Sachin Desai has dedicated much of his career to the care of mothers and their children. His recent interest focuses on the development of effective interventions for outbreaks that build up national health systems. Most of his practical training and experience have been in field settings of resource-limited settings. Understanding the barriers faced by vulnerable and marginalized communities was one of the principal reasons he chose to work with Médecins Sans Frontières upon completing his pediatric training at the Children’s Hospital of Michigan. He has lived and worked in these settings to better understand how health systems operate and learn lessons of what can succeed in various contexts. As a pediatrician managing HIV in Swaziland, his team was better equipped to improve adherence and treatment success when changing their structure to a family-based HIV clinic with nutritional supplementation and strengthened ties to centralized TB care. Bundling interventions to maximize positive outcomes was a big step forward in guiding his future interest in implementation strategy on a population-based level. Following a Pediatric Infectious Disease Fellowship at Yale University, Sachin has reflected on the evolution of his core values over the past ten years, of his perceptions and expectations of what can be competing, but equally important objectives . Balancing immediate, individual benefit versus sustainable population-based impact needs to be carefully considered when defining successful end-goals.