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Dr. Raj Panjabi: I Was the Guy You Screamed At

Dr. Raj Panjabi: I Was the Guy You Screamed At

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What happens when the advocate becomes the authoritySeason 3 of On the Balcony is built around one question: can change be made more predictable? Each episode is one case, told by someone who was personally accountable for a consequential transformation.Our first case begins in 2022, when Mpox was first diagnosed in the United States. Dr. Raj Panjabi was White House Senior Director at the National Security Council, responsible for coordinating the federal response to public health crises. For most of his career, Raj had been on the advocacy side of the table, first as the founding CEO of Last Mile Health in Liberia, where he grew up. Now he was the one behind the door, and the advocates he had always stood beside were pushing on it.Michael Koehler and his KONU colleague Josh Albert, who worked alongside Raj at Last Mile Health, talk with Raj about the moment he read a Guardian interview with longtime AIDS activist Peter Staley and recognized his own talking points as the same wall Staley had faced in the 1980s. What followed was a different relationship with the community most affected, and a set of concrete changes that helped bring cases down from hundreds a day to a handful.What You’ll Explore in This Episode:Uncertainty is not the same as riskWhy the public's demand to know whether a threat is “high or low” asks for a certainty leaders often don’t have, and the questions Raj believes leaders should answer instead.When your talking points become a wallHow careful, well-intended communication can keep out exactly the information a response needs most.Inviting in the people pushing on your doorRaj’s call to Tony Fauci, the one accidental email he’s ever printed out, a tense meeting with advocates who arrived with frustration and with solutions, and how he stayed steady as the target of their anger.From listening to changing the planThe specific moves that followed, including delivering vaccines through Pride festivals and trusted community clinics, orchestrating response from leaders the community already trusted, and a detail no one in government anticipated: a visible injection mark that, for some, felt like being publicly outed.Trust you can’t build in a crisisHow clinics, trial networks, and a decades-long Fauci-Staley relationship built during HIV/AIDS made a faster response possible, why that trust still had to be renewed, and why tension can be read as information rather than a sign of failure.The ArtifactRaj brings the novel No Condition Is Permanent, a phrase his father carried through losing his job and rebuilding a life as a refugee.Quotes from This Episode:“I had been the one pushing on the door, and now I was the one behind the door being pushed on.”- Dr. Raj Panjabi“For my entire career I had been part of the advocacy community, and now for the first time, I was on the outside of it. I was the guy you screamed at.”- Dr. Raj Panjabi“You had to design the response not for somebody, but with them.”- Dr. Raj Panjabi“No talking point I had could stand up to that.”- Dr. Raj Panjabi“Working together is not a webinar, it’s a meaningful seat at the table.”- Dr. Raj Panjabi“[Leaders and employees] misinterpret the discomfort of disruption for failure when, in fact, it could be just the early phase of adaptation.”- Dr. Raj Panjabi“Sometimes when you face tension and frustration that often comes right behind it, perhaps it’s not a sign we’re failing. Perhaps it’s just information. It could be a signal that something hidden in your organization needs to come to the surface.”- Dr. Raj PanjabiLinks & Resources:Safer: A Playbook—Turning Fear into Action and Crisis into Community by Dr. Raj Panjabi (HarperOne, October 13, 2026)https://rajpanjabi.com/No Condition Is Permanent: A Historical Novel on Nigeria by Aliyi Ekineh (Galago Publications, 1989)Last Mile Healthhttps://lastmilehealth.orgAbout Dr. Raj Panjabi:Dr. Raj Panjabi is senior partner at Flagship Pioneering, associate physician at Mass General Brigham and Harvard Medical School, and author of Safer. He served as White House Senior Director and Special Assistant to the President at the National Security Council, helping lead the world out of the COVID-19 pandemic and create the nation’s playbook for future public health emergencies. Before that, he led the U.S. President’s Malaria Initiative and was founding CEO of Last Mile Health, bringing care to communities beyond the reach of any health system. He has been named one of TIME’s 100 Most Influential People in the World and one of Fortune’s World’s Greatest Leaders.New episodes drop every other week.
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