A Clinician at Davos: Prioritizing Health Systems Transformation As An Economic Imperative
Looking for new solutions
I’m a Physician’s Assistant by training and I’ve always gravitated towards the direct, patient-level interventions that I know save lives: detecting pre-eclampsia in a pregnant woman; diagnosing and treating an acute respiratory infection in a young child; teaching a family how and why to treat their water, thereby ensuring a new trajectory of good health for the household.
But after 25 years working in international health, I have learned (and despaired) that these types of interventions, nested within profoundly broken systems, are wasted – or, at best, temporary – efforts. Despite billions of aid dollars, women still died from pre-eclampsia and children from pneumonia at alarming, stubbornly high rates. I put down my clinical tools and put on an implementer’s hat: studying health economics and health financing, working in Africa and Asia on health system-strengthening initiatives and, eventually, founding an organization in Haiti that builds a network of community-based primary care clinics.
As a clinician first, I believe passionately that access to healthcare is the foundation of economic freedom and mobility – particularly for women who, across the globe, suffer disproportionately from the myriad impacts of poverty. There is no shortage of challenges across the world, where 770 million people are living below the poverty line. But without good health – and accessible, affordable, high-quality health services – people cannot participate in a burgeoning economy; they cannot seek or attain an education; they cannot care for themselves, their households and children; they cannot participate meaningfully in civic life. Poor health undermines nearly everything else.
As a philanthropist, I feel impatient with the typical churn of grant-seeking and grant-making across sectors. Incremental grants aren’t changing the game and, too often, they aren’t even generating incremental progress. I worry that this kind of cautious, defensive posture in the grant-making community – an attempt to insulate against perceived risk or waste – is actually wasting more money (and time and creativity and talent) than if we were less fearful of failure. It would free us to experiment – to ask and answer bold questions about which strategies work, and which don’t.
This fuels my passion for Co-Impact. This bold new approach to collaborative philanthropy is seeking a ‘fulcrum effect,’ eschewing the funding models that simply haven’t produced the results we urgently need. Co-Impact embraces a ‘big bet’ approach and invests in initiatives that are at the forefront of true systems-change. This week, Co-Impact announced its first round of grants, totaling $80 million to 5 recipient organizations and in a few days Co-Impact will bring its urgent and compelling message to the World Economic Forum in Davos, where we will ensure that the dialogue about role of philanthropy in systems-change is not an afterthought but, rather, a central theme of economic transformation and inclusion.
As a Co-Impact community member, I am honored to be headed to Davos with this important message at this pivotal time: through collaborative, coordinated efforts – as funders and as implementers – we can achieve the ‘fulcrum effect’ we have been seeking for decades and the kind of systems-level change in global health that ensures that clinical efforts at the micro-level save lives and transform the future for tens of millions of people.
