In a world grappling with pandemics, misinformation, eroding public trust in health institutions, and widening health disparities, public health leadership must evolve. It is no longer enough to train professionals to occupy leadership roles—our systems demand leaders who can practice leadership every day, across sectors, systems, and communities. Our recent JPHMP study, Advancing Pedagogy in Leadership Practice to Enhance Public Health Impact, offers new insights into how leadership is enacted in real-world settings and how leadership education must evolve to meet both current and future demands.

We conducted a comprehensive systematic review of literature spanning a decade (2012–2022) and interviewed 48 experienced public health professionals, including 35 UNC-Gillings alumni and 13 other leaders, selected via snowball and network sampling. Our objective was to explore how leadership is experienced, cultivated, and taught—and to identify where current pedagogical approaches fall short. What we found is clear and urgent: the next generation of leaders must be equipped not just with technical skills, but with cultural humility, emotional intelligence, and real-world experience.

We found that leadership in public health is not about titles. It is about influence, action, and relationships. Effective leaders are shaped by mentorship, real-world experiences, and a commitment to equity and reflection. Leadership is deeply relational—practiced through empathy, collaboration, and the ability to listen and adapt. As one participant put it, “everybody needs to be a leader in some way, from where they are.”

Key Insights from the Study

• Leadership in public health is rooted in influence, reflection, and mentorship, not positional authority.
• Self-reflection and cultural humility are essential for effective leadership.
• Experiential learning through mentorship and collaboration drives growth.
• Communication, empathy, and trust-building are foundational skills.
• Current training lacks emphasis on interdisciplinary collaboration, policy advocacy, and technological adaptation, including the use of Artificial Intelligence (AI).

Read Our Article in JPHMP

So what needs to change in public health education? Traditional leadership training often focuses on models, theories, and competencies. While foundational, these alone are insufficient. To meet the demands of today’s volatile public health landscape, public health education must shift. This requires integrating problem-based and project-based learning, simulation, flipped classrooms, and mentorship into core curricula. Such interactive, real-world pedagogy better prepares students to respond to complex and evolving challenges. We envision a new model of leadership education—where students are not only taught about leadership but are also given opportunities to practice it. This includes facilitating peer feedback, engaging in team-based learning, collaborating with community partners, and learning to navigate ambiguity and conflict. These approaches not only build technical skills but also foster the confidence and self-efficacy needed for real-world leadership.

If we want our public health systems to thrive in the face of growing complexity, the rising tides of misinformation, and widening health disparities, we must stop treating leadership as an innate trait and start cultivating it deliberately—through curricula grounded in equity, real-world experience, and reflective practice. Our study reinforces a powerful truth: Leaders are not just born; people can be trained in Leadership. This is not a call for more training in the abstract—it’s a call to fundamentally reimagine how we define, teach, and support leadership. By aligning pedagogy with the realities of practice, we can cultivate public health professionals who are better equipped to lead equitable, effective, and responsive systems.

For more information, read our article in the July 2025 issue of the Journal of Public Health Management and Practice.

Full list of authors:

Marie Lina Excellent, MD, MPH; Melissa Yu, MPH; Alexis Hartranft, MPH; W. Oscar Fleming, DrPH, MSPH; Karar Zunaid Ahsan, PhD, MIPH, MS; Anna P. Schenck, PhD, MSPH; Rohit Ramaswamy, PhD, MPH

University of North Carolina (UNC) at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina

Marie Lina Excellent, MD, MPH, is a global health servant leader and educator specializing in equity, cultural humility, and HIV/AIDS care. A UNC Gillings professor and researcher, she leads community-engaged initiatives, mentors future leaders, and advances public health education through international collaborations and curriculum innovation. Dr Excellent was approved for roster tenure from the Fulbright Specialist Program. Dr Excellent’s philosophy can be summarized as: learn to Better serve others in needs with compassion and Humility!

Karar Zunaid Ahsan, PhD, MIPH, MS, is an assistant professor at UNC-Chapel Hill with over 15 years’ experience in health sector M&E and research. He has worked with global institutions including the World Bank, icddr,b, and MEASURE Evaluation, and has published widely on impact evaluation, health equity, systems strengthening, and demographic transitions.