AFS Creates Active Global Citizens: Dr. Rich Besser's Story

Before Dr. Rich Besser started his notable professional career, he was an AFS student in Australia. Since then, he has served as the Acting Director of the CDC, the Chief Health and Medical Editor for ABC News, and held many other impressive positions. Today, he is the President and CEO of the Robert Wood Johnson Foundation, a prominent philanthropic organization dedicated to shaping the landscape of health and healthcare in the U.S.
 
Throughout his expansive and varied career, the skills he gained during his AFS experience have proven instrumental. From public speaking to fostering curiosity and adaptability, AFS played a pivotal role in his success.
 
In this interview, we will hear about Rich’s experience in Australia, the lessons he learned, and how he has applied them to his work throughout the years. We'll also delve into the issue of health inequity in America and discover how the Robert Wood Johnson Foundation is diligently working to create meaningful change.

Guest:
Dr. Rich Besser

Study Abroad with AFS-USA: www.afsusa.org/study-abroad
Volunteer with AFS-USA: www.afsusa.org/volunteer
Host with AFS-USA: www.afsusa.org/host
Educator Resources: www.afsusa.org/educators
Contact us: podcast@afsusa.org

Transcript

Kate M.
Hello and welcome to The AFS Exchange. I’m Kate Mulvihill. The AFS Exchange is a podcast by AFS-USA where we open the door to hear from members of our AFS family. This is a place to have conversations, or exchanges, with AFS host families, students, volunteers, and educators.

Kate M.
In this episode, we are shining the spotlight on Dr. Rich Besser, an AFS alumnus whose path has been defined by excellence and impact.

In 1976, Rich went to Australia, a pivotal experience that laid the foundation for his exceptional career. Today, he works as the President and CEO of the Robert Wood Johnson Foundation, a prominent philanthropic organization dedicated to shaping the landscape of health and healthcare in the U.S.

The trajectory from his Australian adventure to his current role has been marked by significant accomplishments. After his exchange, Rich earned his medical degree from the University of Pennsylvania and a Masters in Public Health from Columbia University. He served as the Acting Director of the CDC during the H1N1 pandemic, or “Swine Flu,” under the Obama administration.

Following his time at the CDC, Rich joined ABC News as its Chief Health and Medical Editor. In this role, he provided expert analysis and reporting on health and medical issues for various ABC News programs.
He has been a longtime public health advocate, having written and contributed to many books and articles.

Throughout his expansive and varied career, the skills he gained during his AFS experience have been instrumental. From public speaking to fostering curiosity and adaptability, AFS played a pivotal role in shaping his success.

In this interview, we will hear about Rich’s experience in Australia, the lessons he learned, and how he has applied them to his work throughout the years. We'll also delve into the issue of health inequity in America and discover how the Robert Wood Johnson Foundation is diligently working to create meaningful change.

[Music]

Rich B.   
Yeah, my name is Rich Besser, I was AFS 1976 to Australia. I'm a pediatrician and epidemiologist, husband and father and the head of the Robert Wood Johnson Foundation. A large philanthropy focused on improving health in America.
 
Kate M.   
Where are you located these days?

Rich B.    
I'm in Princeton, New Jersey. That's where our headquarters is. I tend to spend more time now in New York City where we also have offices as well as in Washington DC.

Kate M.    
Right. So let's go back in time a little bit. How did you first hear about AFS?

Rich B.   
You know, I feel like I've always heard of AFS so I grew up in a family. I'm the youngest of four kids, my oldest brother, Mitch was AFS to South Africa, and he's five years older than I am. But my mom was very active in the AFS chapter in Princeton, New Jersey. She was head of that chapter for a period of time we hosted students at our house and so I don't remember not knowing of AFS.

Kate M.   
Why did you choose Australia?

Rich B.   
Well, actually, Australia chose me. so back then you couldn't pick your country and I wanted to go. You have two choices. You can either go from summer to summer or January to January. I wanted to go January to January to be back for the end of my senior year of high school. And I also wanted to go January to January because I figured that I would be going to South America and I would learn to speak Spanish. And so I put in for that program and was selected to go to Melbourne, Australia.

Kate M.   
All right. What did you know about Australia or Melbourne before you began your program?

Rich B.    
I don't think I knew a lot. I knew when I thought of Australia, I thought kangaroos. That was kind of the depth of my knowledge of Australia. Didn't know really anything about Melbourne or other places in Australia. But over the course of the year I spent there. I learned a lot and I saw a ton of Australia, the family I lived with. We traveled a lot around the country. And it was just an incredible experience.

Kate M.   
That's great to hear. What could you talk a little bit more about your host family? What were they like?

Rich B.   
They were terrific. I did my AFS experience 47 years ago, and I'm still really close to the family I lived with. When my wife and I got married we honeymooned in Australia. Our kids have been to Australia with us to visit the family I lived with. I was emailing yesterday with my host mom, who is just over 90. They've remained a really important part of my life. And you have a picture of the mirror on the shelf there.

Yeah, very, very close to the family. It was a family that had three daughters. And so I was the son in the family. And we live just outside the downtown part of Melbourne and one of the suburbs. I was sent to a Church of England boys grammar school. And so for me, that was a big culture shift. I am Jewish and I attended a public high school here in New Jersey and so to go to a private Church of England School with uniforms was a big change for me.

Kate M.   
Let's see. Um, did you try anything brand new while you were there? For example, food activities, things you weren't used to in New Jersey?

Rich B.   
Yeah. I had more. I love lamb. I had more lamb there than I've ever had. But there's a breakfast bread called Vegemite, which is made, it's a yeast extract. And I tried it there for the first time and initially couldn't stand it. But over time I grew to like it. And I have it in my refrigerator. In New York, where we live. I got to try cricket, which is one of the big sports in Australia and Australian rules football. So I definitely got to do some of the sports activities that are really popular there.

Kate M.   
Absolutely. And what does one put Vegemite on, like toast?

Rich B.   
I put it on toast. Yeah, you can put it on all kinds of you can put it on cheese. You can put it on all kinds of things. I like it. I like it thinly spread on toast. It's pretty good.

Kate M.   
So bringing your New Yorker side mixing with your Australian side. Do you ever put it on bagels?

Rich B.   
No, no, I'm a purist when it comes to bagels, cream cheese all the way. But one could put it on bagels.

Kate M.   
Okay, just curious. Let's see. How did your perspectives about Australia change or evolve throughout your program?

Rich B.    
Well, I definitely saw a lot of connections to American culture. And, you know, when you're an AFS exchange student, you have the opportunity to learn about another culture. But you also have an opportunity to see people as people and develop those bonds. And I just saw a lot of connections between Australian culture and culture in America in terms of new clothing and hairstyles, and music and television and, and movies. You know, Australia has a lot of British influence as well, as well as their own robust cinema and television. And so I got to explore those pieces as well.
I also just got a feel for a lot of national pride, pride in the natural environment. Australia is an incredibly beautiful, beautiful country. And it's a very sparsely populated country, the whole center of Australia is pretty challenging terrain. And so it's a country about the same size as the United States with a fraction of the population.

Kate M.
So yes, Australia is about the same size as the contiguous United States- that is, the U.S. minus Alaska and Hawaii. However, Australia has about a tenth of the population as we do here. And twice as many kangaroos as humans.

Kate M.   
And if I remember correctly, most of the population in Australia is concentrated on the coasts.

Rich B.    
That's right. Yeah, especially especially the southeast coast where you have Sydney, Melbourne and Adelaide, which are some of the biggest cities in Australia.

[Animal noises]

Kate M.
For some more information about Australia… it has 6 states, 3 internal territories, and 7 external territories.
More than 80% of the plants, mammals, reptiles and frogs there are unique to Australia and aren’t found in the wild anywhere else in the world… including kangaroos, platypuses, dingoes, and wombats. There are no bears found in the wild. Yep, even if you think of a koala “bear” when you think of Australia… turns out koalas are actually marsupials, like possums. Not bears.
Okay, enough animal fun facts, let’s get back to Rich.

Kate M.   
Let's see. What skills did you gain from that first experience abroad?

Rich B.   
I mean, a number of things. I didn't learn a new language. That was not in the cards. I gained a lot of experience with public speaking. That was really useful for me. It's been useful for me throughout my entire career. So as an AFS exchange student I would, I spoke at my school about life in America and being a student in America, I spoke to different organizations in the community Rotary Clubs, different different groups that would want to have me in to speak. And so I gained confidence in, in public speaking, confidence in meeting new people. And really a sense of, of, of endless possibility that I could go anywhere in the world and make it and know how to handle myself. And that was really one of the most exciting and important parts of the AFS experience to me, and one that has an impact on my entire career in my entire life.
 
I think my AFS experience provided the skills that I've used in every job that I've that I've ever had. And you know, in every job that I've had there's been a focus on trying to make the world a better place. And that's a core value of AFS. The whole philosophy of people meeting people and connecting and building relationships and, and seeing those common threads of humanity are, are one of the most beautiful things about the program. And I think it probably is what steered me towards a career in public health. So, in each of these jobs, they've been different approaches to trying to improve the health of people and creating opportunities for health. But that's the common thread in all of the jobs I've had, and also curiosity. It's pretty hard to be an AFS student, or a successful one, if you're not curious. The whole idea of going somewhere and experiencing something new is about curiosity and wanting to learn more and explore and I brought that curiosity to each of the jobs that I've had, whether it's, yeah, my jobs at CDC as a Disease Detective or at ABC News, as a reporter, or here at the Robert Wood Johnson Foundation. I bring curiosity and wanting to learn and continually learn and grow. And that's kind of what drives me.

Kate M.   
Yes, and that leads great to our next question, how did your AFS program have an impact on your future plans?

Rich B.   
Well, I think after AFS when I came back to my American high school, it definitely felt small, and limiting. And I was ready to graduate, get on to college and get on to life. And I thought that I would be spending my entire career doing something in the global context. It was something very, very attractive to me. After college, I took a year off before going to medical school and bought an around-the-world plane ticket. And at the time you could for 2500 bucks, you could get a TWA Qantas around-the-world plane ticket, good for a year. And as long as you didn't reverse directions, you could just keep going. And you didn't have to decide where you went to, you basically got to the airport. So I took the year and set off from New York and went west and made my way back to Australia but stopped in Hawaii and Tahiti on the way and then from Australia worked my way up through Indonesia and Singapore and Thailand and Malaysia and Sri Lanka and India, and Nepal and then across Europe. It was incredible. It was great to go back to Australia and see my host whose family again after after four years, but it was also just an amazing experience to be out in the world and AFS gave me the confidence to be able to go out in the world and know that that I would be fine and that I would meet great people wherever I went.

Kate M.
That sounds like an incredible experience. And I mean TWA isn't really around anymore. But I can't even imagine how much a ticket like that would cost now, but that sounds amazing, right?

Rich B.
Yeah, no, it was. I don't know if anyone has those kinds of tickets anymore. But it was the toughest decision was okay. When you because you couldn't double back. I remember having to decide whether I was gonna go to Sri Lanka or to Burma. And I made the decision to go to Sri Lanka and I was like, well, was that the right call? But it was a wonderful time of life where those were the big decisions that I had to deal with.
But AFS you know, throughout my career, I've run into people who've, who've done AFS and it's been great to have that shared experience. Because there is a shared experience and then the AFS you know, mantra of, of “walk together, talk together all ye people of the earth, then and only then will there be peace” that's, that's something that I really held on to and my whole career has been in public health. And part of that is the glue from the global perspective that I got through AFS.

Kate M.
And I'm still thinking how amazing of an experience that must have been for you to be able to go to Australia, come back, go to college and then get this ticket to be able to go anywhere. And that's probably you probably had a lot of questions. Okay, where am I gonna go? Where am I gonna go? But Australia was a given.

Rich B.
It was. Australia was a given. My family had come, whose parents had come over to visit when I was in college, and so I'd gotten to see them. But then I wanted to go back and went back and was able to travel pretty extensively around Australia on that trip, and yeah, I've been back several times since then. Australia has a special special place in my heart.

Kate M.   
That's great. What advice would you have for students who are considering a study abroad program?

Rich B.   
I think it can be a life changing experience. Our son was also an AFS exchange student in high school in Italy, and for him, it was a terrific experience. It's not for everybody, you know. But for students who are looking to broaden their perspective on the world, to challenge themselves to learn about different cultures and different peoples, it's an amazing opportunity. You know, it was one of the most important experiences in my life and set me off on. You know, I think one of the things that I came away from AFS with was a sense that I could do anything, and overcome any kind of challenges, because it's over the course of a year, it's a challenging experience, you're away from your family and your friends, and you're having to figure a lot of stuff out. And through that there's a lot of growth. With that growth comes a perspective in terms of what you're able to do. And that's been great. Because I spent a lot of time overseas since then. Because I think of the bug I got during AFS.

Kate M.
So after Rich’s year in Australia with AFS and his post-college trip around the world…

Rich B.   
Yeah, yes. Following AFS, I really  thought that I would be spending my career doing global health work. And so during medical school, I arranged my schedule so that in my fourth year, I could go to India for six months to do medical work. And so I spent six months in a, in a church of being it was again, another church of England experiencing the Church of England Mission Hospital in the Himalayas. And it was absolutely incredible. I came back from that committed to doing global health work for the rest of my life, went off and did a pediatric residency at Johns Hopkins and got to know people in the School of Public Health. So when I finished my residency, I got a job working in Bangladesh for a year and went there to study diarrheal disease, which is the leading killer of children around the world. And worked in Dhaka, the capital then went to a rural community for about six months in Bangladesh to do rural medical work.

And came back and said, Yes, public health is it and I went to the CDC to learn to be a disease detective. And on my first outbreak investigation, I met my wife and she was in advertising and global health was not in the cards and so that kind of shifted my perspective that I would do global work, but it would be a back and forth and not a base in, in developing countries.

And during my 13 years at CDC, I was able to do a lot of global health work and AFS gave me the confidence to do that. While I didn't learn Spanish during AFS, I was at CDC at the, during the cholera pandemic in the early 90s. And they got me a Spanish tutor. And so three days a week I worked with the Spanish professor to learn Spanish and then they sent me off to fight cholera in South America. And again, I think AFS is what gave me the confidence to do it and my supervisor at CDC was also an AFS alum. And so we had that, that in common. And over the course of my years at CDC, it gave me the opportunity to do health work in Africa and the Caribbean and Asia all over and I never had a sense that that anywhere was not a welcome place to go. And that started when I was 16 and an AFS student.

Kate M.   
While your initial goal was to go to the south, a Spanish speaking country somewhere in South America and you ended up going to Australia, one of the few countries that AFS goes to that speaks English. Really one of the very, very few that speak English. I am glad that A, Australia seemed to be a good fit overall and a very positive experience and B, that you still got to learn Spanish it was just a little bit later.

Rich B.
Exactly, exactly.

Kate M.
So it was early 90s, cholera, were all in South America did you go?

Rich B.   
I was first sent to Ecuador to make a movie on how to treat cholera because I was the only person at CDC who had treated cholera patients. I'd done it during my time in Bangladesh. Then I was sent to Peru to do an investigation looking into how cholera was being transmitted through the water system. And then I went to Bolivia and had to give a talk about cholera in Spanish, which was quite an experience. Those were the trips that I went on during the cholera pandemic. I also went to the Caribbean to work on cholera preparedness there.

Kate M.
Cholera is an infectious disease caused by bacteria that's often spread through contaminated water and food. These bacteria can lead to serious stomach symptoms and dehydration for those who get infected. It's a real issue in areas with poor sanitation and limited clean water access, where outbreaks can happen fast. Preventing cholera involves improving sanitation, promoting good hygiene, and making sure people have safe water sources. Rich worked on these kinds of initiatives during his time at the CDC.

Rich B.
And then at ABC News, I was able to travel the globe doing global health stories. To India, Bangladesh, India reporting on polio and Bangladesh reporting on diarrhea in Burkina Faso reporting on Vitamin A Deficiency Pneumonia in Kenya, disease detection in Cameroon, female genital mutilation in Senegal it was quite the opportunity to travel the globe for for health.

Kate M.   
Yeah, just trying to imagine, your passport must be thick.

Rich B.   
Right? Got a few of them over the years. Yeah, it was pretty packed.

Kate M.  
And so I mean, you got to learn more, you got to become more competent and public speaking when you were in Australia and giving speeches in English. And then you got a Spanish tutor and you put that skill together with your public speaking skill. And next thing you know, you're giving speeches in South America.

Rich B. 
There we go. There you go.

Kate M.
So since 2017, Rich has been the President and CEO of the Robert Wood Johnson Foundation, the largest philanthropy in the U.S. focused on improving health.

Rich B.
We believe that health isn't something that just comes about through your interactions with your doctor. It's what takes place in the communities in which we live and where kids learn and play and where people gather to worship. All of those settings are critical to health. And so we're focused on creating conditions and communities that allow everyone to have the opportunity to lead their healthiest life. More and more, our focus is around health equity, and removing barriers to health from racism and sexism and other forms of discrimination. Each year, we make grants of between 600 and $700 million to groups around the country that are focused on creating conditions for health.

Kate M.  
Very important work. Absolutely. Very important work. To dive a little bit deeper. Can you talk a little bit more about the status of health inequity in the U.S.? Yeah, that's a big question.

Rich B.   
Yeah, I mean, in the United States, we spend more than any other country on health, yet we have some of the worst health outcomes. And if you break down most health indicators by race, by ethnicity, we have some of the biggest gaps, biggest disparities in health. And when you dive into why we have disparities, that's where you see potential solutions, because you see differences in opportunity. So much of the differences in health opportunity come from the conditions in communities that are there due to policies that have led to under investment disinvestment in communities of color, laws that have required segregation. And although those laws have been undone, the conditions of generations and generations of underinvestment have led to differences in life expectancy by race.

You know, we believe that because these policies were put in place by people, people can undo them. And so we're focused a lot around policies to do that. We focus around narratives of who in America is worthy of health, and, and trying to change some of those narratives, whether it's narratives around race or immigration status, or sexual orientation, all of these things factor in we saw it in America, critically during the COVID pandemic, where one's race, one's ethnicity, where one lived, how much money they made, were big predictors of how someone fared, especially in the first couple years of the of the pandemic and we want I need to push push forward and understanding that, that the reason for those differences wasn't about personal choice. It was about who in America could work from home and who in America had to go to work to put food on the table? And why was that that there was a disproportionate number of people of color in minimum wage paying jobs that didn't have sick leave, or family leave, or all of the things that are necessary and in a time of crisis? Things that are necessary even when we're not in the midst of a pandemic. So we're working on trying to push, nudge the nation in the direction of justice and equity.

Kate M.   
Right, and I appreciate what you said that we, as Americans in the past are the ones who set up these policies are the ones who put this discrimination and segregation in place, our forefathers did. So in theory, we could also just undo it.

Rich B.   
That's right. That's right. And that's where you find hope. You know, that these are not unsolvable problems. They are problems that were put in place by people. And we and the generations to come can continue to work to dismantle and create a more just and equitable society.

Kate M.   
What is something that the average American wouldn't know about health inequity?

Rich B.   
Well, I think there's a myth in America that anyone can, if they work hard enough, can make it and can achieve. And that's a really destructive myth. Because there are so many talented people who are working as hard as they can, and in spite of that are not able to make it. And it's absolutely critical that we work to change these systems and structures so that, you know, any child can, can can dream and can have the potential to see those dreams become real, that it's not the exception, but it's the opportunity for, for everybody. And it's, you know, it's not just it's not just by race, it's by geography, it's by income, it's by, by gender, it's by who you love, it's all of these things that can have an impact on health and we have the power to to create a society in which which everyone can can thrive.

Kate M.   
Doing incredible work. Um, let's see. hopping back to AFS. Why is AFS’s mission of empowering people to become globally engaged citizens just as important now and 2023 as ever?

Rich B.    
I don't think it's ever been more important. And when you see the divides in our country, which is incredibly polarized, but divides around the world. I think one of the things about AFS is that it allows you to see the humanity in everybody. And by doing that, you can see past differences in religion and political affiliation and, and things that can be very divided. And when you look at the state of the world, and the divisions that are there, and in many countries, the rise of totalitarian regimes… AFS is, you know, an antidote to that. It pushes back on this idea of “other” that people from different countries, or different cultures are “other.” It lets you see people as people and allows you to celebrate the diversity of cultures and the richness of that and what it means for the world.

Kate M.    
Great. Absolutely more important now than ever, and I don't know what 2024 will look like. I don't know what 2034 will look like but AFS is still going to be around and still doing good work. We'll still be doing good work and helping to make the world just a little bit smaller, a little bit more connected. Is there anything else that you would like to share?

Rich B.   
I don't think so. We've covered a lot of terrain. AFS for me was just so important. It was so important just because of you. When you think about a teenager that's trying to figure it all out, figure out their place in the world and having this kind of richness of experience when someone is in such a formative state is really pretty amazing.

Kate M.   
I'm very glad that you had such an incredible experience in Australia and have taken that experience to do amazing things for this country. And I'm sure the impacts have been felt across the world as well. Thank you so much for taking the time to chat with us this afternoon, Dr. Besser about your AFS experience. It's been really interesting learning about your work. And thanks for taking the time to talk with us.

Rich B.    
Really nice talking to you.

Kate M.   
Okay, have a nice afternoon.

Rich B.   
Bye bye.

Kate M.
That was Dr. Rich Besser, AFS returnee to Australia and President and CEO of the Robert Wood Johnson Foundation. It is clear in Rich’s interview how much he values the experience he had as a teenager in Australia, and how it fostered a love of travel that has stayed with him for decades. The skills he gained while in Melbourne- adaptability, public speaking, and curiosity- have served him throughout his impressive professional career.
Also- perhaps Rich’s last name sounds familiar… and not just because of his job. I interviewed his brother, Dr. Mitch Besser, for an episode earlier this summer. Mitch went to South Africa with AFS and has since gone on to found mothers2mothers, an organization that empowers women living with HIV in sub-Saharan Africa. I recommend you check that episode out as well!

[Music]

Kate M.
Well, thank you for listening to The AFS Exchange! I’m Kate Mulvihill. Let us know what you thought of this episode by sending a message to podcast@afsusa.org. You can also rate and review on Apple Podcasts and Spotify. You can also subscribe there as well so you don’t miss any episodes in this 3rd season.

This podcast was created by Kate Mulvihill. Social media by Julie Ball and Nina Gaulin. Special thanks to Candace O’Malley.