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Prabhat Jha, MD, DPhil, is the Director of the Centre for Global Health Research at St. Michael's Hospital in Toronto where his two main areas of focus are on AIDS research and the effects of smoking in developing nations.

Tory Zimmerman/tory zimmerman The Globe and Mail

The Transformational Canadians program celebrates 25 living citizens who have made a difference by immeasurably improving the lives of others. Readers were invited to nominate Canadians who fit this description. Over the next several weeks, a panel of six judges will select 25 Transformational Canadians from among the nominees.

Prabhat Jha, health specialist, has been selected one of 25 Transformational Canadians.


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During the 1990s, when Prabhat Jha was a senior health specialist at the World Bank and working on tobacco control and HIV/AIDS prevention, he earned the nickname Dr. Sex and Death.

Dr. Jha says he and fellow epidemiologists - who study the health of populations - sometimes get labelled as being obsessed with death. "But I think we're actually obsessed with life," argues the founding director of the Centre for Global Health Research, which is based at Toronto's St. Michael's Hospital and affiliated with the University of Toronto.

"We study the dead and these terrible events that happen to people to figure out how to live healthier and what things can be done to reduce mortality."

For more than a decade, Dr. Jha, 45, has explored those questions on a grand scale, with a keen eye on the economics of global health. Thanks to his pioneering efforts, tens of millions of people could ultimately end up enjoying longer lives.

Today, Dr. Jha is leading a survey of 1.3 million Indian households called the Million Death Study. Most people in India die at home, meaning there's no official account of the cause of death. Along with the Indian census department, the health research centre now gathers information about all deaths in the survey households, then a physician determines how each person died. The Million Death Study will create a blueprint of how Indian health is evolving, says Dr. Jha.

For its research on tobacco use in India, the centre has received funding from the Bill & Melinda Gates Foundation. In a 2008 paper, Dr. Jha showed that smoking may cause one million deaths in India each year - more than in the U.S. and the EU combined. "That's only going to increase as India gets richer and people start smoking more," he says.

The centre's study is meant to spur India to take public health more seriously, as the government recently did by mandating tobacco warning labels, but it has broader implications.Countries such as Canada will benefit, explains Dr. Jha, who has two daughters. For example, studying heart-attack deaths in a rapidly changing country like India yields data that help improve prevention and treatment of heart disease worldwide.

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Born in India and raised mostly in Winnipeg, Dr. Jha studied medicine at the University of Manitoba. He won a Rhodes Scholarship to the University of Oxford, where he earned a doctorate in epidemiology and public health. After graduation, he spent five years at the World Bank in Washington.

There, with the Indian government, Dr. Jha set up a $200-million HIV/AIDS intervention program targeting sex workers. As a result, HIV deaths in India are about one-quarter of previous estimates.

At the World Bank, though, Dr. Jha focused on tobacco. In 1999, he was lead author of a landmark report, Curbing the Epidemic: Governments and the Economics of Tobacco Control. Published despite furious opposition from the World Bank's own conservative economists, the report got international attention.

According to Dr. Jha, many economists claimed that tobacco control infringes on individual liberties and results in job losses. Regarding these objections as silly, he dismantled them in his report. "It basically said the economic arguments against tobacco control really are quite weak, and the arguments for tobacco control, including particularly the very effective use of taxation, are an excellent set of tools," Dr. Jha says.

Canada is the best example that raising tobacco taxes works, Dr. Jha says. Between 1999 and 2008, he notes, more than 1.3 million Canadians quit smoking largely because Ottawa and most provinces kept tobacco prices high. "If the world did what Canada has done on smoking, you could avoid, by our estimates, over 100 million premature deaths worldwide in the next few decades."

Looking to India, Dr. Jha hopes other developing countries will take a more evidence-based approach to tackling big diseases - and save many lives by doing so. Like hiking tobacco taxes, he observes, treating an illness such as malaria costs little. "In the next 10 to 15 years, we could really transform health, not just by spending more money, but also [through]a lot of science and hard-headed thinking about how to spend that money well."

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Prabhat Jha on the passion behind his leadership

Global development - worrying about the poor worldwide - is not a one-year proposition. It's basically a life investment. And you think, 'Well, why would anyone do something as nutty and depressing as worrying about deaths in developing countries?'

I firmly believe in it and I'm passionate about it, and that's what keeps me going. There's so many obstacles to doing work overseas - worrying about funding and permissions and politics.

But it's fundamentally the idea that in the next 20 years, we could transform how people live worldwide by focusing on the avoidable causes of death. To me, it's a very exciting proposition, and I can't think of anything else I would like to be doing.

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