Christian John Lillis on C diff, Public Health, and the Role of Pharmacists

At the Peggy Lillis Foundation's 10th National C diff Summit in Washington, DC, advocates, survivors, health care professionals, and policymakers gathered to elevate awareness of Clostridioides difficile (C difficile) infection and advance prevention and treatment strategies.

In this interview with Pharmacy Times®, Christian John Lillis, co-founder and CEO of the Peggy Lillis Foundation, reflects on the key takeaways from the 2025 summit—including the underrecognized role of pharmacists in infectious disease care, the evolving demographics of C difficile advocates, the persistent challenges patients face despite therapeutic advances, and the broader societal and policy factors that shape public health. Lillis underscores the importance of sustained advocacy, interdisciplinary collaboration, and a renewed commitment to public health infrastructure.

Pharmacy Times: What are key takeaways from the Peggy Lillis Foundation's 2025 C diff Summit in Washington, DC?

Christian John Lillis: One of the things that came across at the event, because we had some PharmDs who did presentations, was many of the volunteers, especially the new ones, they didn't fully appreciate the important role that pharmacists play, and particularly infectious disease pharmacists play in our health care system, both as experts, as people who are really side by side with doctors. One of the doctors on our board said to me that he would be lost without his IV pharmacist, and he's an infectious disease doctor, he said, simply because there's so much change, and he's trying to pay attention to the clinical stuff, and having somebody who really knows the ins and outs of the drugs and the dosages and the pluses and minuses, everything is really important to him, and I think that that also helped patients understand that there's a lot more that pharmacists could be doing and that their role is really critically important.

Another thing that I enjoyed this year was that the newer volunteers skewed younger. We actually even had a young mom who brought her, I think, 8 month old baby with her and that was cool. She took the baby lobbying, and it was just—these are American citizens, and they have a right to ask their government to do things for them.

I was really also, in some ways, what was upsetting is, despite the progress that we have made in terms of getting new treatments approved by the FDA, the patient experience for people with C difficile doesn't seem to have improved very much. I think there was some progress, and I think that there may have been a sort of retrenchment or falling back because of COVID. I think my biggest concern, and I think that that many pharmacists would share, which, if I share this with me, is like, I'm concerned about this sort of overarching view of the current administration, current HHS administration, that our problem is all chronic diseases, and like infectious diseases are not a are not an issue. First of all, it's not true. And second of all, even the healthiest person can succumb to an infection. And to say otherwise is to mislead the public. Does a healthier, younger person have a better chance of having an

Microscopic view of Clostridium difficile bacteria colonies. Image Credit: © chaiwat - stock.adobe.com

infection? Some of them sometimes, but there's so much we don't know about the interaction of an infectious bacteria or virus, and the actual person, it's infecting things that we may not appreciate, even in somebody who otherwise appears to be very healthy. So, I think that's an area of concern. And again, regardless of we had a lot of folks from red states, we obviously don't ask anybody how they voted, some of our business, but you sense that these are people who are had more of a libertarian streak, or who had more of a conservative streak, but they, in our discussions, they came to really see that these agencies do really important work, and Maybe they're in need of reform, but they certainly need, need to exist. I think for some of them, there was a recognition that the issue may not be that they are bloated, but that they're actually not big enough, or they don't have enough staff to tackle the important work that they're being charged with.

Then lastly, I think, something that came up, and that we've been talking about in the weak sense, is that many people expressed a sense that C difficile was their fault, that they were to blame for getting this disease. I've talked to several people who had C difficile at some point in the past 15 years, maybe even 20 years, in some cases, and it seemed like that was true for a lot of people, but it also seemed to be perhaps more palpable now, and I think it's a very interesting thing to feel like an infectious disease is your fault. I have to think that it's because we as a society, we as a country, have really not reckoned with COVID and the way that COVID was politicized and weaponized and not really just handled as a public health crisis. So, I think there are people now who think, “Oh, well, if you don't mask and you get COVID, that's your fault,” or “If you didn't get vaccinated and you got COVID and you got really sick, that's your fault.” At the end of the day, public health is public health, and it's really a societal issue, and to frame it as an individual's mistake or an individual's bad behavior led to this is to miss the entire point of public health.

I have talked about this with Pharmacy Times before, but I came out as gay in 1989 and we were definitely being told that HIV was our fault the way we had vaccinated, our fault the fact that we weren't straight made it our fault. It was the devils was God's punishment. And we basically said, screw that. It's not our fault. It's the disease. It's a virus. And I think that we have to come back to the sense that we can live healthier lives, sure we can try to do some things. Some of us, just by virtue of our genetics, might be a little bit more predisposed to illness than others, but putting that aside, like if we want a healthier population, then we actually need investment in our public health, not to diminish our public health when you start seeing public health is everything from what food is available to you to do you get vacation time? Do you get sick leave? Do you have people who are providing care for you, your children, an elderly parent? I mean, all of those things are factors that will determine whether or not you're able to take steps to protect your health. If you are at work and someone comes in with a virus, with a cold because they don't have a sick day, well, is it your fault to pick up that virus? No, it's your employer's fault because they don't give sick time. So I think this is an area where everyone in health care should really be really pushing back at this narrative that we're all experiencing and saying, like a lot of chronic disease, is that is the result of policy choices that have been made over the last 40 years, everything from agricultural college policy to like people not having sick time to the fact that the minimum wage hasn't been increased in 30 years.

There's a lot of things that underlie what makes us sick, and a lot of it is the result of having a sick society and a sick political system.