Having migrated from a small Peruvian coastal town first to Lima and then to London to pursue an education in medicine, Professor J Jaime Miranda has built an internationally acclaimed career on finding complementarity and establishing connections across populations, disciplines and backgrounds to advance public health research and treatment approaches.
His priority as Head of the Sydney School of Public Health, a role he formally commenced in April 2023, is to enhance Australia’s international profile for high-quality scientific research, which he says is currently “undersold” on the world stage.
“In the field of public health, high-income countries are overrepresented – but Australia itself is underrepresented,” Professor Miranda observes.
“I’m just amazed to see the breadth and quality of the excellent work being done here, and I can see that the world has so much to learn from Australia. I want to make sure that what is being done here is visible internationally.”
A related priority that gives a key insight into Professor Miranda’s personal and professional philosophy is supporting early-career researchers in their development as “professionals with integrity”, a quality that is central to his values and which he views as an investment with enormous returns.
“The PhD adventure is solitary by nature, and the pressure to succeed is enormous,” he says.
“Research leadership is one of the things I can confidently contribute, and I consider it one of the responsibilities of my role to support all our researchers in the production of high-quality research and high-quality research products.”
Supporting, mentoring, collaborating with and – importantly – listening to and learning from the experiences of a wide diversity of people is an approach that underpins and informs Professor Miranda’s own research.
One of the projects he will continue to explore during his time in Sydney focuses on models of care for chronic, comorbid and complex health conditions, and how team-based community medicine and integration of care – rather than multiple referrals to individual specialists – could be deployed to enhance the patient experience.
“When someone has a single health condition, we as doctors transfer some of the tasks of treatment to the patient themselves,” he explains.
“For example, if they have asthma, we tell them to use an inhaler, and we assume they will do this because they will do whatever it takes to feel better.
“But with increasing life expectancies, more and more people are living with two or three chronic health conditions at the same time over many years – diabetes, hypertension, Alzheimer’s disease – and so this transfer of tasks becomes enormous.
“We need to listen to what else is going on in our patients’ lives, and whether what we are asking them to do is actually meaningful for them.
“Just as we now quite rightly ask airlines to reduce their carbon footprint, similarly medicine needs to look at the ‘healthcare footprint’ it has on individuals and families.”
Another current project placing patient experience front and centre is exploring the use of artificial intelligence (AI) in the prevention of diabetic foot ulcers.
Patients already struggling with the challenges of the condition will be able to avoid the logistical demands of presenting to their specialist for regular monitoring; instead they will be able to upload pictures to a mobile app to assess their ulceration risk, anticipating and ultimately preventing the onset of ulcers.
It’s another example of considering the broader individual and societal context within which health conditions occur.
“Fundamentally, public health has to do with all the interconnected societal determinants of health,” Professor Miranda says.
“The pandemic has put the connection between health and societal wellbeing front and centre, and we are realising more and more that we need to broaden our scope to support more communities.
“In order to meet our sustainable development goals, we need a healthy planet, and part of that equation is having healthy societies.
“For the health profession, that doesn’t mean business as usual. It’s an invitation for us to reflect on how to build more sustainable societies against a strong public health background."