Rashad Burgess, head of Gilead Sciences’ HIV community operations

Q&A: From the CDC to Gilead Sci­ences, Rashad Burgess works lo­cal for na­tion­al change in HIV com­mu­ni­ty

The Covid pan­dem­ic set back progress in an­oth­er pan­dem­ic, HIV, to dev­as­tat­ing ef­fect. Few like­ly know that as well as Rashad Burgess, the head of Gilead Sci­ences’ HIV com­mu­ni­ty op­er­a­tions and over­see­ing the phar­ma com­pa­ny’s lo­cal am­bas­sadors in cities across the US.

For the first time in 40 years, there were months when more peo­ple were drop­ping out of HIV treat­ment than en­rolling, Burgess said. The preva­lence is par­tic­u­lar­ly pro­nounced in the South, which even be­fore the pan­dem­ic ac­count­ed for 51% of new HIV di­ag­noses, ac­cord­ing to the CDC – and its on­ly got­ten worse in the past 21 months.

That’s part of the rea­son why he’s spent the last few months re­cruit­ing new am­bas­sadors – Gilead is boost­ing its lo­cal HIV com­mu­ni­ty force from 26 to 35 peo­ple.

How­ev­er, far from be­ing de­feat­ed or even dis­ap­point­ed by Covid chal­lenges, Burgess is en­er­gized. He said the set­back “fu­els my fire” to dou­ble down on HIV pre­ven­tion and treat­ment and re­mind peo­ple that the HIV pub­lic health pan­dem­ic didn’t dis­ap­pear when the new coro­n­avirus one ar­rived.

Burgess joined Gilead eight years ago as an HIV com­mu­ni­ty li­ai­son. He stepped in­to the lo­cal role, mov­ing from a na­tion­al role at the Cen­ters for Dis­ease Con­trol and Pre­ven­tion in its HIV and AIDS pre­ven­tion di­vi­sion.

He want­ed to take on the small­er, more in­di­vid­ual con­trib­u­tor role, and did so for sev­er­al years as well as a stint in sales. How­ev­er, Burgess is now back in a na­tion­al role.

He took on the ex­ec­u­tive di­rec­tor role lead­ing com­mu­ni­ty lead­er­ship just a few months be­fore the Covid-19 pan­dem­ic and has since been like most peo­ple deal­ing with the pan­dem­ic’s per­son­al and pro­fes­sion­al im­pact.

Burgess is a Chica­go na­tive who now lives in At­lanta with his hus­band Bish­op OC Allen and their chil­dren – and who were named one of the coolest Black fam­i­lies in At­lanta by Ebony mag­a­zine sev­er­al years ago. He talked to Mar­ket­ingRx ed­i­tor Beth Sny­der Bu­lik about his long-time work in HIV, Gilead com­mu­ni­ty work and why boots on the ground mat­ter.

You came to Gilead from the CDC, right? What did you do there?

When I left CDC, I was the chief of the ca­pac­i­ty build­ing branch for the di­vi­sion of HIV and AIDS pre­ven­tion. So es­sen­tial­ly, my role was over­see­ing all train­ing and tech­ni­cal as­sis­tance for the HIV pre­ven­tion work­force for the en­tire coun­try. Com­mu­ni­ty-based or­ga­ni­za­tions, AIDS ser­vice or­ga­ni­za­tions, health cen­ters and health de­part­ments were all un­der my purview when it came to train­ing and tech­ni­cal as­sis­tance. Peo­ple of­ten joke about the fact that I know every­one. I don’t re­al­ly know every­one, but I know a lot of the HIV pre­ven­tion work­force be­cause they of­ten­times had to come through my shop in some form or fash­ion for their re­spec­tive train­ing.

But there’s still so much work be­ing done that needs to be done. For­tu­nate­ly, Gilead has al­lowed me to work with those re­la­tion­ships that I’ve had and re­al­ly build on those as the field has grown. We have in­ter­ven­tions that al­low us to have a greater role in ac­tu­al­ly pre­vent­ing the spread of HIV as well as treat­ing HIV, so it’s re­al­ly been an in­cred­i­ble op­por­tu­ni­ty.

How has your role changed in the eight years now that you’ve been with Gilead?

I start­ed as a com­mu­ni­ty li­ai­son. I had this re­al­ly big job at CDC and left to take on a very spe­cif­ic in­di­vid­ual con­trib­u­tor role at Gilead. I was a com­mu­ni­ty li­ai­son, work­ing with or­ga­ni­za­tions and health de­part­ments and health cen­ters in north­ern Flori­da and all of Geor­gia. From that role I grew in­to a num­ber of roles to in­clude lead­er­ship as part of the com­mu­ni­ty team, and then had a num­ber of roles in our sales or­ga­ni­za­tions. I ac­tu­al­ly helped do some build­ing out of our HIV pre­ven­tion PrEP sales­force. Then two years ago, I took on the na­tion­al re­spon­si­bil­i­ty of lead­ing the HIV com­mu­ni­ty.

And what do you do as na­tion­al leader of the com­mu­ni­ty team?

We have a team of com­mu­ni­ty li­aisons around the coun­try that are re­spon­si­ble for work­ing with al­lied health care pro­fes­sion­als and pa­tients in pro­vid­ing ed­u­ca­tion both in terms of our in terms of dis­ease states around HIV, and re­al­ly be­ing a part­ner in com­mu­ni­ty. I say we are Gilead’s am­bas­sadors in the com­mu­ni­ties where we have our com­mu­ni­ty li­aisons. Cur­rent­ly they’re ac­tive­ly 26, but by the time this ar­ti­cle pub­lish­es, there will be a to­tal of ac­tu­al­ly 35 com­mu­ni­ty li­aisons across this coun­try.

We’re do­ing their ex­pan­sion as a re­flec­tion of Gilead’s in­creased in­vest­ment and val­ue in rec­og­niz­ing how im­por­tant it is that we have strong part­ners on the ground. We do our work in the train­ing and ed­u­ca­tion of part­ners and with those or­ga­ni­za­tions, but al­so just as im­por­tant is the work that we’re do­ing. We’re go­ing to be in­creas­ing our ef­forts around HIV treat­ment, and re­al­ly mak­ing sure that we’re work­ing to help keep pa­tients in care which is so crit­i­cal.

Where are the li­aisons lo­cat­ed, in any par­tic­u­lar ge­og­ra­phy or in ur­ban or rur­al ar­eas?

It’s a bit of a mix. They def­i­nite­ly are cen­tered in in ur­ban cen­ters, if you will. But we’ve in­creased our foot­print in the South and in the South­east which re­flects what we know about the epi­dem­ic to­day – half of all new HIV in­fec­tions are hap­pen­ing in the South. And al­so un­der­stand­ing the many bar­ri­ers that ex­ist in the South around health­care ac­cess and around stig­ma. We felt that it was re­al­ly im­por­tant that we make our con­tri­bu­tion to re­al­ly change that by hav­ing boots on the ground as com­mu­ni­ty li­aisons to do that work.

Can you give me an ex­am­ple of some of the pro­grams they’re work­ing on? Are those na­tion­al ef­forts or com­plete­ly lo­cal­ized ef­forts?

A cou­ple of things will be fo­cal ar­eas for this com­ing year. The first is in treat­ment pro­to­cols, and what we call pro­to­col im­ple­men­ta­tion work. At the end of the day, we’re work­ing with cus­tomers across the board to help en­sure that they have pro­to­cols in place in their or­ga­ni­za­tion, so that every time some­one comes in for HIV test­ing, and they’re di­ag­nosed as HIV pos­i­tive, they walk out the door with HIV ther­a­py. That’s some­thing we’re work­ing on every day and is re­al­ly im­por­tant.

This is not some­thing unique that we’ve de­vel­oped — we’re shar­ing best prac­tices that have been proven. It’s some­thing the CDC rolled out some time ago about the im­por­tance of rou­tiniz­ing HIV test­ing re­gard­ing guide­lines around treat­ment around the im­por­tance of ear­ly ther­a­py and ther­a­py at di­ag­no­sis. So that’s some­thing that we are pulling for­ward, those proven pub­lic health strate­gies. And re­al­ly in places where HIV is im­pact­ing, re­al­ly mak­ing sure that they’re pulling those ef­forts through. And re­al­ly be­ing a tech­ni­cal as­sis­tance provider in many ways to re­al­ly help them on the ground. It’s some­thing that’s im­por­tant and re­al­ly mat­ters to com­mu­ni­ties across this coun­try, es­pe­cial­ly in places where the health care sys­tems and health care ac­cess are not as strong as an­oth­er places – and po­ten­tial­ly where there is more stig­ma.

One of the ef­forts that we have re­lat­ed to stig­ma is we of­fer an en­tire cur­ricu­lum around cul­tur­al hu­mil­i­ty in health­care. Re­al­ly work­ing with or­ga­ni­za­tions and tak­ing them on a jour­ney to un­der­stand the im­por­tance of cul­tur­al hu­mil­i­ty in health­care and get­ting providers – every­one in the of­fice – to have a mind­set of cul­ture hu­mil­i­ty, and a pa­tient-cen­tric ap­proach to re­al­ly un­der­stand­ing how im­por­tant it is that they do the work them­selves to make sure that they’re not vis­it­ing bias on pa­tients that can re­sult in pa­tients ac­tu­al­ly get­ting out of care.

When we look at some of our great­est op­por­tu­ni­ties, and look at from a com­mu­ni­ty per­spec­tive, some of the great­est needs are in com­mu­ni­ties that are of­ten­times mar­gin­al­ized. Com­mu­ni­ties of col­or, LGBT com­mu­ni­ties, etc.

An­oth­er big com­po­nent of our work is that we be­lieve by do­ing this work, it re­sults in pa­tients be­ing in care and re­main­ing in care, and that their HIV is be­ing ap­pro­pri­ate­ly man­aged.

What are some of the mar­ket­ing ef­forts and mes­sages that you’re get­ting out to peo­ple?

I think one of the things that we’re re­al­ly clear on is that we are part­ners. Gilead is an al­ly and we are a part­ner in this work, where we pro­vide lead­er­ship. It’s re­al­ly im­por­tant that every­one un­der­stand that. And al­so that we un­der­stand that pa­tients’ needs are at the core of our work, and we have to make sure that we are pa­tient-cen­tric in our ap­proach­es to health­care, and our ap­proach­es to mar­ket­ing and ed­u­ca­tion. We have to make sure we have ma­te­ri­als, we have in­for­ma­tion and we have ef­forts that reach peo­ple where they are at. Com­mu­ni­cat­ing with them in a way in which they can un­der­stand and is trans­for­ma­tive for them. We work hard every day re­al­ly to en­sure that our work is im­pact­ful, not on­ly for sci­ence, but al­so for so­ci­ety.

You’ve men­tioned pa­tient-cen­tric­i­ty a cou­ple of times, why is that so im­por­tant in this ther­a­py area?

Be­cause if you’re not pa­tient-cen­tric, that means your mes­sages won’t reach the pa­tients and you will miss the very in­di­vid­u­als that you need to reach. When you look at it from a health dis­par­i­ty lens, there are many mar­gin­al­ized com­mu­ni­ties that need the mes­sages and what we have to of­fer at Gilead in terms of HIV pre­ven­tion or treat­ment. If we don’t make sure that our mes­sages are reach­ing those pa­tients, we then run the risk of miss­ing them.

Go­ing from one or just a few treat­ments and med­i­cines to now a port­fo­lio, how has that changed and where is Gilead to­day?

Gilead has al­ways been a leader and in­no­va­tor in the field of HIV – dri­ving ad­vances in treat­ment, dri­ving ad­vances in pre­ven­tion and dri­ving ad­vances in cure re­search. And so that’s who we are.

To­day we ac­tu­al­ly are more tar­get­ed, and we are in­creas­ing our foot­print in places and in ar­eas where the mes­sage needs to res­onate and have greater im­pact. We have in­creased in­vest­ments in our mar­ket­ing ef­forts to re­al­ly en­sure that they’re in places where we know HIV ex­ists. That’s some­thing that we have, over time, re­al­ly be­come very in­ten­tion­al about.

Al­so the uti­liza­tion of so­cial me­dia, for ex­am­ple, and just mak­ing sure that we are in­no­vat­ing with the times. The re­al­i­ty is that a decade ago, pret­ty much we all just watched tele­vi­sion. Now a decade lat­er, me­dia is so much be­yond tele­vi­sion. We’ve adapt­ed our mes­sages and our en­gage­ment to re­flect that.

Does that mean we’re go­ing to see you in a Tik­Tok soon? Se­ri­ous­ly though, your tar­get au­di­ence is younger than, say, a car­dio­vas­cu­lar drug?

(Laughs) I won’t take that off the ta­ble be­cause you do see us on In­sta­gram, we are on Face­book, so …

We do make sure that our ef­forts are keep­ing up with the young peo­ple, es­pe­cial­ly the age group that is 18 to 29. Some of the most vul­ner­a­ble com­mu­ni­ties and pop­u­la­tions for HIV are in that age brack­et and so we def­i­nite­ly have to adapt.

Our mes­sage is re­al­ly crit­i­cal, and I mean both our mes­sages re­lat­ed to our med­ica­tion, but al­so our mes­sages re­lat­ed to pro­vid­ing ed­u­ca­tion and aware­ness around HIV be­cause we know med­ica­tion alone will not end the HIV epi­dem­ic. There’s so much more that we have to ad­dress to re­al­ly en­sure that we are end­ing the epi­dem­ic. Our mes­sages will adapt to make sure that we’re do­ing our part and pro­vid­ing lead­er­ship, but al­so that we’re reach­ing the peo­ple that need to be reached.

Why is it im­por­tant to have the lo­cal com­mu­ni­ty pres­ence in HIV?

We have re­al­ly have in­creased our ef­forts and our en­gage­ment where HIV is lo­cat­ed to make sure that we’re ed­u­cat­ing our health­care providers, that we’re ed­u­cat­ing com­mu­ni­ties on HIV im­pact, how peo­ple can be pre­vent­ed from ac­quir­ing HIV, and how peo­ple can be treat­ed for HIV. We’ve di­aled up those ef­forts and op­ti­mize those for im­pact on those that need to hear those mes­sages the most.

We’ve been work­ing in this field over 30 years. And so we have in­cred­i­ble trust amongst our com­mu­ni­ty part­ners and they see us as such, and that we’re do­ing our part to make sure that we end the epi­dem­ic.

And you’re not at Gilead head­quar­ters in Cal­i­for­nia, right?

I’m ac­tu­al­ly in At­lanta, Geor­gia.

I did read that when I looked you up on the in­ter­net. And I al­so saw that you were named as one of the coolest Black fam­i­lies in At­lanta a few years ago.

Let me tell you, I will nev­er be able to live that ar­ti­cle down. When you Google me, that’s one of the first things that comes up. (Laughs) It was a re­al hon­or to be rec­og­nized by Ebony in that fash­ion. And one of the first black male, same gen­der lov­ing cou­ples to re­ceive that des­ig­na­tion. But you know, it’s about the work in At­lanta and the work in Geor­gia which is re­al­ly crit­i­cal. One of the things that I do every day, and every op­por­tu­ni­ty re­al­ly, is to make sure that our lead­er­ship as a com­pa­ny is ac­tu­al­ly here in Geor­gia, be­cause when you look at what’s hap­pen­ing in HIV, At­lanta is one of the few mar­kets where over time, HIV con­tin­ues to in­crease when you look at year over year, where­as in most oth­er big ur­ban cen­ters, you are see­ing a de­crease in HIV in­fec­tions. Me be­ing here is re­al­ly a re­flec­tion of, I would say, Gilead’s com­mit­ment to be­ing where the epi­dem­ic is and hav­ing lead­er­ship where the epi­dem­ic is to make a dif­fer­ence.

You men­tion case num­bers, how has COVID im­pact­ed HIV?

We’ve seen it very di­rect­ly that for the first time in over 40 years, there have been months where more peo­ple were drop­ping out of care than go­ing in­to care. I think for all of us who work in HIV, it’s been re­al­ly con­cern­ing and that’s just one of a num­ber of ef­fects from Covid. Peo­ple have fall­en out of care, peo­ple have moved to oth­er places and didn’t have a job and then didn’t have the strength, the ur­gency, or the abil­i­ty to ac­tu­al­ly sign up for health care – or it be­came less of a pri­or­i­ty.

We no­tice what hap­pens in HIV care with oth­er pri­or­i­ties such as hous­ing, such as trans­porta­tion, or even eat­ing can take prece­dence over HIV care. It’s been some­thing that we’ve seen and Covid has ex­ac­er­bat­ed it and al­so ex­ac­er­bat­ed some of the dis­par­i­ties we’ve known have al­ways ex­ist­ed.

It’s some­thing that is top of mind. And in some ways why the de­ci­sion was made to in­crease our ef­forts with our com­mu­ni­ty li­ai­son team to en­sure that we’re work­ing with part­ners – with com­mu­ni­ty-based or­ga­ni­za­tions, com­mu­ni­ty health cen­ters and health de­part­ments – to re­al­ly ex­plore strate­gies to wel­come peo­ple back to care.

Is it dis­ap­point­ing in that there was so much progress be­ing made in HIV and now this set­back by Covid?

For me, it un­der­scores the ur­gency. It un­der­scores why it’s so im­por­tant to do the work that we do, why it’s im­por­tant that we do it with greater in­ten­si­ty and that we don’t give up and we don’t get dis­tract­ed. Not that there aren’t things that are im­por­tant that are hap­pen­ing around us. But we re­al­ly have to make sure we main­tain our laser fo­cus around HIV be­cause HIV con­tin­ues. It’s still hap­pen­ing, it did not go away be­cause of Covid and so that’s al­ways top of mind for me. So I wouldn’t frame it as dis­ap­point­ing – for me, it fu­els my fire.

Any­thing else you’d like to add?

I would just say, in clos­ing that, you know, we’ve all been im­pact­ed by Covid, and pret­ty much in every way. But what is true is HIV did not end and HIV did not stop be­cause of Covid. We are re­al­ly com­mit­ted to our work in end­ing the epi­dem­ic and mak­ing sure that every­one who needs ther­a­py has it. And we have boots on the ground to do that, work­ing with part­ners across this coun­try to en­sure ac­cess to care.

Alexander Lefterov/Endpoints News

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