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Peter Kilmarx, M.D., '90: Working upstream

proven very effective in many parts of Africa and has been well documented in the medical literature.

Since then, Kilmarx has spent much of his career on the front lines of the HIV/AIDS epidemic in hot spots around the world, including Thailand and Africa. From 2002 to 2005, he directed the BOTUSA Project, a collaboration between the government of Botswana and the CDC in the U.S. His team provided technical assistance, consultation, and funding and conducted research in preventing and treating HIV/AIDS. In 2005, he returned to the CDC in Atlanta and soon assumed his current role as head of the AIDS unit's epidemiology arm. He oversees research conducted in the U.S. and abroad to develop new biomedical interventions—such as vaccines, microbicides, and oral chemoprophylaxis agents—to prevent infection in HIV-negative people.

"Public health is about the big picture," says Kilmarx. "I was attracted to this role because I enjoy the management aspects. Listening to people and helping them grow professionally—helping good people do good work—is my focus now, rather than focusing on one particular area and doing the work myself. I can be more effective," he adds, "and have a broader reach."

The ability to integrate himself into new situations, which stood Kilmarx in such good stead in Bakwa Tombe, still helps him as he guides large teams of public health workers. He's a natural leader, says Dr. Tracy Creek, a member of the BOTUSA Project team. "Peter taught me pretty much everything I know about how to survive working for two governments." Creek was stationed with a colleague in a remote Botswana town where 40% of the pregnant women are HIV-positive. "I was responsible for setting up a research station in the northern part of the country, far from the main CDC office, trying to figure out how to effectively prevent pregnant women from transmitting HIV to their babies." Advanced molecular HIV testing was conducted at the station laboratory, based in an old maternity hospital. "The roof leaked into the $100,000 lab machines the first time it rained," Creek recalls, "and there were shortages of every possible thing needed to run a lab. As is usual in international

Grew up: Barrington, R.I.
Education: Dartmouth College '83 (B.A. in biology); Brown-Dartmouth Program '90 (M.D.)
Training: Johns Hopkins (residency in internal medicine, fellowship in infectious diseases); CDC Epidemic Intelligence Service
Favorite activities: Travel, sailing, yoga, squash, volleyball, mountain biking, snowboarding, church, volunteer work, and fatherhood (he has two sons, age 10 and 14)
Fondest DMS memory: His black lab, Sparky, attended class with him, so when Kilmarx graduated Associate Dean Joe O'Donnell gave Sparky a certificate and a bone

Half a dozen children born in the remote village of Bakwa Tombe were named Pierre in his honor.

public health, we took one step forward and five steps backward most days."

But Kilmarx telephoned his remote teams on a regular basis. He would listen to Creek and her colleague, as she puts it, "rant and rave and occasionally cry" in frustration over the "hurdles to bringing high technology to the middle of the Kalahari Desert." Yet by the end of each call, Creek and her colleague "agreed that we were doing just fine, things were about to get better, and we were going to work even harder, start new projects, train new people, and hold big problem-solving meetings."

Another colleague, Dr. William Wester, a 1991 graduate of DMS, calls Kilmarx not only "an exceptional leader . . . one who is able to build a very capable team and inspire them with great vision, hope, and purpose," but a good team player, too. "Peter was always communicating with other large partners—which is how he continually referred to other government stakeholders, [nongovernmental organizations], research institutions, et cetera," says Wester, who worked closely with Kilmarx as a senior research associate for one of those partner organizations—a Botswana-Harvard AIDS initiative. "He truly did treat everyone as equal partners and collaborators," adds Wester, "and was respected by all in the

community and nation as a whole because he was so collaborative and inclusive."

Not long after returning stateside in 2005, Kilmarx was called upon to help respond to one of the biggest natural disasters in U.S. history—Hurricane Katrina, which devastated New Orleans. "After Katrina, everything fell apart, including the public health system," he says. "Everything was so dispersed."

Arriving on the scene about a month after the hurricane hit, he oversaw 40 CDC staff who were divided into seven teams to deal with various aspects of Katrina's aftermath—from mental health issues to violence prevention to emerging mold problems.

As much as he enjoys leading others, Kilmarx still gets satisfaction out of putting his own fingerprints on a project. He has conducted research internationally on the prevention of HIV/AIDS and other sexually transmitted diseases. In Thailand, one of his studies focused on the safety and acceptability of vaginal microbicides to prevent HIV transmission from men to women. He wrote a CDC fact sheet summarizing research by others showing that male circumcision is effective in preventing female-to-male transmission of HIV. And he returns to Botswana a few weeks a year to provide medical care to AIDS patients.

Kilmarx has come a long way from his days at Dartmouth. "When I graduated, I was young and idealistic, and I wanted to contribute to the world in a grand way," he says. He's certainly done that, receiving numerous awards for his international public health work. He was even nominated recently for the USPHS Outstanding Service Medal for his "continuous leadership in the prevention of HIV transmission as director of the BOTUSA Project."

But he hasn't forgotten the individuals that such work is ultimately designed to benefit. He still corresponds with the village chief in Bakwa Tombe, to check on his namesakes and on the community's welfare. He learned recently that several of the ponds he helped to build more than 20 years ago are still intact and teeming with fish.

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Valerie Gregg is a freelance writer who lives in Lilburn, Ga.

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