Following his passion for public health has taken Joel Chehab, MPH, on a journey from the US abroad, where he has contributed to global health initiatives in South Africa, the Republic of Congo, and Mozambique. As a high school student, Joel traveled to Arusha, Tanzania (East Africa), which is often thought of as a gateway city to safari in the Serengeti, or a hub for visitors trekking to Africa’s highest mountain- Mt. Kilimanjaro. It was during this service trip as a student that Joel had the opportunity to teach English and help build schools, which opened his eyes to the fact that much of the world subsists on less than dollar a day and remains vulnerable to infectious disease. In Tanzania specifically, there is a high incidence of HIV and tuberculosis, with both being included in the top ten causes of death in country (CDC Global Health, 2020). While Joel had been interested in health since middle school, this international experience served to solidify his decision to embark on a career in global health, which would eventually lead him to CDC.
Joel has worked for CDC’s Mozambique office in Maputo for the past 4 years, most recently serving as the Health Information Branch Chief. In Mozambique, CDC staff “address HIV, tuberculosis, malaria, and influenza as well as strengthening its laboratory, surveillance, and workforce capacity to respond to disease outbreaks.” (CDC Global Health, 2020). Overseeing its data management, health information 
systems, and the monitoring and evaluation portfolio, Joel first joined the office as a Monitoring & Evaluation Advisor, before being promoted to a Team Lead and eventually, Branch Chief. Joel has mentored three PHI/CDC Global Health Fellows, one of whom, Marcela Torres, nominated him for an Outstanding Mentorship Award in 2020, highlighting Joel’s tenacity for facilitating professional growth: “[Joel] has consistently given me opportunities to lead challenging projects which has enabled me to grow as a fellow while making meaningful contributions to my team, CDC, and USAID Mozambique.” 
LIFE AS A FELLOW FOR CDC SOUTH AFRICA
Having been a Global Health Fellow himself for CDC South Africa in 2010, Joel realized first-hand how important it was to have a good mentor. Among his peers, he observed that fellows who had the best experiences also had the strongest relationships with their mentors. In South Africa, Joel’s secondary mentor not only encouraged him, but pushed him to improve his skills in analysis and publish his work. Joel concentrated on the evaluation of the national tuberculosis and HIV programs, writing a protocol and designing a cross-sectional study to assess the programs and their main barriers. Part of this work included both virtual and in person trainings for partners, PEPFAR staff and national Ministry of Health teams. Joel joined provincial teams in each of the 9 provinces in country to conduct key informant interviews and primary data collection, and a final report including recommendations, was produced and presented to the Ministry of Health. Joel presented results in several international and national conferences and publishing several manuscripts, experiences which proved to be very fulfilling, and a memorable lesson in best practices while working in the field.
SUPPORTING THE U.S. EMBASSY IN THE REPUBLIC OF CONGO (ROC)
After his fellowship, Joel went on to support CDC headquarters’ Mycotic Diseases Branch for two years in the ROC as a Public Health Specialist for the US Embassy in Brazzaville. He was joined by his wife, whom he met in graduate school for public health at Tulane University (she was also an ASPPH Fellow, but was supporting CDC in Vietnam while Joel was in South Africa). In the ROC, the US government is the main funder of the global Vaccine Alliance (GAVI) and global fund that supports HIV programs in country, mainly via procurement of HIV anti-retorival and tuberculosis medications. In this role, “it became clear that Congo was facing a looming ART medicine shortage, which would have serious consequences on HIV clients in country,” which mobilized Joel to write a cable flagging the impending shortage to the State Department leadership. The cable elicited a visit from Mitch Wolfe, MD, MPH, who is CDC’s Chief Medical Officer. As a result of that visit, and collaboration among government stakeholders, the Ministry of Health and Cabinet, WHO, UNICEF and the Red Cross, a medication supply was secured. Joel’s advocacy efforts helped approve medication suppliers that could be funded by the global fund, and which were successfully delivered in time to avoid a disastrous shortage.
“…it became clear that Congo was facing a looming ART medicine shortage, which would have serious consequences on HIV clients in country.”
LESSONS LEARNED IN THE FIELD
As his years in the field have grown, so has his conviction that US personnel are “guests in the countries we operate in”, which makes transparency and respectful collaboration to align priorities even more important. While US hires cycle in and out of host country offices, the local staff are there to stay, and Joel notes the importance of drawing on local expertise: “We have to learn to leverage their institutional knowledge and always be considering the long term sustainability of any activities we implement….essentially will those people be better off in 5-10 years because we implement this activity today? If the answer is no, then we should move on and choose something else to fund, because that’s the right thing to do.” Relationship building and diplomacy skills are crucial, as collaboration involves a “complex mosaic of people…working together to fund a complex picture of global health within a country.”
“We have to learn to leverage their [locals’] institutional knowledge and always be considering the long term sustainability of any activities we implement….essentially will those people be better off in 5-10 years because we implement this activity today? If the answer is no, then we should move on and choose something else to fund, because that’s the right thing to do.”
CDC MENTORSHIP & ADVICE FOR FELLOWS
As a CDC Mentor, Joel has witnessed that “fellow contributions are invaluable”. Fellows have contributed to HIV impact assessment surveys, routine monitoring and evaluation support, epidemiological investigations into variability in partner implementation, abstracts, manuscripts and oral and poster presentations in conferences. Fellows’ thirst for knowledge and experience is an asset, and Joel has seen them succeed most when they take initiative as much as possible. Diplomacy, strong interpersonal skills, and the “ability to cultivate relationships with a variety of stakeholders” are all qualities that contribute to success, along with strong technical capacity such as data analysis and interpretation.
“Fellow contributions are invaluable.”
Although he is now a mentor himself, Joel is a life-long learner, which includes learning from new mentors. Most recently, Stanley Wei, the Associate Director of Programs for CDC Mozambique, has been a hugely inspirational mentor for Joel. Stanley is “incredibly smart, visionary, [and has an] unparalleled ability to interpret data” and they have built a strong working relationship. In the end, Joel has learned that having strong team members is not always enough to create positive change- it’s how that team works together to make a lasting difference and improve people’s health, and even save their lives, that counts most.
Thank you to Joel Chehab, MPH; Marcela Torres, MPH and CDC Center for Global Health. To learn more about CDC’s work in Mozambique, click here.
-Whitney Hall, Administration & Communications Specialist
