Helene D. Gayle, M.D., M.P.H., didn’t start out wanting a career in medicine or public health. She simply went to college to learn how to change the world.

When she realized that a career in health was an avenue to social change, she knew she had made the right choice. Formerly director of the National Center for HIV, STD and TB Prevention at the Centers for Disease Control and Prevention in Atlanta, Gayle is now director of the HIV, TB and Reproductive Health Program for the Bill & Melinda Gates Foundation. “The challenge we all face in our role as public health professionals is finding a way to use the tools we have to reduce the inequities at home and around the world,” she told graduates during her Commencement address at the School of Public Health on May 24.

Events of the last few years have brought an extraordinary pace of change and challenges to our world and our nation, Gayle said, and have highlighted public health in unexpected ways. The terrorist attacks on September 11, 2001, the anthrax threat and the SARS outbreak have underscored our connections to the world community and taught us that we’re not as independent or as isolated as we once believed. “We can no longer afford to pretend that actions taken in one part of the world have no impact in other parts of the world, or that inaction does not have its own dire consequences,” Gayle told the 123 men and women receiving either a master’s or a doctoral degree in public health.

While key health indicators such as life expectancy and infant mortality have long been important measures of societal development, Gayle said that health is now considered a fundamental component of economic and societal development, human rights and social justice. “Healthy people are the foundation on which we build economies, education systems and, ultimately, a strong and stable civil society,” she said.

Noting that individuals can change society, Gayle also spoke of obstacles ahead. “We spend more on health than any other nation, but rank 37th in overall health system effectiveness,” she told the crowd, adding that the disparities in health among different segments of society are “not-so-gentle reminders that we still have unfinished business in our own social and health agenda.”

Stephen Vindigni gave the student address, in which he spoke of the diversity of the Class of 2004 and of the graduates’ shared desire to improve public health. Citing the variety of internships undertaken by his fellow students around the world, he said, “What an amazing contribution this class has made, while simultaneously gaining valuable experience and giving back to the communities in which we worked.” Vindigni encouraged his classmates to use what they learned at Yale to generate interventions in public health that would benefit both individuals and communities. “Trust your power to influence,” he urged the graduates. “All of us are capable of initiating change.”