People Power — Developing Health Equity Leaders to Advance Systems Change

The COVID-19 pandemic illuminated how make-or-break leadership can be. The pandemic provided an opportunity for global health to look at itself in a mirror and begin to address the lasting impact of colonialism and white supremacy on the sector.

A clear resolution that has emerged is to support more diverse, proximate leaders. One particularly sobering statistic underscores the depth of the current gap: women from low and middle-income countries hold just five percent of top global health leadership roles. There’s growing acknowledgment that this needs to change if we want to accelerate progress in building more equitable systems. Proximate leaders are the ones who understand the magnitude of the problems they’re solving; they have the relationships and trust with the community to make change happen quickly. So how can we practically equip them to lead the design and implementation of solutions? How can we shift more power and influence to proximate leaders?

Global Health Corps (GHC) recently teamed up with the Skoll Foundation to host a Town Hall to explore just that. Jimmie Briggs, a Principal at Skoll Foundation, moderated the conversation between our speakers: Gregory Rockson, Co-Founder and CEO of mPharma, and GHC alumni Ann Marie Brouillette (COVID-19 Strategic Advisor at USAID), Angel Chelwa (Managing Director at mPharma Zambia), and Dedo Baranshumaje (Director of Strategy, Africa at the Segal Family Foundation).

Having begun his leadership journey through community organizing before transitioning to philanthropy, Dedo pointed out that when we think about leadership across various sectors and issues, there’s a gap between those with power over funding streams and the communities most impacted by inequities. Oftentimes the people making the decisions are not the ones who will have to face the ramifications of the decisions being made. Then, when we wait for centralized solutions, they arrive too little, too late, or just plain wrong for the context. Dedo’s journey in global health has given him the opportunity to challenge the status quo. As the Director of Strategy at Segal Family Foundation, Africa, he leans on his community organizing background to forge partnerships between philanthropists, government officials, and nonprofit leaders to bridge the gap between those making the decisions and those impacted by the consequences.

When the conversation turned to lessons learned from AIDS to Ebola to COVID-19, Angel expressed the need for a values realignment. Decisions around funding are based on certain values, and if we don’t have people who are proximate to the issues, then it is impossible to adequately define values in a way that delivers the most impact. When we think about the countries that were affected by the Ebola outbreak, and we then turn to their COVID-19 response, we can see that there was already an understanding of community mobilization. In Zambia, for example, the pandemic response to a first and second wave of COVID-19 benefited from wisdom and structures in place from previous outbreak responses.

Cultivating the potential of diverse young leaders is more important than ever. When COVID-19 hit, GHC leaders immediately adapted to meet needs and fill gaps in health systems in their communities. They were at the front lines of the COVID-19 response, piloting new initiatives, leading community health interventions, and mobilizing their own networks. However, these great leaders weren’t born, they were intentionally recruited, trained, and supported early and often throughout their careers, which prepared them for this crisis moment.

Many GHC leaders come to the movement without backgrounds in healthcare, like Ann Marie. When she joined GHC as a fellow in 2011, she brought her background in finance. GHC’s training opportunities and network of leaders provided her with insight and support to brainstorm new approaches and take on new challenges in her work. She is now spearheading USAID’s COVID-19 strategic task force. In her words, “Organizations like GHC are so valuable because they do pair opportunities and training to give people the chance to grow and learn.”

Dedo and Angel shared similar experiences about their time as GHC fellows. For Dedo, GHC shifted his understanding of leadership as something deeply hierarchical to leadership as something to be practiced daily, in community with others. For Angel, who showed up to her fellowship year as a “ball of passion,” GHC catapulted her career through the skills and relationships she built. Since joining mPharma Zambia as a Project Manager four years ago, she’s risen to Managing Director, providing leadership, strategic direction, and resources to her team across Zambia, Malawi, and Rwanda.

Fellow panelist, and Angel’s boss, Gregory, was quick to list the ways in which mPharma has been a long-term beneficiary of GHC’s fellowship program, sharing that, “At the end of the day, what fundamentally transforms organizations is the caliber of people that are brought in.” When Gregory initially went to Zambia to start mPharma, the first community he found himself in was the GHC community, and some of the first employees of the organization were GHC fellows. Gregory acknowledged that GHC fellows show up hungry to make a lasting difference. They believe that we have a dysfunctional healthcare structure, but they are also passionate about fixing it. In Gregory’s view, a key part of driving and sustaining progress if and when the “donor tap” closes up is having more leaders like Angel who are trained to innovate and pursue creative, contextual solutions even in the face of resource constraints.

To be sure, measuring the return on investment in individual leaders and networks of leaders across time on health systems is no simple task. Yet the Town Hall made it clear that it’s time to expand existing approaches of monitoring and evaluating impact on global health. This is required if we truly want to embrace a people-first approach.

While interning with GHC, I recently graduated from The George Washington University in Washington, D.C. As a Creative Writing and English major, I did not think that I was going to end up working in the health sphere. But my college experience was engulfed in politics — I lived next door to the former U.S. President, and I participated in various protests ranging from women’s rights to climate change to racial justice. These moments sparked the activist in me. It was witnessing the other protestors that gave me a semblance of hope for the future. We were all young. We all came from different walks of life. We were individual people, but we all came together for the same reason: fighting for a better and more just world for everyone. I was drawn to GHC because of this. It is the new generation of leaders who can change the world, and GHC is constantly and fervently equipping them to do so.