He was the ultimate professor

George Alleyne, Bethesda, Maryland

The many tributes that have already been paid testify to the extent to which he was loved and admired and his many and varied talents have been lauded. One gets the impression of a man that could play many roles. When I tried to distill the essence of what Phil represented to me apart from being a friend, it boiled down to his being a teacher – an educator in small groups, to large groups and to individuals. He taught. He was the ultimate professor in the pristine sense of the word. He professed economics and its relation to health.

He was the first health economist hired in PAHO and it must have been with some trepidation, if Phil ever did have trepidation, that he must have entered that den of public health physicians, most of whom I am sure knew nothing about economics and perhaps cared less. Phil proceeded to teach – to profess his discipline and the results were impressive.

I recall his seminal studies on the impact of the economic crisis of the eighties on health indicators in Latin America, which demonstrated that the catastrophic effect did not occur that the Cassandras had predicted. He was the editor of the first publication in PAHO on health economics and in that book described the economic returns from the eradication of poliomyelitis, which strengthened enormously our resolve to pursue that program vigorously and the rest is history. No child in the Americas walks with calipers or stick because of polio. He would try to introduce some logic into the allocation of PAHO’s budget to the countries – a process for which there was little but historical antecedent. It was in PAHO that I heard him articulate convincingly the thesis that if health was an essential good, then health expenditure should be countercyclical.

There is no doubt that the seed he sowed is now a tree with branches and deep roots. No discussion of disease in PAHO is complete without reference to the economic impact and if he was present, to the cost effectiveness of the necessary interventions.

Our personal interaction in PAHO was a source of pleasure to me. I recall my first major address on Health and Development for the Eric Williams memorial lecture. Phil patiently corrected and edited my text and introduced me to a long bibliography, headed by Selma Mushkin’s seminal work on health as an investment. He was kind enough to ask me to write the foreword for his book, “Health Economics in Development” and I encourage those of you who have not read it to read at least the introduction and the first chapter which describes what doctors should and should not know about economics. The economists are not all-knowing either and as he says, “Of course, what economists think they know is often a mixture of what they know and what they only think.”

I saw a quote from Pope Benedict which seems relevant in a negative sense. “In the search for sharing, for friends, there is the challenge to be authentic and faithful, and not give in to the illusion of constructing an artificial public profile for oneself.” I thought that if there was one person who overcame that challenge, it was Philip Musgrove. To me he was constancy itself. What you saw was what you got yesterday and today.

His is a friendship forever and I use the present tense advisedly. Our syntactical restrictions cannot cope with the extension beyond death, and his physical absence does not make our friendship any less real. Walk good my friend and may good duppy walk with you.