On June 30, 2017, Michael J. Klag, MD, MPH ’87, will step down after 12 years as the 10th dean of the Johns Hopkins Bloomberg School of Public Health [Ed. Note: He has since been asked to stay on until September 30]. Dean Klag led the School through unprecedented technological change, strengthened its partnerships across the University and the world, raised its profile as a thought leader and policy innovator, and helped establish joint educational programs on four continents. In the retrospective that follows, we take measure of the Klag deanship and its impact.

CHALLENGES FROM DAY 1

On September 1, 2005, his first day as Dean, Klag issued a statement expressing sympathy to the Gulf Coast victims of Hurricane Katrina, among the most destructive storms in U.S. history. “I hadn’t had even one meeting yet,” Klag remembers, “so I still had the flexibility to respond and become personally involved.” The American Red Cross tapped Klag to serve as a liaison with government officials and assess relief efforts at 25 Houston shelters. Klag’s photo of the Houston Astrodome, filled with 16,000 New Orleans evacuees, would grace the cover of Disaster Medicine and Public Health Preparedness. In the ensuing days, when students from the Tulane School of Public Health and Tropical Medicine began showing up in his office with their suitcases, he welcomed them for the rest of the academic year at the Bloomberg School. 

Refugee crises were a constant backdrop to Klag’s deanship, alongside wars, tsunamis, earthquakes, and outbreaks of Ebola and Zika. In September 2012, news broke that the CIA had hunted for Osama bin Laden in Pakistan by conducting a sham polio vaccination campaign, triggering reprisals against health workers in Pakistan, including the fatal shootings of several UN staff administering polio vaccinations. Klag enlisted 11 other public health deans to urge President Barack Obama to end the use of health activities as a ruse for covert operations. In May 2014, the White House sent the deans a letter stating that CIA Director John Brennan had issued a directive that his agency would not use vaccination campaigns in its operations.

More recently, when President Donald Trump issued an executive order on January 27, 2017, suspending the U.S. refugee resettlement program, Klag proclaimed in an open letter to Trump, “We are a School that’s dedicated to engaging with people from all over the world to improve health. We know that openness, humility and respect—not closed doors—are the best means for solving problems.” With Len Rubenstein of the Center for Humanitarian Health, Klag organized a symposium, “The Executive Order on Refugees: An Emerging Public Health Crisis.” He also hosted a town hall to hear the post-election concerns of the Bloomberg School community, including students from the seven Muslim countries affected by the order’s travel ban.

VIRTUAL VIRTUOSO

During Klag’s tenure, the School became the world’s largest nonprofit online provider of public health education. It had already established the world’s first partly online MPH program in 1999 and joined OpenCourseWare in 2005. Klag saw these moves as consistent with the School’s lifesaving mission and leadership role. 

On his frequent travels, people often asked him, “Can we come to your school for free? We need these tools.” When Klag initially proposed to increase access to free or low-cost public health educational programs, university officials resisted, fearing such offerings would undermine the University financially. 

They needn’t have worried. In 2012, Klag announced a partnership with Coursera, a for-profit provider of massive online open courses (MOOCs). Although most users viewed course videos for free, some paid a small fee to earn certificates of completion. With the School’s global brand recognition, its MOOCs generated $2 million in the first year. That figure has increased annually, and the School’s 10-course Data Science specialization is now Coursera’s most popular specialization. By January 2017, cumulative enrollment in the School’s 57 MOOCs exceeded 5.2 million.

Innovative online programs with a lower cost and lighter touch have been essential for realizing Klag’s vision, in which the School “must play a powerful role in helping build the world’s public health educational infrastructure,” says Executive Vice Dean for Academic Affairs Laura Morlock.

SMART GROWTH

Klag presided over historic increases in the size of the faculty (43 percent), endowment (94 percent) and budget (53 percent). He also signed one in three degrees ever conferred by the School. A central feature of growth was the addition of 35 research centers, including three that Klag was directly involved in founding: the Center for Global Health, Center for Population Health Information Technology, and Wendy Klag Center for Autism and Developmental Disabilities, named for Klag’s late first wife. 

Klag also worked toward greater harmony across departments, degree programs, and University divisions, most recently by partnering with the Whiting School of Engineering to establish the Johns Hopkins Department of Environmental Health and Engineering (see When 2 Become 1). 

NEW FUNDING AND AUDIENCES

Three years into Klag’s deanship, the worst economic downturn in 70 years hit the country. As NIH funding stagnated in real dollars, Klag redoubled efforts to create new income streams, attract private support and expand communications efforts. 

Thanks to the generosity of individuals, corporations and foundations, the School raised $1.3 billion in private support under Klag, and endowments for scholarships, professorships and research more than doubled. Foundations drove the growth of private funding, which in turn sustained the School’s overall budget growth. Annual foundation support increased 10-fold from $9 million in 2005 to $91 million in 2016—not including the historic Bloomberg Philanthropies $300 million gift to establish the Bloomberg American Health Initiative. Klag also cultivated the School’s relationship with the Bill & Melinda Gates Foundation to put international family planning back on the global health agenda. Among the fruits of these labors: four international family planning conferences co-hosted by the School’s Bill and Melinda Gates Institute for Population and Reproductive Health.

Klag also broadened alumni engagement and School communications. The School boosted its online presence through live-streamed events, more national media placements and a popular news website and e-newsletter, Global Health NOW. An early adopter of social media, Klag helped Johns Hopkins become the most-followed school of public health with nearly 480,000 on Facebook and Twitter combined. 

GLOBAL PUBLIC HEALTH STATESMAN 

Klag’s intensive collaborations with foreign schools of public health have dominated his travel schedule and complemented his online strategy for democratizing public health knowledge. He has played pivotal roles in establishing new part-time professional cohort degree programs with partner institutions in Abu Dhabi, UAE; Taipei, Taiwan; Kyoto, Japan; and Beijing, China, and brokered a cooperative degree program with a university in Jaipur, India. The partnerships behind these degree programs were built on a common model that included an online component and courses tailored to the needs of health professionals working in regions such as the Pacific Rim, Middle East or South Asia. Aware of the strategic importance of China for global health, in 2009 Klag launched the first of a series of meetings of Bloomberg faculty with more than 50 Chinese public health deans to discuss important public health issues and how to strengthen China’s educational programs to meet them.

The unprecedented boom in new public health schools and programs has also hit the U.S., where public health enrollments (graduate and undergraduate) in schools across the country more than doubled from 2005 to 2017. Working closely with the late Harrison Spencer, executive director of the Association of Schools of Public Health, Klag led two major shifts during his chairmanship: opening the ASPH to schools outside North America and to programs as well as schools, which in 2013 resulted in the rechristened Association of Schools and Programs in Public Health. Klag counts these hard-won accomplishments, which will shape the quality and scope of public health education globally for decades to come, among his proudest moments.

PRACTICE AND LOCAL PARTNERSHIPS

As a physician, Klag had treated many low-income patients in East Baltimore and had studied racial disparities in kidney disease. He was therefore committed to forging School-community partnerships that strengthened practice, research and education. Under Klag’s leadership, faculty revived collaborations with the Baltimore City Health Department and its chief epidemiologist began a half-time appointment at the School. These efforts helped the city achieve major reductions in teen pregnancy, infant mortality and gun violence; improve long-term health and learning outcomes for public school students; expand healthy food options across the city; and distribute thousands of car seats, smoke detectors and bike helmets.  Klag said his emphasis on Baltimore “reflected the ethos of the School.” Under Klag, 4,478 Bloomberg School volunteers have logged 107,429 service hours (through June 2016) at SOURCE (Student Outreach Resource Center), which anchors the Johns Hopkins Medical Institutions’ commitment to service-learning and community partnerships.

In January 2015, Klag appointed former Baltimore City health commissioner and Maryland secretary of health Joshua Sharfstein as associate dean for public health practice. Three months later, in the wake of the national outcry over Freddie Gray’s death while in Baltimore City Police custody, Klag asked Sharfstein to lead the Engage Baltimore initiative that pledged to involve every part of the School in an institution-wide effort to improve the city’s health and well-being.  With the School of Nursing, Klag also doubled the budget for SOURCE. 

THE MAKE-OR-BREAK YEAR

In 2015, Dean Klag faced three major referenda on his leadership: the U.S. News & World Report rankings announced in March; the reaccreditation decision by the Council on Education for Public Health (CEPH) in April; and the launch of the School’s year-long Centennial celebration in July. 

Klag scored a trifecta. The School retained the No. 1 U.S. News ranking it had held since 1994 and met all 29 CEPH criteria—a rare feat. And the Centennial was, by all measures, a tremendous success.

Not all of Klag’s achievements were so high profile. Marsha Wills-Karp, EHE chair, praised Klag for bringing “a deep commitment to fairness and respectful treatment of all faculty, staff and students to the School,” noting his recruitment of women to chair five departments and many other senior leadership positions.

Says Pierre Coulombe, chair of Biochemistry and Molecular Biology, “Mike has been so easy to follow and so admired because he has an incredible ability to capture the entire spectrum of activities at our school. He manifests a high dose of enthusiasm for everything the School’s about. He was so effective as the glue that binds us all together.”