Former CPC Director Tsui profiled in The Lancet's family planning series

Jul 16, 2012

The Lancet published an important series of articles on family planning in its July 14, 2012 issue. That issue also includes a profile of Amy Tsui who is "a scholar, an outstanding researcher, a leader in her field, and someone who's helped to move [the reproductive health] field forwards." She was Director of the Carolina Population Center from 1997 - 2002. She also co-authored this article in the series: "Contraception and health" (Summary | Full Text | PDF).

About the family planning series: "The Lancet Series amalgamates the latest thinking underpinning these crucial deliberations, showing how lack of access to family planning carries a huge price, not only in terms of women's and children's health and survival but also in economic terms." Find the articles here.

Amy Tsui: population expert for whom people count
(The Lancet,
Volume 380, Issue 9837, 14-20 July 2012, p. 100)
http://dx.doi.org/10.1016/S0140-6736(12)61164-7

Some of us like to display pictures of our children on the office desk. Others may favour a potted plant or a vase of flowers. Amy Tsui's choice, I'd heard, is less conventional: a wooden bowl filled with birth control devices. Could this be true? A phone call to her office at Johns Hopkins Bloomberg School of Public Health confirmed it. The call was swiftly followed by an email bearing photographic evidence. "I teach a graduate course here on family planning", she explains. "I taught the same course when I was at the University of North Carolina. Over time I've accumulated things. I don't have anything that's really prehistoric, but I collect packages of condoms and IUDs and injectables and cycle beads and things like that. They're great conversation starters in class."

Tsui's bowl of contraceptives speaks simultaneously to two aspects of her life. First, a round-the-clock enthusiasm for her work in reproductive health and family planning; second, her unstuffy approach to an area in which she's come to be highly regarded. "She's been a scholar, an outstanding researcher, a leader in her field, and someone who's helped to move that field forwards", says Herbert Peterson of the University of North Carolina's Gillings School of Global Public Health. "And not just as a researcher; she's widely known for her ability to communicate her findings." By whatever means--including, perhaps, the bowl on her desk.

Director since 2002 of the Bill & Melinda Gates Institute for Population and Reproductive Health at Johns Hopkins, Tsui's international role is one for which childhood began preparing her. Her father left China to become a doctoral student in agriculture economics in the USA. He never returned. Instead, he joined the Food and Agriculture Organization and his first posting in the 1950s took the family to what was then East Pakistan. From there Tsui herself returned to USA to finish her schooling, initially to Minnesota and later to Hawaii where the family had by then settled. She studied sociology at the University of Hawaii at around the time it was starting a new population institute. "That seemed a rather engaging topic, so I got into it", she says. "At the time population growth was the global issue." With a PhD in demography from the University of Chicago she moved first to the University of North Carolina, becoming Director of the Carolina Population Center, and subsequently to Johns Hopkins to take up the Gates job.

To those who then knew her, Tsui's potential was apparent from the outset. Duff Gillespie, now a colleague at Johns Hopkins, was first introduced to Tsui while she was still a student. "I've just met this extremely bright, highly motivated, energetic student", someone told him. "She's going to be a leader." The prophecy was spot on. And Tsui was soon making waves in academia. On finishing graduate school in the late 1970s her supervisor, the distinguished demographer Donald Bogue, gave her the task of predicting population growth in the world's developing countries. The pair were roundly criticised by their peers for making what were regarded as overoptimistic assumptions about fertility change. "We projected world population to be 6 billion in the year 2000. And for 2050 we thought it would be around 9 billion. 2000 came around and our estimate was fairly close." The UN, the World Bank, and others had all thought the figure would be higher.

Tsui continues to believe that much can still be done to prevent the world population plateauing in the upper range of current projections. Contraception, pregnancy termination, delaying age of first sexual activity, and reducing coital frequency are all demonstrably important and subject to behavioural change. "The one I happen to feel is the most important, because so many women express the wish to manage their fertility, is contraception. There are many populations that don't yet have the knowledge or the information or the services for that." One man well aware of this is Frank Taulo, of the Department of Obstetrics and Gynaecology at the University of Malawi College of Medicine. He's known Tsui since 2006. "She sees areas of opportunity in our country and tries to unlock them. She wants things to happen. She's an achiever. I view her as a leader, but as one who is good at leading from behind, encouraging other people to have ideas." That's in the spirit of the Gates Institute, according to Tsui. "Its aim is to use evidence-based information to help our peers in developing countries build capacity so that they can resolve their problems on their own."

"Amy seems to know everyone", says Taulo. "She has working relationships with people across the continent." And she remembers them. "She has an exceptional memory for names and faces", adds Gillespie. Whether visiting some African country with which her institute has links, or helping to arrange one of the several highly successful and hugely oversubscribed conferences in which she's been involved in recent years, she's become familiar with the continent, and values it. "As a result of being in this position I have got to know a lot more about the Africa than I would ever have dreamed", Tsui tells The Lancet.

Tsui, Gillespie sums up, is respected as a social scientist and thinker, "but on top of her scholarship is a physical and emotional commitment to reproductive health and especially family planning. She doesn't seek out titles or honours. She does what she does because she thinks it's the right thing for the field. With Amy there's no hidden agenda."

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