Dr. Saul Levin left his native South Africa in 1984, a time when his country was still under the grip of a racially driven apartheid system and HIV/AIDS awareness was uncertain territory.
He has seen firsthand how socioeconomic inequities can affect a community and the evolution of a worldwide fight against the AIDS epidemic. Now, he is taking the reins of the D.C. Department of Health while the nation is at a crossroads for health care — particularly in its capital city, where affluent neighborhoods are starkly counterbalanced by areas of high unemployment and great need.
The District recently hosted the 2012 International AIDS Conference and is making strides against the virus within its borders. It is launching a health care marketplace as part of President Obama's sweeping reforms and turning the corner on its carefully planned medical-marijuana program. It also is tackling new challenges, such as fighting the damaging effects of synthetic drugs on city youth.
Mayor Vincent C. Gray tapped Dr. Levin, 54, who lives in Adams Morgan, to lead the department when its permanent director, Dr. Mohammad Akhter, took a yearlong leave to work on the city's health care exchange. The exchange is a marketplace of insurance plans that must be operation-ready by the end of the year to be in line with Mr. Obama's health care law.
"I can understand why he wanted to take the job," Dr. Levin said. "When you get asked to do something, you're a team player and you say, 'Yes, I'm going to do it.' But, you know, the health exchange is going to be one of the most important health care changes we are going to be able to effect in the city."
The city's health department is tasked with managing the delivery of quality health care services to D.C. residents and, in emergencies, all the visitors who come into the city, Dr. Levin said. Its administrative duties run the gamut from immunizations for children to challenges such as diabetes, hypertension and substance abuse.
The mayor's spokesman, Pedro Ribeiro, said Dr. Levin brings "immense experience" that "dovetails directly into the challenges that the District is facing."
Dr. Levin answers those challenges with a question: "How do I begin to bring all the areas I've had in my past careers to a nexus to see how I can help further the District's health?" he said.
Dr. Levin made the District his home in the late 1980s. It was several years after he took up studies at the University of California, Davis as part of his flight from an inflexible system in South Africa, where apartheid was still years away from its epilogue.
"The military was about to call me up as well," he said. "Even though I'm a very strong protagonist of a strong military, there also comes a point in time when you're going to go and fight for a system that essentially was inherently wrong — so I left."
During a wide-ranging career over the past two decades, Dr. Levin operated a health care consulting firm that carried out contracts for the D.C. government, so he is no stranger to local politics. He served as the president of the Medical Education for South African Blacks — an organization that provided scholarships —and took a job in Chicago from 2009 to 2011. But the District lured him back.
Dr. Levin asked to head the Department of Health's Addiction, Prevention and Recovery Administration in March before he was tapped as interim department director in July. While settling into the top job at a large city department takes time, Dr. Levin readily outlined at least two specific goals for his tenure.
Statistics on HIV/AIDS in the District show deaths and new cases are decreasing, and no child has been born with the virus since 2009. Yet a disproportionately large number of the city's black women — 2.6 percent in 2010 —are infected by the virus, compared to less than 1 percent for Hispanic and white women. As part of the city's outreach to the black community, Dr. Levin is promoting an expansive awareness campaign with churches in the city.
"I understand the issue of stigma in terms of HIV and wanting to talk about it," Dr. Levin said. "But, you know, I believe every pastor, every priest, every minister, every rabbi, every imam wants to do good for their congregants."
His second pointed initiative is an awareness campaign that targets the use of synthetic drugs such as K2 and spice. These substances have garnered widespread attention in recent years and prompted legislation on both the state and federal level to prohibit their use.
A bill is pending before the D.C. Council to effect such a ban, a measure made difficult by the ability of manufacturers to alter compounds and evade statutes that specify a list of substances. Meanwhile, Dr. Levin wants to leverage federal grant funds from the Substance Abuse and Mental Health Services Administration.
"We're now going to create this campaign with the feds — the schools are involved, the clinics will be involved, the emergency rooms," Dr. Levin said.
He views the campaign as the confluence between Department of Health's expertise and the needs of other city departments. It was Metropolitan Police Chief Cathy L. Lanier who approached the department, he said, to note that some city youth were "acting really strange on the streets" as a potential result of synthetic-drug use.
While the city shines a light on the deleterious effects of new substances, it is trying to relieve the suffering of the sick and dying through a burgeoning medical-marijuana program.
Dr. Levin said only one of the six applicants allowed to register for a cultivation center has taken affirmative steps to obtain a business license and pass the final regulatory hurdles. Among dispensaries, one of the four approved registrants has taken bona fide steps toward operation.
"At this moment, we now wait for them to go through those processes before we then move to the next step of getting it implemented," he said.
The District has tread carefully in rolling out its program since residents voted in favor of it in 1997. After years of congressional interference, the council established a legal framework for the program in 2010. But the U.S. Department of Justice has taken a wavering stance on the legality of medical marijuana, leaving some states' program participants under the threat of prosecution.
Dr. Levin is hopeful that all factions will rely on one of his favorite motifs — integration.
"I think the federal government has their perspective, the citizens had theirs —it was voted on and we'll do it," he said. "And we'll do it right."
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