Jirair Ratevosian (SPH‘07) believes there ought to be more healthcare leaders in the halls of Congress. With over 20 years of practice in the field of public health, Ratevosian is not shy to say science should be in the driver’s seat when it comes to decision-making around health.
He points out that among 535 total members, fewer than 30 are physicians, nurses, or have doctorates in public health. “The proportion pales in comparison to the percentage of funding that Congress controls and spends on healthcare and on public health matters,” says Ratevosian, who earned a master’s degree in public health at Boston University School of Public Health in 2007 and completed a doctorate at Johns Hopkins Bloomberg School of Public Health this past spring.
The lack of representation struck Ratevosian as particularly troubling in the wake of the COVID-19 pandemic, which thrust the effects of underinvestment in public health institutions into the national spotlight and escalated public health to the top of the political agenda, he says. With the 2024 elections on the horizon, Ratevosian decided to leave his position as the senior advisor for health equity policy in the Biden-Harris Administration and move home to Los Angeles to run for public office himself.
“To me, it was an aha moment,” says Ratevosian, who has joined a crowded field to campaign for the 30th Congressional District seat being vacated by Representative Adam Schiff (D-Burbank) as Schiff seeks to succeed the late Senator Dianne Feinstein (D-California). “When I look at policy challenges facing Americans, I very much look at issues through the lens of equity and policy solutions through the lens of equity. That equity framework and that equity approach are what I have learned from public health.”
Ratevosian, 43, has been politically involved from a young age. The eldest son of a Lebanese mother and an Armenian father who met in California after seeking asylum in the US, Ratevosian grew up in Los Angeles and later studied political science and physiology at the University of California, Los Angeles (UCLA). As an MPH student at the BU School of Public Health, Ratevosian organized with his peers to raise awareness of the Darfur Genocide and has fond memories of hosting a variety of events on campus to ensure university investments would not fund violence in Sudan, going as far as involving former BU President Robert Brown. Ratevosian also founded a service learning club at SPH whose membership was particularly active in fighting malaria and twice won the global fundraising competition Madness Against Malaria modeled on the NCAA March Madness college basketball tournament.
Advocacy and community organizing are key tenets of advancing public health, says Ratevosian. “Those are the skills that I learned through my experience at BU and in Boston.”
After graduating from SPH, Ratevosian brought his advocacy training to the fight against HIV/AIDS, first working with the Planning Council of the Boston Public Health Commission to administer Ryan White HIV funding in the Boston area before becoming the national field organizer for the Health Action AIDS campaign at the nonprofit Physicians for Human Rights—all while continuing to organize for the Massachusetts Coalition to Save Darfur.
In 2011, Ratevosian moved to Washington DC to assume the role of deputy director of public policy at amfAR, the Foundation for AIDS Research, where he worked to lift national restrictions for syringe access programs and eliminate the travel entry ban for individuals living with HIV. The move would ultimately lead him to Capitol Hill, where he joined the office of Representative Barbara Lee (D-Oakland). In his four years as Lee’s legislative director, Ratevosian helped to shape implementation of the Affordable Care Act, served as lead staff author of the Health Equity and Accountability Act, and worked to start the Congressional HIV/AIDS Caucus to secure federal funding for diseases disproportionately affecting minority communities.
In 2016, Ratevosian was named a 40 Under 40 Leader in Health by the National Minority Quality Forum and profiled by SPH for the honor. At the time, he was midway through what would become a seven-year stint in the private sector, working to deliver innovative medicines in areas of unmet medical need as executive director of global patient solutions at Gilead Sciences. Most recently, Ratevosian built on his public health legacy as the first ever health equity advisor in the US State Department, where he advised the Office of the US Global AIDS Coordinator and Global Health Diplomacy, helped oversee the President’s Emergency Plan for AIDS Relief (PEPFAR) program, and aided the Biden-Harris Administration to issue the first ever national strategy on gender equity and equality.
While a newcomer to political candidacy, Ratevosian is no stranger to the campaign trail. He shared with The New York Times that door-to-door canvassing for Biden during the depths of Iowa’s winter in February 2020 was the make-or-break moment that solidified his relationship with his now husband, Micheal Ighodaro, a fellow HIV activist. Ighodaro, who was born in Nigeria and granted asylum in the US, was named a 2015 “Champion of Change” by then-President Barack Obama and today works as executive director of the Prevention Access Campaign, a global nonprofit fighting the HIV epidemic. Ighodaro cares for the couple’s dog in DC, travelling back and forth to visit Ratevosian at his apartment in Burbank, California.
Ratevosian spoke with SPH about his identity, political views, aspirations as a congressional candidate, and perspectives on governing as a public health professional.
With Jirair Ratevosian
Your campaign website says you are “the son of Armenian immigrants” and “an openly gay public servant.” How do your various identities shape your politics?
As you say, I am Armenian American, and this district is nearly 15% Armenian in terms of the electorate. This district is also one of the queerest districts in the country; it includes West Hollywood, which was the first incorporated LGBTQ city in the country. My identity very much informs the way I show up to engage on issues. It informs the way I approach building bridges between different communities and building diverse coalitions to be able to tackle challenges. My identity also was a big part of the struggles that I had growing up, in terms of battling stigma and discrimination, not having gay, Armenian role models—certainly not gay, Armenian, political role models. But the resilience that I have developed informs the way I tackle social justice issues and issues around the need for more visibility for trans rights, the need for more visibility for Armenians who experienced an ethnic cleansing in our homeland just two months ago where we saw silence on the global arena for our rights. And so, it very much informs the way I show up to defend the rights of Armenians, LGBTQ [people], and immigrants.
You mentioned building diverse coalitions. What strategies do you have in mind for engaging with the diverse communities in your congressional district?
One of the reasons why I love this district and what motivates me to want to be the representative of it is how diverse the Los Angeles area is. You have such a rich coalition of—we have talked about Armenians and LGBTQ Americans—but there is also a robust Asian American and Pacific Islander community. There is a huge Filipino American community and many of them are nurses that work and live in Los Angeles. There is a huge Korean American community. A lot of war veterans that have come to Los Angeles and started families and have contributed to the fabric of Los Angeles. There is also a large and active Latino population in Los Angeles, almost a quarter in this particular district. They are business owners, they are students, they are dreamers, and all of those issues that face Congress today are represented by communities here in Los Angeles.
Trying to be a representative of such a diverse community takes a different mindset. We expect for our representatives to have the humility to know that they do not have all the answers [and] the humility to surround themselves with people who are smarter than them to be able to solve those specific community challenges. It also takes a representative who knows that their team and their staff have to be representative of the many different ways [of life] that this Los Angeles district represents. That is the way I conduct my work and my approach to this race, and that is what I would carry with me to lawmaking in Congress in Washington DC.
Could you elaborate on some of the specific policies that you support and hope to implement at the federal level were you to be elected?
One of the issues that is front and center is healthcare. People remain concerned about the rising cost of healthcare and not having healthcare that is accessible, either because of a language barrier or because of distance or location. I hear a lot about people who are fearful of engaging with a healthcare system or going to a hospital or seeing a doctor because of the medical expenses.
Beyond healthcare, housing is top of mind. There is a massive housing affordability crisis in Los Angeles. There is a massive crisis—which I think is a moral crisis—in terms of the number of people who are unhoused. That is related to housing affordability and making more homes available to address the root causes of homelessness, but also supporting the mental health and social services that [people] need to be able to [utilize] the temporary housing solutions that are available.
I will also say that people are concerned about education, having access to student loans, and not falling prey to a for-profit student loan repayment system that prevents borrowers from finishing their student loan payments or [necessitates] juggling multiple jobs to be able to pay their payments in the first place. I am someone who finished grad school 15 years ago and I am still paying student loans—and I had good-paying jobs over the last 15 years. How is it that I am still paying for my student loans, and I am one of the lucky ones? That is something we have to address, because I believe education is the greatest equalizer and if students are afraid to get an education because of fear of debt that is going to severely impact our country’s ability to continue to out-innovate and out-grow our competitors on the global stage.
How do you intend to balance public health considerations in broader legislative decisions? During the height of the pandemic, for example, lawmakers often had to weigh both health and economic concerns when drafting policies around isolation, social distancing, etc.
First, I am very concerned about the erosion that we are seeing in the trust that people have for health agencies and for the government in general. And that is because of the highly polarized and hyper political way in which the previous administration responded to COVID and their denial of facts, their denial of evidence to inform their choices in response to the [pandemic]. That has led to, I believe, a very dangerous spillover effect now [with] other immunizations, where we are seeing a drop in other immunizations, and we are seeing flare-ups of diseases that we once eradicated in this country. It is a real threat. We have to always be mindful of the public health impact of our policies, of course, but also be intentional about what we are doing to ensure that we are trying to restore that trust that people have in public health. That involves dedicating resources to fully funding public health departments in the country, that takes respecting nurses and public health workers every single day—not just during pandemic times—[and] ensuring that their pay and their working conditions are respected, and that they get what they deserve. It also means removing politics from decision-making as it relates to healthcare, as it relates to guidance development, as it relates to FDA recommendations, and as it relates to CDC guidelines.
What role do you think science should play in policy making?
Data and evidence should always inform, not only the advocacy and the lobbying that outside constituencies do to push legislation forward, but also should inform the way Congress considers and writes legislation. As a public health practitioner and freshly minted, doctoral-degree recipient in public health, that will always be the approach that I bring to decision making.
I am very concerned about the damage that the Trump administration did to CDC, NIH, and the United States’ credibility on the global stage by pulling us out of the World Health Organization. I was proud to have played a role on the Biden-Harris transition team developing those executive orders that the president executed on day one to put us back in the World Health Organization [and] to put public health leaders in front of politicians to talk about the COVID response. I think it has helped turn the narrative around, but we still have a long way to go to be able to be evidence-based in our decision-making to help restore that trust that people have in science, in data, and in public health practitioners, including doctors and nurses.
We all learned under COVID that diseases have no borders. Gone are the days where we can isolate ourselves from things that happen outside our borders. We are all one humanity—that is the approach that we have to have, not only to address our local public health challenges in different cities, but the US is positioned around the world as a leader of global development, as a leader of humanitarian work, as a leader of global health [in] the HIV response, the maternal health response—all things that we do because not only do we care about other people, but also because it is in our interest to support the health and wellbeing of others on the planet. We as humanity are interconnected more than ever through technology and through our movements. We have to approach these issues as a global health security matter, and that is something that [the Biden-Harris] administration has championed, and that I will be championing in Congress.