When he took over as Baltimore health commissioner, Dr. Joshua M. Sharfstein says, he was unsure whether he would last three days.
Recalling that beginning in a letter to friends and colleagues this month, he described the public health challenges facing the city as "awesome" and named a few: young mothers unable to get needed support before, during and after pregnancy; thousands of residents who can't access drug treatment; tens of thousands shut out of preventive health care.
Sharfstein made it three years as health commissioner. Now he leaves to become principal deputy commissioner of the federal Food and Drug Administration. While Baltimore didn't unravel what he described as a "tangled web of problems" during his tenure, it did achieve some measurable change: a citywide ban on lead in children's jewelry and the nationwide withdrawal of over-the-counter cough and cold medicines linked to the deaths of four city children; declines in drug overdose deaths and increases in immunizations.
His department enlisted hundreds of local college students to help the poor get access to health services, worked with pediatricians to distribute tens of thousands of books to children, and partnered with police to take on violence as a public health issue. Governing magazine named him a 2008 Public Official of the Year; Mayor Sheila Dixon calls him a "superstar."
Now the city must find a way to replace him. Dixon has named Olivia Farrow, the city's assistant commissioner for environmental health, to head the department pending a national search for a new commissioner.
Dr. Peter L. Beilenson, who preceded Sharfstein as health commissioner, says the city should look for "passion" in choosing a successor; Police Commissioner Frederick H. Bealefeld III wants "a Josh Sharfstein clone."
Ask Sharfstein whom he would want as a successor, or the public health priorities Baltimore should pursue, and he demurs. Beilenson didn't burden him with public comments about the job when leaving, he notes. Sharfstein wants to extend the same courtesy to the next commissioner.
He is similarly reluctant to discuss his achievements in the city. To a degree unusual for a public official - and particularly one so widely lauded - the Harvard-trained pediatrician deflects the credit to others: To Mayors Martin O'Malley and Dixon, for what he says was their insight and support; to Beilenson, for broadening local perceptions of what public health can encompass; to the officials and academics and volunteers who make the programs work.
