Young Global Leaders Blog

Young leaders of global health ask for a seat at the table if they are to be the ones to usher in the Sustainable Development Goals (SDGs)

This blog was written by Caity Jackson, Co-Founder & Communications, Women in Global Health and Director of European Engagement, CFHI. It summarizes Panel 4 from the GHLS 2015 Symposium titled Young Global Leaders Reflect – How Will I Shape the SDGs?

The 2015 Global Health Landscape Symposium’s final panel, ‘Young Global Leaders Reflect: How will I shape the SDGs,’ challenged today’s leaders to institutionalize young peoples’ involvement in the Sustainable Development Goals (SDGs).  Three themes guided the discussion, including recognizing the important role the enormous population of youth have in ushering in these goals, ensuring young voices are heard in these discussions and invited to the decision-making tables, and encouraging true collaboration at all levels, with a focus on capacity-building and training in this skill for young leaders.

Moderated by Kyle Peterson of FSG, the stage was alive with ideas and energy as all the panelists considered on their own experiences as young leaders and what they see as the role they can play in the SDGs. Sahil Angelo from the Center for Strategic and International Studies (CSIS) started out the discussion focusing on the immense number of young people in the world – almost 2 billion between the ages of 10 and 24. This is in-part due to the successes of past global health efforts, but as a community, we have not really considered or planned for the implications of these strides. What does 2 million young people (and rising) mean in the context of the SDGs? Nowhere in the “Means of Implementation” section of the SDGs’ text does it mention that youth would be the ones to usher them in.

Many panelists commented on the comprehensiveness of the goals and saw them as tangible objectives that address the root causes of inequity in health outcomes, even as a chance to do it ‘right this time’, referring to the previous Millennium Development Goals (MDGs). Yet in terms of young leader involvement, Oliver Anene of the New York City Department of Health commented that young leaders need to be invited to the decision-making table and their voices need to be heard – especially since they are currently on the receiving side of the policies created by today’s leaders. Anne Heerdegen of the Global Health Fellows program echoed this thought, commenting on how young leaders should be invited to speak at conferences and events alongside their experienced colleagues.

GlobeMed Executive Director, Alyssa Smaldino, spoke to amount of collaboration needed in order to achieve success. She discussed how true collaboration is very difficult, but essential – especially at the local community level. There is a need for proper training, capacity building, intention, and bi-directional thought leadership at every level. These activities will empower young leaders change pernicious power dynamics that pervade the donor community, helping them to ensure their voices and the voices of their respective communities are represented as they see these goals through.

The final take-away messages from this group were powerful, with the panelists warning the current generation of global health workers that the youth of today will hold them accountable to their actions and the goals they have set. The young leaders of today are demanding to be heard so that the solutions for tomorrow’s global health challenges can be adapted and addressed today.

GHLS 2015 Panel 4 - Young Global Leaders Reflect – how will I shape the SDGs?

GHLS 2015 Panel 4 – Young Global Leaders Reflect – how will I shape the SDGs?

The Women Leaders in Global Health Initiative Launches at GHLS 2015

This blog was written by Caity Jackson, Co-Founder & Director of Communications, Women in Global Health. It summarizes the launch of the Women Leaders in Global Health Initiative that took place at the GHLS 2015 Landscape Symposium on November 19, in Washington, DC. 

At the recent Global Health Council’s Global Health Leadership Series, the Landscape Symposium 2015, the theme focused on Achieving Universality in Global Health: An Imperative for Change. Deliberately crafted to follow the adoption of the UN Sustainable Development Goals (SDGs), the Symposium provided a high-level forum of exploration, debate and creative thinking on how we must collaborate in the post-2015 landscape. Following the plenary focusing on gender equity in leadership titled ‘Promoting women as leaders: Are good intentions enough?’ was the launch of the joint initiative ‘Women Leaders in Global Health Initiative’ (WLGHI) forged with the partnership of Global Health Council and the Women in Global Health movement. This exciting initiative was conceived in spring 2015 in response to the question, “Why aren’t there more women represented in the highest levels of global health and what can we do about it?” with the aspiration to recognize and develop female leaders in global health through a gender equity lens.

The launch was well received both online and during the Global Health Landscape Symposium in Washington, DC., with one participant writing:

“Pushing aside the incessant replaying of Beyonce’s “Run the World (Girls)” that has occupied my subconscious since the launch and the exciting new connections I’m still forging on social media, the most important takeaway I have from the launch is a bit of a challenge to all of us. Doing what we can to spread the word about Women in Global Health isn’t just a personal prerogative—it’s an imperative of the SDG era.” –Rachel Sellstone, GlobeMed Alumni

Susan Papp, Director of Policy and Advocacy at Women Deliver, moderated the panel preceding the launch announcement that looked at women leadership in global health and challenged the audience to list as many visionary leaders in Global Health they could think of. After a pause, the audience was asked to raise their hands as to how many of those on their list were women and sadly, very few audience members had more than 5 women on their visionary leaders in global health list. Furthermore, Desirée Lichtenstein of the Women in Global Health movement highlighted that to see a women in the google search results for ‘great leaders’, one must enter ‘great female leaders’. With all of this evidence that our society has a gender bias lens on, it could not be more clear that there is a strong need for an initiative focusing on increasing access to leadership positions for women, as well as the visibility and recognition of women leaders in global health through advocacy, which is one of the WLGHI objectives.

WLGHI_Twitter“While most of my coworkers and role models in public health are women, the faces of people who are making important decisions do not represent those of the people working in the field.” – So Yoon Sim, graduate student at Johns Hopkins SAIS and Bloomberg School of Public Health, former Global Health Corps fellow

The initiative will focus on strategic priority areas of advocacy, networking, mentorship, and capacity building to achieve a world where women are represented in equal numbers to men at the highest levels of decision-making and visibility. Specific focuses of the initiative are to increase access to leadership positions for women, as well as the visibility and recognition of women leaders in global health through advocacy, increasing networking and mentorship opportunities for women, and optimizing opportunities for capacity building and skill development.

During the Global Health Landscape Symposium event, members of the Global Health Council and Women in Global Health teams were onsite to record audio and video clips asking participants to comment on their reflections on gender equity within the global health leadership sphere, the role of women leadership in global health, how to overcome the barriers these women face on the path to leadership, suggesting an action the global health community can take towards a gender equity solution, or a personal/organization commitment on achieving global health leadership gender equity.

Through live tweeting and in person discussions, audience members engaged in a lively discussion around gender equity in the global health field.

Director of Global Health Council, Christine Sow, introduced the initiative by talking about how global health is about equity, power, participation, and voice, saying ‘to meet the SDGs we can short-change 50% of the labour pool’. When looking to the SDGs and global health agendas across the world, it is important to reflect that they won’t be achieved if half of the world’s bright minds are cast aside. All voices must be present at the table, and it is up to us to bring gender equity to global health if any progress in the field is to be made.

Innovative Financing Mechanisms for Global Health

This blog was written by Rachel Sellstone, a Global Health Policy Research Intern at CSIS and GlobeMed Alumni. It summarizes Panel 2 from the GHLS 2015 Symposium titled Financing Health in the SDGs: What Does it Take to Open a Closed Universe of Funding?

GHLS 2015 Panel 2: Financing Health in the SDGs: What Does it Take to Open a Closed Universe of Funding?

GHLS 2015 Panel 2: Financing Health in the SDGs: What Does it Take to Open a Closed Universe of Funding?

As we turn to the SDG era, discussions around innovative financing mechanisms for global health are becoming increasingly important. As bilateral donors seek to engage developing countries in a more active role in achieving greater health outcomes, creative approaches at domestic resource mobilization are vital. At the Global Health Landscape Symposium hosted by Global Health Council, panelists on the “Financing Health in the SDGs: What Does it Take to Open a Closed Universe of Funding?” proposed a variety of approaches that governmental programs and non-state actors alike are piloting in order to move away from traditional development assistance and towards integrated, sustainable financing mechanisms for the successful attainment of the SDGs. Below are three major takeaways for implementers, advocates and other stakeholders from the panel.

1) Experts Agree: innovation is important and exciting.

All of the panelists offered ideas of ways that both the US government and non-state donors can, and currently are, fostering innovation in global health financing. One that has seen particular success as of late has been the Global Financing Facility. Tiaji Salaam-Blyther of the Congressional Research Service used the GFF as an example for how the US Government and other donors are integrating multiple innovative financing mechanisms for achieving important health outcomes—in this case, in the area of Maternal and Child Health. Domestic Resource Mobilization is core to the ideology behind the GFF; stemming from, according to Salaam-Blyther, a realization that too much ODA actually can be a bad thing—that is, that some Ministries of Finance were seen to actually be slashing their own health-related budgets because they could rely more on foreign aid. The GFF promotes Domestic Resource Mobilization by employing a results-based financing model, where additional foreign assistance is conditional on domestic governments providing a certain amount of services first. As Salaam-Blyther simplified in her incredibly clear explanation of this model, the donor is saying to recipient governments, “If you achieve A, B, and C, I’ll give you X, Y, and Z.” The U.S. is incredibly optimistic about this strategy, with Secretary Kerry personally promoting the pilot effort, and it remains to be seen if the 63.5 USD (over 3 years) that is currently being provided by PEPFAR—with the goal of generating a billion dollars in revenue—will be scaled up in the future.

Salaam-Blyther’s colleagues from the private sector shared her optimism. Andy Wilson of the Abbott Fund astutely pointed out that just 5 years ago, you would be hard-pressed to find a room of Global Health experts so intently discussing domestic resource mobilization. In its 15-year long relationship with the Tanzanian government, Abbott Fund has found that partnering to develop new external auditing systems and Monitoring & Evaluation guidelines fostered innovation and efficiency in public hospitals. Ambassador John Simon of Total Impact Capital highlighted that point. For him, an inefficiency is that often times, the private sector does not realize how burdening the high cost of healthcare can be for both employees and consumers.  Donors can disrupt this cycle of inefficiency, in turn providing higher quality, more accessible care, just by providing their funds in an innovative way. One non-traditional idea he provided: moving payments for healthcare services to a mobile app platform.

2) Context and Integration Matter

 Questions from the audience

Questions from the audience

As a longtime senior civil servant to DFID, Simon Bland, the Director of the UNAIDS New York office, acted as the panel’s expert voice on integration. His comments seemed framed in an effort to remind all of us in the room that these creative, at times convoluted, financing mechanisms are coming from a place of real vision. That vision is the attainment of the Sustainable Development Goals. The SDGs build on the MDGs in many ways, but perhaps the most important way is their particular focus on those who were left behind in the MDG era. With that in mind, Bland pushed his fellow panelists and the audience to realize that we’ll never reach those whom the MDGs left behind if we approach the SDGs in the exact same way.

This was more than just a poignant criticism of the status quo, but an excellent reason why these conversations on innovation are so important. The SDGs beg stakeholders to be more targeted in its approach, and Bland argues that if you intend to do that through investing, you can do it most effectively by understanding the politics and geography of poverty. It seems obvious, but in reality this is a complete shift of the paradigm of the MDGs; in Bland’s words, “to effectively transition from the MDGs to the SDGs, we need to start thinking differently than the North-South, Donor-Recipient paradigm.” For all the criticism that the SDGs have received for being so lengthy, we must recognize that they force integration—you won’t achieve 17 goals by thinking of them as isolated from one another—and we need to force financing flows to act in that same integrated way. Failure to do so entirely misses the point of the SDGs in the first place!

3) Even the most innovative approaches cannot succeed where trust and confidence is missing.

So you have the resources, and you have the ideas to make those resources go farther than ever before. Sounds like a recipe for success! There’s just one problem. Bilateral donors might be on board, and the governments of developing countries are more ready than ever to make major gains towards the SDGs, but all of this leg work is for naught if you don’t have the buy-in of civil society.

All of the panelists shared anecdotes of incidences where a lack of trust was the downfall of an otherwise promising health program. Andy Wilson gave one example; with the recent emphasis on Health Systems Strengthening, many governments are focused on the establishment of a health insurance system. However, in places where citizens have built a distrust of public services, they are unlikely to want to pay into a government system. Plain and simple: it’s really hard to mobilize domestic resources if your citizens don’t want to cough up those resources, and even harder the more a society is marred by a history of unaccountability. Any innovative financing mechanism will have to focus on bridging the trust gap just as much as bridging the financial one.

There is no better way to encompass the prevailing consensus from the panel than the exact way that moderator Amadou Sy of Brookings Institution did. The oft-cited saying rings true: “More money for health, more health for the money.” The challenge now is funneling that money into devices allowing it to reach each and every person the SDGs aspire to capture.


Three Ways to Achieve Meaningful Accountability

This blog was written by So Yoon Sim (@YoonieSim), a graduate student at Johns Hopkins SAIS and Bloomberg School of Public Health and former Global Health Corps fellow. It summarizes Panel 3 from the GHLS 2015 Symposium titled Meaningful Accountability: Rethinking Roles and Responsibilities in the SDG Era.

Meaningful Accountability: Rethinking Roles and Responsibilities in the SDG Era

GHLS 2015 Panel 3: Meaningful Accountability: Rethinking Roles and Responsibilities in the SDG Era

Accountability has become part of our speech, but how to implement effective accountability mechanism is a whole different story. In the MDG era, voluntary commitments made by individual countries were not legally-binding nor enforceable, and the nature of joint commitments made it difficult to attribute outcomes to specific actors. The Sustainable Development Goals present an even more dynamic and challenging landscape, as they are based on multi-stake holder partnerships in support of 17 SDG goals and 169 targets. There is a goal for everyone, and we are facing a myriad of questions regarding many aspects that determine accountability—what gets done, who decides to do what, and how the impact is measured.

“Meaningful Accountability: Rethinking Roles and Responsibilities in the SDG Era” panel of the Landscape Symposium 2015 presented by the Global Health Council featured four leaders from public, private, and non-profit sectors and asked a critical question: how can we achieve meaningful accountability in the SDG era?

Here are three main takeaways from the panel:

1) Accountability does not mean a lot if we are not reaching the most remote and marginalized communities and improving their health outcomes

According to Jason Taylor Wright, Director of USAID LMG Project, the SDG era is characterized by desegregation of the data that enables decoupling of key populations that the aggregate data often overlooked. The dual role of civil society as a watchdog and implementer ensures that services reach the remote and marginalized communities, and civil society should play a critical role in encouraging conversation between different actors, not merely duplicating the existing power dynamics.

Nancy Wildfeir-Field, President of GBCHealth, said that legal ramifications often cause discomfort with the language of accountability. The private sector should rethink the notion of accountability and be alarmed by the consequences of “non-delivery” of services especially on maternal and child health. The next step is to work closely with civil society for effective delivery and use their core competency to build capacity within the community.

Ariel Frisancho, Country Director of CMMB Peru, said, “we cannot talk about rights-based approach if do not listen to the people.” People who are at the center of the services are often absent from priority settings and review process, and it is important to study multidimensional factors that prevent people from accessing health care and achieving universality in global health.

Questions from the audience

Questions from the audience

2) Measuring and addressing corruption is important

The moderator of panel, Jennifer Kates, Vice President and Director of Global Health and HIV Policy, Kaiser Family Foundation, asked a critical question about the reality of corruption. To what extent can we achieve accountability by (or without) looking at corruption?

According to Frisancho, almost 20 percent of public sector resources in Peru were lost because of corruption, and it is often difficult and challenging to address corruption. However, the first step is to recognize the problem and start talking about it, which should be backed by political support from the international community.

Some organizations came up with institutional mechanisms to address corruption issues. For example, The Global Funds to Fight AIDS, Tuberculosis, and Malaria, does not only reinforce the independence of the inspector general, but it also created a position called Chief Risk Officer as well as a fully outlined risk management framework to effectively respond to corruption and risk. In addition to organizational initiatives, collective corporate voice will incentivize many countries to take actions and reduce negative effects of corruption in the business environment.

Despite many challenges, it is also important to measure corruption. The USAID’s LMG project conducted an online Health Sector Corruption (HSC) survey in 2013 with more than 1000 frontline health managers and leaders working in more than 95 countries. Tackling corruption requires multi-sectorial and multidisciplinary approaches, and understanding how people experience corruption in the field will be a critical step to bring people to the process of achieving meaningful accountability.

3) Focus on what is working and capitalize on existing tools that have proved effective

In the past decade, there has been increasing civil society participation in priority settings and review processes. Civil Society Organizations were actively involved in the post-2015 consultation process, and they have become critical actors in the development and implementation of SDGs. The recent development is a succession of many successful examples from the past.

The Global Funds’ grant proposals are developed and overseen by Country Coordinating Mechanism (CCM) comprising representatives from government ministries, non-government organizations, the private sector, international partners, and people with the diseases. Wright said that CCM was symbolic at best in the beginning but it has grown to be an effective tool to strengthen local ownership and participatory decision-making.

Community of Practitioners on Accountability and Social Action in Health (COPASAH) is another example of effective community monitoring for accountability in the health sector. This movement was created by of a group of practitioners who believed that accountability is a missing piece for many of the health systems around the world, and it has expanded its base of community knowledge and capacity to Africa, Asia, and Latin America.

Each sector has a role to play in ensuring accountability, not for accountability’s sake but for accountability for greater impact. On the road to universality, effective accountability will enable the realization of our dreams and promises.