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Remembering Joel Breman, Ebola pioneer and beloved global health mentor
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Joel Breman, a leader in efforts to control smallpox, Ebola, malaria and several other infectious diseases, died this month in Chevy Chase, Maryland, at the age of 87.
Peter Piot, a fellow disease investigator, remembers the exact date that he met Breman. It was October 18, 1976, and Piot, then a young physician and microbiologist, had come to the city of Kinshasa in central Africa (in current-day Democratic Republic of the Congo) to investigate a terrifying, deadly, nameless new disease. Breman, already 40 years old and with several epidemic investigations under his belt, was there working for what was then called the U.S. Center for Disease Control.
Piot says it was clear that the pilots dropping them and others into the remote epidemic zone never expected to see them alive again.
Once on the ground, Piot watched how Breman did his epidemiology. "He taught me that when you go into a village, you don't just start talking about why you're here," Piot said. Rather, they went early in the morning, talked with the village elders and asked them how they've been. "And then, and only then, you start with your questions."
Born in Chicago and raised in Los Angeles, Breman showed his talents and leadership early on. In high school he was student body president and a football player; in college at UCLA he was president of his fraternity and rowed varsity crew.
Breman graduated from the University of Southern California School of Medicine in 1965 and spent the next 11 years working on various diseases with the CDC and World Health Organization. He would go on to earn a doctorate in public health from the London School of Hygiene and Tropical Medicine.
When they met in Africa, Piot says he was struck by Breman's broad knowledge of epidemiology and infectious diseases. "I immediately called him the walking encyclopedia," Piot said earlier this week.
Piot, Breman and others spent several months on the ground in central Africa. The disease they were investigating turned out to be Ebola, which at the time had a 90 percent death rate.
"It was super stressful," said Piot. The team was sharing mattresses, working day and night, collecting data from people who didn't necessarily want to see them. "But [Breman] remained calm always."
By the end of the trip, Piot says he was bowled over by Breman's equanimity, patience, kindness, respectfulness, and his ability and enthusiasm in telling jokes in both English and French.
In the following years, Breman worked on guinea worm, onchocerciasis, polio, measles and malaria at the CDC, the National Vaccine Program Office and the NIH Fogarty Center. He trained scientists, wrote books and published articles in medical journals. His first publication came in 1969, and his final publication was in October 2023.
As president of the American Society of Tropical Medicine and Hygiene he led the organization through the first year of the COVID-19 pandemic. Then-CEO Karen Goraleski said that working closely with him during that stressful time "was a joy and a master class in being the best human you can be."
Through it all, say those close to him, he engaged with people. "He was equally comfortable speaking with an African Minister of Health, a global leader on a specific disease, a class of public health students, the bus driver, the custodian in his office building or the parking attendant at the hotel," Rick Steketee, a mentee and former U.S. Global Malaria Coordinator, said at Breman's funeral.
Breman was always encouraging his wife and children to go to interesting places and do interesting things.
"Adventure first, safety a close second," remembers daughter Johanna Tzur. She says her father encouraged her to do a high school year abroad in the Soviet Union at a time when few Americans traveled there. It would be interesting, he promised. And one more thing, says Tzur: "I remember him vividly explaining I was never to eat anything that couldn't be peeled."
In later years Breman's children accompanied him on some of his trips. His son Matthew's high school graduation trip was a swing through The Gambia, Burkina Faso, Côte d'Ivoire and Nigeria for malaria surveillance. Matthew recalls watching his father in action. "He would speak to the level of the person he was interacting with. He would interact with villagers using dialects and local language. Even if he only knew one word, he would say that same word repeatedly and it would go from there."
Sometimes he offered a combination of humor and adventure. "He used to sign me up for things," says Matthew, who vividly recalls coming home from college for Thanksgiving weekend only to find his father had signed him up for a half-marathon he wasn't quite ready to run.
Breman summitted Mt. Kilimanjaro with Johanna, celebrated his 70th birthday dancing in the streets of Brazil during Carnaval and, according to his family, loved full moons, colorful clothing, licorice and music.
In a 2020 segment of the oral history series StoryCorps, Matthew asked his father to point to the most gratifying part of his career. Breman couldn't stop. "Public service, partnerships, mentoring and teaching," he said, before adding two more: Being at the World Health Organization in Geneva for the announcement of the end of smallpox and working with partners in poor countries.
In the year before his death, Breman was still teaching a course on infectious diseases at George Washington University and working on a textbook as well as a memoir.
His interest in other people never faded. During his final hospitalization for kidney cancer, just a week before transferring to home hospice, a palliative care physician came in to check on his comfort. His daughter says her jaw dropped as Breman, who was quite ill, quickly turned the doctor's questions about him into questions about the doctor. He asked with great warmth: How was she doing? Did she enjoy her training? Was she married?
"It was just so striking in this greatest moment of need in the ICU that he was" (and here Vicki, Breman's wife of 57 years, finishes her daughter's sentence) "thinking of other people."
Not long before he died, Breman told family members he wanted his funeral be more celebratory than mournful. And so, his casket was followed out of the synagogue by musicians playing a tuba, a clarinet (an instrument Breman himself played), a drum, an accordion and a trumpet. It was a New Orleans touch, except for perhaps the music – "Amazing Grace," and an upbeat version of a Jewish hymn.
Earlier in the ceremony, Walter Cohn, his friend since 3rd grade, summed up Breman's life by referring to tikkun olam, a Hebrew phrase that means "to heal the world."
"Joel's life was tikkun olam on steroids," he said.
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