimed at decreasing domestic violence. It’s a partnership that Halim says she owes to Simon’s skills as an “academic matchmaker,” saying: “I couldn’t make the connection of how a collaboration could take place.”

According to Simon, about 6 million kids under age five die every year, which is a vast improvement over the 18 million who died annually only a decade ago. Still, he believes most of the deaths are unnecessary. If the technologies we already have available were introduced into third world countries, he says, 80% of the children that died last year would still be alive.

“There is an absolutely criminal amount of avoidable mortality in children,” he says. “The ones that bother me the most are the malnutrition wards” he says. “I see some depressing shit, to be honest,” he says. “And I don’t get depressed…the key to staying in this industry long-run is to wake up every morning and delude yourself to believing that the professional work you’re going to do today is going to improve the life of a person in the world.” He smiles wryly. “And then just do that every day for forty-five years and then retire.”
at Boston University, Jon Simon is well versed in finagling with businesses and government agencies alike. But he also has an indelible soft spot for children—Simon often invites faculty members’ kids to play in the conference room during meetings.

Simon’s work centers around improving the health of populations in third world countries, with an emphasis on helping children. But he won’t describe it as pediatrics—his approach to health care is more integrative. “Often it’s not clinical things,” he explains. “Often it’s knowledge things. Moms know when their babes are sick. It’s their ability to act upon that knowledge, and that has to do with family dynamics.” He has found that issues of female empowerment often are central to a mother’s ability to care for her sick children. In cultures that operate under purdah, in which women cannot even leave the house for medical assistance without being accompanied by a man, health care systems must be structured differently to meet families’ needs.

By taking a holistic approach to health care, Simon works to target world health crises at their roots. All too often, the focus in targeting disease remains grounded in the drugs themselves, an approach that Simon believes misses the big picture. This has become clear to him with HIV treatment. When the South African government asked his group what it would cost to begin treating HIV at an earlier stage Simon knew there was more to look at than the cost of HIV therapy itself. He and his team measured costs associated with doctors, nurses, auxiliary training for health care workers, transportation, a working day missed to receive medical treatment— real world elements that are often overlooked. Only after three years of intensive research could they confidently approach the South African government with an answer that accounted for those various actors.

The structure of Simon’s team is crucial to uncovering the complexity behind each seemingly simple question. The Center consists of three groups: clinical sciences, applied economics, and evaluation sciences. The clinical group covers the medical side of things, performing standard trials for, say, antibiotics, while the applied economics group accounts for the complexity of cost. The evaluation sciences group sees if existing programs are working and tries to optimize them when they are not. “One of the interesting aspects of the center is that it’s quite a horizontal structure. It doesn’t feel like a hierarchical organization,” says Dr. Jacob Bor, who works in applied economics to answer questions about HIV treatment in southern Africa.

Dr. Nafisa Halim, a social demographer who researches women’s empowerment and gender equality in public health, admires Simon’s ability to bring people together. After earning her PhD in sociology, Halim knew that she needed to apply her skills to the real world in all its messiness. ““I am from Bangladesh. I saw poverty. I saw the illnesses and diseases firsthand.” When she learned about Simon and the culture he has created in the CGHD, Halim knew she had found a place where her work could have an impact. Halim now works with her colleague Emily Rothman, Associate Professor of the Committee of Health Sciences, to study an intervention in Bangladesh aimed at decreasing domestic violence. It’s a partnership that Halim says she owes to Simon’s skills as an “academic matchmaker,” saying: “I couldn’t make the connection of how a collaboration could take place.”

According to Simon, about 6 million kids under age five die every year, which is a vast improvement over the 18 million who died annually only a decade ago. Still, he believes most of the deaths are unnecessary. If the technologies we already have available were introduced into third world countries, he says, 80% of the children that died last year would still be alive.

“There is an absolutely criminal amount of avoidable mortality in children,” he says. “The ones that bother me the most are the malnutrition wards” he says. “I see some depressing shit, to be honest,” he says. “And I don’t get depressed…the key to staying in this industry long-run is to wake up every morning and delude yourself to believing that the professional work you’re going to do today is going to improve the life of a person in the world.” He smiles wryly. “And then just do that every day for forty-five years and then retire.”

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