By Orna Herr, Communications Officer (Education) at the British Science Association

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Building trust from the bottom up and the top down

Professor Kevin Fenton CBE didn’t spend his earliest years dreaming of working in medicine – as a child growing up in Jamaica, he hoped to become a pilot. But after a series of pivotal moments (which you can read about in part 1) led him into public health, Kevin found himself playing instrumental roles, not just in stemming the HIV/AIDS epidemic in the USA, but controlling the COVID-19 pandemic in the UK.

At his BSA Presidential Address at the British Science Festival 2024, held in East London, Kevin sat down with the journalist Kirsty Lang to share the wisdom he has gained from his experiences, and some top tips for a healthy life.

“Building trust required consistent relationship building…And we did it.”

Kevin moved to the USA in 2004, the year George W Bush won the election and his second term as President. It was also at a time when the HIV/AIDS epidemic was raging; AIDS-related deaths peaked in 2004, with around 3.1 million people dying across the world.

In 2005, he began his job at the Centre for Disease Control (CDC) as Director of the National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention. It was a role he would occupy for over seven years, as the U.S. presidency was passed from Republican, Bush, to Democrat, Barack Obama.

The landscape Kevin arrived in was one of intense dissatisfaction. The people most at risk of contracting HIV – gay men and members of Black communities – were suffering from sky-rocketing numbers of infections and deaths. They felt angry and abandoned as the Government focused more on the global effort to combat HIV/AIDS. It was anger Kevin was equipped to take on, and he allowed it to motivate him.  

Learning to listen, being humble, understanding that when they’re shouting with you, and being angry with you, you are a representative of government and the inactivity and the inertia of government. And to be able to hold that, and say we will do better was hard, but it was a lesson that needed to be learned. Those lessons I think I wouldn’t have had [in the UK] to the same extent.

Kevin realised that along with building relationships with affected communities, he had to build trust with the Bush administration too. A change in tack from policies that were “geared towards abstinence-only until marriage, removing sex education in schools, not promoting condoms” was sorely needed, he told Kirsty.

Building trust which required consistent relationship building, communication and doing that hard work that needs to be done. And we did it.

“We…revolutionised the work that we’re doing on HIV”

By focusing on finding the win-win propositions to present to the Republican leadership, Kevin made huge strides on stemming the spread of HIV/AIDS, and on improving the outcomes for those who became infected.

We got new funds for the domestic programme, we launched the first HIV campaign for African American communities in the United States under my leadership. We were able to get new money into PrEP research...that lead to the availability of this new lithium drug which has revolutionised the work that we’re doing on HIV.

When the Obama administration took over the Oval Office in 2009, Kevin was one of just three executives at the CDC who was invited to stay, because his achievements had been so significant and groundbreaking.

However, by 2013, after over eight years working in the U.S., Kevin was ready, he said, to return to the UK.  

I could see the role of structural racism, long-standing intergenerational poverty. The problems we were trying to solve in the U.S. were deep and structural, but we weren’t able to have those conversations about what really needed to be done. And as somebody who didn’t grow up in the U.S., the longer I was there the more alien that felt to me.

“It wasn’t normal to me that you would have this level of discrimination… within a society.

“We needed to recognise the role that structural racism was playing”

After working for Southwark Council for a few years, Kevin stepped into a new role as London Regional Director of Public Health…one week before the UK’s first COVID-19 lockdown.

“How was that?” asked Kirsty, packing a punch with three little words.

It felt right but it was bizarre. It felt right because there comes a point when you say, actually, everything I’ve done and everything I’ve trained for in my life has brought me to this point.

This proved to be true. Just as Kevin had looked at the more marginalised communities in the U.S. suffering from the HIV epidemic and provided a voice for the voiceless, so too, in the UK, as COVID-19 swept across the country.

As the faces of those who were dying from COVID were shown in the media, Kevin and his colleagues noticed that a disproportionate number of those people were people of colour working in healthcare.

Kevin was asked to lead a public health inquiry to understand why the pandemic seemed to be impacting some groups and communities more than others. The report was completed in June, around the time of George Floyd’s murder and Black Lives Matter protests, when “issues of structural racism were coming to the fore.”

It was the first Government report that explicitly said in order to tackle and address what is happening, we needed to recognise the role that structural racism was playing both in terms of preventing communities from trusting the health service, the ways people were treated when they were in the health service.

He continued:

That finding unlocked…a lot of research which to this day is helping us to tackle vaccine hesitancy. Why are there some people who are not taking up vaccines or other health interventions in the way they should, and what can we do about it?

This is a complicated and multi-faceted question, not one easily answered in an hour-long chat. Kirsty finished up by asking a somewhat simpler question: what are Kevin’s top five tips for living a healthy life?

One, keep moving. Be physically active. If I had a miracle drug, it would be physical activity…Two, be kind on yourself. Life is hard, be forgiving…Three, eat right…Four, Connect with others. Your friends, your family, really investing in that time…Five, connect with nature. Being outside, connecting with nature is both emotionally and mentally rewarding.

Kevin’s work has saved countless lives and continues to improve the health outcomes for millions of people around the world. Today he is the President of the UK Faculty of Public Health, and for the next year will serve as President of the British Science Association.   

Read parts one and three of this blog

BSA Presidential Address: Professor Kevin Fenton CBE (part one)

BSA Presidential Address: Professor Kevin Fenton CBE (part three)