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Ko enrolled at Harvard Medical School, where he completed his studies in 1991. After his residency, he went to Brazil as a Cornell faculty member to lead a public health project co-funded by the country’s ministry of health and the US National Institutes of Health. In Salvador, one of Brazil’s poorest cities, Ko trained a local group of doctors and public health professionals to face numerous public health challenges.

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“It was a period of rapid urbanization,” he says. “We have seen multiple outbreaks of infections transmitted by rats or mosquitoes that have become epidemics in the city’s crowded slum communities. Infections such as dengue fever, meningitis, leptospirosis and Zika.”

Ko left Cornell and Brazil in 2010 to go to Yale, where he worked at the intersection of public health and social justice. “So far, it’s clear that poverty is a major driver of public health,” she says. “But we need to go further, we need to understand exactly what poverty affects poor health outcomes. And above all, we need to invest in the capacity of vulnerable communities to solve their problems.”

New Haven is both geographically and socioeconomically distant from Salvador. And covid-19, an airborne virus, is quite different from the diseases Ko faced in Brazil. But one element of the epidemic experience was the same. “The Covid virus has taken advantage of our fundamental social inequalities, just as the Zika epidemics did in Brazil,” he says. “Here in the US, we have had a devastating first wave affecting nursing home communities. We have seen death rates in Black and Latino communities five to six times the national average. But by increasing widespread access to testing, enforcing guidelines and policies on face masks and social distancing, and – even more so. importantly – by providing social protection to our most vulnerable populations, we have been able to bring these levels down.”

The lessons he learned had profound implications. “We saw 5 million [deaths] in this epidemic [globally as of the end of 2021]” he observes. “If we don’t want 5 million more people to die, we need to inoculate the world. Currently, those who receive the vaccine are mostly people living in countries that can afford the vaccine. You can make a difference if you deal with the social determinants that affect unequal health outcomes. And if we can’t protect everyone, we can’t really protect ourselves.”