Q&A with Michelle Hsiang, Assistant Professor, University of Texas, Southwestern

We connected with Michelle Hsiang, Assistant Professor of Pediatric Infectious Diseases at the University of Texas, Southwestern, and one of the members of our 2020 Leadership Journey. Read our Q&A to learn about her Leadership Journey project, who inspires her, and how COVID-19 has impacted her work.

What is your Leadership Journey Project and why did you choose it?

As a Malaria Epidemiologist and a Pediatric Infectious Diseases Clinician, much of my work is focused on low- and middle-income countries. I have been looking at the COVID-19 response and have observed that many of the approaches used in resource-rich settings may not make sense in lower-income countries. I have been specifically focused on therapeutics, which will continue to be necessary in parallel to vaccines and public health efforts. With therapeutics, most of the focus in resource-rich settings has been on sick patients who are already hospitalized, not on therapeutics you can use in the community. These could potentially have a bigger impact in decreasing transmission rather than just slowing disease progression.

I have been working with a team at UT Southwestern and UCSF to explore COVID-19 therapeutics with the potential for the greatest impact in low- and middle-income countries, specifically ones that could be delivered quickly and administered orally. The team did a systematic review of all the trials available and identified 17 classes of therapeutics and summarized the current evidence for these agents. These are all drugs that are repurposed, so they have a known safety profile, but what we really need is a coordinated effort to evaluate these in clinical trials to see if they have an impact on disease progression and potentially even transmission.


What has surprised you about the WomenLift Health Leadership Journey experience?

What has surprised me most is that the US cohort is a diverse group of women working in different parts of global health, yet we still experience similar challenges. These range from biases that impact us in micro and macro ways in our day-to-day work, but also when it comes to grants, promotions and negotiations.  I did not anticipate how helpful this network would be in equipping me with the appropriate tools to overcome these barriers.

I have not had many women colleagues to look to for support throughout my career and I am also in a University setting, so many of my immediate colleagues are not in global health. Having a network of women directly focused on gender and leadership in my field has reassured me that there are ways to overcome these shared challenges we all face. Many of the women in my cohort have natural leadership skills, but what has been made clear is that to maximize potential and break the glass ceiling, one needs to be intentional about leadership. There is not as much focus on developing women as leaders in global health as there should be – that is why I have really appreciated the intentionality of WomenLift Health’s Leadership Journey.

How has COVID shifted the focus of your work within your organization?

Like many people’s work in global health, most of my projects needed to pivot to address the pandemic. But I am also working in areas that are already neglected or underrepresented so I could not let my focus on the pandemic completely compromise this work. It is a shared challenge for many in the field, and something we are all aware of. For example, there are estimates that due to the challenges of COVID-19, malaria deaths may double in the coming year. While we do need to address the challenges of COVID-19, it will be detrimental if we also lose focus of the other global health-related work. Another challenge we are trying to overcome is understanding the actual burden of diseases in LMICs. With limited availability of diagnostics and incomplete data, it has been difficult to know how to form a response to the pandemic in LMICs. For me, it has emphasized the importance of data, surveillance and coordinated efforts.

How can we ensure that women are at the center of not only COVID recovery plans but also long-term strategies for the improvement of health?

Having women in positions of leadership can help ensure more inclusiveness in COVID-19 response and recovery efforts. For example, it might be something as obvious as excluding pregnant women from vaccine trials and therefore not having data about vaccine efficacy with pregnant women. As a pediatrician, I also have been frustrated with the lack of focus on COVID-19’s impact on children. The role children play in transmission is important to know, and although they generally do not get a sick compare to adults, they can become very ill and there are likely long-term impacts.

Additionally, how COVID-19 affects women professionally is another important issue. Women tend to take on more of the burden at home, and COVID-19 has only amplified this issue. I have seen many colleagues take a step back professionally. Consequently, women are not as productive or achieving as much in the workplace. Having women in positions of power, where they can create more support structures, whether that is flexible work programs or childcare, will ensure women can achieve their full potential in the workplace.

Who inspires you?

I am inspired by two groups of people. First and foremost, I am inspired by my patients and their communities. Malaria, just like COVID-19, is a social disease – there are a lot of factors that contribute to transmission, and a lot of that has to do with poverty and inequity. While the technical aspects – medicine and biology – are fascinating aspects of my work, I see the people who suffer from these diseases and I know it does not have to be this way. Decreasing this suffering, that is health-related but also has social and economic relevance, is something that drives my work immensely.

I am also continuously inspired by my colleagues. It would be hard to do this work without being surrounded by people who share the same goals as I do, who are incredibly smart and driven. Being part of the global health community, a group that is thinking about health equity on a global scale, inspires me. I think this is in large part because I am from an immigrant family. Realizing that we are all interconnected has made me inspired to work in health on a global scale. There is no doubt being part of a community who is globally minded inspires me every day, especially through these particularly challenging times.