The Answer Is on the Playground

Stories of Survival and Resilience in West Africa with Dr. Judy Monroe

Contagious Conversations  /  Episode 10: The Answer Is on the Playground

West Africa, five years after the Ebola epidemic

Dr. Judy Monroe, president and CEO of the CDC Foundation, shares stories from her recent trip to West Africa: a personal conversation on the 2014-15 Ebola outbreak, global health security, vaccination and more.



(View full transcript)





Below: Desmond Williams, CDC country director in Liberia, tells Dr. Judy Monroe of Ebola’s burial challenges while visiting Disco Hill Cemetery.





Claire Stinson: Hello, and welcome to Contagious Conversations. I'm your host, Claire Stinson. Every episode, we'll hear from inspiring leaders and innovators who make the world healthier and safer for us. Contagious Conversations is brought to you by the CDC Foundation, an independent nonprofit that builds partnerships to help the Centers for Disease Control and Prevention save and improve more lives.

Joining me today is Dr. Judy Monroe, President and CEO of the CDC Foundation. Dr. Monroe is a former deputy director of the Centers for Disease Control and Prevention and she previously served as Indiana's State Health Commissioner. Dr. Monroe was also President of the Association of State and Territorial Health Officials from 2008 to 2009, and has served on many national advisory committees and boards. As CEO of the CDC Foundation, Monroe leads our team to mobilize philanthropic and private sector resources to support CDC's lifesaving work.

In this episode, Dr. Monroe shares stories from her trip to West Africa, including meeting Ebola survivors and the many individuals who are making an impact in global health. Welcome, Judy.

Dr. Judy Monroe: Thank you. Great to be with you.

Claire Stinson: We're so excited to talk to you today. So Judy, you just returned from a trip to West Africa. Can you tell us about your trip and its purpose?

Dr. Judy Monroe: Yes, so I had the opportunity to join a delegation from CDC, led by Dr. Rebecca Martin, the Director of the Center for Global Health, to visit the West African countries that had been impacted by the Ebola epidemic back in 2014 and 15. We visited the four countries of Sierra Leone, Nigeria, Liberia, and Guinea, with the purpose of taking a look on the ground in these countries to see how they are doing five years after the epidemic. The spotlight, as you know, is always bright during a crisis. But have the lessons been learned? Are systems strengthened in the years that follow a crisis or an epidemic like this? And we wanted to see also the investments that had been made by the U.S. government and the CDC Foundation and whether or not they had long-term impact on the public health in these countries.

Claire Stinson: Fascinating. So had you ever been to West Africa before?

Dr. Judy Monroe: This was my first time.

Claire Stinson: What did you think?

Dr. Judy Monroe: It was an amazing trip. I have to tell you, I'd read a lot about, obviously, that bright spotlight had been on West Africa. I was at CDC during the Ebola crisis as a deputy director, but I worked on the domestic response, so it was quite interesting to be in West Africa.

Claire Stinson: I'm sure. So tell us about some of the people you met during your visit. Are there any experiences that really stood out to you, Judy?

Dr. Judy Monroe: So actually, there were a number of experiences that stood out and we met some incredible people on our trip. We heard many stories from Ebola survivors themselves and from the Ebola fighters that were on the ground during the height of the epidemic.

I have to tell you one thing that stood out was being in Freetown, there in Sierra Leone. We stood right there on the site and in the neighborhood of where a massive operation western area surge had been initiated in December of 2014, and it was very moving to be there and to hear the stories. You know, this is an area – I had read about the western surge and had heard others talking about it, but it really makes it real when you're on the ground talking to the folks that lived this and actually survived it.

At that time to… you know, for the listeners that aren't familiar with this, Sierra Leone, at the height of the epidemic, they were having 400 new cases a week, which had surpassed the number of Ebola cases in Guinea and Liberia. In fact, it was three times as many at that point in time. And so a meticulous plan had been put together by and coordinated with a number of partners.

One of the things that was remarkable about the surge is that Bill and Melinda Gates Foundation had funded a malaria campaign that involved distribution of anti-malarial medicines that were going out to tens and thousands of households, and so they masterminded this plan and said, "If we could marry the anti-malarial medicine distribution to really having this surge for Ebola, that could make a big difference." But they needed to move quickly to make that happen. There was also a lot of technical thinking around this. They did – bed and laboratory capacities were increased to be ready for the surge, and they trained a number of staff to be able to do contact tracing. And again, all of this was done through a coalition: WHO was involved, CDC, NSF, UK government… so this took a lot of partnership to make this happen.

But one of the things that struck me in listening to the stories was, and I think it was secret sauce of all of this: they applied a lesson that we continue to learn in public health, and that lesson is listen to the community. And so before this surge, they took well-known religious and traditional leaders, consulted with them, worked with the community, listened to the community. And the result of that was thousands of community volunteers came forward to help with the surge. And that's what was needed. Because think about this, 400 new cases, almost 400 a week, a lot of Ebola, and that meant going door to door into each household to find out, "Are you sick? Does anybody have symptoms?" Isolating those individuals and doing the contact tracing, otherwise we were not going to be able to beat back Ebola.

So it was incredibly inspiring to talk to those leaders five years later that had actually helped mastermind this, had done the community mobilization because they were trusted. Trust is such a factor when we're doing anything in public health, but especially when you have the fear of an epidemic like Ebola. We can all remember the news during that time and how scary it was. So imagine living in a community where folks are dying and they had… they would have anywhere from 30 to 50 burials a day because of Ebola. So that was quite moving.

Claire Stinson: So Judy, for our listeners that don't know what contact tracing is, can you talk a little bit about that?

Dr. Judy Monroe: You know, so this is kind of a public health boots-on-the-ground when we talk about epidemiology and talk about, really, the work of public health. Anytime there's an infectious disease, obviously someone has encountered that, and they're sick with that disease. In highly infectious diseases, anyone that comes in contact with that individual, in the case of Ebola touching the individual, in other cases, if you're talking about influenza, that may be airborne, so diseases transmit differently…

Once you've identified the person with the illness, the contact tracing is doing the history with the person and finding out who they have had close contact with. So clearly, it may be family members, but it may have been neighbors that came into the home. It may be that they were in the early stages of illness and went to work. So it's who might they have exposed and then all of those people need to be identified. The work of public health is then to go and talk with those individuals and convince them that they need to be isolated and followed for symptoms. And that's how you stop an epidemic.

Claire Stinson: So it sounds like a really important process during an outbreak like Ebola.

Dr. Judy Monroe: It's really critical. And it takes an intense effort, especially when an epidemic like Ebola had taken place in Freetown.

Claire Stinson: Absolutely. Any other stories that really stood out to you while you were there in West Africa?

Dr. Judy Monroe: So to drive home thinking about Ebola survivors, we talked to a gentleman, this was now in Liberia, and we had an opportunity to talk to a gentleman that told his own personal story of survival. And in his case, his brother had become ill and so he took his brother into the city to be cared for. They diagnosed him with Ebola, and sadly the brother died rather soon after being taken. The brother knew of his brother's death, but in the meantime then he became ill, and so he was hospitalized and they asked him to take his cellphone. So he was cut off from all communication. In the meantime, while he was recovering and was quite ill with Ebola, his mother became ill with Ebola, that he learned later, and his mother was also brought into the city and she passed away, but he didn't know that.

Back in his village where his family lived, word went out that all three of them had passed away and so they actually had funeral service for his mother, himself and the brother. And then a few days later, he was surviving. He was feeling better. They allowed him to have his phone. He made calls then to folks back in his village and he found out, they said, "We just had your funeral," and he learned of his mother's death.

And this is five years later and he's telling the story and he teared up, he choked up, he couldn't hardly get through it, especially talking about his mother's death – but he also then told the story of the stigma that came to the family. They were now an Ebola family, a lot of stigma in the community. He lost his job and five years later he still doesn't have employment. That long impact of Ebola… and then many of the survivors we talked to are having eye problems and other – other health related issues that are a consequence of having been a survivor of Ebola.

Claire Stinson: So I hear you visited a clinic in Liberia where some things stood out to you and you had a powerful experience. Can you share a little bit about that?

Dr. Judy Monroe: So one of the real standouts for the trip for me on a number of levels was… so it was a bright sunny day and we had the opportunity to visit a clinic. And as we arrived, there was a very large area outside of the clinic that was basically dirt, but it had become a playground for children. So there were just a number of young children out playing. Soccer was the game that most were playing. And then folks with little kids were walking with their siblings arm in arm and it was a happy day and you could feel this energy of these young children.

They were curious about us. We had pulled up and we're going in and there was one particular little boy that was playing soccer and I will tell you, he was very athletic and a very good soccer player, but he kept kind of coming around me. He was curious somehow about me, I think in particular. So I tried to ask his name. Oh, he had nothing to do with me, he was not about to give up his name. I asked him, "Could I take a picture? Could we have a picture?" No, nothing to do with any kind of picture. And I thought, he's curious. He seems to want to relate. And so I thought I got to do this differently. And somehow in the moment I said, "Kick me the ball." And by golly he did. And the next thing I know, we're playing soccer on the field. Now of course that drew another crowd, right?

So you know, I was not one of the children. I would be recognized on, on this playground. But so here we are and he was quite kind to me because he was very athletic and he hit the ball at an appropriate speed so I could return it, which I appreciated. But I connected with him in a really powerful way and it was really meaningful to me to be able to connect with him in that way. After we finished playing soccer, other children were coming around. And so I kept asking, "What's your name?" No one would give up their name. No one was about to tell me their name. And so again, I had this moment of, "Okay, I'm not getting the answer I want. I need to do this differently."

So this little girl comes up and I flip the question and I said, "Do you know your name?" And she looked at me rather indignantly and was like, "Yes, I know my name." I said, "Well, what is it?" She says, "Judy." I said, "No." I said, "I'm Judy. How can you be Judy?" And we had this moment of bonding and they have this big grin. The kids were all, everybody's laughing and they're smiling. And it was a connection point. So I had these two remarkable connections with these children on this bright sunny day. And I stood back kind of reflecting and looking over the playground after a few moments. And to me, it was just this moment of realizing the potential on that playground, the potential that these young, bright minds, athletic, inquisitive, curious, in a country that needs that generation. They need – the answer is on the playground. But to be able to have those children have the education, the opportunities to develop all that potential, it's a missed opportunity when they're not afforded those opportunities of education.

Claire Stinson: That's a really powerful story. So do you think that will stick with you? And there were lessons learned from that interaction?

Dr. Judy Monroe: That, they will stick with me for the rest of my life. There was something about the moment on the playground. It will stick with me in my own decision making and as I think about our programs through the CDC Foundation and as I think about, so at the end of the day, everything we do, we need to be looking at the impact, what's the real potential and what's the impact that we can drive. I think I saw that potential on that playground.

Claire Stinson: That's very powerful. Thank you for sharing that. So Judy, what about your visit to Nigeria? What stories stood out to you there?

Dr. Judy Monroe: So there are many. I will also share with you another one. So this one was now in Nigeria. We were in Abuja and we were visiting the National Primary Healthcare Development Agency. And the executive director was incredibly impressive as well as the entire staff. So one of the things that struck me, the first thing was when we went to have our formal meeting, they took us into a large room and they called it their war room. Their focus was taking… like an emergency approach to the maternal mortality in the country, as well as child mortality. And they were really approaching this. They meet every day, they've got a drill about it, they're watching their data, they're looking at if they take an action, what's the impact of that? So I was quite impressed that they were taking the emergency preparedness lessons that we've learned and applying that to something like maternal and child mortality.

One of the things that really stood out and was very moving was the executive director told us that when you look in Nigeria at the number of maternal deaths, that it would be equivalent to a full planeload of pregnant women crashing every day. And of course, his point was that if we had anywhere in the world, if there was a jetliner filled with pregnant women that crashed, that would be world news. There'd be outrage. We would all be looking at how in the world could that have happened, how do we prevent it? If you look then at children under age five and Nigeria, it's multiple planeloads. It's, you know, 10 planeloads, 15 planeloads. But again, the outrage that would come if we were losing children, you know, from a plane crash. So he put it in a way to really begin to understand the numbers and the tragedy.

And then the other takeaway that I heard loud and clear, and it really struck with me… there's been a lot of effort around the world and particularly in Africa to try to assure that there's family planning and that women have choice and, you know, understand that. But what he said was that that's never going to be effective as long as so many children are dying because women feel that they need to have many children to have enough survive, to have children there when they become old. And so there's this idea of families taking care of families and children taking care of their parents when they age. Here in the U.S., you know when we have, when a woman becomes pregnant, it's a joyful moment. And we all say, the first question is, "Do you know what you're having?" Right? I mean, that's the first question is, everybody wants to know the sex of the child.

And it's a joyous moment because we know that the survival is quite high both for the mother and for the children. In Africa, what he told us in Nigeria, is when a woman becomes pregnant, the response is, "Are you going to be okay?" and, "We hope you're going to be okay." Because they know how high these mortalities are. And so it's almost like the woman has, you know, is going into this really danger zone, which in fact she is. Very, very markedly different. So that was a powerful moment for me as well.

Claire Stinson: Absolutely. And these are all such powerful stories that I'm sure will stick with you throughout this process.

Dr. Judy Monroe: No question.

Claire Stinson: We'll be right back with Judy.

Since this is a show about contagious conversations, we want to hear from you. Each episode, we ask you a question and this episode's question is, have you ever taken a trip that really impacted your life? Just email to answer. That's And if you share your thoughts with us, you'll have the chance to win some CDC Foundation merchandise.

And now, back to our conversation with Judy.

So Judy, Ebola is again in the news with the second largest outbreak on record currently occurring in the Democratic Republic of the Congo. Are there similarities and differences between the West Africa outbreak from four to five years ago and the current DRC outbreak?

Dr. Judy Monroe: The DRC outbreak of Ebola has now been declared a public health emergency of international concern, and that's a similarity to the West Africa Ebola. There was also that declaration at that time. And Ebola is obviously a very, very serious disease and a contagious disease. One of the differences now is that we've got a vaccine that actually has not been licensed yet, but the vaccine was actually tested during the 2014-15 Ebola epidemic in West Africa. That is a difference at least in terms of what's available. I think for me, the big thing about the Ebola situation in the DRC is it drives home why we need the global health security agenda to be very active, and everyone really needs to be part of that if they can be.

Claire Stinson: So that's a good transition. Let's talk a little bit about global health security. Global health security is a term that is familiar to people working in global health but not well known outside those circles. What is global health security and why should we care about it?

Dr. Judy Monroe: So first of all, global health security is a shared responsibility that really cannot be achieved by a single actor or sector of government. Its success is going to really depend on collaboration of multiple sectors, from health to security, environment, agriculture, private sector, and individuals can contribute to this as well. So the global health security agenda actually has been with us, it was started in February of 2014. Interestingly enough, this was kicked off just actually before the real crisis of Ebola in West Africa. And it's been this growing partnership, I think they're up to maybe 64 nations now. A number of nations have stepped forward.

The idea behind it is that nations need to have in place certain infrastructure, public health infrastructure, to identify emerging disease, emerging infectious diseases that then could spread. So Ebola, Zika, you know, you can – you can begin to look at those diseases we know about. If every country has this infrastructure in place, you can stop the disease, the idea is to stop the disease at those borders. So everybody should care about this because, you know, we certainly have world travel. We can be… a disease can travel very quickly, as we all know, within hours around the world, especially these highly infectious diseases, and folks can have an incubation period. They may not be sick, they may not... depending on the disease, they may not have symptoms until they've already traveled. But in that, there can be a period of time where they are infectious and that's obviously a problem.

What they've done with the global health security agenda, they have actually these 11 action packets that have been agreed upon by all of the countries. You know just to give an example, it's all the way from antimicrobial resistance to biosafety and biosecurity, immunization… and so they're like these 11 really important areas. And then what I love about the global health security agenda is what's called a joint external evaluation process, or JEE, and it comes in two stages. So it starts with an initial self-evaluation conducted by the country itself using a tool that has been put together, the JEE tool. And then the second is an in-country evaluation conducted by an external evaluation team of subject matter experts done in close collaboration with the country.

With that, they get a score, and it's red, yellow, green, and then they can say, "Oh, these are the areas that we need to improve upon," and they then overtime can improve those scores and it gives them language-standard objectives to reach toward. And so I'm quite excited about the global health security agenda. I think it's something we all need to be aware of and embrace and help wherever we may be.

Claire Stinson: A truly important initiative. Can you discuss any other priorities when it comes to work on global health security?

Dr. Judy Monroe: CDC is known worldwide and their technical assistance and support is so valued. We saw that on the trip to West Africa. It was just such an honor to hear how revered CDC is and how valued their technical assistance is. But one of the things they've done around global health security, they've kind of looked at the core four.

And so if you look at the priorities: laboratory capacity, so think about that, right? You need to be able to diagnose as close to where that infectious disease may be emerging. So lab capacity, epidemiology, we talked about – surveillance, that being able to detect the disease and then if you find it, doing that contact tracing that we talked about before. The workforce and workforce is pretty broad. You need technical workforce development, you need the boots on the ground. And then emergency operation centers because when it comes to global health security, if there's an emerging epidemic, applying, and I go back to what I was saying in Nigeria where we saw them applying the principles, they basically have set up an emergency operations center if you will in the war room that I talked about for maternal mortality and child and infant mortality, when there's an infectious disease that's emerging, we have learned as a world that if you have an emergency operation center and you apply those principles of emergency, there's an incident command basically that takes place.

If you apply those, that makes a huge difference in how effectively you manage that epidemic. So those are the four areas that I think are really important and something that CDC is quite involved in.

Claire Stinson: Thank you for sharing that, all really important priorities. So Judy, before coming to the CDC Foundation about three and a half years ago, your career was mostly focused on healthcare and public health in the United States. Today though, you are immersed in significant global health work. What's similar and what's different about working domestically versus globally?

Dr. Judy Monroe: Yes, so, my career has not necessarily gone the way I thought it would. I thought I would be a practicing physician in Appalachia, to be honest. I had a National Service Corps commitment and I spent four years in Appalachia and I loved it. I love being on the ground, really understanding families and communities.

I moved on. My husband wanted an academic career and I found myself directing a residency program, which again, I loved. I became a state health officer, got tapped on the shoulder to do that and then a senior leader at the Centers for Disease Control prior to my current position.

People all over the world are concerned about their families and their loved ones. Mother and child health are fundamental to strong societies. So when we visited these large immunization clinics on this trip to West Africa, I was struck with how similar it felt to being in a clinic here in the U.S., beautiful mothers swaddling their adorable babies, and how humanity connects all of us. The difference is the stark poverty in the developing countries, the limited number of physicians and healthcare workers, the lack of infrastructure.

One thing that really drives home this point for me is when we were in Sierra Leone and they told us the number of physicians that are in the country for medical care, it was less physicians than were on staff at the hospital that I worked in in Indianapolis.

Claire Stinson: Wow.

Dr. Judy Monroe: Yeah. When we look at global health, you know, there's so much need, but that also gives me great hope because quite frankly, even a little help goes a long ways. It's rather remarkable. The emergency operation centers is an example that were set up in these countries, the four – well, in three of the countries, Sierra Leone, Liberia, and Guinea, they have emergency operation centers that were built during the Ebola epidemic. Those have become the center of public health for those countries and today you see, and it's not – there's a structure there which was left behind, but it's really the meetings that take place, the thought leadership, the trainings that take place in those facilities, that make, make a big difference.

Claire Stinson: Absolutely. And it sounds like your background as a physician really helped launch you into the position you're in now. Do you feel like your background as a family physician really helped you get to where you are today?

Dr. Judy Monroe: Yeah, there's no question. Having been a family physician, I said this when I became state health officer in Indiana, I was like, "Wow, I am using every ounce of my experience," because I never knew from one day to the next was I going to be dealing with infant mortality or was I going to be dealing with long-term care, you know, on the other end of the spectrum for the life cycle. And so that served me well, I think throughout all of my public health career. And then being here at the CDC Foundation, we do… we do global work. I mean, my career has become very, very global.

Experience is the best teacher, my Latin teacher put that on my graduation card. I don't remember a lot of Latin but I remember that message from my teacher, that experience is our best teacher. And I think for a career you build on your experience and I will tell you, I also bring to work every day my experience being a mom, I think, you know, being a daughter, being a wife…I mean, I think all of our life experiences, not just professional but in other walks of our life can really come to bear, especially in public health.

Claire Stinson:The CDC Foundation and its donors invested millions of dollars in projects aimed at stopping the West Africa Ebola outbreak and in improving health systems there following that outbreak. How have those investments played out and when you were there, did you find that they're still making a difference?

Dr. Judy Monroe: Yes, absolutely. Actually, that was one of the takeaways being on the ground and being in each of the countries, the investments by the CDC Foundation donors during 2014-15 have had a much greater reach. I mentioned the emergency operation centers, those were actually built through donated funds through the Foundation. And today, they're the center of public health in these... they're like, that's where everybody goes, and that's where people want to – they love the space. And those buildings have been gifted to the ministers of health. We've left behind infrastructure that's really critical.

One of the areas that CDC is involved in, again that really was a takeaway from me is the... it's called the field epidemiology training program, or FETP. But when it comes to epidemiology, that's what CDC is grounded on, is the field of epidemiology. And so the idea behind FETP is to be able to train individuals on the ground in their own countries.

And so these are individuals that are from Sierra Leone or Liberia or Guinea, that as an example that are being trained at different levels. So they have kind of three tiers for the FETP program that I learned more about on the trip. There's kind of the front line FETP training where you need folks to have basic knowledge to go out do that contact tracing, you know, do some of the identification, that type of thing. There's then an intermediate FETP program that takes longer. There's more training. We actually attended one of the graduations of an intermediate FETP class when we were in Sierra Leone and it was just fantastic to hear their presentations and the pride that they were taking and their new knowledge and how they were going to be able to take that and turn that into protecting their nation of Sierra Leone as one example. And then there's an advanced FETP program.

But CDC has been involved in this for a number of years. CDC Foundation, some donations coming through the foundation, go to the FETP program. There's also some funding from the U.S. government for this. It's an incredible investment on so many levels. I've really wanted to do a shout out for that program.

Claire Stinson: I'm glad that you got to see that work in action on the ground, and it sounds like you really had some amazing experiences when you were over there in West Africa.

Dr. Judy Monroe: We did. It will be a trip that stays with me the rest of my life, no question.

Claire Stinson: I'm sure. So, one tool in the global health toolbox is vaccines, but there are people who are skeptical of the benefits when compared to the perceived dangers of vaccines, especially in today's world. How are vaccines making an impact in global health?

Dr. Judy Monroe: So vaccines are absolutely critical in global health. I mean when we look at, when we talk about childhood mortality, the number of childhood illnesses that vaccines can protect against, it's remarkable. We need ongoing research and development of new vaccines, but the ones that we have really need to reach everyone and make that available.

My personal story on, on vaccines… I actually just while I was in West Africa, the trip ended, my very last day I was at lunch and my husband, I had internet and my husband contacted me and I was given the news that my 97-and-a-half year old mother had passed away. Now that was expected, and when I think about that, at 97 and a half, she had lived probably twice as long as life expectancy in West Africa, a very long life. That long life was really attributed to incredible medical care and advancements in medical care and public health.

The story I would say about vaccines, when it comes to my mother, is that in 1952 at the height of the polio epidemic here in the United States, she contracted, at age 30, polio. I was born after she had survived polio and I was born after, after that. And so I was a child that grew up hearing the stories of the iron lungs, of the scores– thousands of children that died or were left crippled because of the polio epidemic. I remember my mother's emotion when I stood in line to get vaccinated for polio. Because she feared for her children. The fear of parents across America in 1952 for their children, and polio, was unbelievable. Parents today don't know that fear because they haven't – because we've made such advancements. We've nearly conquered polio, you know, across the world, but there's still a little ways to go. But when you look at the diseases…

Or the other thing, you know, from a clinician vaccine story, I would say: when I was an intern, Haemophilus influenza was a pretty common illness that caused meningitis in infants and young children.

And as an intern, when I was in the emergency room, we would have, every night, children would come in incredibly sick. And I remember the nurses would literally grab – grab you by almost the scruff of the neck and pull you into room because you needed to do the spinal tap on a really, really sick child. And sure enough, I mean, literally pus would come out instead of clear spinal fluid. And it was because of this disease that was so devastating, the vaccine for Haemophilus influenza was developed and made the market during my residency. So by the time I was a third year resident, we were already dramatically seeing the drop in Haemophilus influenza meningitis. And today, pediatricians and family doctors training have never even seen the disease! Because the vaccine eliminated that disease. That also means the parents haven't seen the disease. So again, parents don't have the fear, they don't know the devastation. They don't realize the thousands and thousands of children that have lost their lives or have been afflicted one way or another by vaccine preventable diseases.

So again, when it comes to global health, vaccines are critical. When it comes to domestic health, I mean, vaccines are really important. They're not just important for children, but they're important for adults. Part of the reason my mother lived to 97 and a half, she got a flu shot every year. Influenza takes the lives of older individuals. It can take the lives of young as well, but we know that if you get a flu shot every year, it decreases the number of hospitalizations, it decreases the number of illness, and you live longer, longer, healthier lives. And I can go on and on about the number of vaccines that are out there.

Do vaccines have some consequence? Yes, there are some vaccine adverse effects. Those get recorded. They need to be studied. We need to be diligent on that. But when you look at the good versus the harm, that's what worries me is that our parents today just haven't seen the diseases because we prevented them, thanks to vaccines.

Claire Stinson: Well, thank you for sharing that. And we're sorry for the loss of your mom, but she led an incredible life and she raised you to be an incredible physician and leader for the CDC Foundation, so we're grateful to her.

Dr. Judy Monroe: Thank you.

Claire Stinson: So Judy, what excites you about the future of global health?

Dr. Judy Monroe: So one of the exciting things, I think if you look at global health, we've actually made progress. Right? I mentioned polio, you know... it's exciting to see that we actually can move toward the vision of eradicating diseases. You know, let's eliminate some of these diseases.

Dr. Judy Monroe: So that's exciting because I've seen progress made. When you look at global health, one of the things that impacts health, and I mentioned it before, is poverty, stark poverty – extreme poverty has improved. I mean, so we've got reason for hope on that side of things.

There's innovation. I think probably if I really got excited, the most exciting thing is where our technology and our innovations can go and how those can impact global health and make such a difference. I – I go back to that playground again. The exciting thing to me about global health is, let's allow these children, let's give them the opportunities to live into adulthood, to unleash their potential. Because the world needs – we need creative minds. We need great citizens. We need folks that are there for the greater good. If folks don't even have a chance to live to age five, we've lost how much – how much brain power, how much opportunity.

Claire Stinson: Absolutely. Absolutely. Well, we really appreciate all of your stories today and it sounds like you had an amazing and powerful trip to West Africa.

Dr. Judy Monroe: Thank you. Great to be with you.

Claire Stinson: Thanks for listening to Contagious Conversations, produced by the CDC Foundation and available wherever you get your podcasts. Be sure to visit for show notes and bonus content. And if you like what you just heard, please pass it along to your colleagues and friends, rate the show, leave a review, and tell others. It helps us get the word out. Thanks again for tuning in and join us next time for another episode of Contagious Conversations.