CGH Welcomes Dr. Patti Gravitt as the New Deputy Director for the Center for Global Health

July 6, 2021, by Nina Ghanem, M.Ed.

On July 6th, we welcomed Dr. Patti Gravitt as the new Deputy Director for the Center for Global Health.  Dr. Gravitt is a molecular epidemiologist whose research in human papillomavirus and cervical cancer spans the translational spectrum from natural history to the implementation of global cervical cancer prevention strategies.  At CGH, she will lead implementation science efforts and provide scientific and programmatic direction across our research, training, partnership, and dissemination goals.  In addition, Dr. Gravitt will work in collaboration with the Cancer Moonshot^_SM initiative to accelerate cervical cancer control worldwide.  In this Q&A blog, Dr. Gravitt tells us a little about herself, including when she finds her most insightful ideas.  

How did you begin your career in global health?  
My mentor, Dr. Keerti Shah, was working on a grant proposal to discover new biomarkers of cervical cancer progression in India.  I was finishing my Ph.D. in Epidemiology at Johns Hopkins Bloomberg School of Public Health, helping him to write the grant proposal, and this led to my first project in Hyderabad as an Assistant Professor.    

Describe your approach to global health.  
I take a systems approach to understanding the determinants of health and to designing interventions to improve health by reducing disease burden.  The balance between health and disease occurs as a result of dynamic interactions between individuals, health systems, and their physical, socioeconomic, political, and sociocultural environments.  I look at our mission of reducing the global burden of cancer through this system lens.  We need to focus equally on understanding these complex systems and finding the high leverage points to intervene and improve health.

Can you share a turning point or defining moment in your work?
I mentioned my first global health project, which was designed as a natural history study of HPV infection and cervical dysplasia in an unscreened population, with a goal to simultaneously provide screening services to underserved women and to identify biomarkers associated with disease progression.  Based on what I had heard at conferences from global health professionals, I expected our study to be embraced by the community as an opportunity to be screened.  Beginning with low participation rates in the study and extending far beyond that into health system dysfunction and sociopolitical and sociocultural contexts, my perspective on what is important to reducing cervical cancer burden broadened significantly.  It was by listening to the realities on the ground that I realized that evidence-based interventions alone were not enough; we need to equally focus on changing behaviors at both individual and systems levels and work together to find solutions that are both feasible and desirable given the context into which they will be applied.  This requires a lot of collaboration, and group problem solving with collaborators who are equally passionate about making sustainable change is what I love most in this work.

How have experiences throughout your career led you to NCI’s Center of Global Health?
As I transitioned over my career from thinking about things like the molecular dynamics of host response to HPV infection and control in the cervix to the sociopolitical dynamics which influence adoption and scale-up of HPV vaccination and screening in many countries, I found myself increasingly interested in how we can supplement our tried and true reductionist approaches in cancer research to better capture the emergent properties of complex adaptive systems.  We need to both listen carefully to the stakeholders to help us understand problems in all of their messy reality and be able to be flexible to find the right expertise and new approaches that meet their specific demands and challenges.  The Center for Global Health has a track record of broad stakeholder engagement and expertise in disseminating evidence to program development in cancer control.  This seemed a perfect place to see how we could tackle the ‘wicked problems’ of global health in a bidirectional way, with broad knowledge translation and adoption of novel strategies to advance our cancer control goals. 

What challenges and opportunities do you hope to address in your new role at NCI?
I see tremendous opportunities with the expertise at CGH, the broader NCI community, and our extramural colleagues and partner institutions to make progress on broadening our research approach to embrace the challenge of complexity science.  This will require openness to change, which is difficult.  So, the challenge is for us to recognize that adoption of anything new can be painful, especially when we have strong expertise in the old way of doing things.  Just ask my research assistants who have struggled to get me to move from Dropbox to google docs and other project management applications.  I recognize the challenge associated with change, but I also believe that the times call for more actionable advancement of systems and team science if we are to meet the current global health challenges.  Part of this change will require that we expand the definition of expertise in cancer control to bring in more voices.  This will enable us to more comprehensively map out our ‘problematical situations’ from multiple relevant stakeholder perspectives and use that as a baseline to enact systemic change in all of our cancer control systems: research, training, and capacity building.

This year marks the 50-year anniversary of the National Cancer Act and the 10-year anniversary of the Center for Global Health.  What would you say is a significant milestone NCI and CGH have accomplished over the last decade?  What opportunities lie ahead for CGH?   
I believe that NCI and CGH especially have been extraordinarily effective through some of their initiatives, like the ECHO project, in bringing together scientists, researchers, health professionals, and implementers from various world regions together to accelerate the translation of basic biomedical discovery into routine clinical and public health practice.  The platforms they have established are well-positioned to serve as a model to support the kind of systemic change that I believe is needed.  I think by strengthening and expanding our partnerships and harnessing the strength of NCI's portfolio of expertise, we can serve as thought leaders for how to facilitate positive change in this new environment.

What do you like to do when you aren't working?
While I’d love to say I do all kinds of adventurous things, the truth is I most like to read outside of my own scientific area and spend time cooking and traveling with my partner, Pascal.  I love to color – I have great Mandela and Penguin adult coloring books, and when relaxing with this activity is when I find I have my most insightful ideas.