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Eradication &Health Systems Bill Brieger | 21 Dec 2013 07:06 am

Remembering a Pioneer in International Health and Health Systems: Tim Baker

Honoring people in their lifetime is important, and fortunately Prof. Timothy Baker and his wife Prof Sue Baker were jointly recognized for their many years of service, not only to the Johns Hopkins University Bloomberg School of Public Health, but generally to the fields of global health systems and management.  A portrait of the couple was presented and hangs at the School to remind all of their contributions. Unfortunately Tim Baker left us earlier this week.

DSCN1653While such departures are not often surprising when people have passed their three score and ten, Tim Baker at 88 was still active in teaching, research and service.  In fact we served together on the School’s MPH Admissions Committee where Tim Baker brought his wealth of experience and compassion for training students to bear at each meeting.  From the student’s point of view, I can saw that even though Tim Baker was not my adviser in during my DrPH at JHU (1989-91), he always looked after my academic progress and was the one to nominate me for Delta Omega (Public Health Honor Society) membership.

On the occasion of the portrait unveiling in 2011, the school shared these brief notes on Dr. Baker’s career: “

Timothy Baker, MD, MPH, a professor in International Health, joined the School as a faculty member in the Department of Public Health Administration and as an assistant dean. In 1961, he founded the School’s Division of International Health and served as acting director. Over the next five years, he was instrumental in building the Division into the Department of International Health. Baker’s fundamental contributions to the Department include faculty recruitment, curriculum development, student mentoring and fundraising. He was instrumental in establishing one of the School’s first endowed professorships—the Edgar Berman Professorship in International Health.

“In more than 50 years as a researcher and consultant, Baker—who holds joint appointments in Health Policy and Management and Environmental Health Sciences—worked in over 40 countries, focusing on health services and assessment of disease and injury burden. He also held leadership positions in several international public health agencies.”

Dr Baker touched many lives. Prof. Peter Winch, Director of International Health’s Social and Behavioral Interventions Program expressed the following in his e-mail to colleagues:

Tim Baker passed away today at the age of 88. I first met him in 1987 as an MPH student when he lectured in Introduction to International Health. It is truly impossible to summarize all of his contributions to the Department of International Health, and to the field of Global Health. This is a quick of superficial overview of his contributions. It is always difficult to know who originated any given idea. But if Tim was not the first one to push the elevator button, he was definitely at the ground floor before the elevator went up. So here is my partial list of his conceptual contributions. This is my paraphrasing of his thinking. He usually expressed such ideas in a more circuitous manner, or did not make a statement at all but rather demonstrated the idea through his actions.

  1. Public health professionals from low and middle-income countries need training not only on disease prevention and control, but also the design of health systems, management and supervision, leadership and advocacy.
  2. A central task of global health spending by the US government in low and middle-income countries needs to be capacity-building of local institutions and health professionals. If we don’t do good capacity building, the investments will not yield any lasting results.
  3. Health systems in low and middle-income countries need to address not only infectious causes of morbidity and mortality, but also occupational health, environmental health, injuries and chronic disease.
  4. Health workforce development is a complex matter, and warrants high-quality planning, evaluation and research.
  5. Our School of Public Health benefits from a dynamic, multi-disciplinary, problem-based Department of International Health. Such a Department is an asset to other more disciplinary departments, rather than a threat or a problem.
  6. Finally: There are no problem students. Every student is an asset. If the faculty identify a student as a problem, there is a good chance the problem lies with the faculty.

Likewise Prof. Adnan Hyder, Director of the Health Systems Program with which Dr. Baker was most recently associated expressed these thoughts:

It is with great sadness that I email you to announce that our beloved Dr. Tim Baker passed away yesterday. This is an incredible loss for our program, the department, and the school to start; but really the entire global health community. As the founder of our department, he was a powerhouse of knowledge, inquiry, and persistence; as a teacher and mentor he was a giant in the field; and as a proponent of the poor and vulnerable, he hid a warm and glowing heart under his witty exterior. So many of us were fortunate to be his students, colleaugues and friends; and how lucky we were to receive his wisdom, insight and sharp advice. Not a man to appreciate praise, he always cut it short; not one to stand pomp and ceremony he often avoided it; and not one to accept failure he believed in the power of humanity to succeed. We will dearly miss him, his humor, his flowers (for ladies only) and his raisin bread – and always remember that he asked us to work harder, and better than anyone else in the world for the cause of social justice and international health.

Let us make sure we never forget his legacy.

Although tropical diseases per se were not Tim Baker’s primary focus, he was concerned about the health systems implications of control programs. In 1962 as the first global effort to eradicate malaria was underway, Tim Baker made the following observations in the American Journal of Public Health:

Malaria eradication “contributes to our own protection. Malaria can be reintroduced into the United States, as several local epidemics have conclusively proved. Just as in the case of yellow fever, where our shores were not safe from imported epidemics until the disease had been controlled in the major ports throughout the world, so it is with
malaria; the world is not safe from the threat of disastrous epidemics until malaria has been eradicated everywhere.” Dr Baker was well aware of challenges that still face us today when he noted that, “widespread development of insecticide resistance lends overwhelming urgency to the completion of eradication.”

He further explained that, “health workers are presented with the opportunity of developing and proving a new method of attack on disease that has tremendous economic import.” The economic impact of malaria remains today one of the driving forces behind efforts to eliminate the disease.

More recently (2007), Dr Baker demonstrated the importance of maintaining a long term perspective. Concerning India’s efforts at controlling malaria from its first through 10th five-year plan, Dr Baker drew on 50+ years of experience to comment that, “The drop from a million to a thousand deaths underscores the value of the malaria program.” It may be another 50 years until malaria is truly eradicated, but if we keep a critical long term view as exemplified by Dr Baker we will be alert to both the challenges and opportunities to bring malaria to an end.

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