The Eradicator: Ellyn W. Ogden, MPH

[0:00] With every job I try to learn something that I didn’t know before and it helps prepare you for opportunities in the future you never know when that one little thing you learn is going to become incredibly valuable for some opportunity in the.

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[0:21] Paging dr. cook paging dr. cook dr. Kirk you’re wanted in the or doctor.

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[1:20] Well my guest today has been the worldwide polio eradication and senior technical advisor in health and child survival for usaid for the past 25 years.

[1:33] For most of us polio is an historical issue.

[1:37] In other parts of the world it’s still very much a threat so let’s your public health expert Ellen Ogden tell that story.

[1:45] Music.

[1:50] I am really excited today to be having a conversation with.

[1:55] Ln Ogden who has been a fierce Frontline combatant and the war against a number of infectious diseases over the years especially polio.

[2:05] And it’s really an interesting story that we’re going to hear Alan I’m so excited to have you here thank you so much for taking the time.

[2:12] I’m delighted and I know you just got back into the u.s. from Nigeria quick question what were you doing over there this time,
thanks for asking I was over there looking at their polio eradication outbreak response activities in Abuja Alpin Cano State as well so I had a great chance to talk to the vaccinators supervisors check out the,
the cold chain and see what’s happening with the vaccine listen to people’s concerns about vaccine hesitancy,
um and made some recommendations back for improvement fabulous so and how do you think they’re doing or they are they going to are they going to make polio go away.
Well if you’re in polio eradication you’re always an optimist I’ve been at this for 30 years and we continue to see progress.
There have been setbacks but you keep working the problem and keep trying harder and understanding what’s motivating people to get vaccinated or where the obstacles are and getting vaccines out to children
and we have yeah consistently overcome.

[3:18] All of those obstacles well we’re going to get more into the details of that a little bit later but as we always do Alan I want to start with your origin story.

[3:28] And as I look over your bio I noticed that
in your early life you actually spent some time as a nursing assistant working around I see using CC use in emergency rooms and
whatnot and it made me wonder if at that time in your life you had an interest in becoming a practitioner of some sort either a physician or a nurse or whatever or what.
What was in your head at that time in your teenage years,
my first interest in things both medical and international started when I was about 7 years old when I started hearing about smallpox eradication
and it was about the same time I started hearing about the UN and I asked questions my mother was a nurse my dad worked internationally for IBM and really became
very curious about how diseases spread and populations sort of what we could do to make it better
I mean my very young seven-year-old mind thought oh I could be a doctor and go out and help people and and prevent diseases
and as I profound for a seven-year-old all right it was an epiphany back then but I was just so excited about it
and throughout my younger years I did try to travel I,
you know studied a lot of the Sciences I studied international relations.

[4:55] My undergrad degree is in international relations with a minor in pre-med yeah and I wanted to I wanted to ask you about that and and again to help myself and our audience get a little focus when you
matriculated it to Lane with that international relations degree
in mind did you have a plan for what it was going to look like or did that come later there was actually an important thing that happened a little before then I actually started undergraduate at Emory
in Atlanta I did huh
and I was a pre-med major and an international relations minor and I ended up needing money and took a year off and that’s when I did a lot of the work in hospitals
that’s when I worked as a nursing assistant I see you see see you also drug and alcohol rehab for a little bit
and ended up reapplying to school and ended up at Tulane and I was
signing up for courses as a junior my first courses as a junior at Tulane and I’m flipping through the course catalog and seeing all of the Sciences all of the
international relations courses which was great but then in the back of the book is this little thing called the school of Public Health and I started reading the courses that were being offered there.

[6:15] And I had never been exposed to a school of Public Health before wasn’t even whereas before the undergraduate programs and international health and public health were being offered
so you were not even aware that Tulane was one of the most respected Public Health
universities on the planet at that time that is correct I went there really 242 further in pre-med and international relations and then that moment I switched majors
and wanted to be the international relations major
pre-med minor with the idea of going to Public Health school for international health and epidemiology
a happy accident I know just flipping through the catalog I was sitting on the floor and my dorm room what was your picture what was the picture in your head at that point of what a career in international relations would look like
I had a vision of walking around in sort of remote Villages talking to people
and I knew about smallpox so I had this vision of a bifurcated needle and going up to people and just asking if they wanted vaccinations.
It was a very simplified view yeah.

[7:28] Of of what I imagined so the the dream obviously I had a way to go before
maturity and and I’m gathering just by looking at your bio once you had your degree in hand that was about the time that you embarked on your service in the Peace Corps is all right
that’s true it actually what I’m one of the things I learned about International health is you actually have to have experience and.
In order it’s a chicken and egg how do you get experience if you need to be working to pay your loans and student debt
so I knew I had never had the opportunity to work overseas but yet knew how important it was
and in this time in my graduate. I met my husband and
we decided that the best way for both of us was to join the Peace Corps
I would get International experience he would also get some experience he loves to travel and we would come back to the DC area,
and he would look for a job in his field and I would have the experience needed to look for the job in my field and yeah
it took us about two years to get placed in Peace Corps as a married couple both with master’s degrees by that point and,
um we were in Papua New Guinea I had a remote island.

[8:55] And I was running the provincial Disease Control program and mostly T be leprosy STDs and,
various outbreaks of things coming along we had no money we had no drugs
I the people I was working with barely had a high school education but that was the health system,
and it taught me a lot about how to work in lower-income country,
with limited resources how to engage with people in the community how to
provide health promotion and messaging and to really understand what it was like to do Service delivery in those kinds of settings it was groundbreaking
for me yeah I bet it was and I’m wondering if after your Peace Corps training where you sort of given the
the admonishment that now we have told you how to do your job go out there and do it or.

[9:54] Were you aware that you were going to be totally dependent on your own resourcefulness when you got there we had a little bit of support but pretty much we knew we were going to be on our own when we were out there
I mean this was all pre cell phones and,
oh yeah and everything so we were very isolated and you just had to be resourceful and make do with what you have
and I bet that was to say the least valuable part of your education leading up leading up to what would become a really Stellar career for you and and I’m interested in that next step.

[10:29] Tell us the story of your connection with usaid and what happens from there
when I came back from Papua New Guinea my husband and I moved back to the Washington area because that’s where a lot of the international jobs are in public health
it’s grown since then but it’s still really The Hub of where things are happening and I was,
in my husband’s office actually writing up my resume on an old typewriter and his boss came in and said who is this and
they said this is Neil’s wife Ellen and what she doing she’s looking for a job,
this is all you need to talk to George Carlin over at niaid.

[11:12] The National Institute for allergy and infectious disease so I did I called him and he said what are you interested in and I explained I was interested in international Health infectious disease epidemiology
he says you really need to talk to
somebody at usaid we do more medical research if you want to do field operations you need to talk to somebody at usaid and he shared a couple of names and numbers.
And so I called them and within
a fairly short period of time I had been interviewed and found a couple of opportunities that looked good and picked one that was actually called a data for decision-making project with what
the predecessor to usaid’s Global Health Bureau
and it was right at the time of the child survival Revolution when there was a huge push on immunization and oral rehydration therapy.
To reduce vaccine preventable diseases and diarrheal disease and the developing world
and so I came in at a time when that was just taking off and so was able to help craft
some of those projects to analyze their midterms develop and design the follow-on projects and really look at how we were implementing
field programs around the world to better the health of children.

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[14:42] And now let’s get back to today’s interview well that’s really interesting and so what happened next what was I mean you clearly you had had,
quite a bit of overseas experience with the Peace Corps but this was going to be quite a different quite a different challenge for you what was the next stage.
This particular job allowed me to fill a gap in my background so,
because I came in as a project manager of a child survival contract I got to learn management financing
budget I learned how to develop consultancies in terms of references and all of the nuts and bolts that you need to have when you work with a development agency.
And so my technical knowledge and my knowledge of international things and how to work in an international setting is useful if you want to be a subject matter expert.

[15:42] But in usaid were donor funder we fund programs you have to understand the money side,
and how to get policies set and how to get all the documentation ready so that you can actually put the money behind the programs that you want to develop
and this job offered me that opportunity yeah and it sounds like you were a bit of a rarity my thinking right now hearing your story is that you are a person
who actually has an interest in the disease eradication and public health and that sort of thing that typically you might expect someone with a scientific background to be involved in but
the logistics of making that happen with funding and knowing how to apply for it and find it and make it happened is typically.
I’m thinking not the sort of thing that,
you’re prepared for during your education undergraduate or even graduate education for example but they were ready to give you the training and you were.

[16:47] Apparently a pretty good learner if I got that right.
Absolutely I got on that right away and really started to understand how us Aid worked how contracts grants Awards work understanding the money the budget Cycles.
All of that but then also using my technical expertise to design things in a way that we’re going to make a difference
I think that makes you a rare individual that you were willing to embrace to relatively disparate
disciplines and you did it very well it has served me very very well we’ll talk about that when we.

[17:26] We talked about my work in polio eradication because not only do I manage a technical side but also a huge financial component
as well the other thing that this job first out a Peace Corps offered me was the opportunity to learn about communication media.
Things like that how you get your message across.
And I was fortunate enough to work on some of the usaid documentation for the world Summit for children in 1990,
and the press kit that we put together actually won an award at the time among government Publications for one of the best press kits that year
with every job I try to learn something that I didn’t know before
and it helps prepare you for opportunities in the future you never know when that one little thing you learn
is going to become incredibly valuable for some opportunity in the future well you were clearly A Gifted learner and you also are a gifted
interview guests because you’ve just given me the perfect segue and and I do want to
go into great detail I would like for you to go into great detail about your work with polio eradication,
most of our audience I think.
Will be people who have either careers in healthcare or some connection with health care and and there may be a few among them who.

[18:56] Are aware that.
Polio is not gone in other parts of the world so I’m just going to let you take it from there how did you get interested.
And interested in polio eradication and what were the steps for how you got there.

[19:12] It’s been quite a journey my second job out of Peace Corps was I was offered a fellowship to work within usaid’s Latin America Bureau.

[19:25] And that was a really interesting experience it was done through Johns Hopkins University and I was called a health and child survival fellow.
And I was responsible for a fairly large portfolio working in Central and South America and my portfolio included,
things like nutrition health and human rights Pharmaceuticals breastfeeding maternal Health maternal mortality but it also included child survival
and immunizations,
and at the time usaid was funding the Pan American Health Organization to do work in polio eradication in the Americas.
And so I got to be part of those discussions and help manage the awards to paho
Pan American Health Organization and learn about what they were doing in polio eradication,
and I was fortunate enough to work closely with the man who is.
One of the most influential people in my life dr. Sierra de quadros who was a brilliant.

[20:37] Brazilian physician and really envisioned,
how to do polio eradication he worked with Albert Sabin to Think Through what would be the steps for Global eradication and so usaid was helping to fund that and really test it out to see if it works.

[20:56] And so I learned an enormous amount from him when I worked in our Latin America Bureau.
And was there during the whole certification part of that process so how did countries actually prove that polio is gone and that involved,
looking at polio surveillance it looked at campaign quality.
Immediate Mass immunization campaigns it looked at the factors of routine immunization what the underlying immunity you would get from well baby immunization.
And what are some of the factors that would inhibit us from actually stopping polio transmission.
There was insecurity there was a sandinistas there was a shining path that were blocking,
some of the efforts to vaccinate children when I hear things like an organized resistance to vaccinations
I need a little explanation do you do you have any idea of what mindset is behind that nonsense it’s the reasons Barry and I’ve worked now with many,
groups that are resistant or.
Blocking access to vaccination most of the time it is not because they actually oppose immunization.
They opposed strangers coming into their area that they’re trying to control as an Rebel group or an anti-government group.

[22:26] They don’t want people nosing around in in what’s happening there they definitely don’t want people going house to house.
Searching for kids because you don’t know what else they’re recording and Reporting back on.

[22:40] So many of these Rebel groups are anti-government groups are not necessarily anti-vaccine
it’s really about field operations I see so it’s more a matter of concern about for an ideologies that might be introduced along
with the vaccine sometimes but not not so much I mean you can imagine being an anti-government group you have weapons.
Stashed away you have people who are unwanted lists you have other folks wanting to know.
Sort of how well setup or these communities to fight against the government it’s more about an Intel Gathering than it is about foreign ideas being introduced.
This is this has been a an issue.
For health workers working overseas for a long time making sure there’s a bright line that there is no intelligence gathering during these periods when we’re out doing Public Health that is not what we’re about.
But the suspicions are deep and they don’t know you and it’s just easier to borrow access than to to let people come in and vaccinate.

[23:54] That’s really fascinating and I apologize for the interruption to do go ahead no it’s a really important thing and we’ll come back to it because I’ve had it’s one of the key things I learned from Syria to quadros,
is how to approach those situations.
And what you need to do to be successful and I really learned a lot from him that I was able to apply later on which which I’ll tell you about when we get to that.
That point great time.
Yeah so in 1996 the US Congress created the usaid polio eradication initiative
and provided us with our first tranche of specialised funding and the agency was looking around for who could manage
this new initiative and so I was known in the agency for our work and polio and Latin America for a working immunization.
They knew I understood financing and they earmark process and how Congressional money works.
I had been helping to manage grants to who the World Health Organization and UNICEF and so all of those skills.

[25:09] We’re really valuable when the agency needed a polio coordinator and polio.
Require not only knowledge of immunization but surveillance and the laboratory network communication and.
Your public awareness about vaccines and so the job of being the polio eradication coordinator for us Aid really brought together.
Many of the skills and lessons that I had gathered in the previous jobs in my career.
Mmm tell us more what was next you’re all the logistics are done what’s it like to be there and be on the front line.
Well working with usaid has really been my dream job I have a bipartisan Congressional support.

[26:01] We have a budget.
I have senior leadership that understands what we’re trying to do I work not only with who and UNICEF but I also manage a network.
On ngos and Civil Society organizations to work in immunization and we’re growing that to now include more than just vaccine-preventable diseases but also.
Other pandemic threats and diseases of Public Health concern,
we’re growing Community Based surveillance activities we’re promoting strongly evidenced space communication to overcome vaccine hesitancy so it’s a very rich.
Portfolio.
And I’ve been managing it since 1997 mostly through grants and agreements to as I said who and UNICEF and this Consortium of non-governmental organizations.

[27:00] And since 96 we’ve put in almost two billion dollars.
For polio eradication just through usaid that I’ve managed over my career it’s a pretty successful.
It’s success it’s successful in the sense that it so it’s a lot of money.
But we’ve also seen a very dramatic results in terms of polio around the world so when eradication first started there were 125 countries with.
Poliovirus almost 400,000 cases a year.
All three types of Wild Virus recirculating there’s three types one two and three and last year there were only two countries.
With wild polio virus and five documented cases in 2021.
That’s got to make you feel pretty good it really is a remarkable program we estimate.
That again since the beginning of eradication we have prevented almost 20 million cases of childhood paralysis.

[28:08] And vaccinate well over 500 million children a year.
Against polio that is really amazing and I’m hoping you’ll tell us something about what was.
The Experience like of being in these underdeveloped countries and living in those conditions and trying to do what you came.
To do was it how did you find it difficult was the resistance demoralizing what was the story,
in most of the places that I’ve been,
people are very enthusiastic your it’s rare to have money political commitment technical.
Knowledge on how to do something this big it was a big goal and in the mid 90s early 2000s.

[29:04] You could not generate more excitement when you were in the field.

[29:08] People welcomed you there I was monitoring polio campaigns in dozens of countries participating in disease surveillance reviews working on communication talking to communities.
There was this can-do attitude at the time.
And we started to see big declines in the virus so the virus itself was telling us that we were being successful,
and that was pretty remarkable but then as most big programs go not everything goes according to plan and you start bumping up against,
various obstacles so in Nigeria in 2003.

[29:53] There was a lot of concern about the vaccine.
And whether it causes sterility or other problems was it spreading HIV
and the northern Governors have Nigeria essentially put a halt to the polio program for a year until they could gather the evidence and understanding.
That the vaccine itself was not hurting people you have any idea where those Notions came from.

[30:20] They have been circulating for a while there had been a test done in a lab in South Asia I won’t mention which country.
That just thought they’d take a look.
At whether there were any hormones or anything like that and polio vaccines so they did a test to look for it but they did it at a.
Bench in a lab that also did pregnancy testing and so the the potential for cross-contamination was high and they published.
About it and rumors take off and misinformation takes off sometimes it’s.
It was truly just not understanding what was going on and then other people amplify it
um quite intentionally as mr. disinformation
but there were other factors it wasn’t just about the myths and rumors there were issues about the North and the South of Nigeria the north is predominantly Muslim the south is predominantly Christian,
and who was running the program and who was being selected as the vaccinators and was this an equitable program across the various tribal and religious groups
and what you begin to realize pretty quickly when you work on these Global scales.
Is that the epidemiology and science is is one part of it.

[31:46] But the really important thing to focus on or the people-centered issues the culture household decision-making perceptions.
Of sort of what the West is doing is their Equity among the various groups
and understanding these cultural and socio-economic barriers are really the keys to success.
Because you can’t just say take the vaccine we know it works it’s a great vaccine it’s going to help your kids that’s not going to be enough.

[32:21] Yeah and it’s a tough lesson and it’s Unique to every location.
And so you need tailored messages tailored approaches to be successful I’m wondering if you can reach back
in your memory and think of an instance or two that we did that was particularly,
memorable when there was maybe a watershed moment where you’d been struggling to get the message across and it was
seemingly just not going well and then something happened that changed it all have you got anything like that you can share with us.
I do have a pretty interesting story and it is one I’m very proud of it actually.
In the Democratic Republic of Congo it’s one of the largest countries in Africa.
It has some of the poorest populations very remote very isolated populations and it’s been at War for quite some time,
and the polio program had been trying to get access in the Eastern very large eastern part of the country.

[33:33] Millions millions of kids out there had not been vaccinated because of tribal fighting and rebel group fighting and
at the time the US ambassador to the Democratic Republic of Congo and asked me if I would see what I could do to negotiate a ceasefire among the three main Rebel groups.
In the Congo and see if I could broker a deal to get the kids back sedated and so I agreed and.

[34:04] You’re channeling what I had learned from Syria to quadros went out to DRC.

[34:12] To the eastern part of the country I came in through Goma and was able to meet with.

[34:19] The three main Rebel faction so summoned Goma I meant with Jean-Pierre bemba up and bought Elite and wamba day wamba.
Out near the Ugandan border and I shared with them the issues about polio that their children were getting paralyzed that we had good vaccines.

[34:40] That would prevent them from getting this this horrible paralysis,
and explain what it is we wanted to do to organize Mass campaigns for everybody in the eastern part of the country but we needed their agreement to not fight on the days of the campaigns,
and so going between them and really explaining and answering their questions it was almost all about logistics.
Who’s coming in what planes coming in what vaccines coming in they really wanted to understand all the aspects of the campaign preparation and who was going to be there.

[35:19] We identified what their roles and responsibilities were we said what the international community’s roles and responsibilities were.
And on a handshake I was able to get agreement from all of these three groups,
and they agreed to allow the polio campaigns.

[35:38] To go forward and that they would not fight and within six weeks.
We vaccinated 6 million children wow CRC.
You must be some kind of talented negotiator is all I can say that I don’t even know how to respond to that six million.
What a huge number and you you are rightfully proud I am very proud of that I am really.
Grateful to what I learned from dr. De cuadros the opportunities and the you know the confidence that people had in me.

[36:18] I went in with no security I went in with data I went in with a desire to find a way forward that everybody could agree on I was able to represent,
both the US and the polio program at the time to deliver on our promises and things actually went fairly smoothly.
And so those cease-fires held for most of the next 15 years that on the days of the polio campaigns.
None of the groups were fighting and that’s one of the things I’m most proud of,
well that is one of the most remarkable stories that I think I have ever heard of with respect to dealing with.
People who are at war with one another because I think as we all know it’s hard to convince people and a warlike State of Mind to listen to reason so clearly.
Helen there is something about you that rises above that and my goodness congratulations to you for being able to pull that off I have a philosophical question for you the numbers that you gave me before our,
to me astounding in terms of the numbers of virus that we know about that remains in the world do you think that we will see.
The eradication of polio In Our Lifetime and I’m a pretty old man by the way.

[37:44] As I said at the top you have to be an optimist working in polio we are we are very very close to interrupting wild poliovirus transmission right now with five cases,
um last year in some pretty isolated Geographic areas of Afghanistan and Pakistan there are many opportunities to vaccinate in the last remaining pockets in the last,
couple of weeks we were informed of a wild virus case in Malawi,
and there’s a big investigation now underway to figure out how it got to Malawi and to vaccinate.
Kids along the eastern coast of Africa but we have a good tool we have a bivalent vaccine that’s very good against
type 1 which is while virus type 1 which is the only Wild Virus circulating right now so full Interruption of of wild type virus is,
very feasible in my mind we know what to do we know where it is and we have the tools to do it.
Well and I do love to end the conversation on an optimistic note and you certainly have given me
great cause to be optimistic I had no idea that the the scale of the eradication over the past 24 years 25 years had been so profound
and I certainly think that that has given us good reason to be optimistic.

[39:09] And with that I’m going to close out the interrogation here and we’re going to move on to what’s my.
Favorite part of the program and that is when I get out of the way and allow our guests to speak to us person-to-person as it were so I’m going to close my mic and,
Ellen Ogden is going to give us her personal prescriptions for success.
Thank you so much Randy I look back on sort of this path that I’ve taken and what I was like as a young girl.
In growing up my father was fairly strict and you didn’t really speak too much unless you were spoken to.
You didn’t challenge authority you listen to what your elders were saying and your teachers were saying and As I Grew in my career.

[40:05] I realized that.
I could no longer sit there silently and listening when I saw something or heard something that didn’t make sense.

[40:17] The need to challenge assumptions the need to speak up the need to ask questions.
And one of the things that I have really learned is to be respectful but challenged Authority.
Challenge underlying assumptions.
Don’t be afraid to speak your opinion if it’s well-reasoned and you really have honest questions about it,
I learned a lot taking the Army’s red teaming course where they teach you how to be a good Devil’s Advocate.
And I think that that perspective is often missing as people get on the bandwagon and just start doing things because other people are doing them.

[41:03] So the the need to to challenge things to look at things differently it’s okay.
To do that I think it’s been one of my most important lessons and the place that I’ve probably grown the most since I was very very young.
I think the second thing is that I’ve learned not to be so serious and to have fun.
And bring in my family and friends into my experience.
When I was growing up I was very serious a very serious student and it really was until I got to Tulane in New Orleans where I met people that kind of pulled me out of the shell
and that allowed me to experience.

[41:50] A lot of diversity I got out of my comfort zone I met with people that I would never have met with before.

[41:58] I got new experiences I got to eat new foods and then when I traveled internationally all of that ability to.
Be plopped down into a location you didn’t know you’re not aware of their culture but to feel comfortable
to ask questions to understand the diversity around you to build relationships outside of your own culture,
to be yourself to have fun it’s okay to joke around with people you take the job seriously but you’re soft on people.
And that has been A Life Lesson since I was growing up so don’t be too serious be yourself have fun,
seek diversity get out of your comfort zone I think all of those things have really contributed to my ability to be effective.

[42:53] On the ground you see these opportunities the Dr Congo moment I told you about its being a normal,
person in an extraordinary situation and knowing how to address and seize that moment when you can really make a difference but you have to take that leap of faith forward,
I had never done it before I had heard about it I can do this I can make a difference here and don’t hold yourself back.

[43:25] You can make important contributions to this world if you seize the moment.
Seek the opportunities and don’t be afraid just be yourself and I’ll stop there with my journey and my prescription for success.
Well and thank you so much for sharing with us today this has been very inspirational
for me and particularly your prescriptions for success and we’re all better off for having the opportunity to hear you before we go I want to give you a chance to
tell people where they can find you and more about you so please go ahead and share what you will.
I think if you Google me Ellen Ogden usaid polio
a lot of things will come up I do have Publications I have been in some documentaries and so had done some other events.
But you know what I value really is my relationships with the people that I’ve met.

[44:30] Um and so encourage All of You Learn learn if you can from anything that I have to share and I do respond to emails and questions if I get them,
and I will add that it’s Ellen with a Y EA LL y n Ln Ogden and yeah you certainly can
learn a lot by Googling and we’ll have lots of information about you in the show notes that our listeners can consult as well so once again it has been a great pleasure to have a conversation with you and I thank you so much for being with us.
A great pleasure and you know good luck to all of you out there I know you’re going to do big things
thank you so much for joining us today as always we really appreciate a review from you and a five-star rating helps us a lot these ratings give our show much more visibility and they help us reach more listeners.
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Dot-com and while you’re there you can offer your very own personal prescription for Success on.

[45:54] As always very special thanks to Ryan Jones who created and performs the theme music for the show and remember be sure and fill your prescription for success with my next episode.

[46:06] Music.