Atypical Partnerships Lead to Breakthroughs in Global Health–with Barbara Bush

Global Health Corps was born from frustration alchemized into opportunity. It was the gripping frustration that despite sufficient knowledge and treatment, millions of people continued without care, which left Barbara Bush looking for solutions–solutions she found, in part, in a growing cohort of educated graduates and young professionals keen to confront the problems they saw.

Adanna Chukwuma, Olivia Khalili, Barbara Bush (l-r)

Barbara co-founded Global Health Corps (GHC) in 2009 to “mobilizes a global community of emerging leaders to build the movement for health equity.” Taking inspiration from Teach for America, the one-year fellowship matches a pair of young professionals with government and nonprofit partners working in health. Since 2009, GHC has placed 216 fellows with partner organizations in seven countries (in East and Southern Africa and the United States). With its reputation growing internationally, the program attracted 4,000 applications for 90 available slots in the current class. Applications for the 2013-2014 fellowship are now open.Barbara and GHC Fellow Adanna Chukwuma were invited to speak about their work and collaborative model of leadership at the recent Social Innovation Summit in Mountain View, CA. I sat down with them afterward to talk about systems-change approach to health, the value of humility, and public health role models.

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Olivia Khalili: What was the impetus for founding Global Health Corps?

Barbara Bush: Frustration triggered an opportunity. I was frustrated that we [as a global society] had the knowledge and technical skills to vastly improve global health, but that we weren’t doing enough, quickly enough, to deal with the scale of the problems that existed. So this was a frustration, but at the same time I realized there was an incredible opportunity to engage a huge segment of young professionals who are interested in global health. Why not tap into this interest and funnel talent into the global health field? I think for many people frustration can be motivation. When we’re frustrated that systems aren’t working, we’re driven to make change.

OK: How do you address global health concerns from a systems level?

Adanna Chukwuma: GHC Fellows approach an issue by thinking about the different factors that influence global health, such as taxation and agriculture. As Fellows, we think critically about the health challenges within the context of a system, versus as siloed. How do different factors interact to create problems? Then we look to design solutions that incorporate all of these factors. Out of 2012’s class of 90 Fellows, only two are doctors; the rest are business graduates, education specialists, ICT4D, anthropologists, or architects. We also look for bright spots, trying out new things, seeing what works and then scaling them up. It’s a system and you can’t control a system. All you can do is try to understand what works within that system.

BB: Part of our theory of change is that you need every skillset to create new solutions in global health and to change systems. Adanna is a doctor but she’s interested in working on the systems behind health care to minimize the need for people to see doctors in the first place. And, because we expect our Fellows to end up in leadership positions, our bet is that they will model this type of systems thinking, creating an exponentially larger impact.

OK: How do you act on the trends and patterns identified through this work? Do you use them to influence policy?

BB: There’s a lot more we can do now from a knowledge-sharing perspective. Our Fellows approach systemic issues from different angles, with unique perspectives and skills. We’ve anecdotally seen cool outcomes but need to find ways to build in more knowledge sharing.  I’ll share one example from last year. Fellows placed with the PEPFAR office in Washington, D.C., lived with Fellows working for a very grassroots organization that addressed health education for sex workers and supported HIV-positive populations in D.C. So we had people helping to shape policy at PEPFAR living with people representing those for whom policy is shaped.

OK: How do you measure GHC’s impact?

BB: It’s tough, in part because we have two main goals. The first is that our Fellows make an impact during their year of fellowship. We work closely with our partner organizations to assess what the organization was able to accomplish by virtue of having the Fellows on their team. The second goal is our investment in our Fellows. We expect they will continue to shape health solutions in their sectors, and we track the career paths of past Fellows. We’re committed to investing in and supporting them after the fellowship as much as during it.

OK: to Adanna: What drew you to this program?

AC: The opportunity to partner with someone who brings a different set of skills, who isn’t a doctor like me. We work in teams of two, and I see this as a new model of leadership. There’s also a strong emphasis on social justice. I applied for this specific health policy position in Newark because I felt it mirrored the situation back home in Nigeria. Many of the factors are the same: the same war. In 1967 we had a civil war in Nigeria, and 1967 there was large-scale civil unrest in Newark that started its decline. I felt I could carry some of what I learned during my fellowship in Newark back home to Nigeria.

OK: to Barbara: What criteria do you look for in Fellows?

BB: It parallels a lot of what Adanna said. We look for commitment to social justice, leadership potential, rejection of the status quo. Critically, because our model is one of partnership in which our Fellows work in teams of two, we look for a collaborative approach. Zainab Salbi [founder of Women for Women International] talks about the importance of respecting people you serve. So we look for humility, which is hard to measure for but critical.

OK: Who do you look to for inspiration?

AC: Rifat Atun [former director of strategy for Global Fund to fight AIDS, Tuberculosis and Malaria], Julio Frenk [dean of Harvard School of Public Health and former health minister of Mexico]. Julio Frenk straddles the academic and policy worlds. He moved forward national health reform in Mexico. Rifat Atun underscores the importance of having advanced technical skills to address the magnitude of the issues.

BB: Zainib Salbi. Everything is so pure in her approach to what she’s doing. She’s driven by purpose. From a health perspective, Dr. Agnes Binagwaho [Rwandan minister of health]. She gets stuff done every day and can navigate the systems and politics that exist so smoothly. Rwandan health outcomes have changed drastically. She tweets routinely and made everyone in the Ministry of Health get on Twitter because she sees it as a tool for greater accountability. For example, if a patient shares that she went to the health center in Kigali and a drug wasn’t available, there’s accountability for it and people aren’t able to deflect responsibility.

OK: Are there enough female role models in global health?

BB: 70% of GHC applicants are female. So if there aren’t enough role models in health now, there will be!

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If you liked the interview you can thank Barbara and Adanna and pose follow-up questions at @GHCorps.