Good morning everyone and Asalaam Alaikum.

Your Excellency Imanaliev Kanybek Kapashovich, Minister of Education and Science of the Kyrgyz Republic;

Your Excellency Saidzoda Rahim Hamro, Minister of Education and Science of the Republic of Tajikistan;

Altynbek Ergeshov, Governor of Naryn Oblast;

Mirzonabot Alisher Khudoberdi, Governor of Gorno-Badakhshan Autonomous Oblast;

Princess Zahra Aga Khan;

Dr Shamsh Kassim-Lakha, Chair of the Board of Trustees;

Members of the Board;

Dean Maxim Khomyakov, Dean of the School of Arts and Sciences;

President Sulaiman Shahabuddin, Aga Khan University Pakistan and East Africa;

UCA faculty and staff;

Parents and family members;

Distinguished guests;

And dear graduates:

Thank you for inviting me here today. It is such an honour to deliver this year’s commencement address.

And, to the University of Central Asia Class of 2023: Congratulations! You did it. Today is your day and I hope you truly enjoy it.

I had two tasks for today. The first was to dress properly. You see, I live in Seattle, Washington, a city where even jeans are considered fancy, so this is not something I’m used to wearing any more.

My second task is to impart some wisdom to help you succeed in this next phase of your life journey. I will draw lessons from my own life and career which have been focused on tackling infectious disease killers of children, and now, a much harder job, creating a more gender-equal world.

The task that I have been given today is a big one. It’s specially difficult because the thing is – you already know how to succeed. The fact that you’re sitting here before us, surrounded by these majestic mountains, proudly dressed in cap and gown, and about to accept your diploma is proof of that.

About three-quarters of you grew up in small rural villages. Many of you are hundreds, if not thousands of miles from home. Half of you are women. And for some of you, classes here were taught in a different language than you spoke at home, or spoke in previous classrooms. But, over the last many years, you persevered. You learned through a pandemic. You became fluent in the challenges that affect this region. And as a reward, you gained friendship and you have gained scholarship. Through late-night study sessions, hackathons, cooking battles, campus concerts, and ramen-eating contests, you have created lifelong bonds.

You know hard work, and you know sacrifice. You also know to eat your vegetables. Make your bed. Respect your elders. And to be kind. You know all this.

So what can I share? Some commencement speakers give lessons about what they regret. Their mistakes in life. But I am an eternal optimist. I have to be in my line of work – making the world a better place for women, for children, and ultimately for everyone. So, I’d like to share with you the lessons I’ve learned on how to lead a life of purpose, meaning, and joy.

As I look out at you, Class of 2023, I see 76 graduates who are ready to change the world – much more so than other students your age around the world. And, the conversations with you yesterday were really proof of that and inspired me so much. You are the third class to graduate from this university that was built with the mission to help this region prosper. It’s such a wonderful mission. I urge you to remember it, and to strive to fulfil it wherever you go from here.

If it’s not presumptuous of me to say so, I see a reflection of myself in you.

As Chairman Shamsh Kassim-Lakha was just saying, not too many years ago – it seems like only yesterday – I was a member of the first graduating class of medical students from the Aga Khan University in my home country of Pakistan. The Class of 1988. My classmates and I, we all had big dreams. We wanted to do important stuff. I knew I wanted to help children by becoming a children’s doctor, a paediatrician.

Right after our graduation ceremony, we had the opportunity to meet with His Highness Prince Karim Aga Khan. We asked him many questions, but one exchange really resonated with me. We asked him, “As the first graduating class of medical students from AKU, do you have a special message for us?” Without hesitating, he said: “Serve Pakistan.”

That’s it. Two words. And these two words, they have stayed with me for my entire life.
At university, we were taught to be thoughtful leaders and responsible citizens of the world. To me, His Highness the Aga Khan’s words beckoned us to pay that education forward, and we talked about that yesterday. I had big dreams – and I still do – but those words, they helped focus my dreams with a deeper sense of purpose and mission.

After graduation, I spent time in the Northern Areas of Pakistan, not so far from where we are today. I was working for the Aga Khan Health Service. That was my first job. It was a very formative time for me, learning about the issues that affect people living in hard-to-reach mountainous areas. I can still feel the stark contrast – being surrounded by breathtaking beauty at a truly humbling scale while working in communities coping with such difficulty and scarcity. I fell in love with the high mountains, and with the people, and I considered spending my entire life there, having the Rakaposhi Mountain as my view. Instead, I followed my calling to become a paediatrician and I left for America to study some more so I could best serve Pakistan. I stayed for 11 years. It was a long time. Long enough to build a life and get comfortable. My husband and I started a family. But I was at a crossroads. It was an inspiring time in paediatric infectious disease in America, because the new miracle drugs had just come out that would treat children with HIV. The children did not need to be admitted to hospital anymore because you could take care of them. But I knew these drugs, and many other life-saving interventions, were not available to children of Pakistan.

So this was my choice: do I stay in America and contribute to this transformative era in paediatric infectious disease or do I go home to Pakistan? I chose Pakistan. Why? Because I recalled His Highness’ words, “Serve Pakistan.” I knew I could help. It was the easiest hard decision I ever made, and I’ve never regretted it. My family and I, we packed up our things and we headed home.

There are enormous challenges here in Central Asia. The cruel effects of climate change are all around us and threatening to change every aspect of our lives, especially here in the high mountains. The glaciers are disappearing. More areas are turning into deserts. Farmers must grow crops with less water. Children must walk through dust storms to go to school. Floods, landslides, cyclones, droughts – all are becoming more severe and occurring more frequently.

So, how do we adapt to this hotter future? It will take hard work. So I say to you, graduates of University of Central Asia – serve Central Asia. Give back. Pay forward. Among you could be the future scientists who will invent new ways to farm, the economists who will devise how to leverage our abundant natural resources for economic prosperity, the entrepreneurs who will build new businesses and create jobs in renewable energy, and many other areas, the computer scientists who will develop the technology to detect extreme weather events, and the journalists who will hold our governments accountable and tell our stories to the world.

I know it can be overwhelming. All these problems with seemingly faraway solutions.
A quick example from my own life: when I returned to Pakistan, I wanted to work on all of the infectious diseases that were killing children. But the problem felt so big.

I had to start at square one. I needed to establish research, public health, and infectious disease training programmes. Then, I needed to convince more doctors in Pakistan to focus on newborn infections and vaccine-preventable diseases which were the major killers of children. We applied for countless grants, conducted so much research, and then we used that research to convince the people in power to make changes.

We struggled, we learned, and we struggled some more. But we also got some wins and, over time, things started improving. My team and I laid the foundation for Pakistan to introduce many vaccines, including one shot that protects against five different killer diseases of children. These vaccines now protect millions of children from preventable infections around the world, including in Pakistan, here in Kyrgyzstan, and in Tajikistan.

When a problem feels impossibly huge, the important part is to start. Find your square one, then take a step. You can’t do everything all at once, but you can take one small step, then another and then another – and that will all add up to something. One of my favourite quotes is from Nelson Mandela, who said, “It always seems impossible until it’s done.”

In Pakistan, I was proud of what I was accomplishing. I was making a direct impact on my community. But at the Aga Khan University Hospital, I kept seeing children with severe typhoid fever. This bothered me a lot.

I treated so many children with typhoid. The first research paper I published at AKU when I was a medical student was about typhoid and how resistant it had become against the drugs available. There was more research, more papers, more treatment options, and countless sick children in the years that followed. But no signs of a vaccine – nothing to prevent typhoid.

So then, in 2014, out of the blue the Bill and Melinda Gates Foundation offered me a job. I hesitated. I loved my work in Pakistan. My husband had a career, my son was only 13. I wasn’t crazy about uprooting their lives. But, once again, I remembered His Highness’s words: “Serve Pakistan.” Twenty years before, that meant coming home. But now, it started to dawn on me that it meant leaving again. In this new role, the Director for Enteric and Diarrheal Diseases, I could steer attention and resources towards developing a typhoid vaccine for the children in developing countries.

So, I went back to America after 14 years.

And then, in 2019, 34 years after I treated my first typhoid patient at AKU, we introduced the first ever typhoid conjugate vaccine to low-income countries. The first country to introduce it for all children, free of cost – it was Pakistan.

Class of 2023, this university, your university is a truly special place. Not just for its brilliant beauty, inspiring professors, and the lifelong friendships you have forged here. It’s a place where men and women are equal. The world has not caught up to UCA. (I thought you would enjoy that.)

As you leave here with your diplomas packed in your suitcases, you will all face different barriers. And some of those barriers will inevitably be there because of your gender. Women: chances are you will face more of them.

I did what I could to help. In Pakistan, I mentored students, and residents, and research trainees. At the Gates Foundation, I created a programme to help women navigate their way to leadership positions. Yesterday, you graduates were asking me about if I had found that gender inequality was not a problem in the United States, and it is a problem in the United States. Then, three years ago, my bosses, Bill and Melinda Gates, asked me if I’d accept a new job where my sole objective would be to clear the barriers holding women and girls back. I said yes.

So, here is my charge to you, dear graduates – yes, as the head of gender equality at the Gates Foundation – but also as a product of what is possible, when women are afforded the same opportunities and respect as men: now that you’ve been in this environment, I urge you to take this ethos with you as you venture out into the world. Champion the men and the women in your lives. Show us what kind of challenges can be conquered when women and men are equally empowered to realise their full potential.

Class of 2023, it’s time to get started. I hope that in a few decades you don’t look back on today with mere nostalgia. I hope you marvel at how much progress you have made since. I hope you work hard, and when things get tough, I hope you persevere. I hope you apply the knowledge and experience you’ve gained at UCA to make life better for those around you, and more. I hope you answer the call to serve and use that as a guiding light.

Graduates, many say that the world today is in a dire state. But, as I said earlier, I’m an eternal optimist. And all I see before me is promise, potential, and people who will do amazing work. Tomorrow is a new beginning. I cannot wait for you to take your first steps.

Thank you for the honour of being your commencement speaker, and for the good that you will do in the world.

And, congratulations!

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