Reflections from the Global Health Community: Changing the Way We Operate

By Melissa Chacko, Policy Associate, Global Health Council

As global health organizations in Washington, DC are preparing to hit quarter one goals, they are juggling advocacy around both the Fiscal Year 2018 and 2019 U.S. budgets as well as advocating for global health legislation and policy. This robust agenda requires the global health advocacy community to stay one step ahead of possible roadblocks. But sometimes, it’s worth stepping away from the routine and reflect on how our community operates, which gives us the opportunity to understand the “why” of how we work and if our approaches are appropriate in the current global health landscape.

While there are multiple perspectives on this topic, we spoke with a few members of the global health community and compiled five ways that the community can change how it operates. These perspectives range from rethinking global health assistance to working toward bold goals. While these interviews do not represent the perspectives of the entire community, it springboards discussions about how we can think outside of the box to reach our advocacy goals.

1.) Putting LMIC Priorities First

“The global health community needs to embrace a new way of operating in global health assistance. Global health assistance is primarily framed around donor priorities, and low – and middle – income countries (LMICs) then work to develop a plan for using related funds. While we have seen successes in priority areas, particularly around HIV/AIDS, malaria, and child health, these efforts have not transformed health systems. To transform health systems we need to change how we engage with LMICs, especially those experiencing economic booms. Many middle-income countries have transformed their health systems by prioritizing primary health at the community level. Donors should collaborate with these countries to help other LMICs improve their health systems through South-South partnerships. The United Nations defines  South-South cooperation as a broad framework of collaboration among countries of the South in the political, economic, social, cultural, environmental and technical domains. Triangular cooperation occurs when traditional donors facilitate such initiatives. The global health community should support these types of partnerships and donors should leverage them to ‘work ourselves out of a job.’ ”

 

Tiaji Salaam
Global Health Specialist
Congressional Research Service


2.) Rethinking Public-Private Sector Partnerships

 “In addition to changing the way we operate with countries we need to reconsider how we use the term ‘public-private partnerships.’ At the moment, most public-private partnerships supported by donors in the health sector are collaborations between industrialized nations and large private companies based in those respective countries. The global health community could benefit from broadening those partnerships and including more frequently entrepreneurs and private companies in LMICs. Engineers in Cameroon and Uganda, for example, have developed inexpensive devices for expanding access to cardiologists and diagnosing pneumonia, respectively. We need to increase our support for local private companies. Broader use of innovative technologies developed in the field can increase sustainability, decrease costs, and may be more suitable for the local environment, both culturally and technologically.”

 

Tiaji Salaam
Global Health Specialist
Congressional Research Service

 

3.) Building Equal Gender Representation in Global Health Leadership

“One of the moments in 2017 that I believe pushed the global health community to do better and change the way we operate was the lack of equal gender representation in global health leadership. An example of this was the photo taken of global health leaders at the Universal Health Coverage Forum in Japan that perfectly depicted the lack of equal gender representation in global health leadership, where only one leader was a woman. This lack of representation is evident throughout global health, as women make up 75% of the health workforce yet occupy less than 25% of the most influential leadership positions. We can change the way we operate by identifying these discrepancies in global health leadership and push for equal representation in global health leadership.”

 

Roopa Dhatt
Executive Director
Women in Global Health

 

4.) Breaking Out of Silos

With the UN High-Level Meeting on Tuberculosis (TB) taking place later this year, I think there is a worldwide understanding that Tuberculosis cannot go any further as the leading global infectious killer. As a global health community, we need to break out of our silos and understand what it takes in terms of resources and programs to stop the TB epidemic from growing.”

“While it’s easier said than done, there are opportunities to break out of our silos and work together. From a science perspective, there are naturally sort of communities that find themselves as key stakeholders on cross-sectoral global health issues. For example, we know that TB is the leading cause of death for people living with HIV. Knowing this, the TB and HIV/AIDS communities often work together to share best practices and tactics based on historic wins from both the domestic and global level. However, some connections are not as obvious as HIV and TB and it is up to organizations to have the courage to cut through the red tape that limits the NGO space and cooperate better. For example, Treatment Action Group (TAG) connected with the maternal and child health community to collaboratively lead advocacy on a federally-mandated task force on the inclusion of pregnant and lactating women who have tuberculosis in clinical trials who for unfound reasons are often categorically excluded. TAG and other grassroots activists saw this is as opportunity to put pregnant women with TB on the map and connect with maternal and child health stakeholders and understand how TB affects maternal and child health issues.”

 

Suraj Madoori
U.S. and Global Health Policy Director
Treatment Action Group

 

5.) Working Toward Bold Goals through Incremental Improvements

In our interactions with policymakers, their staff, and others who shape key funding and legislative decisions that affect global health, we need to keep striking the right balance of being passionate advocates for our issues, deeply committed to solving big problems and savvy partners who can propose targeted policy solutions that are workable in a challenging environment. We can continue working towards big, bold goals through measurable, incremental improvements. The maternal and child health advocacy community’s effort to pass the Reach Every Mother and Child Act is a great example. This bill sets an incredible goal – to end preventable child and maternal deaths globally – and outlines specific, targeted steps the U.S. government can take to contribute to achieving it: by focusing on the poorest and most vulnerable populations; improving coordination among U.S. government agencies, foreign governments, and international organizations; and requiring a coordinated strategy with ambitious, measurable targets annually reported to ensure accountability and maintain the pace of progress towards our goal – a world where no mother or child dies needlessly. As advocates, we’re able to accomplish tremendous things when we’re smart, strategic, and persistent, with an eye towards the steps we can take year by year to continue progress towards goals with decades-long horizons.”

 

Emily Conron
Senior Advocacy Associate
World Vision US

Be the Catalyst!

When we question how we operate, we are also challenging our community to do better by addressing the “elephant in the room” and thinking strategically of who we are missing in our discussions. However, it is important to emphasize that these conversations, while fruitful, can end in wishful thinking when we do not follow them with action. Moving from discussion to action requires courage and the ability to work beyond our comfort zones and hold each other accountable. But when we do it, we become catalysts and more effective global health advocates.