Exploring Impact in Global Health: Conversation with Dr. Malabika Sarker on Implementation Research and Career

Q. Your journey from a clinical degree in Bangladesh to a global health academic is truly inspiring. Could you share the key momentum and inspirations that guided this path?

Malabika Sarker: There have been several pivotal moments in my life, and I have been deeply inspired by colleagues, friends, and mentors. At every stage of my professional journey, I have been fortunate to be supported and guided by remarkable public health leaders. I would not be where I am today without their presence in my life.

1. Joined WHDP (Women Health & Development Program) at BRAC in Dinajpur in 1991 because of my longtime friend, Dr. Shahaduzzaman, who was working as a community-based physician there, which led me to abandon my plan to pursue a clinical career in obstetrics and gynecology.
2. Meeting the late Professor Richard Cash, pioneer of oral rehydration therapy in 1993 was another defining moment; he became my lifelong mentor.
3. My decision to leave Heidelberg University to join the BRAC James P. Grant School of Public Health in 2011 was facilitated by Dr. Tim Evans (then Dean of BRAC JPGSPH) and was also motivated by the need to look after my parents.
4. Transitioned to implementation research in 2015 as a result of a discussion with Carlos Acosta Bermudez, then Chief of Social Policy, Evaluation, Analytics, and Research at UNICEF Bangladesh. With generous support from UNICEF, I established the Center of Excellence for Implementation Research at BRAC JPGSPH.
5. Received an email from Prof. Andrew Foster, Economics Department, Brown University, USA, who was the chair of the search committee for Brown SPH, requesting that I share my CV.

Q. For our audience, how would you define implementation research in practical terms? What specifically drew you to this field and why do you think it is such a powerful tool for improving health outcomes?

Malabika Sarker: Implementation research examines how preventive, promotive, and curative health services are delivered in real-world settings, with a focus on context and implementation strategies. I spent many years as a community-based implementer at BRAC. Although I later became an academic, I felt I was missing my activist side and the chance to create direct impact. Too often, research-generated knowledge is not translated into action. Implementation research bridges my activist passion and academic rigor.

Poor implementation leads to intervention failure and wastes resources. Implementation strategies must be tailored to the population's characteristics, geographic setting, health system capacity, and resource availability. Applying a uniform delivery strategy without contextual adaptation often results in ineffective interventions and limited health improvements.

Q. Could you tell us about the focus of your current implementation research at Brown University?

Malabika Sarker: I am currently engaged in a five-year implementation research project in Kenya that delivers pre-exposure prophylaxis (PrEP) through emergency departments to reduce the risk of HIV-1 infection. I also submitted an NIH grant proposal on non-communicable disease comorbidity, in partnership with Augusta University (Georgia, USA), which is under review. Additionally, I am preparing a multi-country NIH implementation research proposal on hypertension in collaboration with Yale University for submission in May 2026. In both proposals, Bangladesh is a partner.

Q. If you had unlimited funding for one global health project, what would you pursue and why?

Malabika Sarker: I would invest in strengthening primary health care and developing multi-skilled community health workers, with structured implementation support systems and functional feedback loops. Primary health care is the backbone of health systems. Strong linkages between community health workers and primary care can enhance preventive and promotive services, improve population health, and reduce the global health-system burden, especially amid rising non-communicable diseases, mental health challenges, and emerging infectious diseases.

Q. Having earned your MPH from Harvard and your PhD from Heidelberg University, two world-renowned institutions, what is one key philosophical insight that has shaped your approach to global health most?

Malabika Sarker: For me, it was intellectual exposure to diverse public health scholars and the opportunity to attend different courses. I learned that multiple perspectives are essential because reality is complex and that what counts as knowledge always depends on method, context, and perspective. This understanding has fundamentally shaped how I approach global health and implementation research.

Q. Looking back at your career across program implementation and academia, what has been the most fulfilling aspect of your journey?

Malabika Sarker: I feel deeply grateful for the privilege of working with outstanding public health professionals, from grassroots practitioners to global leaders, and for exposure to diverse cultures, contexts, beliefs, and practices through personal/professional interaction and working in different countries. These experiences enriched me by fostering tolerance, compassion, empathy, and humility. The world is profoundly diverse, yet we often fail to recognize and value it, which is crucial for effective policy formulation and better health care delivery.

Q. You are widely recognized for mentoring emerging public health professionals. What motivates you to invest so much effort to guiding the next generation of leaders? Is there any opportunity cost of this spare effort?

Malabika Sarker: Yes, I enjoy mentoring for several reasons. I believe I can make a meaningful contribution to public health by supporting young public health professionals. Mentoring also allows me to continue learning through ongoing interactions that expose me to intellectual, socio-cultural, and political perspectives, keeping my multi-perspectival mindset alive. It brings hope, joy, and purpose, and preserves my optimism in today's world. I see no opportunity cost, only gain. I want mentoring to be my legacy.

Q. In your view, what three essential skills should future global health leaders focus on developing?

Malabika Sarker: Emotional agility, strong analytical ability grounded in data, and an understanding of diversity, interdependence, and global complexity.

Q. Who is your public health role model, and what about their work inspires you?

Malabika Sarker: Late Professor Richard Cash for his unconventional thinking, impactful work, excellent teaching, humility, and kindness. I am also continuously inspired by my students, mentees, colleagues, and peers.

Q. What book are you currently reading and is there a particular insight from it that has stayed with you?

Malabika Sarker: I am reading Steve Jobs's autobiography by Walter Isaacson. Actually, it's from Apple's "Think Different" commercial (1997), which is quoted at the beginning of the book, "the people who are crazy enough to think they can change the world are the ones who do." Jobs's complex character and the way he created "Apple" reflect the quote, and it's true for all game changers in this world. His ability to translate vision into reality resonates with implementation science because the challenge is not only to invent ideas but to make them work in practice.

Q. Do you have a personal motto or mantra you live by?

Malabika Sarker: My mantra is continuous growth, both personally and professionally. I am ever grateful for what I have and believe that "No act of kindness, no matter how small, is ever wasted." The world would be a better place if we all practiced kindness.

Q. Given your rewarding career and cozy life in the United States, do you see yourself returning to Bangladesh at some point?

Malabika Sarker: Yes. I am actively contributing to my country through teaching, research, and advisory roles at BRAC JPGSPH and Sajida Foundation, and I am always available to mentor and support anyone interested in Public Health in any way I can.