Dr. Demetre Daskalakis on HIV Activism, Mpox Lessons & Leaving the CDC

Hey everybody. 

This week on Duke’s Download, I sit down with Dr. Demetre Daskalakis — infectious disease physician, longtime HIV activist, former CDC leader, and one of the most influential voices in LGBTQ public health.

We talk about his journey from early-1990s HIV activism at Columbia University to national leadership during the COVID-19 and mpox outbreaks — and what ultimately led him to leave the CDC and return to frontline care at Callen-Lorde in New York City.

Dr. D shares how teaching safer sex and organizing an AIDS Memorial Quilt display became his lifelong “North Star,” shaping his approach to HIV prevention, public health strategy, and community-based care.

We explore the evolution of HIV activism, the importance of U=U (Undetectable = Untransmittable), the lessons learned from the 2022 mpox outbreak, and why humility is essential in infectious disease response.

This conversation is a powerful look at leadership, stigma, science, and the fight for LGBTQ health equity.

Dr. D is an exemplary example of a true LGBTQ leader. 

If you care about HIV prevention, LGBTQ health equity, mpox vaccination, public health leadership, or the future of the CDC, this is a conversation you won’t want to miss.

Be sure to follow Duke’s Download for more in-depth interviews on politics, culture, and public health.

For more information about Matt Mahan go to MahanForCalifornia.com

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You can write to us at: Questions@DukesDownload.com

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Transcript

SPEAKER_00 0:03

Welcome to Duke's Download, my new weekly podcast. I'm Duke Basin here, and each week I'll bring you candid thought-provoking conversations with incredible guests from the worlds of politics and pop culture. Together we'll explore the stories, ideas, and moments that shape our lives and drive change. I'm so glad you're here. Now let's get started. Hey everybody, welcome to Duke's Download. I'm your host, James Duke Mason. And today I am thrilled and honored to welcome Dr. Dimitri Duskalakis, an infectious disease physician, longtime gay health activist, and former leader at the CDC. I just have to say right off the bat, um, perhaps more than any person I've literally ever seen in my whole life, you kind of exemplify and embody the whole the phrase purpose-driven life. And um, you know, and and you know, I've always found it incredibly inspiring, you know, when you meet somebody who, you know, you know, yeah, I mean, I'm I I could drone on, I'll let you speak for yourself. But the first thing that sort of stood out to me, starting with your work as NYC's Deputy Commissioner for Disease Control, and then obviously the work that you've done at the national level, um, I think the fact that, you know, sort of history lined up with your own life direction, life story. And I found that sort of combination not only so um thrilling and exciting, the notion of like, you know, you you stepped up at this historic moment, but um, you know, I can only imagine just you know, someone who started getting involved in activism and advocacy young, uh, in a way, how how empowering that is to have a sense of purpose in your life. And so, anyway, um, there's so much to discuss. But I just wanted to thank you first of all for being here.

SPEAKER_01 1:54

And uh a nice thing to say. So I'm really excited to get to talk to you. I appreciate it. Thank you.

SPEAKER_00 2:01

It's true. I mean, like I said, you started as an NYC's Deputy Commissioner for Disease Control, then obviously directed the CDC's division of HIV prevention, led the National Center for Immunization and Respiratory Diseases, and then helped coordinate the national MPOX response. Um, but I thought we'd start at the beginning. Maybe uh, you know, I'd I'd be interested for those who don't know, if you could talk a little bit about your origin story and how you first got involved in activism.

SPEAKER_01 2:31

Yeah, I mean, so I I it for me it started when I was really young as well, actually. So I was um an undergraduate at Columbia University. And um, you know, when I moved to New York when I was 17, and really early on in that time, you know, being out as a sort of gay man in New York City and a young gay man in New York City, like I started to meet people, and then all of a sudden I would not see them again because they were getting sick. And so that was in the uh in the early 90s. And so um, you know, you know, even early on while I was an undergrad, I started doing things to sort of work to teach high school students about safer sex in that era. Um, and then ultimately, like my my my sort of aha moment, like where I generated that North Star that I've been following ever since, was in my senior year in college when I was uh working on a uh large display of the AIDS Memorial quilt, which if you don't know what that is, is uh a quilt that uh people submit panels for people that they've lost to HIV AIDS. And you know, it's it started as a few panels and now it's like acres and acres and acres of panels um that represent a lot of lives. And so um, you know, I was working um with that display, and I just remember standing on College Walk at Columbia on 116th between Broadway and Amsterdam, and just deciding that, you know, what I wanted to do was work um to make sure that no one would either get HIV or or suffer or die from it. And you know, that was like the the the beginning of the origin story of like what what what became my North Star. And I've gotta say that North Star has stayed, but but like slightly evolved to really be about infectious diseases in general, um, but has always had at its core the HIV work, even when I was doing you know work in vaccines. So it started like that, and then you know, I was gonna be a doctor. And so I I went through the process of you know, my my schooling. I decided to move up to Boston to do my residency training and my fellowship and kept on track um to do infectious diseases, which is how you had to do HIV medicine at that point. And, you know, I remember there was one moment where I was up there doing lab work and there was an infection in New York City of a gentleman um with HIV with rapid progression of disease, so got really sick really fast with multi-drug resistance. And they were like, oh, he got his HIV because he was at a bathhouse having like unprotected sex. And he was actually someone who also was dealing with crystal meth addiction. And so I was like, never mind this lab, let's go back to like my source and start doing work in New York City, where I landed as a doctor at Bellevue. Um, and there I was doing, you know, just HIV medicine, but then knocked on the door of the venue where the gentleman acquired his HIV and said, Hey, I want to come and do HIV testing here. And they said yes. And that is the actual beginning of my career, which is that going from the like doctor in a room taking care of patients to like, you know, I can take care of populations, um, potentially doing the work. So I started doing that, um, received my master's of public health supported by a family who donated some money to NYU to make sure that no one would die like their son did of HIV. And so that my North Star continues, and then the rest is the story. I, you know, went to HIV in New York City, did a lot of work there, kept getting advanced to be the head of all of infectious diseases at the Department of Health, led a bunch of crazy responses like measles and COVID, went to CDC, led HIV, got pulled into COVID, then got pulled into MPOX, and then got pulled into immunization and respiratory diseases, all with the North Star of making sure that people don't suffer and die from these things.

SPEAKER_00 6:24

Did you know? So you knew, because obviously HIV uh first became a national crisis in the early 80s, but were you always aware from when you were super young, when you were a kid, that that medicine and biology was something that you wanted to do? Or were those two things like was it a totally separate notion in your head, or it was always inter interconnected in some way?

SPEAKER_01 6:47

Yeah, no, like so. HIV was like not a thing when I was a kid because I I you know grew up. I mean, I I mean it was a thing, but like I was it was not the reason that I wanted to do medicine. And by kid I mean when I was three. So I want to do medicine since I was like a little kid, not because of any role models, but just because I I was it was my thing. Like I had like a doctor's kit when I was a kid, and that's like the thing that my favorite toy, and it's played out, it continues to be my favorite toy.

SPEAKER_00 7:15

That's incredible. Uh, I mean, also the fact, you know, of course, I'm I'm familiar with the AIDS quilt because not only you know uh did I start learning and reading about uh the history and of activism of gay activism at a young age, but I actually later on became friendly and worked with Cleve Jones on a bunch of different um advocacy projects over the years. But did you connect did you connect with Cleve back then? Did you meet him? Or what was it? How did you even begin to get involved with the AIDS quilt? And yeah, I mean, so what are historic moments too?

SPEAKER_01 7:50

Yeah, I mean, for me, I I didn't I didn't know Cleve then, but like I definitely, but for me, it was like I started at the grassroots-y as grassroots in the history of grassroots. Like I was, you know, going to teach like kids in the Bronx how to use condoms. Like, so that's how it really began, like when I was an undergrad. And then, you know, as as I sort of did more and more work, I'll say that the AIDS Memorial quilt and and like a a benefit that we did that sort of aligned with it, like really introduced me to some of the activists in the city. And then, you know, as my career went on, like these people went from like act, like people that I thought of as activists to being friends. And so I have sort of, you know, had this group of people who like really go back into the roots of like act up all the way into the present era. And so I feel like, you know, that's that's how I happened upon it. I think it was all about like I wanted to be a doctor. And then like I was a part of a community that was being, you know, really hurt by infectious diseases. And so, like, those two things, those Venn diagrams overlap in a way where it all started to make sense.

SPEAKER_00 8:56

Why did, you know, uh you touched on it already, but that point about, you know, prevention, specifically, obviously, in areas where HIV prevention and areas where, you know, there is a potential uh higher risk in terms of, you know, uh sex clubs, bathhouses, night, you know, those sorts of establishments, why uh other than the fact that there obviously is a disproportionate potential uh you know uh exposure to to not just HIV but STIs, TB, all sorts of different things. What what what why did you decide that that was an area that you really wanted to focus on? And what was that experience like? Like how successful did you feel your efforts were? And uh, you know, what was that what was that whole experience like? And you and you are in a place like New York City, too.

SPEAKER_01 9:46

Yeah, great question. And I think the answer is that one of the things that you learn in HIV is that you have to let people living with HIV be the ones that guide you to what you need to do, because they're like ultimately like the the folks that um I think are you know the most important in that calculus in terms of figuring out what to do. So for me, sort of hearing that you know, that that one case, that what one person um acquired HIV in that space made me think this is a good place to go. And I'll tell you that, you know, it's it's influenced my entire career in a way that's like I think good to like kind of good to think about, which is you know, I know a lot of people that have that do a lot of work in HIV, right? And I feel like one of the things that sort of like set me apart was that I wasn't just writing the grants to get people the money to be able to go into the venues to do the work. So I I mean I did eventually write the grants to get the money to get the people to do the work, but at first it was it was me with like HIV tests in my backpack and a couple of other people who I had like convinced to volunteer to go in there to do it. And so for me, like this idea of a community wasn't one that was very abstract, it like actually was like right in in front of me. And what I what I learned is that you know, people, you know, the barriers that people have to being able to sort of get what they need from the system revolve around the system's ability to create barriers that further stigmatize them. So like I I feel like you know, I have personally tested like with my hands, hundreds of men who were potentially at the highest risk for HIV. And like in the 20 minutes that I ran the test, I got to speak to them and I learned more from them than I have from any professor that I've ever met around how to do this work because they told me how and like what the issues were. And so, like, I really sort of think that for me, it was less about the venue. I mean, ultimately, like, you know, I took that venue idea and like then like what I learned there became like the framework for how we're doing HIV prevention in the country, right? So that's a big deal. But like it's it's like learning from the real, from the people um that are affected by the infection, and then using that learning to design how you like work to make it better for them is the way to go. And that's why the venues were interesting to me then and like even more that's why grateful I was in them.

SPEAKER_00 12:29

Well, no, absolutely. Uh, you know, you can learn in a venue like that, you know, you can learn a lot in a sort of condensed uh environment, if that makes sense. So that I, you know, and there there's a lot, there's there's a lot of to work with in terms of uh in terms of knowledge and uh practical experience. Um what was that like to go from working in an environment like New York City, where obviously, you know, like I said, you were at the forefront of of disease prevention there, but to then sort of scale that to the national level and going to work at the CDC? Um, you know, obviously we're in a very different environment now when it comes to uh CDC than we were than we were even three or four years ago. But was that an environment that you felt um comfortable in, I guess is the right word? Did you feel like to make that sort of, even though you were working for the biggest city in America, what was that jump like to go from that environment to working in a place like the CDC that had obviously also going back to the AIDS epidemic or the onset of it, the CDC and the gay community always had kind of a complicated uh relationship? Yeah, so a couple things.

SPEAKER_01 13:37

So I think first, um, you know, I'm a very big skeptic of government. And so one of the best ways to address your skepticism of government to is to serve in government. And so for me, um, you know, I it was a great opportunity to sort of, you know, having been like a person in a city that was highly impacted by HIV, who then became like the person who got to sort of influence like how the city responded to HIV and infectious diseases, um, and seeing sort of like what we needed more from the federal government that we weren't getting, like what like frameworks they were that that we needed from them that we weren't getting, sort of getting to bump up that level to try to figure out how to make it better was really exciting. Now, you know, do I always walk in the room and like I'm totally confident that I'm gonna take over like a $1 billion organization and it's gonna be just fine based on the fact that I've like ran infectious disease in the city? Hell no. Right. Like when you start, you're like, oh my God, this is like this giant fire hose I'm drinking from. I barely know what you're talking about. Like CDC is like, as an example, like a huge glob of acronyms. And like I they were like talking things that I was like, I do not know what you're talking about. But like the only way to do things is to do them. And so, like, I think that there's a lot of like learning that you can get, lots of background, lots of experience. But at the end of the day, like the way that you learn how to be the division director for HIV prevention in in the US is by doing it. And so, so like I, you know, definitely I feel like that that anxiety goes away after you like realize that the skills that you learned, you know, running COVID, running measles in New York City when there were big outbreaks aren't that different than the skills that you need nationally. Um, I think are good. But then also I learned a I learned so much stuff that I never knew I would learn by doing it.

SPEAKER_00 15:36

And so But what a time I loved it. I mean, not I love, but like, you know, what I can only imagine what an unbelievable four or five years that was, where you went from, you know, uh running basically, you know, tackling two major crises, you know, uh COVID and uh and um I guess you were already with the national at the CDC when when uh Mpox came around in 2022.

SPEAKER_01 16:03

But I got pulled, I mean, speaking of like imposter syndrome, like I got pulled to the White House. Like what infection, like there's not a lot of infectious disease doctors that get pulled to the White House to run to run an outbreak. And so was I like fully confident when I walked in the door at the White House? No, but boy, like I learned how to do it and it was great.

SPEAKER_00 16:24

What were the sort of lessons do you think that we can take away from the whole? I mean, so I obviously remember living in West Hollywood, getting vaccinated, and that whole experience. Uh, you know, and you hear occasional rumblings about there being another outbreak. Uh, and I think even re very recently I think there was there was talk of that. Um what do you think? What do you do you think that sort of I mean, not I guess unless uh disease or uh you know it goes completely, you know, whatever, not extinct, that's not the correct word, but goes completely dormant. You can say eliminated, maybe like eliminated, it can always come back. But yeah uh where do you think that that's a uh imminent possibility just based on what you've heard anecdotally from your from your experiences? Yeah.

SPEAKER_01 17:11

I mean, so I think definitely, I mean, think about like what's going on with measles. Measles was eliminated in the United States too, right? So if you like lose, if if like people are like not getting either not protecting themselves appropriately, whatever that may mean for them, um, or not getting vaccinated, then all of a sudden, like you'll have uh a bigger population of people that could be at risk for uh for MPOX. Um, and that could mean like outbreaks. And so I think that definitely, you know, we're always at risk for uh for a resurgence of MPOX just because there's always new people who are either not immune because they've had it or not immune because they've not been vaccinated. And so like that's why it's important that that that drum beat continues about making sure that folks are up to date on their MPOX vaccine if they're folks that are at risk for getting MPOX. You know, I think we hear about cases here and there. Um, there's a couple of different flavors of MPOX. There's there's um the one that we were pretty familiar with during the outbreak in 22 and 23. And then there's another strain that pops up every now and then in travelers um that may even be more severe. So, you know, the thing about uh taking it from MPOX to just in general, like one of the most important things in infectious diseases is having like a huge amount of humility because like you can never predict really what these viruses are gonna do. Like you never know. And every time you like, so whenever you hear someone who has like full confidence about anything in infectious diseases, you need to question them because there is nothing that we are fully confident about, but we can say, like, you know, most likely if you're vaccinated against MPOX, the chances that you'll get the disease are a lot lower. And if you do get the disease, it will be a lot milder.

SPEAKER_00 18:53

Um these things are ever evolving too, where there's new strains and new right. And and so there's no guarantee, there's no guarantee, no guarantees about anything really, except that you do everything you can to put yourself in the best possible you know, situation. Um we just need to be humble. We need to be humble. We don't have absolutely um before I talk to you about sort of the current environment, I wanted to ask you, you know, during your time at the CDC and at the White House, what were some of the um things that you were most proud of in terms of bringing certain things to pro, for instance, what something that stood out to me, which I feel like given that from like 2017 to 2021 or 2022, you know, a lot of these topics in the, you know, when it comes to LGBTQ plus health, you know, the whole top the whole uh notion of um, you know, undetectable equals untransmissible, that didn't really I mean, yes, it existed in 2017 or 2016 during the Obama administration, but for those four years, I feel like that whole concept sort of rose to national prominence. And then when we had a president in the White House again who, you know, was willing to sort of allow the government to talk about these topics again. I feel like that notion under your under your tenure sort of rose to prominence in the on the national level. But maybe you could talk a little bit about that and some of the other issues that you were proud for part of bringing to bringing to light on the national level.

SPEAKER_01 20:22

Yeah, I mean, I think you equals you, undetectable is equal to untransmittable is like a really, a really great sort of example. I mean, I think that, you know, for me, um, you know, I was the first public health official um in the country, maybe the world, um, that sort of took along a government, uh, a government organization to sign on to say that undetectable is in fact untransmittable. And so like it was almost instant, like what the aftershock was, which is that people were like, well, like that is like potentially like a great tool to address a lot of the stigma around HIV. And so like very quickly it got pulled into like, you know, guidelines, even. So if you look at the like national guidelines for HIV treatment, they say like you need to talk to your patients about the idea that undetectable is equal to untransmittable, because it means that they are, you know, that they won't transmit infection sexually. And so like it's it ends up being a pretty liberating moment, um, sort of from the perspective of some of the stigma. Now, with that said, like, you know, it shouldn't have taken you equals you to liberate from stigma. Like it's just, but you know, unfortunately it did, but like it is a good idea.

SPEAKER_00 21:32

How much ignorance and ignorance there still is about about that issue. I mean, yeah, and you leave and living in a city. I mean, you know, granted, I mean, I've you know, I grew up from a young age with my mom having friends who were HIV positive. And so for me, it was never something that I was that I, you know, I mean, of course, you're always learning new things, but point being that you know, the whole that whole notion, undetectable equals untransmissible, is something that a lot of people, even within the gay community, still don't understand. understand, you know, or don't aren't aware of. I mean, there's still a ton of. So I think what you did in sort of um, you know, putting that sort of notion into now not just the culture, but into, you know, into, into guidelines around the country and the world, you know, it's it's kind of a massive, uh, massive accomplishment and achievement.

SPEAKER_01 22:24

Yeah. And I mean I feel like, you know, when I got to CDC, like, I mean, interestingly enough, when I when I landed at CDC, they still hadn't sort of, you know, changed all of their materials to say that undetectable is equal to untransmittable, because there was like a little bit of, you know, like hesitance because you know nothing is absolute in infectious diseases, but it is, it is, you know, absolute to the it is absolute. Therefore, like we we were able to move the needle. I think that the other thing that I'm really proud of was the in the MPOX response, um, which is that like what I what I did as MPOC started to unfold is I like look back at the history of HIV and try to use like the lessons that we learned at the beginning of the HIV outbreak to sort of try not to make those same mistakes with MPOX. And so like I literally like was like okay this is what like you know I remember vividly when I was a kid like there was this whole like HIV is a gay disease, HIV is a gay disease. And I was like I am never going to say MPOX is a gay disease because MPOX is just a disease. Right. There are behaviors that can cause transmission of MPOX. And we need to make sure that people who are engaged in those behaviors are aware of the risk. That is a very like enlightened by HIV approach as opposed to the like just making it industrial strength and saying like gay gay men are at risk for MPOX period and that's the end of it. Like and so it's more nuanced and complicated but you know you know it it I think is like one example for me of like the lesson that I learned by living that and sort of seeing the activism and seeing the impact of like words on like stigma that lasts decades on how important it is to sort of you know try to like actually learn and and and uh implement the lessons that I learned.

SPEAKER_00 24:18

It's the least it's a perfect example of how knowing history actually you know what do they say people I mean it's uh you know it's a little the cliche expression but those who don't know history are doomed to repeat it basically and and so no I think that's incredible.

SPEAKER_01 24:34

Um yeah you know well I was like I have the opportunity for a redemption story. Yeah like I can be like I can like say I can have this conversation with you years out after after Mpox and say like you know it wasn't perfect but we learned from those lessons to try to make it better and it ended up being a little better. Absolutely now I mean obviously you guys uh you know it it stopped you know I mean of course it can always continue but I mean in terms of the the you know the the war path that it was on it was stopped in the tracks but then also I I feel like you're right there wasn't quite so much of a cultural stigma you know as as there was with a with HIV you know um and I remember distinctly seeing the press and seeing you know like you know this is uh this is deaf this is not a gay disease you know this is not a gay and it was a lot of work because it's so easy just to say that right right it's so easy because then you're done right so you can just be like I I've made it clear like you know I've communicated in like a sound bite but the problem is but then like then what happens is like it's a not true and B it creates like potentially years of stigma afterwards. And so anyway I'm glad that you felt that there was like a difference in something that felt different.

SPEAKER_00 25:53

I remember it for I remember it you know actually remember it being in the moment and hearing it and and uh it meant a lot you know um but but I I wanted to ask you you know I don't know how how much uh you know I I know you have talked about it but I also don't want to ask you to talk more about it than than you feel comfortable with obviously but you know given the change in direction uh that's taken place at the national level not just in the White House but CDC or HHS again you feel you talk about it as as much or as little as you want but what what was that whole uh the the end of that tenure like and also how do you feel about some of these changes that have happened not just on LGBTQ rights but obviously measles and lots of different areas in which HHS with Secretary Kennedy has gone in a very different direction.

SPEAKER_01 26:49

Yeah I mean I I you know I think that you know I when I think of CDC now like while I was there right before I left like the best way to describe it to people who aren't there is it feels like a hijacked plane. Right. So you have like a lot of scientists a lot of really excellent public health you know people who range from science all the way to administration who are there trying to do work and you know it's it's been hijacked by people who are really looking at you know using it as a tool for like ideologic purposes as opposed to like the the what it's supposed to do um which is to deliver on its mission to improve the health of America and Americans. So like it's it it it feels you know for me um you know I I stuck it out for about eight months almost nine um because I you know felt that that you know as a civil servant that I was able to sort of mitigate some of the harms that were coming but then for me when I got to the point where you know it was clear that that you know in that hijack plane there was no pilot that had any scientific expertise and it was driven purely by ideology and there was like less and less that we were able to do I felt that that's like when my doctor my two oaths that I've taken in my life that I've taken very seriously are the Hippocratic oath that says first do no harm and then the oath that I did that I made when I became a a civil servant which is to serve the Constitution I thought neither of those were was I able to be able to was I gonna I gonna be able to sort of deliver on and so I couldn't stay. Yeah I just felt that I was going to just be you know that by by sort of staying there while people were were sort of doing things that were bad for health, but then sort of being the face of that for immunization and respiratory diseases, I was like I can't really do that and sort of be feel like I'm trusted by the people I'm supposed to serve. I thought it was going to cause harm. And then again the my oath as a civil servant was very clear. And I I thought that the sort of you know more authoritarian stance that was not listening to science and experts um was not going to be something that really uh reflected what the constitution wanted me to do as a civil servant. So I had to go.

SPEAKER_00 29:07

I know this is kind of a digression but like you know I have in full disclosure I have friends or people I know who uh actually know and are friendly with or were anyway with our RFK Jr. And uh and I gotta say aside from a lot of the thing there are a lot obviously a lot of different things on which I disagreed with him or disagree with him even before he you know became HHS secretary. But the thing that I found I mean again there's the vaccines there's a lot of stuff but the thing that I remember from when he ran for president that just made me go like this is excuse my language like fucking insane is when he did I don't know if you saw I'm assuming you probably did see this clip of him from I think it was five or six years ago where someone who was you know says they're steeped in you know scientific knowledge and and um when he made that claim that you know he remembers anecdotally in the early 80s how you know gay men were who did a lot of poppers were getting AIDS and I was just like that I mean okay there's a lot of other things that were deal breakers but that was the one where I was like you know I just in general it's weird to have a secretary of health who doesn't believe in germ theory.

SPEAKER_01 30:26

Right. Yeah like he you know is there a is there some ether or some miasma that's causing the illness when we actually have like very clear scientific evidence that the that the cause is a virus.

SPEAKER_00 30:38

And so I think you know I I I I think AIDS denialism still exists or HI HIV denialism still exists and I know it's been sort of debunked in a lot of ways especially because a lot of the people not to be glib about it but a lot of the people who advocated for it are dead you know but uh the fact that that still is a thing that and now that the Secretary of Health and Human Services has has advocated or or is just kind of scary.

SPEAKER_01 31:06

I mean there's a there's a theme right there's a theme of like very sort of anecdotal in my experience I mean like the entire drug policy for the so forget infectious diseases like the entire like drug policy for the United States is now based on the feels from from RFK right like that's the bottom line it's like this is my this is like he'll share what his voyage was and then all of a sudden the entire thing is based on his voyage which is that of a very very well resourced white man in Massachusetts which is a lot different than like the child in the Bronx that has a completely different experience. And so I like to base things on epidemiology and data they like to put to base things on feels and so we are living in a universe where feels um are coming from a from uh the Secretary of health that are influencing policy and that's going to mean potentially not so great outcomes for people that aren't from his experience.

SPEAKER_00 32:11

I mean I'm sorry that you that that sort of experience ended the way it did but I'm also admire you you know tremendously both for that for your taking a principled stand in that moment but also as I mentioned earlier just you your entire sort of lifetime so far of incredible purpose driven work. I mean given that given that you know that continues to be your North Star, what are you focused on now? And what are the ways that you that you think that you that you anticipate that you might continue to give back in the future.

SPEAKER_01 32:43

Yeah I mean so I've kind of gone back to my roots so I'm currently working at like a great community health center in New York City called Callum Lord. It's the like really like the preeminent LGBTQ serving uh community health center in the country. And so it's like you know all the things that I helped design now I'm like on the ground implementing and so I'm kind of this like full circle experience back to New York and back to sort of the front line. But then also staying connected to the national scene and making sure that like you know I I the the part about leaping government is that you that now I'm an advocate again. And like that is like both a lot of responsibility but then also I think a lot of uh of of liberty to be able to sort of be more uh sort of you know clear about what needs are not being met and all of that. So I feel like you know I'm not sure where I'm gonna, what the future holds like long long term, but I think that right now it feels really good to be somewhere where I'm like you know making making good on the vision that um that I I I held for the country as we moved into like a the the sort of uh strategy for helping to end the HIV epidemic.

SPEAKER_00 33:50

Yeah what a what a time what a time to to be involved in that mission. It's like we we we could be almost there. I mean depending on what the federal government does to try to either help or veer it veer us off course but it feels like that goal is in our sights.

SPEAKER_01 34:07

You got to keep the North Star. So even when I my dumb story is like when they asked me to be the head of the immunization and respiratory disease uh center, I was like, this is great. If I can figure out how like the vaccine infrastructure works when the time comes for an HIV vaccine I'm gonna be able to actually figure out how to make it happen, like how to implement it in the world. And so like it's it's just keeping that North Star no matter where you land because it's like the thing that sort of you know makes waking up in the morning exciting and that makes me feel like every day I go to work and it feels like I'm playing rather than working which is how it should feel absolutely well thank you seriously I know it sounds uh perhaps you're but trite or whatever but I mean it from the bottom of my heart.

SPEAKER_00 34:51

Thank you you you're you're an incredible public servant and thank you for on a personal level and on behalf of our community thank you for all the the work that you do.

SPEAKER_01 35:01

It means great to talk to you thank you so much.

SPEAKER_00 35:04

Great to talk to you thank you everybody for joining us for this episode of Duke's download with Dr. Dimitri Duskolakis truly an exemplary public servant and such a nice guy and so many important lessons that I think we can take away from somebody who has lived a life of true effective public service and advocacy please like share subscribe if you have any questions feel free to email us at questions at dukesdownload.com and I will see you next week with another super cool super interesting special guest. So thank you for joining us see you soon thank you for joining me today on Duke's Download. This podcast is part of Pridehouse Media hosted by me Duke Mason and produced and edited by Josh Rosen's whike original music composed by Nell Balaban if you enjoyed this episode please subscribe wherever you listen to podcasts. While you're there leave us a rating and review it really helps others to discover the show. I'd love to stay connected with you so join the conversation by following me at James Duke Mason on Instagram and X or by emailing me at questions at Dukesdownload.com