HARVARD School of Public Health
A gift to support the campaign for Harvard school of public health is a
gift to improve the lives and health of people everywhere. please join us.
powerful ideas for a healthier world
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a message from the dean about the campaign
In the 20th century, advances in knowledge about how best to protect the public’s health helped double life expectancy. But today, our progress is under attack by four major threats that cause disease, disability, and death around the globe: old and new pandemics, harmful physical and social environments, poverty and humanitarian crises, and failing health systems. The Campaign for Harvard School of Public Health is about building on 100 years of experience tackling big challenges like these. It is about discovering new solutions to complex problems and acting upon this knowledge. It is about working with friends, partners, and supporters to achieve large-scale, long-term impact. The Campaign will drive efforts to prevent outbreaks and halt the spread of diseases that claim millions of lives. It will advance our understanding of the complex interactions among our own personal choices, the physical and social spaces where we live and work, and the genetic cards dealt to each of us at birth. It will sustain efforts to defend health as a universal human right. And it will propel a transformation in public health education to foster effective leadership and promote wise policies. An investment in the people, ideas, and infrastructure of HSPH has immediate effects both here at home and around the world, and it pays off again and again— in the lives and dreams of individuals, and in the health and well-being of entire societies. With your help, we will change policies, practices, and personal behavior. We will advance scientific understanding. And we will empower new generations of public health leaders to create a healthier world for all of us. The pages that follow describe our four major undertakings in this Campaign, as well as a few of the people who are tackling these threats—what they are doing now and what they are capable of doing with your support. Please join us. julio frenk Dean of the Faculty, Harvard School of Public Health T & G Angelopoulos Professor of Public Health and International Development, Harvard School of Public Health and Harvard Kennedy School 3
our miss togethe Reverse global h threats old and new pandemics / harmful physical and social 4
sion er: e four health s. environments / poverty and humanitarian crises / failing health systems 5
Old and new pandemics
THIS TEXT IS NOT MEANT TO BE READ. TO CALL SOMEONE A VICTIM OF ELDERLY DISENCHANT 6
Developing tools to reverse killer diseases Imagine a world where… • Boarding an international flight no longer sparks the risk of a deadly pandemic • The underlying genetic and biological causes of conditions such as diabetes, cancer, and Alzheimer’s disease are better understood and addressed • Diseases that now kill millions—such as AIDS, TB, and malaria—are prevented through affordable vaccines and common sense changes in behavior
www.hsph.harvard.edu/campaign/pandemics
working for everyone’s health
uncovering root causes Today, HSPH faculty, students, researchers, and alumni are on the
front lines of efforts to halt the next global pandemic. They are working together to ensure that we never again suffer an outbreak on the scale of the 1918 influenza, which killed 50 million people worldwide, afflicted over 25 percent of the U.S. population, and caused
average life expectancy in this country to plunge by 12 years. They
are mining big data to find new clues that may one day stop TB in
its tracks. And they are discovering the genetic keys to understanding diabetes and other chronic killers.
From obesity to AIDS, from metabolic syndrome to malaria, HSPH is challenging accepted wisdom and pushing forward the frontiers
of knowledge for the common good. We are building on lifesaving
work that slowed and ultimately reversed the spread of HIV/AIDS.
We are harnessing cell phone technologies to better understand, and
move to halt, the spread of malaria. We are revealing molecular codes that influence how and when we get sick. And perhaps most importantly, we are at the forefront of efforts to identify and stop diseases that have yet to arise, long before they take hold.
Initiatives seeking support include: • Predictive Pandemic Modeling—finding new ways to forecast, track, and treat pandemics • Metabolic Diseases Initiative—tackling the root biological causes and effects of inflammation, stress, and metabolic processes that result in lifeshortening diseases • Defeating Malaria—a partnership with the U.N. Special Envoy for Malaria
on the front lines: outwitting malaria To stop the spread of malaria, HSPH molecular entomologist Flaminia Catteruccia is learning everything she can about the reproductive biology of mosquitoes. She is developing innovative ways of rendering male mosquitoes infertile to reduce the incidence of mosquito-borne malaria, which kills roughly one million people each year and for which no vaccine is yet available. With mosquitoes increasingly resistant to insecticides and other traditional countermeasures, innovations like these have never been more important.
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harmful physical and social environments
THIS TEXT IS NOT MEANT TO BE READ. TO CALL SOMEONE A VICTIM OF ELDERLY DISENCHANT 10
Preventing pollution, promoting healthy communities Imagine a world where… • People make healthy food choices in accord with sound science—and lead longer, happier lives • Substances that threaten our environment and health are less prevalent in the air we breathe, the water we drink, our homes, and our workplaces • Smoking, violence, and alcohol abuse no longer threaten health in the U.S. and beyond
www.hsph.harvard.edu/campaign/environments
working for everyone’s health
Where DNA meets daily life Some of the world’s biggest health challenges emerge as a result
of a complex combination of factors. Genetics, poverty or relative affluence, choices we make about how we live our lives, even the physical and social spaces where we live and work—all can play a role. Chronic conditions like heart and respiratory diseases,
diabetes, and certain cancers—not to mention public health crises like gun violence and suicide—are just some of the problems that can be caused and sometimes controlled by human actions.
As chronic diseases sweep through rich and poor countries alike, they are straining already over-extended health systems. These
diseases—many of them tied to obesity and overweight, many tied to pollution—will take a staggering economic toll of $47 trillion
on the world economy over the next two decades. And unless we take action, they are expected to kill 52 million people a year by
2030. That’s roughly the population of England. It is the equivalent of about 285 jumbo jets crashing each and every day.
Our faculty and students are in the vanguard of efforts to thwart this
catastrophe, working to change individual behavior and to understand
and address the big picture: both the physical causes of disease and the effects of toxic social and emotional environments, which can give rise to violence and a host of mental and other health problems.
Initiatives seeking support include: • Obesity Prevention—turning the tide of the global obesity epidemic • Health Mapping—geographic information systems to map environmental exposures and health effects • Injury and Violence Prevention—conducting rigorous research to support evidence-based policy approaches to reducing gun violence
on the front lines: a champion of healthy eating If you were asked to name one person who has changed how we eat and live, the answer could well be Walter Willett MPH ’73, DrPH ’80, chair of HSPH’s Department of Nutrition. A leading voice in national and global campaigns for healthier food, Willett and his collaborators are widely credited with proving that diet plays a major role in the outbreak and prevention of ailments including cancer, cardiac disease, and diabetes. The dangers of trans fats, the link between sugary beverages and the global obesity epidemic, and the association of red meat consumption with colon cancer are just a few of the breakthrough insights we owe to Willett and his HSPH colleagues. One of the most prolific and widely cited researchers in his field, Willett’s stature in the scientific community has accorded him an outsized role in shaping nutrition policy and influencing individuals’ eating habits. Willett is one of the driving forces behind HSPH’s The Nutrition Source— a website that provides clear, scientifically sound advice on healthy eating to millions of visitors a year—and he has been at the forefront of many healthy eating campaigns targeting the leading causes of obesity and related health problems such as diabetes.
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poverty and humanitarian crises
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Advancing health as a human right Imagine a world where… • Nearly one billion people no longer go to bed hungry every night • Humanitarian workers have the skills to operate consistently in effective ways in overwhelmingly difficult conditions • Poor women in developing countries no longer die of preventable causes during childbirth
www.hsph.harvard.edu/campaign/poverty-humanitarian
working for everyone’s health
When disaster strikes Even when aid dollars are flowing, humanitarian intervention doesn’t always work as it should. Tragically, despite the best intentions, aid
workers often lack the training, coordination, and systems needed to identify and implement effective and culturally appropriate aid. The Humanitarian Academy—the first comprehensive educational pro-
gram for aid workers offered by a major global university—is teaching humanitarian workers to operate effectively in crisis situations and
training the future leaders of aid agencies and government programs. Meanwhile, every two minutes, a woman dies in the act of giving life. Every year, about 3.1 million newborns die and 1.2 million
are stillborn due to complications during delivery. Almost all of
these deaths are preventable. The Women and Health Initiative at
HSPH is working to change the forces that threaten the lives and
livelihoods of women and families around the world. Collaborating with international aid groups, local agencies in several countries,
and numerous programs across Harvard, the Initiative coordinates,
convenes, informs, and advocates on behalf of women’s and children’s health as well as women in their roles as health care providers.
Initiatives seeking support include: • Global Nutrition—roll-out of proven nutritional interventions to improve health despite poverty and deprivation • Women and Health—a portfolio of initiatives to improve health conditions for mothers and children worldwide and advance women’s roles in health systems • Harvard Humanitarian Academy—building knowledge and skills for people on the front lines of humanitarian relief work
on the front lines: lessons in resilience Theresa Betancourt, SD ’03, has dedicated her life to helping the world’s most abused and traumatized children. An HSPH alumna who is now associate professor of child health and human rights at the School, Betancourt has been working in some of the most war-ravaged parts of the world for more than a decade to trace the emotional lives of former child soldiers and other exploited youth. She is learning what it takes to promote resilience and healing, and working to identify the conditions that move deeply scarred children into meaningful and productive lives. “We need to devise lasting systems of care [in war-torn countries], instead of leaving behind a dust cloud that disappears when the humanitarian actors leave,” she says. Her work, which draws on both large-scale numerical analyses and direct, one-on-one interviews with affected youth, helps guide the interventions of countless professionals working across local and international aid organizations, United Nations agencies, and government programs.
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failing health systems
THIS TEXT IS NOT MEANT TO BE READ. TO CALL SOMEONE A VICTIM OF ELDERLY DISENCHANT 18
leading change, changing leaders Imagine a world where… • Public health learning as a lifelong enterprise helps enlightened leaders save lives • Affordable, high-quality health care innovations rapidly advance from laboratories to people’s lives, and disparities in care are eliminated • Health officials worldwide learn quickly about proven policies and interventions that work
www.hsph.harvard.edu/campaign/health-systems
working for everyone’s health
leadership for a healthier world We need better results for the money we spend on health care.
Yet even powerful ideas to transform health systems in the U.S. and around the world will only be as effective as the people who put
them into action. This is why HSPH is dedicated both to leading change and changing the leaders of health systems.
Our faculty are identifying ways to prevent costly and life-threatening medical errors, determining which prevention programs and medical treatments deliver better care more efficiently, and ensuring that
access to affordable care is viewed universally as a right, not a privilege. Simultaneously, HSPH is reaching health leaders globally at all
stages of their careers. For example, new programs for Ministers of Health and of Finance have brought more than 40 current cabinet-
level leaders from Africa, Asia, and Latin America to the School in just two years. Working with Harvard’s Kennedy School and the
African Development Bank, programs like these, and their built-in intensive follow-up, are designed to help these leaders achieve
specific policy goals by equipping them with new information, resources, and connections.
Initiatives seeking support include: • Ministerial Leadership Program—executive education for public health leaders around the world • Health Systems Innovation—better, safer, and less expensive health care through innovations in electronic health records, payment policies, checklists, malpractice reform, and other strategies • HarvardX—delivery of public health education online, providing previously unimaginable global access
on the front lines: getting things right in the operating room Powerful ideas aren’t always complicated. One remarkably simple intervention devised by HSPH Professor and alumnus Atul Gawande— a brief checklist for surgeons, similar to the safety checklists used by airplane pilots—has already prevented tens of thousands of deaths and injuries in dozens of countries around the globe. Beginning in 2007, Gawande, MD ’95, MPH ’99, led the Safe Surgery Saves Lives program at the World Health Organization (WHO), which created the WHO Surgical Safety Checklist based on his pioneering work at HSPH. In a worldwide pilot study, the safety checklist was shown to reduce deaths and complications following surgery by more than a third. Today, Gawande and others have launched Ariadne Labs, a joint center at HSPH and Brigham and Women’s Hospital that extends this approach to areas such as childbirth and end-of-life care.
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Campaign Priority: People
Supporting scholars and scholarships HSPH prepares bright, dedicated people to tackle health issues
affecting millions around the world. Our graduates drive the discovery and implementation of big and important ideas. But we need
significantly more funding for student aid to ensure that a lack of
financial resources and heavy debt burdens do not prevent the very best students from attending HSPH and pursuing a public health career when they graduate. Working to change the system Bethany Holmes, SM ’12, Health Policy and Management, had a rewarding job raising money to help deaf children hear. When she witnessed a five-year-old boy learn to hear and speak after receiving cochlear implants, she was deeply moved. But she was also outraged that the U.S. health care system makes such care available to only a few of those who need it. “It makes you want to change the system so that everyone who is suffering has access to what they deserve,” she said. With much needed financial aid, Bethany came to Harvard to do just that. “When the department chair called me and warmly invited me to the program and offered me the Carson Fellowship, I was floored,” said Bethany. “That’s when I knew I’d be coming here.”
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An investment in financial aid supports not only our students but
also the countless lives these students will touch in the course of their public health careers.
Enrollment 1,212 students
35%
65
International students
Percentage of students who depend on grants from the School and other sources to cover all or some of their expenses
Average debt load of HSPH graduates
$75,454 2012 figures
The product of many kindnesses “There have been few heroes in my life and Dr. Donald R. Hopkins is one.” With these words, U.S. President Jimmy Carter paid tribute to HSPH alumnus Donald Hopkins, MPH ’70, a legendary leader in the field of disease eradication whose accomplishments include a leading role in the elimination of smallpox. One of 10 children, the son of a carpenter and a seamstress, Hopkins likes to describe himself as the “product of many kindnesses,” referring to the financial support he received for his education. He has served as both Deputy Director and Acting Director of the U.S. Centers for Disease Control and Prevention. He has headed up health programs at the Atlanta-based Carter Center since 1987. His 1983 book Princes and Peasants: Smallpox in History was nominated for a Pulitzer Prize, and his many awards include a MacArthur “genius” grant. Hopkins’ sights are currently trained on Guinea worm disease, a parasitic disease so intensely painful that it has been dubbed “the fiery serpent.” In 1986, there were an estimated 3.5 million cases. Today, thanks in large part to the eradication campaign Hopkins leads at the Carter Center, there are fewer than 600 cases worldwide and the goal of complete eradication is within reach. “I’m increasingly confident that it’s less and less likely that the disease will outlive me,” the 71-year-old Hopkins recently told the New York Times.
COLLABORATION ACROSS CAMPUS
THIS IS NOT MEANT TO BE READ. IT IS HERE THAT HE HAS MOST CLEARLY THE PLAIN MARK OF THE MAN UNDERSTAND WHAT GOES.
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Campaign Priority: People
attracting and supporting the best faculty In the classroom, in the lab, and in the field, our faculty members teach students and conduct research that advances the frontiers of knowledge. Our faculty also travel widely, working directly with governments and organizations to translate research into public health programs and policies.
Currently, HSPH faculty raise more than 70% of our total revenue from
research grants, mostly from the U.S. government—far more than any other
Harvard school. This success in winning competitive grants is impressive, but
without additional sources of support for faculty, the School will be vulnerable to potential federal funding cutbacks, and our best and brightest will have to
spend even more time writing grants, rather than executing powerful ideas to create a healthier world.
Looking ahead, we need to increase the number of endowed professorships,
both to support and retain our most talented faculty members and to make sure that they can devote their best energies to research and teaching. We also need
adequate funding to attract the best young faculty and fund their early and most creative research ideas—ideas that frequently have difficulty gaining financial support from more established sources.
how public health should work When it comes to understanding and improving the environment’s effects on health, few have had greater impact than HSPH alumnus and faculty member Douglas Dockery, SM ’74, SD ’79. Today, Dockery is chair of our Department of Environmental Health. But in the mid-1970s, he was a young researcher at the School about to embark on what would become a world-changing air pollution study. The so-called “Six Cities Study”— one of the single most influential research projects in public health history—found that the most polluted air in the U.S. translated to about a two-year loss in life expectancy. Work by Dockery and his colleagues paved the way for the nation’s Clean Air Act regulations on fine particulate matter and continues to influence air quality regulation around the world. The Six Cities Study is also a textbook illustration of how public health should work: Good science shapes policy. Good policy saves lives. 26
Turning the tide on AIDS in Africa By the early 2000s, AIDS was increasingly viewed as a treatable chronic disease in the developed world. But for most patients in Africa it remained a death sentence. This was the state of things when Phyllis Kanki, SD ’85, professor of immunology and infectious diseases, spearheaded an HSPH application to the President’s Emergency Plan for AIDS Relief (PEPFAR), a $15-billion U.S. government program announced during then-President George W. Bush’s 2003 State of the Union address. Kanki’s application led to generous PEPFAR support for HSPH’s work with government ministries, universities, and non-governmental organizations in Nigeria, Botswana, and Tanzania. Ten years later, the legacy is enormous: Newly refurbished and equipped clinics and labs, thousands of trained health care workers, and treatment of more than 160,000 people who would otherwise not have received lifesaving AIDS drugs. “Everyone was surprised by what we were able to do,” said Kanki. “In the grant application, we said that we would enable 100,000 people to obtain treatment in Nigeria. That number seemed astronomical at the time, but in the end, we far exceeded it.” Moreover, the impact of the work by Kanki and her colleagues extends far beyond the AIDS crisis, in the form of resources, strategies, and guidance for addressing other treatable infectious diseases, including tuberculosis, malaria, and chronic diseases such as cancer and diabetes. “PEPFAR changed the way we think about what public health can accomplish,” Dean Julio Frenk concluded.
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Campaign Priority: Ideas HEADER GOES HERE AND ON THIS LINE AS WELL
transforming public health education Education at HSPH has never been more vibrant. Our traditional degree programs are undergoing a renaissance, incorporating exciting innovations and experiential
approaches to teaching and learning. A new Doctor of Public Health program will
launch in 2014, and a re-envisioned Master’s degree program is also planned. We are
expanding our executive education programs to serve current and future public health leaders with unique leadership programs for every career stage. And we are reaching
tens of thousands of new students around the globe with online learning opportunities
through edX, Harvard’s joint venture with MIT, which has now been joined by dozens of other leading universities from North America, Europe, Asia, and Australia.
But these efforts need resources for faculty, field programs, technological innovation, and physical space—the building blocks of a 21st-century educational experience.
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Learning. To change the world. The talented individuals educated at HSPH advance knowledge through groundbreaking research. They educate new generations of students. They transform lives as leaders in government, non-governmental agencies, private firms, and health care systems. To succeed, today’s students need both in-depth knowledge in specialized areas of public health and a wealth of practical skills that enable them to work nimbly and collaboratively across the wide range of disciplines involved in improving the world’s health. In short, they must become “T-shaped” public health leaders. We are re-envisioning our approach to educating public health professionals to meet the changing needs of these students, help them build practical skills, and prepare them to work effectively in the field. We are replacing lectures with case work and field studies, team-based learning, simulations, and other experience-oriented opportunities. We are harnessing the latest advances in educational technology. And above all, we are building a faculty that is well-versed in innovative teaching methods, public communications, and leadership skills, all of which are vital to achieving broad impact in public health. With your support, this transformation has the potential to reshape not just the School, but the entire field of public health education.
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Campaign Priority: Ideas
advancing research HSPH is an engine for innovation and discovery, extending
the limits of human knowledge, and putting that knowledge
to work to produce visionary ideas and cost-effective solutions that improve the lives of people everywhere. Through rigorous
research sustained over years and even decades, we are connecting great minds with big problems and working to overcome many of today’s greatest threats to human health.
An investment in HSPH is an investment in large-scale, longterm impact. Today, as it has for the past 100 years, research at HSPH is changing the world.
Ramon Sanchez, SD ’11, sees the future of energy production—and cleaner, healthier skies—in microalgae. 30
driving innovation The Dean’s Fund for Innovation offers a critical
source of unrestricted funding for the School, allowing the Dean to invest in pioneering new initiatives, educational improvements, and junior faculty
research. It enables the School to take advantage of
fast-moving opportunities such as the recent launch of HarvardX and provide bridge funding when it is needed to sustain important research.
With your help, the Dean’s Fund for Innovation
supports our ongoing activities, makes the School
more nimble in responding to emerging challenges and opportunities, and fosters new discoveries that
lead to improved health for people across the globe.
70%
of HSPH total revenue comes from research grants, mostly from the U.S. government—far more than any other Harvard school
percentage of total revenue from endowment distribution Harvard School of Public Health
All Harvard schools (average)
14% 33% 2012 figures
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Campaign Priority: infrastructure
big data Our ability to generate data has moved light-years ahead of
where it was only a few years ago, and the amount of digital information now available to us is essentially unimaginable.
Buried in all these data are clues for everything from how to prevent tuberculosis to how to cut health care costs.
Faculty in our departments of biostatistics, epidemiology,
and genetics and complex diseases are at the forefront of the burgeoning field of “big data” and their work forms the bedrock of much of the School’s research. But they require both technological resources and significant financial support
to translate these countless terabytes of information into meaningful public health interventions.
Support for biostatistics, epidemiology, and genetics
research and faculty strengthens the building blocks of all
public health research and reinforces the School’s scientific and intellectual foundations.
“If you think about the scientific revolutions that have occurred in history, they’ve been driven by one thing— the availability of data. From Copernicus to quantum mechanics, from Darwin to the human genome project, it’s data that drives innovation.” John Quackenbush, professor of computational biology and bioinformatics 32
a campus for the 21st century People engaged in 21st-century learning and research need 21st-
century facilities and technology to do their best work. However,
the School’s aging buildings and technological infrastructure require renewal if we are to continue to attract and retain the best students and faculty.
Some of the best opportunities available to leave a lasting mark in
this Campaign surround the creation of a campus that is worthy of
Harvard School of Public Health, built to foster continued innova-
tion and global engagement and to ensure that its second century of impact is as remarkable as its first.
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in which health is treated as a right, not a privilege. Where the threat of pandemics is mitigated by scientific intervention. Where communities bond over smart choices in nutrition, exercise, and preventive medicine. Where the costs of health care actually decrease in direct proportion to the improved health of the world. These are some of our goals—and they point to areas where Harvard School of Public Health is having a critical real-world impact today. But continuing to change the course of history requires more than determination, and the Harvard name on our door. It also requires you. imagine a world
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a message from the campaign co-chairs
The Campaign for Harvard School of Public Health is an historic effort to transform HSPH and to achieve sweeping results in the wider world. Focused on turning back four major threats to public health around the globe—old and new pandemics, harmful physical and social environments, poverty and humanitarian crises, and failing health systems—the Campaign will support the people, ideas, and infrastructure HSPH needs to translate research into world-changing influence and impact. The faculty and students at Harvard School of Public Health are dedicated to solving some of society’s most daunting and important problems. They recognize the importance of mobilizing expertise within the School and across Harvard to achieve lasting change. That is why we have enthusiastically volunteered to help Dean Julio Frank lead the capital campaign effort. The Campaign can seed exciting new collaborations and bold new ideas that will reverse killer diseases, prevent pollution, and promote healthier communities. Furthermore, the Campaign will enable HSPH to lead change and change leaders while advancing the work of everyone at the School to promote health as a human right. We are honored to be working on this Campaign effort with fellow Harvard Business School alumnus, Richard Menschel, and his wife Ronay, who will serve as honorary co-chairs after successfully leading the School’s last campaign. The Menschels have identified HSPH as one of their top philanthropic priorities for more than 20 years—and it is no wonder. In supporting HSPH you are investing in an institution with a long track record of using evidence-based research to create a safer, healthier world. You leverage the immense talent assembled at the School to improve millions of people’s lives. We are proud to support the School and help Dean Frenk accomplish HSPH’s goals. We hope you will join us—and invest in the people and ideas that are truly changing the world. Jonathan Lavine, MBA ’92 and Jeannie Lavine, AB ’88, MBA ’92 Co-Chairs, Campaign for Harvard School of Public Health 35
a message from harvard university president drew faust
The Harvard School of Public Health has always recognized the global nature of knowledge, collaboration, and action, pushing the frontiers of discovery forward and translating rigorous research into action and influence that change the world. At the same time, the School plays an important integrative role across the University. Bringing ideas and people together, it draws on the remarkable strengths that exist at Harvard, posing questions and developing answers that have the potential to shape a better future for all of us. The public health moment in which we are living poses many challenges. We have an unsurpassed capacity to rise to them. When you support the Harvard School of Public Health today, you invest in a healthier and safer world tomorrow. drew faust President of Harvard University Lincoln Professor of History
For more information on how you can support the Campaign for Harvard School of Public Health, visit the campaign website: www.hsph.harvard.edu/campaign
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Principal photography: Kent Dayton and Aubrey Calo. Additional photography: Olivier Asselin/ Alamy, Suzi Camarata, Paul Cowan, Joe Driscoll, Louise Gubb/The Carter Center, Corey Hendrickson, imagebroker/Alamy, istockphoto.com/Andrei Tchernov, istockphoto.com/barsik, istockphoto.com/ Joakim Leroy, J. D. Levine, Rose Lincoln/Harvard University, Look Die Bildagentur der Fotografen GmbH/Alamy, National Geographic Image Collection/Alamy, Richard Nowitz/National Geographic Society/Corbis, Tony Rinaldo, SPL/Science Source, Susan Young. For detailed photo credits, please visit www.hsph.harvard.edu/campaign/case-photo-credits. Printed on Monadnock Astrolite PC 100. Astrolite is made using 100 percent renewable electricity and is manufactured carbon neutral.