Get to Know Dr. Robert Murphy

• Murphy comes from a Boston-based family, but he was born in Evanston, IL, home of Northwestern University, and lived there briefly early on in his father’s engineering career, but grew up in the Boston area.
• As a child and young adult Murphy was interested in aviation and decided to attend college at Southern Illinois University, one of the only schools at the time offering a degree in aviation. 
• He had a bout of food poisoning while in college and ended up in the infirmary and was impressed how everything in the infirmary worked systematically. He later took a job there as an orderly. The experience led him to switch majors and schools to pursue premed at Boston College and came back to Chicago for medical school at Loyola University.
• While in medical school he did a rotation at Northwestern in infectious diseases and enjoyed the experience. His mentor, John Phair, MD, was very supportive of his career early on and encouraged Murphy who ended up doing his internship, residency at fellowship at Northwestern and has been here ever since. 
• In 1981, during the first week of his fellowship at Northwestern, the first AIDs patient was admitted to Northwestern Memorial Hospital. This patient would be the first of thousands of AIDS patients Murphy would encounter for the next 30 years. 
• He dedicated a special clinic in early morning hours to AIDS patients and at one point this evolved into Murphy being the biggest emitter of patients to the hospital and unfortunately, signer of death certificates because all of his patients died.
• Northwestern eventually opened half of a floor to the care of AIDS patients and along with Dr. Phair, Dr. Palella and others, Murphy helped to build a program in HIV.
• Working with these patients led Murphy to  be interested in early drug development clinical trials that launched his research career.
• Around the same time his interest in public health and AIDs prevention grew and that opened a door into global health. Murphy spent time training Peace Corps volunteers in sub-Saharan Africa about sexually transmitted disease prevention. This was necessary as many volunteers were returning from tours in Africa infected with AIDs.  
• Murphy details several pivotal global health experiences that followed such as becoming the Nigerian country director for the U.S. President's Emergency Plan for AIDS Relief, bringing  Fogarty International Center grants to Northwestern and transitioning the Center for Global Health into the Institute it is today. 
• While he is not retiring soon, Murphy says succession planning for his roles at Northwestern and internationally are taking place.

Rob Murphy, MD [00:00:06] Welcome to the Explore Global Health podcast. I'm Dr. Rob Murphy, executive director of the Harvey Institute for Global Health here at Northwestern University Feinberg School of Medicine. Many of you may know me as your professor, colleague, physician or during the pandemic, a regular face on WGN Morning News. But today you're going to find out a little bit more about me and my career in global health with help from Northwestern University, student Megan Gauger. Megan is a third year undergraduate student studying global health and psychology on the pre-med track and today is turning the tables, and she's going to be interviewing me. Welcome, Megan.

Megan Gauger [00:00:44] Thank you so much and thank you for having me today and giving me the opportunity to ask you some questions so that we can all learn a little bit more about your background and what led you here. So, let's start at the very beginning. You grew up in Evanston, home of Northwestern University, of course. And could you tell me a little bit more about your family and your childhood? What kind of child were you and what was your family like?

Rob Murphy, MD [00:01:03] Both of my parents are from Boston. They're from West Roxbury, which is a neighborhood in Boston, and they lived a block away from each other. But they didn't know each other until they went to Latin school, and they met and got married very young. He had graduated from MIT. My mother was only 19 and his first job was in Chicago and they moved to Evanston. And as soon as they got here, I was born. And so I was born in Evanston, raised there for a couple of years. We ultimately ended up back in Boston. I ended up back working at Northwestern, which is all pulling it together. But I actually grew up in the Boston area.

Megan Gauger [00:01:40] Quite the full circle story from starting in Evanston and ending up back here. As for your educational start, it sounds like you began by wanting to study aviation. So, why aviation in the beginning and what happened that steered you off that path and ultimately led you to medicine?

Rob Murphy, MD [00:01:55] My family is a whole family of engineers. Everybody is an engineer. My grandfather was a civil engineer and was Park Commissioner of Boston for awhile. My brother's a corporate jet pilot. It's all his engineering kind of math people, and I was very good at math and sciences, and I hadn't really thought of medicine, but I had thought of more in terms of what I wanted to do as a kid was aviation. Jet planes were relatively new, and that just expanded travel so much, and I was interested in geography and meteorology and aviation. There were only two schools that the time that I was aware of that had a bachelor's degree associated with an aviation degree, and one of them was in Southern Illinois University, and I had been in Illinois for quite a while. I don't know where southern Illinois was. I had no idea what I was doing and I went there. I was in the aviation program and I was studying meteorology, and that was all going great. But I realized pretty quickly that I didn't really want to make that my passion. And at school, I really didn't know what I wanted to do, and I got food poisoning at a place called Charlie Pickles in Carbondale. And I was really sick and they took me to the infirmary. The school had its own little like hospital, and I was just like, so impressed with, you know, how everything worked systematically. And I was really sick. I was really out of it. And then the head nurse came up to me. I got to be friendly with them, and she said, Oh, the guy taking care of you, the orderly, taking care of his leaving, and we're looking for another person, are you interested in his job? And I said, Oh, OK, I'll do that. That sounds good. And so I took his job, so I was an orderly. I had never really thought of medicine before, but I really enjoyed it. And then she hired me to help her take care of her husband, who had very severe Parkinson's disease. They only lived maybe one or two blocks from me, so it was a very close walk back and forth to their house, and I helped her take care of him. And he was a very sick guy and wheelchair bound. She really had trouble handling him physically, and so I would be helping her. And so that started me on the whole medicine path. I had never really thought of it before, but it was enough that I said, Hey, I think this is what I want to do. And so I changed majors, careers. I transferred schools. I moved back to Boston, went to Boston University. I was pretty good in the sciences and in chemistry and everything. So it was an easy switch actually to the pre-med program, but it was so much more competitive. I ended up going to Loyola, so I ended up back in Illinois at Loyola University, and that was a three year school. I zoomed through that and I had done a rotation. I was living up, married and living downtown in Lincoln Park, actually, my wife was from the Chicago area from Flossmoor so she wanted to stay in Chicago. I did a rotation at Northwestern in infectious diseases. It was just whatever was available. I said, OK, I'll do infectious diseases. But then ended up being I really liked infectious diseases and they help me apply for my internship. They wrote nice letters of recommendation is stuff that I did my internship and residency at Northwestern. So I came to Northwestern in 1978 as an intern and did three years internal medicine to 1981. Then I went on the staff and I did a part time-ish infectious disease fellowship for three years. So I finished that in 1984, and that's where I met John Phair, Doctor Phair. He got me very interested in it, was very supportive of my career, and that's how I ended up in infectious diseases. On the first week of my fellowship, one of my friends called me from the emergency room said, Hey, I think I have one of those patients with the MMWR that's the Morbidity Mortality Weekly Report from the CDC that those guys that are getting Pneumocystis pneumonia and Kaposi's sarcoma. They didn't call it AIDS at the time, and I don't know what they call. They call the GRID. They called it all sorts of other crazy names because they didn't know what caused it. And so that was the first case that got me very interested. And then my career was in HIV for the first 30 years, really.

Megan Gauger [00:06:31] That's quite the story from food poisoning to you right now.

Rob Murphy, MD [00:06:36] Yeah, that was quite a jump.

Megan Gauger [00:06:37] Yeah, lots of things in between. But could you tell me a little bit more about your experience with the HIV aids epidemic as it hit Chicago.

Rob Murphy, MD [00:06:44] When the AIDS patients came in in 1981, we didn't really have a place to take care of them, but part of my duties in 1981 was I had to have an outpatient clinic. And so I started seeing the AIDS patients in that clinic. And then the numbers got hired higher. It was a lot of discrimination back then. A lot of hospitals didn't want to see those patients. Even doctors at Northwestern didn't want to see the patients. No one knew how contagious it was. And it turns out it's actually not very contagious. You really have to have blood or body fluid contact, sex contact. It just doesn't spread communally. We figured that out right away because if it was spread like how COVID is spread, if it was aerosolized or environmental, a lot of other people would have had it. But at the beginning it was all gay man. Then it was from blood products. So the hemophiliacs got it in blood transfusions. People got it. And then we had our first heterosexual transmission to women who were primarily the wives of hemophiliacs or drug addicts or bisexual men. And then it morphed into what everybody knows about HIV today. But there was no treatment back then, and we took care of the people as well as possible. But everybody died. Every single patient died. If they presented with Pneumocystis pneumonia, they were dead within six months. If they presented with Kaposi's sarcoma, it was 18 months. We were studying the epidemiology, so we knew all the numbers and what the risk factors were. And then they were getting a variety of terrible, opportunistic infections that overlap somewhat with what cancer patients get. So we were very good at treating infections in cancer patients. So that was the overlap. And then a lot of the patients also got cancer. So Dr. Jamie van Rooyen and myself really took care of the bulk of the patients in those first couple of years. And at one point this evolved into me being the biggest emitter of patients to the hospital and unfortunately, signer of death certificates because all my patients died. I remember Steve Rosen, the head of the Cancer Center, he patted me on the back one day. He was just a couple of years older than me, and he said, 'Oh, I feel sorry for you and in your profession because all your patients died' he goes. My patients, a lot of my patients lived for a long time. Cancer, quite a few people live with cancer, and the mortality rate is dropping constantly with cancer. People are really surviving. But with HIV. It was really pretty, pretty dismal there at the beginning. They gave us two clinics a week, I think 8 to 12, but they wouldn't give us any more clinics. And then we started coming to work at 7:00 am and then we started coming to work at 6:00 a.m.  And then they said that the security people won't come before 6, so you can't come in. We're going to come at 5. It was just crazy. And then the hospital, there were so many people in the hospital. The hospital said, Wow, these people are. The HIV group is admitting so many patients. Northwestern was very good about it by the way, the hospital was incredibly supportive and they gave us the whole half of the floor and that really made a huge difference in our seeing the patients and we grew this big program. So Dr. Phair myself. Dr. Palella, in infectious diseases, and many others. We built the whole program in HIV there and I couldn't possibly see any more patients than I was seeing. I said there has to be a better way. That got me thinking and there's got to be some either better public health approach or there's got to be some better drugs or better treatments are something other than just continuing just to see people and using what's on the shelf. And so that got me interested in research. Our first actual clinic was called the AZT clinic. It was one drug, the first drug they did, 1987. And then it just morphed from there. And I did the early clinical trials with virtually every one of the HIV drugs that's out there. And the combinations of those drugs. And I got more interested in the development of the drugs and the early stages of the drug development, not the later stages. So that got me on another track altogether.

Megan Gauger [00:11:12] Thank you for sharing all that. It sounds like you had a pretty unique experience of the AIDS and HIV epidemic as not only a physician, but also a scientist.

Rob Murphy, MD [00:11:22] It also opened up the door for global health. I joined a collaboration with a group of Europeans, French, British, German and Spanish, and we started like an informal network that studied many of these new combinations of drugs, so I got involved with them. They had much more, especially the French had much more contact in sub-Saharan Africa, much more involvement there. And so that got me involved a little bit with the African community, especially in terms of HIV. And then an opportunity came along with the Peace Corps at the time. Some women had come back. Peace Corps volunteers and the Peace Corps was run by. The State Department is not run by any health agency or anything like that, and they came back and they were HIV infected and the State Department just washed their hands, said, Well, we don't know how you got it. We don't know, you know, you're gone. And so there was a congressional investigation, basically said the Peace Corps is not taking care of these people well enough, not warning them about how HIV is transmitted and they're not getting any advice, preventive advice or policies or anything like that. And so I had a grant from the CDC looking at training people in sexually transmitted infections, which included HIV. There were seven of these networks in the United States, and they asked all the directors of the networks. I was one of them who wants to go and train all these Peace Corps and State Department people in western Africa, southern Africa, Asia and Latin America. So I signed up for all of them. And so they sent me to Benin, the sliver of a country next to Nigeria and Togo. I went there, trained all these people working for the State Department and the Peace Corps, who were mostly not Americans. They were mostly nationals from a variety of countries. It was very international group. There were some Americans in there. I trained them and developed a good relationship with them, and that started my experiences in sub-Saharan Africa.

Megan Gauger [00:13:27] It sounds like from 2004 to 2010, you were appointed the Nigerian country director for the U.S. President's Emergency Plan for AIDS Relief. Can you tell me a little bit had that opportunity arose and what you accomplished during that time? Yeah.

Rob Murphy, MD [00:13:41] So I got involved with that and  Nigeria in particular, I'm very deeply involved in Nigeria in the late 90s. There was a doctor, a civilian doctor working for the military there named Ernest Ekong, and he got a a European Commission grant to come to France to learn how to take care of patients with HIV. So he was up there for, I think, a year and I was there also on one of my own, my other projects with the Europeans. And he was very happy to meet me because I spoke English and we got to know each other and he said, Oh, you have to come to Nigeria. And at that time, it was run by a dictator Abacha. Nigeria was very chaotic back then. I said, Look, I'm not sure I really want to go there because at that time, everywhere in the United States, even if you were in Bangor, Maine or Nantucket, Massachusetts, there was a sign in the airport that said, Don't go to Murtala Muhammed Airport in Lagos, Nigeria. I don't know what had happened there, but it was an every U.S. airport. So I was a little bit too curious. But I said, Ernest, I don't know if I really want to go down there. It seems kind of dangerous. And he said, Oh no, one of the military guys meet you at the airplane. Don't worry. So I go down. Sure enough, there's two guys with machine guns and the jet bridge. We want Dr. Murphy. Oh, hi, go off with them, and they just take me right through customs. Nobody signed the passport. Nobody looked at us. We just walked out of the airport and got in a military car and took me to the 68 military hospital in Yaba, which is a neighborhood in Lagos. So I met all the people there and discussed everything. My friend Ernest was there that started the whole Nigeria thing. So I stayed in the country for a couple of weeks and I met all the key players. I met the Minister of Health, I met all these other people, and it was soon after that that Abacha died and Obasanjo general that I think he had put in jail for a while, was elected the first president and he was a very good president. He pulled that country together and AIDS was just becoming a big problem there. And he started one of Africa's first big HIV treatment programs 10000 adults and 5000 children. Relatively speaking from a population level, a small but still it was the first one. And so I got hired by the Harvard School of Public Health, who had a grant from the Gates Foundation on HIV prevention in Nigeria. So their epidemiologists and virologists and I'm a clinical doctor, so they needed a clinical doctor to do the clinical component. So we went and we trained 50 different squads of people a doctor, a nurse, a psychologist or psychiatrist and a pharmacologist. So we trained 50 of those and they took their drugs and they went to the all the corners of Nigeria to treat people. That was the first treatment program. Then in 2004, George W. Bush, with very strong bipartisan support, launched PEPFAR President's Emergency Plan for AIDS Relief. That was huge. And so as part of Harvard, we got one of the track one programs, which started at $100 million for five years and ended up being 350. I was the country director for Nigeria because I had at least been there before I had met all the players. I know Ernest, who I hired down there as my coordinator on the ground, and I was buying like pickup trucks by the dozens. I was designing medical clinics and convincing the medical directors of these regional hospitals to build a couple of walls so that I could say I was remodeling the structure because we couldn't build a new building, but we could remodel buildings, so they had to have a foundation. There's all these rules. We followed every rule. They would build a platform, build a couple of walls and say, We need this remodel, OK? And the government was OK with that. We followed the rules. We ended up with 55 clinics and treated over one hundred seventy five thousand people. And that was a real eye opener. And the Harvard philosophy then under Phyllis Carnegie, was that I offered to go live there, like most of the other groups that were participating in this program. But she said, No let's do it remote, not remotely, but let's do it interim anyway and it will build up the confidence and the expertise of the Nigerians. So it was a different philosophy and it worked great. And within five years they took over the program. It was an incredible achievement. And so I remained a consultant to them for another five years and then now they just they run everything themselves. So I knew them when I first went to the University of Lagos in the laboratory. The only working instruments was a capillary tube centrifuge and a mononuclear microscope. There was nothing else. They even have electricity. The whole place was in shambles under that dictatorship. And you should see it now. We have freezer farms. We have BSL three or two plus laboratories there. We've got it's just incredible to be able in my career to watch the development of that. We have a dozen grants with in Nigeria right now. It's just so incredible what's going on there?

Megan Gauger [00:19:10] Yeah, those numbers are remarkable, opening up over 50 clinics and over a hundred and seventy five thousand patients to circle the conversation back to your time at Northwestern. Could you explain a little bit more about your research with Dr. John Phair and how that allowed you to then go from being a doctor, working in a clinic, in a lab at Northwestern to then working in Africa and becoming internationally known as a global health expert?

Rob Murphy, MD [00:19:34] It's really critical to have a great mentor. Dr. Phair was so good with his mentees, including myself, that he was a scholar. He was a gentleman and he just was, he was an incredible role model. He fostered the independence and gave us a direction. And that was really critical because now there's all sorts of training for faculty on how to be a good mentor and everything. I was just lucky. I was just lucky. I had a a great mentor. So Northwestern gave me the as long as you're busy, you're doing good work, you're bringing in grant money, which we through the NIH and CDC and the Gates Foundation. If you have that independent financing, we call it extramural financing, which we've always had. You can do your thing. Nobody's there telling you don't do this or don't do that. They've been very supportive. The hospital has been supportive and the university has been very supportive. So why go? I've been offered some leadership, jobs and stuff, but I had my kids in school here and my wife, I'm now divorced. But my wife had a job in Chicago, didn't really want to move. Her family was from here. So I just said, I'll just stay here. This has worked out fine. I worked through multiple different deans. The current dean called me in his office one day in 2019. He said, You know, it's time we make the Center for Global Health and Institute for Global Health, and he set the structure in place that actually has worked incredibly well. And just in the past year, we raised $40 million to endow the institute and the Center for Global Primary Care and several million dollars towards communicable and emerging infectious diseases. That's really something that wouldn't have come together without the institute because we'd been trying for a long time as a center, but we needed more breadth and we needed more funding, and now we have it. This is just a great sort of late stage career development, and I'm just really happy to be part of it.

Megan Gauger [00:21:40] Northwestern is certainly lucky to have you and have you keep coming back. You've led the global health efforts here at Northwestern for quite some time, and we got to hear a little bit more about that Harvey Institute for Global Health and how you were helping to build it from the ground up in the first episode of this podcast. And speaking of mentorship, how has student and trainee involvement? How important has that been in shaping the partnerships within the Harvey Institute and helping make a difference in low and middle income countries around the world?

Rob Murphy, MD [00:22:08] It's critically important, and we've been really fortunate since 2008, when we started getting our first Fogarty International Center grants. It's a very important center that really coordinates most of the global activities that are going on, and they partner with many of the other bigger institutes that has been really critical. Those those are not big grants. They're in the like $300,000 a year for five years and you train like you give people PhDs, master's degrees, very specialized training and in the fields that we're working in. And a lot of them are HIV related. So HIV and TB, HIV and diagnostic tests, we have a big two big programs with the biomedical engineering department and McCormick at the Center for Innovation and Global Health Technologies. We have all that stuff in the Africans that we've been working with because most of my programs are all in sub-Saharan Africa. I've trained dozens of scientists in Africa through these grants. And it takes a while to give somebody a Ph.D. that's minimum four years. The Masters are one to two years, but we've been doing it now since 2008, so we have a whole group of people that we've trained over there. They know us, they've been to Chicago, we've been there multiple times. And like during the pandemic, I've traveled anywhere since February 2020. We have not skipped a beat because everybody's got Zoom, everybody's got Skype. You can communicate well, actually being there better to be there on site every once in a while. If I'm looking on a screen and the person on the other screen is somebody I'd trained who has a Ph.D. now, I know the person that's really the story. So during the pandemic, we really boomed and it actually gave our partners, our African partners, even kind of more independence because they couldn't travel really either. It's really worked out great.  Besides the PEPFAR's program and the big success of that, this training programs and training the African scientists has been really just the highlight of my career. I have two kids named after me. That's their middle name. So what is in Bamako, Mali? His name is Mohamed Robert Maiga, and the other one is Jeremy Robert Moussa. They call him Little Robert. Anyway, it's really cute because I have girls myself. I never had any sons, so I have these two African godchildren. It's really it's incredible. It means so much to me. I have so many good friends. I can fly into Cape Town, Johannesburg, Dar es Salaam, Nairobi, Lagos, Bamako, Dakar. I know people. I feel very comfortable in those cities and European cities do with all the Europeans I've worked with over the years. It's very rewarding.

Megan Gauger [00:25:04] Is looking back over the course of your whole career, what are you most proud of? I know you spoke a little bit about the highlights, but what are you most proud of and maybe what do you hope to accomplish next?

Rob Murphy, MD [00:25:13] Really most proud of the PEPFAR's infrastructure work I did in Nigeria because that was such a big public health project. I'm very proud of that, and I think we really turned HIV treatment and care around in that country where we played a big role in the project work we're doing in Mali. One of the poorest countries in the world, they had another coup just a month ago. I've been through three coups in that country. Everything keeps working, you know, it's like, it's really kind of amazing. We've really worked with that group there and they've developed a beautiful program in HIV tuberculosis, and now we've expanded that to cancer. So we started it at one of our first cancer breast cancer programs. Actually, there, those two projects are really things that stick out and then all the stuff we're doing and with biomedical engineering in combination with McCormick School of Engineering and Kellogg School of Management building all these devices in April 29, 2020. We had a project called C-10 Center for Innovative Technologies for HIV AIDS at Northwestern and Sally McFall up at McCormick and Matt Glucksburg and me and Chad Achenbach down here. We set up this whole program to make a point of care medical devices related to HIV, but that would include tuberculosis, hepatitis, syphilis and anything related even tangentially to HIV. And that's going great. We give out six or so awards per year of $100 and help them develop their products. Matt Glucksburg and I set up three departments of biomedical engineering in Africa, two in Nigeria and one in Mali, and that's been incredibly rewarding. That is, it's really boomed. And then COVID came along. And it was April 29, 2020. Congress asked the NIH to pivot whatever they could to focus on COVID. We pivoted to COVID, and the COVID pivot was actually bigger than the original grant. So, so not only do we have to keep doing the original grant, but then we got another huge giant project on it to help develop point of care testing for COVID. Based primarily in the United States. But we are opening up a site in South Africa at Stellenbosch University. First of all, we're in a pandemic. Things are certainly not normal. Back in April 2020, we didn't have any tests. We don't even have enough PCR tests. There was no test. This country was absolutely flat on its face. Rada it's called red x rapid acceleration of diagnostics for coronavirus. The short term as radical was going to change that. So they've supported. They've pushed out over a billion dollars in development with over 100 companies, including one, a spinoff from Northwestern called Minute Molecular. It's about the size of a Nespresso coffee machine. OK, and very simple. We designed it for Africa. Or it was designed for Africa, not me. Sally and the other people up and engineering and Dave Kelso and has very few moving parts. And you they develop a cartridge. It's actually all being manufactured in Evanston, by the way. And you put the swab into the cartridge, stick it in the machine, turn the machine on. You don't have to be a lab technician or anything. Students can do it 15 minutes later. You get a full thermos PCR test result. That's huge. The normal thermal cyclic PCR or take like hours and hours and are very complicated. You have to have a central lab with all these technicians and highly trained people to run those machines. This is like simple. It's a snap and it's going to get you approved by the FDA. We expect it's going to be a giant giant thank. The original projection was that was going to take five years. Yeah, and that was done and actually 18 months. So those things, those are the big things that have really moved me and where I'm going. I've already started all this basically set up a whole transition plan for all the projects I'm doing and it's already happening. The junior faculty I've trained are all doing great and you know, they're going to just take over where when I decide to step down, which is not yet, but you know, it can't work forever. I think I'm all prepared for that. Both the international group and the local group.

Megan Gauger [00:29:37] Thank you, Dr. Murphy, for giving me the opportunity to come on the podcast today and allow all of the listeners to learn more about your background and how you went from being a doctor to being very involved in global health and everything in between. So thank you for talking to us today, and I look forward to hearing more episodes with more guests.

Rob Murphy, MD [00:29:56] Thank you for hosting the podcast this time. I really do appreciate it and I appreciate your questions and. Your interest in global health. Follow us on Apple Podcasts or wherever you listen to podcasts to hear the latest episodes and join our community that is dedicated to making a lasting positive impact on global health.