London School of Hygiene & Tropical Medicine

Dr Kuganantham Periaswamy, a senior public health director and former city health officer, passed in June 2024. He lived a glorious life and career dedicated to public health and to lending a voice to the voiceless.

While many tributes rightly celebrate his impact, fewer highlight the quiet public health revolution he led, helping to change the course of the HIV epidemic in India, particularly in Tamil Nadu, once marked by high prevalence and stigma.

His life shaped mine in every way, by giving me my voice and purpose, and helping me to discover my passion for Global Health. To mark the anniversary of his passing, I am writing this blog for his and my alma mater, LSHTM. 

My father, Dr Kuganantham was a public health visionary. He was my compass, my fiercest critic, and my greatest champion. His work in HIV prevention, pandemic response, and health system reform touched the lives of millions. But to me, he was the man who taught me how to fight for what’s right, how to lead with both intellect and heart, and how to never lose sight of the human being behind every data point. He spoke to me about feminism and struggles faced by women, which sparked my interest in gender, stigma and intersectional identities, and their role in sexual and reproductive health. His influence was felt in many ways in my life. Growing up and listening to the experiences of transgender and PLHIV communities taught me that every term represents a real person fighting for dignity and access to care. Later, while working at the WHO, this understanding shaped my work on global guidelines that clarified terminology relating to sex, gender and sexuality, thereby strengthening research and ensuring more respectful and accurate practices worldwide. 

My father’s journey into public health was shaped by both circumstance and conviction. He had a thriving clinical practice in one of the busiest neighbourhoods in North Chennai, a neighbourhood where most daily labourers and socioeconomically disadvantaged people lived, and he worked with the City Health Corporation. By this time, he was a sought-after expert for many public health issues faced by the city corporation of Chennai in Tamil Nadu, so he sought a deeper, global perspective to strengthen his work. In the early 1990s, he served as Director of the Communicable Diseases Hospital in Tondiarpet, Chennai. During the devastating cholera outbreak of 1993, he oversaw the treatment of hundreds of patients who were collapsing from severe dehydration at the doorstep of the hospital or sometimes even in restrooms after bouts of diarrhoea. It was in this crisis that he and his team pioneered the use of wide-bore needles to administer rehydration solutions more effectively, saving countless lives. His work also led to the identification of a new strain of cholera, later referred to as the “Chennai strain.” In the late 1990s, when India was grappling with the rising tide of infectious diseases and the complexities of urban health, Dr Kuganantham - affectionately known as Dr K - stood at a crossroads between clinical medicine and public health. That search led him to the London School of Hygiene & Tropical Medicine, where he pursued the Professional Diploma in Tropical Medicine & Hygiene, a decision that would shape the trajectory of his career and deepen his commitment to health equity.

His time in London was more than academic - it was transformative. Immersed in a multicultural environment of global health strategists and thinkers, he found both intellectual stimulation and a renewed sense of purpose. The rigorous training in infectious disease epidemiology broadened his perspective and equipped him with tools he later applied during his tenure as Chief Health Officer of the Chennai Corporation. LSHTM opened doors to new avenues in public health, reinforcing his commitment to tackling epidemics and strengthening health systems in India. But it was the camaraderie with fellow students, the late-night debates over ethics and access, and the quiet walks through Bloomsbury that left a lasting imprint.

Back home, Dr K became a driving force in Tamil Nadu’s public health evolution. His leadership in the Prevention of Parent to Child Transmission (PPTCT) program was nothing short of visionary was pivotal in stabilising the HIV epidemic in the state from a prevalence of 1.5% in 2001 to just 0.25% within a decade. He championed innovations like husband-friendly antenatal clinics, community-based counselling, and mainstreaming HIV services across departments ensuring that public health was not just about systems, but about dignity and inclusion. His ‘eureka’ moment led to the implementation of PPTCT in Tamil Nadu. It was not just a technical fix; it was a moral imperative. He saw the heartbreak of children born with HIV and refused to accept it as inevitable. PPTCT became Tamil Nadu’s gift to the world. From that seed grew Integrated Counselling and Testing Centres, which rolled out swiftly across health posts in TN and later across India. These weren’t just clinics; they were sanctuaries of dignity, where “one window” and “patient-friendly” were guiding principles in every conversation he led. He mainstreamed HIV services across departments and built networks of support for positive mothers.

He played a pivotal role in rehabilitation efforts after the 2004 tsunami, working in coastal districts such as Cuddalore and Sivaganga, which were among the most impacted. As part of the emergency rescue teams, he coordinated relief and health interventions for vulnerable communities. Years later, during the COVID-19 pandemic, he served on Tamil Nadu’s state taskforce, advising the government and the Chief Minister on strategies to contain the crisis. His leadership and dedication were recognised when he was honoured with the “Lifetime Achievement Award” in 2020.

Dr K believed public health was inseparable from social justice. Even as a trained physician, he thought beyond clinical medicine, consistently lending his voice to the voiceless.

For future LSHTM alumni and global health professionals, his legacy offers enduring lessons: that systems must serve people, that data must be paired with empathy, and that leadership is not about authority but about accountability. His journey reminds us that the most powerful public health interventions begin with listening and that sometimes, the most radical act is to treat every patient as fully human.