I began my public health career more than 20 years ago, at a time when H.I.V. was ravaging many countries around the world. The U.S. government’s strategic response to attack this cruel disease abroad was PEPFAR, an American initiative that has saved more than 25 million lives and shaped my understanding of what muscular public health policy could accomplish.

Today, as New York City’s health commissioner and a practicing doctor, I see a desperate need for similar focus and ambition here…


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