Leadership to Inspire Global Change: Julio Frenk

0:00:10 DuBois Bowman: Thank you for joining us for Ahead of the Curve, a new speaker series from the University of Michigan School of Public Health. We're looking forward to welcoming a guest who is revered in his work in public health and higher education, Dr. Julio Frenk. My name is DuBois Bowman, and I'm privileged to serve as Dean of the University of Michigan School of Public Health. This is our second event for Ahead of the Curve, it's a speaker series that will focus on conversations about leadership. Leadership is a critical component of navigating complex public health challenges in building a better future through improved health and equity. For about a year, we've been living through a public health challenge of historic proportions and the COVID-19 pandemic, and we've also confronted persistent issues of racism and the intersection really of these two things as we think about the widespread health inequities across the country that we've witnessed due to COVID. As problems become increasingly complex, we must turn our attention and resources to developing leaders, building from the well-known assertion of Warren Bennis a preeminent scholar in the study of leadership, leaders are made rather than born.

0:01:33 Bowman: Regardless of one's inequalities, certainly development is a clear component of leadership. Throughout this series, we will bring contemporary leaders spanning many sectors to share their insights, their vision, and stories really about perseverance. We wanna hear about those important factors that shape great leaders and learn how leaders continue to evolve and grow so that we can help make the next generation of leaders. With that, I'm delighted to welcome Dr. Julio Frenk to Ahead of the Curve. Julio serves as President of the University of Miami and is a proud alumnus of the University of Michigan School of Public Health. Julio, welcome, and thank you for joining us.

0:02:15 Julio Frenk: Thank you very much DuBois.

0:02:18 Bowman: Today's topic is leadership to inspire global change. As we begin 2021 leadership weighs heavily on the minds of many, due in part to national politics, but as we know, leaders are all around us in our immediate environment, influences our daily lives to a high degree, and that includes life on college campus. I anticipate that in today's discussion, there will be important lessons for seasoned leaders, for new leaders, and importantly for future leaders as you reflect upon your future path and find ways to contribute now, even from where you are.

So Julio, I'd like to start by going back just to discuss and hear about your personal and professional leadership journey. And as I think about prominent leaders, the richness is often not fully captured by one's current position. I find it fascinating to hear the arc of one's career and yours has certainly been a remarkable one where you've worn many significant hats in different sectors, in different capacities. So, will you please tell us about your pathway to becoming President of the University of Miami? 

0:03:38 Frenk: Well again, thank you, DuBois. For me it’s always a pleasure to come back to my alma mater. I'm so grateful to everything I received from the University of Michigan and five glorious years, I lived in Ann Arbor, so it's an honor for me to participate in this discussion. I'll be brief and I'm grateful for the question because sometimes it's more important that your CV is your biography, it explains more about who you are and not what you are or what job you have. But I will say it in a minute. My family on my father's side were refugees. They were forced to leave their home country of Germany in the 1930s. They were escaping from the Nazi oppression, and they found a country that was much more, not from an economic and material point view, but a much richer in what matters most and that country was Mexico. My father was six years old and arrived with his parents, my grandparents, and his one sibling, my aunt. And started anew in a county that they didn't know anyone, they didn’t speak the language.

And one of the motivations of my life has been this idea of the generosity of strangers. It's easy to be generous to your family or friends, but the real test of generosity is when you're generous to strangers and Mexico was very generous to my family. They saved their lives and made my own life possible. So to me the overriding concept to me and my siblings and we were brought up with a strong sense of debt of gratitude, and that's been my driving force. How do you give back? How do you reciprocate that generosity of strangers by doing something that's meaningful for people who you may never meet, but where you have the satisfaction of knowing that you're doing something that will help them?

And I have found my vehicle through healthcare and through higher education. Those have been my two avenues to fulfill that dream. I went to medical school. I’m the fourth generation of the Frenk side of physicians. We say medicine is a genetic risk factor. So I went and followed in the footsteps of my father, who has been a great inspiration for me and his father and my great-grandfather. And then when I was in medical school, I decided that I would pursue a career in public health because I still wanted to see patients, but I want a society to be my patient, which is the way I think about public health. And fortunately for me, I found that space at Michigan. As I said I spent four years and one year as faculty, and then although I had, I think, a promising career, it could have been, I was already an assistant professor at UofM. But I was called back to Mexico by an inspirational Minister of Health who was launching a reform, and offering me the opportunity to start what eventually became the National Institute of Poverty Health. And I had the privilege of founding that organization right now, I think the leading institution in higher education and research on public health in any developing country.

0:07:01 Frenk: And then I went to the World Health Organization. I was called back to Mexico to serve as Minister of Health, Secretary of Health at the federal level and a historic moment. I served in that capacity for a full administration of six years. It was very satisfying in that public service. And then I went back to academia. Came back to the United States as Dean of the Harvard School of Public Health and from there I was offered or invited to be considered for the position of President of University of Miami. By then I was very interested in the role of higher education broadly. 

And so my life has asserted between healthcare and higher education, between life in the academy and life in the policy-making world. But the unifying theme, although it appears as a very disparate set of positions, has been this overriding idea of giving back, of serving, of recognizing that I wouldn’t have been alive have it not been for the generosity of people who didn't know me and didn't know my family, but made our lives possible. And that's what I'm trying to pay back.

0:08:15 Bowman: Thank you very much. I think a fascinating story and journey in a very inspiring one for all of us, not only the positions that you've held really what you described for most is like a number of different careers packaged into one, but also some very inspiring messages that I think all of us can borrow from and reflect on those lessons even in our own work. So given the distinct kinds of positions that you've held and the tremendous success that you've had in those positions, you are an alumnus, as you've noted from the School of Public Health at the University of Michigan, what role did your education play and preparing you for the careers and the ability to move through different types of careers?

0:09:14 Frenk: You know, the best decision I ever made was to attend the University of Michigan. I was brought there because I had read the work of Avertis Donabedian, the most outstanding figure in the field of quality care, and I was very interested in issues of healthcare and quality specifically, and I wanted to study with him. Avertis became my mentor. He taught me all the essential things I needed. Avertis was a scholar, a true call. I mean, the breath of his wisdom was amazing. So I know a lot about healthcare, but that's not what I got from my education. To have some factual and foundational knowledge is very important but Avertis taught me how to think in a rigorous, systematic way that includes both rigor in adherence to evidence, but it includes also ethical reason as a way of thinking about healthcare because healthcare is so fraught with ethical questions. And I had other outstanding professors, Rashid Bashshur who is to this day a dear friend. I met some of my long life friends, some of whom unfortunately have passed, but I'm still very close to Hillary Murt who still lives in Ann Arbor and we were classmates. And those are friendships that last for your entire life.

So that was part of my experience, but having a mentor in those formative years is absolutely crucial. And that has guided me to one of the great strengths of Michigan, which was the flexibility. I ended up doing a joint PhD, it was called then, I don't know if it's still called the individual departmental degree program in the department of what was then called Medical Organization (the successor department now is the Health Services Management and Policy) and the Department of Sociology in Literature, Science, and the Arts. And that duality was incredibly enriching. It was truly an experience that was tailored to my need, my interest, and that has allowed me to do everything I have done, including that career plasticity, I call it, where because I didn't become a narrow specialist, but rather I had this training in how to think about problems and how to address them, that I've been able to move from the world of policy to the world of academia and academic administration.

So I have many degrees. I got three degrees from Michigan: my master of public health, my master of arts, and my joint PhD between the School of Public Health and the Department of Sociology. And then I was very honored to receive an honorary doctorate. So someone told me that I had more degrees from Michigan than a thermometer. And I’m very proud of those degrees and very grateful for the superb education I received.

0:12:42 Bowman: Terrific. Again, a wonderful story. And the message really I think is more timely than ever, as I think about the world, how rapidly it changes and what our graduates will have to face throughout their careers. And pulling from a phrase that I've heard you use before, this idea of career plasticity, which is so important as we think about preparing the next generation of leaders. So I'd like to transition into a set of questions that really focus on your position in higher ed, but really it's your unique position in higher ed as someone with the public health background. And so you lead an institution during a time of intersecting public health crises of racism and COVID-19 and with your background as a public health professional and also a physician, how has your public health training informed your leadership over the last year at the University of Miami?

0:13:53 Frenk: Well, you know, if there was the time to have the training I’ve had, that's been it. My education at Michigan has helped me not only during the pandemic, because of that issue of career plasticity, and I do think for the students who are watching us, I think my career path was a bit exceptional when I went through that, but I think it's the dominant pattern today. No longer do we have fixed lanes in our career path. I think we need to have that flexibility, that creativity to seek opportunities and take advantage of them. And I think career plasticity is going to be the dominant feature as our graduates are facing the most dynamic labor marketing history and that kind of critical thinking, ethical reasoning, ability to communicate persuasively, teamwork, and it was those themes that actually attracted me a lot to become a university president. I think we're at the threshold of an educational revolution, and already the education I received in the 1980s at the University of Michigan really was ahead of its time because it prepared me exactly for the type of reality, Back then, may be my experience was exceptional, but today, I think it's going to be more of the career path of current graduates, graduating into this very dynamic labor market where conditions are changing all the time because of automation and artificial intelligence.

0:15:30 Frenk: So it's helped me a lot even before, but this year because of the pandemic it’s been absolutely crucial. My public health training of thinking about populations, of thinking dynamically, understanding the fundamentals of epidemiology has just been very, very, very important. And I would highlight, when we were trying to decide to have in person instruction or continue online, I did a very rigorous comparative risk analysis. I tried to compare the risks to our students of either having classes on campus or not allowing them, and it was my ability to look at data, to understand patterns, to know that whatever I was looking at today in terms of number of cases was reflecting patterns and decisions that had been made two weeks before, that I needed to understand what had happened before to understand where we were and to project where we're going, and public health gives you exactly that way of thinking. It’s thinking in a dynamic way so that you understand that your current circumstances are determined by events in the past and will shape what comes ahead. So it allows you to do this sort of prospective planning and that has been the key. I believe in public health. I decided that there was a risk in re-opening for sure, but that if we follow the science, we could do so safely.

0:16:59 Frenk: So we invested a lot of money in reconfiguring spaces and changing filtration systems. We produced very rigorous protocols of mandatory use of face coverings, regular testing, and contact tracing. Applying everything we know. And we were able actually to have a very successful, most in-person, we gave a choice to students or students didn’t have a choice because they had an underlying medical condition or there were international students who just could get to the United States, but for about 75% of the students who did show up, we were able to have a healthy, secure, successful semester, with cases but with a very robust system for testing and tracing. And it just reaffirmed that science does work, public health does work when you adhere to that and you avoid the politicization of some of the measures, which has been one of the sad parts of the way the larger society has handled it. But we managed to do that.

And then as you say, it's been a unique year because it's been that public health crisis, but that has triggered an economic crisis and it has also brought to light a social crisis stemming from deep inequalities and racial injustice. So handling all of that has required a lot of very focused leadership and certainly my experience at Michigan has helped me enormously to do so.

0:18:32 DuBois: Terrific. Thank you so much for that. And I'd like to ask, maybe for you to expand a little bit. You alluded to it really in your comments, and you talked about your public health approach as a university leader to think about concrete and safe plans for reopening. But of course, as university presidents or other administrators across the country face this challenge, it's really not a challenge in isolation, it's really the balancing of safety on the one hand, but then really the precious part of our mission in terms of fulfillment of education. And so I'm wondering for you how you thought about the coupling of those two things as you approached the last fall semester and now moving into the spring semester at University of Miami.

0:19:31 Frenk: No, that is exactly right. One of the attributes of leadership, I think, is to try to strike the adequate balances, understand that there are no perfect solutions when you're dealing with a complex situation, and that it's never an all or nothing situation. For example, a lot of the discussion as we were considering our plans for the fall, having like every university we pivoted in the Spring of 2020 at the beginning of the pandemic where there was so much we didn't know, we did what every university did. We pivoted quickly to finish the Spring of 2020, the early months of 2020, fully online. But then came the dilemma, what to do after the summer. And the idea was exactly to balance the richness of an in-person instruction with the risks. But a lot of the discussion seemed to suggest that all the risk was concentrated on opening up for welcoming students back on campus, as if letting students stay at home, not allowing them on campus, was a risk-free alternative. And I spent countless hours, literally of the day and the night thinking about this, and I concluded that there was also a risk in not welcoming students back. As it turns out, our students, like many students, here I’m talking about mostly our undergraduates and I appreciate that the School of Public Health is mostly a graduate school, but for the younger students on our campus, it’s a moment they've been waiting, it's a moment when they leave their parents home. So a lot of the students have literally moved to Miami and they had rented apartments literally across the street. And so as I thought this carefully, I realized what we were trying to avoid where the more of the social interactions where there was risk and exposure to the virus, but keeping the students outside, although it was an easier solution for us, didn’t mean that they would be risk-free. And in the end I concluded in that balance of risks, that offering the opportunity with very careful protocols, where a quarter to a third of our students were not going to be on campus, so we were able to de-densify, where we were going to introduce rigorous testing, we also started like Michigan, a program of Public Health Ambassadors, peer students who were trained to respectfully but firmly provide positive peer pressure to other students so that they comply with what we were doing, and then millions of dollars invested in rearranging spaces and filtering. We also, like Michigan which has a superb program in music, we have a school of music. That's a high risk, especially wind instruments. Well, we changed all the air handling systems.

0:22:52 Frenk: And the idea was, if you do this the right way, and it is a message for the larger society. The problem is we've been in a full dilemma between protecting people's health or reactivating the economy. Those two objectives go in synergy. You have to think about them, and if you do the things the right way, you can re-open safely. The problem is we open too soon and too carelessly without instituting the necessary protocols. Where I felt that in a more controlled environment we could do that, not carelessly, but carefully, very carefully and very cautiously. And we were able to do it. We did have cases, of course, we knew we would have cases, but we were never overwhelmed. And we had zero cases, we couldn’t document a single case of classroom transmissions. All transmission happened in the dorms, most infections occurring outside of campus, and the vast majority of students actually complied. By that, I mean literally 98%. Now, with that 2% with a virus that's highly contagious, is very dangerous. But the other thing I thought about the last thing I'll tell you is, if we had just decided to keep our doors closed, which probably would have been an easier solution, first of all, I wasn’t denying my belief in science and in public health. Because I had to say, “Well, if I believe in public health, we apply the science, we've gotta be able to do this safely”, but most importantly I thought that giving up sent a terrible message. And the message was that we couldn't trust students in that generation, students 18 to 24 years. If you think historically, that's the age group of students that have fought almost all wars, that have been the leaders of social movements, activists who risked their lives for civil rights, for equality, for many other causes, and we're saying that we can’t trust young people to sacrifice the social aspect of their education, which is the sacrifice because it's an important part of college experience, but we're asking them to sacrifice for a higher objective, which is the rest of the educational experience. And saying that we cannot trust would have meant giving up on your people, and I thought that was just not right.

So we trusted, we tried to inspire students to do the right thing, we used positive peer pressure, and for the minority that did not follow the rules, we did institute sanctions including expulsion or losing the right to be on campus if you couldn't live up to the trust that was deposited in you. But by and large it was a good experience and was driven by all of those considerations. All of that, driven by a public health mindset, I would say.

0:25:51 Bowman: Yeah, and the University of Miami is certainly very fortunate to have your leadership, with your public health background, your medical background, and commitment to education. Expanding, one of the things that has played out even more broadly in society during the COVID pandemic is this tension between individual interests or even liberties and contributions to the collective good. And drawing parallels in higher education and other sectors, the most effective leaders are ones who are able to motivate and inspire individuals toward a shared vision or goal, and I'm wondering if you can share with us at any point in your career, whether related to COVID or not, an example where it was important to align people and comment maybe on the strategies that you used to do it.

0:26:48 Frenk: Absolutely. I mean, in every position I’ve had, articulating not the what but the why, why are we doing this, is a fundamental element of the communication that has to proceed any proposal for action. And that requires identifying a goal that's worth pursuing, and almost all goals that are worth pursuing involve other people. It's very hard, unless you're an incredibly self-centred person, just to think about your own goals. Your own goals are important as well and you certainly need to take care of yourself as an individual, but it's when we as humans connect to something that transcends us, that we really fulfill our sense of mission and a sense of legacy of leaving something behind, because we're all here for just a limited period of time. And to me, the idea of legacy is the cornerstone of leadership. It's thinking rigorously, what do I want to live behind when I am gone? And being gone means, you can be gone from a job, we have terms. I had six years to be Secretary of Health in Mexico. I started thinking on day one, how am I going to make sure that if I survive the six years (with politics you never have that guaranteed, but I did last the six years) how do I assure that I leave things behind better than the way I received them? And being purposeful and understanding that legacy is fundamental and we always build those legacies with others. So to me, that's a central attribute of leadership and being able to communicate persuasively about that is critical.

0:28:47 Frenk: Coming to the case of the pandemic, since it’s the topic the absorbs us now, one of the striking features is the huge variation in the way that countries at the same level of economic development, how widely differing the effectiveness of their responses has been. These are countries of equal level of development, it's the same virus, it's the same human species, and yet some countries have been able to control the virus very effectively, and others have had a very poor performance in dealing with the virus. And when you look at that comparison, what you find is that it's in the countries where leaders had set to unify people around managing the pandemic and have convincingly persuaded everyone that their own individual wellbeing is depending on the collective wellbeing, those are the ones that have done best. The countries where they have done the worst, far from that have politicized the response to the pandemic. And a consistent pattern around the world is that around the worst performances, you have countries led by populist leaders, and I'm not just talking about the United States, because I do not want to politicize this statement, but this is around the globe. Whether it's Russia or Turkey or Hungary or India or Mexico, my country now with a populist leader, or Brazil, it is a uniform element because part of the essential logic of populism is to divide people, to identify people that are defined as others, and then quickly blame them for whatever it's going on, include a pandemic. And part of that is translated into politicizing some public health measures. The most sad of them was the face covering and this should have never been allowed to happen if you explain that wearing a face cover certainly protects you but most importantly it protects others. And by thinking or framing that as an issue of individual freedom without understanding the element of neutrality and reciprocity that is signified by using a face cover, I think perverted the whole debate.

This is the exact same reason why we do not allow people who are intoxicated, for example, with alcohol to drive. It protects them, but it protects other people who would otherwise be innocent victims of drunk driving and we don't question that. But somehow in those countries that have not done well, we fail to put some of these public health measures in the same line. And we're paying a big price for that. I think if there's one lesson, it’s that we need to be able to persuasively connect people to something that's bigger. And then it also happens to be the best way to protect themselves, then again, that becomes a false dilemma. My own health is hugely dependent on what I do for other people's health, and nowhere is this more obvious than with infectious diseases. So if we can align enlightened self-interest with generosity and compassion, then you have a very powerful, a very powerful formula to address a crisis.

0:32:49 Bowman: Very profound statements, ones that we could probably spend substantial time digging into but thank you for sharing those remarks. Referring back to something that you alluded to earlier, illuminating health inequities will undoubtedly be a legacy of the pandemic. The pandemic has also revealed inequities in many other areas, including education, thinking about the rapid change that you mentioned back in March, the rapid pivot to remote education and the circumstances and conditions that people return to. As we start 2021, how should we focus our efforts as a field from a public health perspective, but even more broadly in thinking about higher ed, to address these inequities.

0:33:47 Frenk: Yeah. It's that confluence of the three crises and they interact. The trigger was a pandemic, but the economic crisis has not affected everyone. The iniquity starts there. Not everyone has the ability to work from home. There's people who I live literally day-by-day. Most of the essential workers, the so called essential workers, were out there risking their lives being more exposed to the virus, we’re also the poorest members, members of minorities, people who suffer racial injustice. And then on top of that, we had the events in the summer leading to a reactivation of the cry for racial justice. And it's been all of this against the backdrop of a very serious polarization...exactly what you don't need in an emergency, which is divisiveness.

So, I think universities have a huge role in continuing to address this confluence of crisis. Now, the public health crisis is the one where I think we can see an end to that because I think thanks to the brightest element of this pandemic which has been the unprecedented level of cooperation among scientists to produce a vaccine in record time, a safe and effective vaccine in record time, that has to stand as an incredible achievement. We now need to match our distribution and logistics to the scientific feat of developing a vaccine, but we can see now there is light at the end of the tunnel of the pandemic, but we're still in the middle of that tunnel.

0:35:32 Frenk: And we're still, in the middle of that tunnel, there's the other crisis. And we can not just come out and think that the pandemic is over and we can go back to where we were before. Because the economic and especially the social crisis are not going. They’re going to outlive the pandemic for many, many years to come. This is an opportunity, because the pandemic has brought out to light some of those fundamental inequities, to really, really commit ourselves to addressing their root classes. And that's another element of public health. We're not content with dealing with the symptoms or the manifestations of a health problem, we dig deeply into the roots, and that includes the social determinant of poor health. And among them, racial discrimination, anti-Black discrimination, in the United States and other countries is a fundamental root cause.

I strongly believe and one of my motivations to work in the university is that universities have to serve as exemplary institutions. This is a very old idea, the idea that this community of scholars and students, who are united by the thirst for knowledge and learning, can develop a set of values, adhere to those values and a set of behaviors that serves as an example for the larger society of which they're a part. And if there ever was a time to serve as exemplary institutions, it is now. We need to model for the world out there this sense of, first of all, that we value diversity. It's not tolerance, it's embrace of difference. The difference makes us stronger, that diversity is not just the right thing to pursue from an ethical point of view, which it is, it’s also the smart thing to do because different allows difference of perspectives. We need to embrace the balance of freedom of inquiry and speech and model our ability to disagree respectfully. And then show that at a time when civil interactions, civil discourse has rapidly deteriorated and we don't listen to what other people are saying, we just dismiss them ahead of time if it happens to not coincide with our views. So allowing ourselves to show and demonstrate respectful disagreement, the ability to debate ideas, use reason, we commit ourselves to truth. Understanding that the pursuit of truth is contradictory, dynamic, it's constantly changing, but we gotta say it is not okay to say whatever you want, especially in the public arena and lie, and say that's okay. It’s not okay. We do have standards to judge the truth content of a statement. We need to show that’s our core actually. We are here in the pursuit of truth. We need to show and redouble that commitment and show that it is possible. Truth may not be absolute but there are standards to judge the truth content of statements. Bring back stability, ability to interact to disagree, celebration of difference, inclusiveness, and the relentless pursuit of equality of opportunity, which is at the root of the ideals of higher dictation. If we do that, not only will we be out of the pandemic, but we will get over the economic crisis, and we may make momentous progress like what we haven't seen since the civil rights movement on addressing the racial justice crisis.

0:39:16 Bowman: Thank you very much. And I go into 2021 with a sense of optimism of the role that institutions of higher ed can play in really facilitating much of the change that you just referenced. So the last question I'd like to ask just in terms of the COVID pandemic and your role as University President, for many leaders, the pandemic has brought a relentless pace of very complex and challenging work activity, and I can only imagine how busy your schedule has been over the last several months, and I'd like to just prompt you to comment on any lessons that you've learned about the importance of self-care or care for other leaders in your organization or other members, including students at your university.

0:40:09 Frenk: Yes, it's crucial to understand that this is a marathon and not a sprint. That we need, especially when you're a leader you have a special responsibility to remain healthy because you're not healthy enough to fulfil your duties you put others at even higher risk. So it's a tough one because we're all very driven people, and we tend to work long hours. One liberation here has been the inability to travel and I'm not going back to my travel schedule from before the pandemic. That's one of the lessons. There's so much that we can do more productively using some of this technology. Some travel is essential and I do look forward to many in-person encounters once we are out of that, but that has liberated a reservoir of time that I don't know how I would have done without that. But being mindful is important. I try probably not enough as I should to take care and to be mindful about my own health, being introspective, being self-aware, understanding when you're reaching a limit and then protecting also the team. Leadership is never solitary, even though there are moments of great loneliness when you need to make a decision that's very involved and you own it. You cannot tell anyone that it's the team, that's you. It's not withstanding those elements. It is a team effort and making sure you take care of the team in the service of the larger community is absolutely critical. And so I try to take up a few moments in the day for deliberate exercise in mindfulness, in understanding my own, being aware of my own sensations, where I am, being aware of my surroundings. And trying simply to take, sometimes it's a 5-minute or a 10-minute break of focusing on the moment and trying not to be consumed by the anxiety of the uncertainty. 

Pandemics are defined by uncertainty. It’s the first time we're encountering that particular pathogen. There's a lot we don't know. You have to be very thoughtful about mastering the anxiety that unavoidably accompanies uncertainty and not let that get the best of you. And that requires a lot of focus on what you have at hand, understanding the various elements that you need to master in that moment. Even as I was saying before, you're taking into account what happened before to understand the present and you are projecting towards the future. I use models extensively. But once you understand that dynamic, part of taking care of yourself is mastering the uncertainty and being very self-aware about your own feelings and accepting your own vulnerability. We're not called to be...let me tell you this. It's related to the resistance of some political leaders, mostly these populist leaders I was talking about to wear a face covering. It’s a false idea of leaders being strong, and I see this most in men. Because the other interesting pattern is, among the best performing countries you have an over-representation of countries where the leaders are women: New Zealand, Taiwan, Germany, Denmark, Norway. You have this over-representation. And instead in the worst places, some of these populist leaders like to portray themselves as strong men, and that false idea of strength.

0:44:21 Frenk: When I wear a mask, I'm not showing weakness, I’m showing the strength of caring for others. Because a mask is not so much “I'm so strong because I'll be vulnerable and I'm not gonna get sick” it's, “I am strong to care for you, to think about you”. And re-thinking what strengths means as a leader, it's not the alpha male mindset. That's a common stereotype of leadership. It's actually your ability to think about others and care about others that actually provides you with the inner drive to then take care of yourself because there's something higher that's calling to service. So service, along with the send of legacy, is the other overriding attribute I think of a good leadership. And in my case, it comes back to the story I told at the beginning. The idea that you're giving back, that you're serving, and that actually is what builds in legacy.

0:45:23 Bowman: Excellent. You've touched on the impact of politics and the context of politics, as I think about your career, there's a clear global component. And you've held leadership positions in Mexico, the World Health Organization, different regions of the United States, how does national or regional culture, possibly politics, impact or affect how you lead or how individuals expect for you to lead?

0:45:57 Frenk: Well, there's a lot of cultural specificity. This thing about what is a strong leader, it's very cultural, and you will find other societies where it's not like that. And there is this gender consideration that I described. I do hope they're one of the big lessons of the pandemic, one of the positive outcomes of the pandemic is we put to rest forever the idea that women cannot be effective political leaders because they have been the best leaders in managing this emergency. So there's a lot of specificity. But look, I like to make a distinction between politics and politicking. Politicking is the usual almost caricature of back-stabbing and lying at convenience. To me politics, non-corrupt politics is the art and science of reaching agreement for valued and shared goals. You can articulate a goal that’s shared and valued and then you reach compromise and agreement. That is good politics, and it's unavoidable whether...I was asked to serve in the cabinet when I was minister or Secretary Health in Mexico, not because I was a politician, I did not belong then and I still don’t belong to any political party, but I was brought as an expert. What a crazy idea, right? Bring an expert to the cabinet.

0:47:33 Frenk. But the President then, President Fox had that idea that not for all positions in cabinet, but those that had a strong technical core, like health, environment, education, those secretaries, members of the cabinet, we were all people who were not appointed because we were politicians. But I always understood that this was a political job. I used to say, I am not a professional politician in a health job, I am a health professional in a political job. You need to understand that it is a political job, and it goes from government, but also you can’t be dean or a president if you don't understand the politics of universities, of faculties, of student life. But it's turning politics into that positive exercise, and again, I hope we rescue that concept of the art and science of reaching agreement through compromise, through respectful disagreement, through finding common ground, in order to pursue shared and valued goals. And if we do that the other thing we might come out of is healing the political landscape, which is so fractured and so much the opposite of what I just described. It’s much more politicking than politics. And the key here is not to confuse the ends and the means. Politics becomes corrupted when power becomes the end and service the means. If you oppose that and power, having some power, some control over resource of decision becomes the means to a higher end, which is to serve people, then politics is a dignified activity.

0:49:24 Frenk: And you need for that to have a strong sense of integrity. You don't do things that your ethical code of conduct doesn’t allow you. I, when I was in the cabinet, I walked with a letter of resignation in my pocket and the President knew it. And if he asked me to do something that I didn't believe in, I would put it out. You need to be able to do that and you need to be able to communicate that you will behave with integrity. And again integrity is core to honest politics. So yeah, I was in the political job, I'm still in a political job. But if you understand that your ultimate goal is service, serving others, and you act with integrity, then you can make that a very dignified part of your job as a leader.

0:50:14 Bowman: Excellent. I'd like to ask one final question, and this is a light question, but it'll play on actually the name of this leadership speaker series Ahead of the Curve. Is there anything that you'd wanna say to the audience about how you as a leader stay ahead of the curve?

0:50:32 Frenk: Yeah, I love this title. Because the key with this pandemic has always been to say ahead of the curve. But generally, that’s an enormously valued proposition. Look, the first thing I would say is to cultivate diversity of thought. We need to cultivate diversity in every dimension, but that includes purposely surrounding yourself with people who think differently than you, and identifying your own weaknesses and recruiting a team that complements and compensates even for some of your own weaknesses. Self-awareness and the ability to say “I don't know everything, I have my own blind spots, I need to build a team that's diverse in every dimension, racial, gender, national origin, sexual orientation, and diversity of thought”. Because as I was saying, diversity is not just the right thing to do ethically, which it is, it’s also the smart thing to do. And if you have that diversity of perspectives, you are much more likely to get ahead of the curve because whatever bias any one member of the team, including yourself has, and we all have biases, they will be neutralized by other people. Encouraging disagreement and you know, very often, people will start when we have regular, almost every day meetings to see how we're doing with managing the pandemic on campus, and very often, I see a colleague say “with all due respect” when they’re going to say something that disagrees with me, and I say “Please understand, I don't interpret disagreement a disrespect. It's good for us to disagree.” Those are elements of staying ahead of the curve. Because the curve, if you take it, it's very hard to see what's on the other side of the curve, and the way you lift yourself is when you stand on the shoulders of a large group of people who think differently and figuratively they allow you to see beyond the curve, so you can stay ahead of the curve.

So those are elements that I would bring and then integrity, rethinking what it is to be strong. So integrity, community, team-building and be driven by evidence, not by prejudice, listening to the science, and mix evidence that is science driven with experience-based intuition. Also trust your intuition when you have experience, that's another thing, and I know at some points when the evidence was not that clear, I drew into my reservoir of experience to try to say what makes sense to me. Some of the things I was saying before about the relative risk of keeping students outside or allowing them into the campus, that was more intuitive, but it was based on experience. And getting that balance, always use the evidence you have available, but also rely on your experience and not just yours, but the team. That's where the diversity of perspectives is so, so valuable. If you do that, I think you have a good chance of staying ahead of the curve.

0:53:58 Bowman: Absolutely. We're just about out of time now, but I can't think of a better way to end than on those very insightful remarks. I've certainly enjoyed a lot myself, and it's always a pleasure to have an opportunity to sit down and speak with you. And I'm sure our listeners have benefited a great deal as well. So I'd like to thank Dr. Julio Frank for giving of his time and insights into leadership and current events, and even ideas just about handling leadership through challenges and risk-taking. So thank you all again for joining us. Thank you to Dr. Frenk. Be well, stay safe, and Go Blue.