Most recently, I served as a Louis Stokes Urban Health Public Policy Fellow for the Congressional Black Caucus Foundation, Inc. (CBCF). I began my tenure in the office of Rep. G.K.. Butterfield, (NC), who is the Chairman of the Congressional Black Caucus (CBC). He also serves as a member of the Energy and Commerce Committee, the oldest standing legislative Committee in the House of Representatives. Among other areas, Energy and Commerce has jurisdiction over public health research, energy policy, and food and drug safety.
While working in Rep.Butterfield’s office, I assisted in drafting legislation to provide funding to fight the Ebola outbreak. It was my job to work with the team that gathered co-sponsors for the bill, and to aid in the process of submitting a letter to the Appropriations Committee. This involved researching and providing the most up-to-date information on the epidemiology of the disease, while working with legislative staff across dozens of offices in a bipartisan fashion. The outcome was the declaration of Nigeria, Liberia, Mali, and Senegal as Ebola-free countries. To chronicle part of the experience during the height of the Ebola epidemic, I submitted an opinion-editorial to the CBCF titled “The Face of Ebola.” The article highlighted the death of Thomas Eric Duncan – the first person to die from Ebola on American soil.
The Energy and Commerce Committee also has jurisdiction over the new Precision Medicine Initiative – a model of patient-powered research that promises to accelerate biomedical discoveries. To frame the narrative within the context of health equity and health disparities, I wrote a policy brief titled, “Diversity as Strength: Increasing Minority Participation in Clinical Trials.” Since 1993, federal law has required the U.S. Department of Health and Human Services (HHS) to include people representing diverse racial and ethnic backgrounds in research studies. The purpose of the policy brief was to provide substantive recommendations such as: 1) HHS should survey local healthcare providers regarding reasons they are not active participants in the clinical trial arena, and to educate students about the value of translational research and how it will benefit patients in the future; and 2) entities considering establishing a navigator program, for example, should form community and medical advisory boards because they have provided invaluable insights into local needs. Further, leadership and institutional support, infrastructural process control, data analysis and reporting, and follow up with clinical investigators are all essential elements in developing meaningful sustainability and impact.
In order to further maximize my policy and research interests, I transitioned to the office of Rep.Barbara Lee, (CA) Rep. Lee serves on both the Appropriations and Budget Committees, and also serves as co-chair of the bipartisan Congressional HIV/AIDS Caucus. HIV/AIDS is a particularly poignant issue for me because one of my uncles died of AIDS in 2001. In 2003, Rep. Lee was an original co-sponsor of the President’s Emergency Plan for AIDS Relief (PEPFAR), the largest investment in history dedicated to addressing a single disease. It was gratifying to work with Rep. Lee on advancing support for the prevention, education, and treatment of HIV/AIDS, domestically and globally.. I helped organize several congressional “HIV/AIDS 101” briefings that highlighted different aspects of the fight to move towards an AIDS-free generation. I also assisted with reintroducing the Repeal Existing Policies that Encourage and Allow HIV Discrimination Act of (REPEAL) 2015. Current state and federal laws lag behind medical advances and scientific discoveries in the fight against HIV/AIDS. My activities include analyzing the bill, updating language with current HIV/AIDS data, working with external groups with a vested interest in decriminalizing HIV, and garnering support from other member offices. Globally, there are 92 countries that have only minimal initiatives, or have made no effort to decriminalize HIV. There are eight countries that have had measurable success. The opportunity to inform policy on an issue that adversely impacts the African American community, was very exciting.
A new opportunity was then made available to me on the Health Policy Team for the Senate Health, Education, Labor, and Pensions (HELP) Committee. The Ranking Member on this Committee is Sen. Patty Murray (WA). In addition to the day-to-day operations of the Health Policy Team, the administrative work entailed managing the interns and fellows. I worked closely with the Food and Drug Administration (FDA), National Institutes of Health (NIH), the Center for Disease Control and Prevention (CDC) and other stakeholders, on advancing legislation, policies, and proposals in the bio-medical arena. One of my accomplishments was drafting the Health and Equity in All Policies Act of 2016. The purpose of this bill was to reauthorize programs under the Public Health Services Act to build a culture of health equity at the Federal, state, local, and tribal levels.
As a conscientious African-American male, scholar-activist, and thought-leader, the journey in the halls of Congress was very enlightening for me. Part of this experience is what noted scholar and philosopher, Dr. W.E.B. Dubois called “Double Consciousness” in his 1903 essay, “The Souls of Black Folk.” In short, this phenomenon describes how African Americans must handle the dual role of being true to who they are in their homes and communities, while reconciling that image with the perceptions of those who typically do not see you as an equal. For example, in the meetings and briefings in which I participated on Capitol Hill, I was either the only African American, or one of a handful in rooms filled with of dozens of Hill staffers. So, part of the challenge was finding my voice and negotiating on a bipartisan basis on issues germane to constituents who historically have been underserved and marginalized.
This lack of diversity on Capitol Hill in terms of race and ethnicity was further highlighted by a study released by the Joint Center for Political and Economic Studies in 2015. The study reported that while people of color make up 36 percent of the U.S. population, and 28-percent of those old enough and eligible to vote, they are included in just over 7-percent of all senior-level Senate staff. Those figures are scarcely better than they were a decade ago, when people of color made up 6 percent of the Senate staff. Further, of the 336 people who hold top Senate staff positions, there are only 24 people of color: 12 Asian Americans, seven Latinos, three African Americans and two Native Americans. In other words, African Americans make up 13-percent of the nation’s population but less than one percent of top Senate staff, and Latinos are 16-percent of the U.S. population, but just over 2-percent of all senior Senate staff. While the Senate Diversity Initiative was put in place several years ago in an effort to increase diversity on Capitol Hill, we must continue to work at all levels to ensure that the multiplicity of voices that make up the United States are well-represented in the U.S. Congress.
Okechuku Kelechi Enyla works at the Division of Policy and Strategic Planning at HHS – working with the Assistant Secretary for Preparedness and Response as a Management Analyst.
Louis Stokes Urban Health Public Policy Fellows Program
This fellowship is named after retired Congressman Louis B. Stokes of Ohio, who is the founder of the Congressional Black Caucus Health Braintrust. The primary goal of the program is to increase the pool of qualified, minority health policy professionals who are committed to eliminating health disparities in the United States and abroad.