Dr. Ashwin Vasan on Public Health as a Moral Endeavor

What happens when a doctor trained to fight HIV in rural Uganda takes charge of public health for the largest city in America? In this episode of Good Medicine, Dr. Rohan Ramakrishna sits down with Dr. Ashwin Vasan, the 44th Health Commissioner of New York City, whose path ran from trailing his immigrant neonatologist mother through Chicago's ICUs to delivering AIDS treatment alongside mentors Paul Farmer and Jim Kim. Vasan reflects on the WHO, PEPFAR, and the real promise of ending AIDS in our lifetime, then turns to the hardest years of his career: leading the NYC Health Department through the pandemic's backlash, launching HealthyNYC to reverse falling life expectancy, confronting Black maternal mortality, and building TeenSpace for youth mental health. He also makes a candid case on the MAHA movement, nutrition, and taking on the corporate food system. A conversation about medicine, public health, AI, and why health is fundamentally a moral project.New episodes are released every other week, wherever you get your podcasts.For more from Roon, visit: https://www.roon.com/Sign up for our substack: https://rohanramakrishna.substack.com/Find us on Instagram and X: @roondoctorsIf you have a question, comment, or suggestion for a future guest, please email us: [email protected].(00:00) Intro(03:02) Trailing his mom through Chicago's ICUs(05:05) The immigrant physician's contribution to American medicine(08:41) From development economics to public health(12:54) Partners In Health in Uganda, Rwanda, and Lesotho(14:31) The beat-up Camry and a Jay-Z playlist(16:30) Building trust with patient communities(18:45) Inside the WHO and the case for reform(22:52) Can global health delivery survive US funding cuts?(26:35) PEPFAR, lenacapavir, and ending AIDS in our lifetime(29:42) Why public health is a moral endeavor(31:57) The call from Mary Bassett to join NYC Health(35:49) What surprised him as Health Commissioner(38:57) Protesters at home and his daughter's wisdom(41:31) Launching HealthyNYC and a life expectancy North Star(48:03) Confronting Black maternal mortality(51:35) Why healthcare affordability is a public health issue(53:16) Hospital price transparency and medical debt(56:12) TeenSpace and the youth mental health crisis(01:01:53) AI as prevention infrastructure(01:04:14) Modernizing public health data systems(01:07:46) MAHA, nutrition, and where medicine dropped the ball(01:13:14) Would he work with RFK Jr.'s HHS?(01:15:41) Quick Hits: mandates, mentors, and book picks(01:18:19) Why a physician community like Roon matters