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Alliance exclusive: Interview with Dr Tedros of the WHO
Article featured in the December 2020 issue of Alliance magazine
In the Covid-19 response, why are some high-income countries being outperformed by countries with fewer resources? What are the merits of a multilateralist approach in a crisis like Covid-19? What is it like being in the eye of the storm as head of the World Health Organization through a global health crisis? These are some of the questions Dr Tedros Adhanom Ghebreyesus, director-general of the WHO discusses with Professor Senait Fisseha, director of Global Programs at the Susan Thompson Buffett Foundation
Senait Fisseha: We’re approaching a year since the first cluster of Covid cases were reported to the World Health Organization. On this and on other major global health issues, how is the WHO using its experience of working with philanthropy?
Tedros Adhanom Ghebreyesus: Even before Covid, philanthropic organisations were committed to contributing to global health, so I was not surprised when many scaled up their response in very flexible ways, not only in building up the health systems of individual countries, but also investing in global and regional institutions like WHO and Africa CDC. The response of philanthropic organisations in general has been very encouraging. Their flexibility has helped them move quickly to change their priorities.
Supporting StepUpTheFight commitment to end Aids, tuberculosis and malaria. Credit: WHO/Mark Nieuwenhof
SF: In recent years we have seen a growing trend for private foundations and donors to contribute to the WHO alongside member states. What are your thoughts on that shift and what are some of the benefits and challenges of working with philanthropists along with member states?
TAG: There is a growing trend of private foundations and donors contributing to WHO and this is very important as it broadens our donors base. We welcome this. There is great potential, and great need, for the philanthropic sector to partner with WHO and health organisations around the world. And this is possible if you agree on the objectives, especially at country level, then you can cooperate with anyone because your interests are aligned.
But there have been challenges. For instance, they can come when a donor member state or a donor philanthropic organisation has their own priorities, which may not be fully aligned with those of the country. If the priorities are not aligned, then any assistance will not remedy the problems that country is facing.
This lack of alignment comes for two reasons: one, when a donor country or philanthropic organisation says, ‘I know their problems so I can help them’. But it is the country itself which knows its own challenges best.
The second problem is when the donor has a deep attachment to something they want to do. That passion is very important but it is essential that action reflects the needs on the ground, in the country. This is why flexibility in funding is important.
Whatever the challenge, the solution is the same: if we are interested in saving lives, then we have to listen to those who are seeking support and provide it based on their interests and priorities.
SF: I agree. I think listening to the voices of affected communities or countries and putting them in the driver’s seat is still a big gap in global health and development. One of the things you’ve done as director-general is to open up WHO to wider public interaction and donation, both through partnership with the UN Foundation and the WHO Foundation. How do you see that developing?
TAG: Generating more flexible funding is part of WHO’s transformation so it can be fit for the future. One of the challenges we first identified was that WHO is dependent on a few major donors, and if any of them change how they support then the organisation faces a potential shock. One of the solutions has been to build a new model of partnership for resource mobilisation and also to create a foundation. Working with the UN Foundation came about because Covid created the need to speed up the mobilisation of money, but the WHO Foundation has come about through the transformation. You, Senait, are a founding member of the board, of course, and we hope to have the first CEO very soon.
With members of the WHO internship programme. Credit: WHO/Christopher Black
SF: Getting support to the WHO from private philanthropy remains a thorny issue. You hear a lot about the disproportionate impact of foundations or private groups at the WHO despite the adaptation of the framework for the engagement of non-state actors. What do you say to critics?
TAG: What we tell them is that when we cooperate with philanthropic organisations, we do it on the basis of WHO’s priorities. For instance, we truly believe that SRHR (sexual and reproductive health and rights) should be a priority for WHO because many countries told us that it’s important for them and as long as we focus on what country needs are, then working together should not create any suspicion.
SF: This year will be forever defined by the pandemic, and you have had a front-row seat for the entire journey. Covid-19 has exposed the stark weaknesses of national health systems as well as the incoherence and insufficiency of health financing, the state of unpreparedness of many countries and the disproportionate impact of the pandemic on the poor, the uninsured and historically marginalised communities. You’ve made it very clear that national governments should be leading coordination of their country’s response, but what is the role of philanthropy in helping to mobilise political will and contribute resources to ensure an equitable response?
TAG: Losing more than a million people is a disaster. As you rightly said, many of these deaths could have been averted if we had a strong primary healthcare and strong public health. It’s very strange to see that the death toll and infection rates are higher in high-income countries. The reason for that is they have invested in medicine but neglected public health and primary healthcare. That’s where we can do better in emergencies or even prevent an emergency from happening. WHO has been warning about this. Maybe many Asian countries performed well and listened because of their own experience from SARS. That’s why Vietnam did well, South Korea did well – these are neighbours of China that should have been affected more than countries further away.
SF: You mention strong public health systems, and even low-income countries like Rwanda that have a very strong primary healthcare system have fared very well in this pandemic.
TAG: Yes. There is a view in some quarters that primary healthcare is for low-income countries. That has led to some high-income countries not prioritising it. I am convinced it’s the other way round, because WHO’s knowledge and experience is the sum of all approaches and countries. We developed a test kit with Germany, it worked very well, it’s still working. Such collaboration, between WHO and high-income countries, produces dividends for the world. WHO does not work only for low-income countries. It is in the interests of all countries, high, middle and low income, to collaborate among themselves and with WHO and the multilateral system.
Philanthropic organisations can also invest in high-income countries, not just in developing countries to create awareness of the need to strengthen primary healthcare.
SF: You said in April that if you politicise the virus, you’ll end up with many more people losing their lives, and you’ve reminded us to focus on values like solidarity and love and resilience.
TAG: When I remarked in April about people unnecessarily dying, there were 84,000 deaths, now it’s October 15, the numbers are 1,087,000, and we have 1,003,000 more dead. I still believe the politicisation was a key reason behind all these deaths.
Accompanying the helicopter evacuation of a wounded health worker in the Democratic Republic of Congo. Credit: WHO/Junior Kannan
In WHO, we saw it coming. It’s just like when you feel something, when you see something, when you’re worried about something, when you see the trends, you develop this fear inside, ‘Oh we’re heading this way’. We could see that trend. It’s not without reason by the way, it’s not without evidence. We could see the trend. The only thing you need to do is to connect the dots.
When you look back now, and consider the number of deaths we see today, this was actually a very insignificant representation of this situation now, so what we said was true, we wish it wasn’t true. And it’s very sad and it could have been prevented.
SF: Among the many downstream effects of this pandemic, the impact on the health and rights of women and girls around the world is of particular concern. Women represent the vast majority of frontline health workers, and political and religious leaders who are hostile to women’s bodily autonomy have used the pandemic as an excuse to categorise sexual and reproductive health services as non-essential. What is at stake here and what kind of guidance is WHO providing in this area?
TAG: Sexual and reproductive health and rights (SRHR) were a contentious issue in global health even before this emergency. For me, the health of women is central to the family and to society. I am a very strong believer that by guaranteeing sexual and reproductive health and rights you can even bring countries into the path of prosperity because that’s how you release the energy of the women to contribute to the economy and the focus on women and girls is more important than ever. So when people say ‘we’re in an emergency, this is not the right focus’, my answer is that the crisis aggravates the situation, and this is actually when we should do even more, not less. With philanthropic organisations, I think the thing we need to do is push, push, push. We now meet regularly virtually with civil society and we’re also installing a youth council. We need to leverage those contributions. But it should start from WHO. WHO should focus on doing the right things based on science and evidence, and SRHR should be at the centre. I hope you will support those civil society and youth initiatives so they will be more active and add their voices.
SF: I agree that philanthropy can help drive positive impact on global health, but we also have to grapple with the reality that there is a colonial and often very paternalistic history in global health and philanthropy. Many funders are based in the Global North, trying to solve ‘health issues’, concentrated in the Global South without the wisdom and the perspective of those most affected. How can we harness the power of private philanthropy to address some of these imbalances?
TAG: As you say, only communities know their problems and support should be tailored to them, but they’re also ready to listen. Something that they see is important, like family planning, they accept. The issue is how can we discuss this honestly with funders. When it comes to addressing global health problems, it’s better to align with the needs at the country level, listen to those who should be supported and tailor the support based on that. But as you rightly say, there is the power imbalance and those who have the power, whether it’s political or financial, try to dictate.
SF: This issue of Alliance is also covering mental health as a key part of the global health agenda and we are enormously grateful for how much emphasis the WHO has given this issue. I just want to ask: how do you personally stay calm and maintain your own mental health given the challenges and the pressure of leading the WHO in the middle of a global pandemic?
TAG: I don’t know if I have advice! I can tell you one story though. One of our colleagues was asked how WHO kept going in the midst of a crisis and he said, ‘we do what we do in good faith, and we have faith in each other’. If you say ‘in good faith’ it means internally you are at peace. When you have faith in each other, it means there is trust and good relationships that emanate from everybody doing things in good faith. I have seen WHO’s worth, because it’s tested now, and through this very difficult time I have seen how my colleagues actually work and behave. Another thing about good faith is that it keeps you in balance. Of course, we were affected, because we’re human beings. But the most important thing was we were focused on the pandemic and the people dying. So you have a bigger agenda; you cannot confront those who are trying to distract you, you focus on the most important thing which is saving lives. We need to think about each other, to really help each other. That’s how we can finish this pandemic.
SF: Finally, what message do you have for the philanthropists who want to do more to support your efforts but are struggling with the complexity of the current context?
TAG: I have already mentioned things that philanthropic organisations can do to help us to advocate for countries to focus on public health and primary healthcare. As you know, after I became director-general in 2017, we have been designing the transformation of WHO, which we officially launched in March 2019. But even before then, while designing WHO to make it fit for the world’s current needs, we were already implementing changes – the low hanging fruit – side-by-side with the design.
Special Session at the WHO on the response to Covid-19. Credit: WHO/Christopher Black
It is true that the agenda was influenced by a threat that a pandemic may happen and, when we look back, many of the new additions were very relevant to prepare WHO for this and future situations.
We established the independent Global Preparedness Monitoring Board to ensure preparedness for global health crises. We created a division focused on improving emergency preparedness in countries around the world, especially the most vulnerable. We appointed the first-ever chief scientist to drive research and development on emerging diseases, and established the WHO Academy, which is now training five million medical personnel for emergencies. The WHO Foundation is a new addition to mobilise resources. So one more thing I would like to ask philanthropic organisations is to help us ensure that these transformation ideas are implemented properly.
Second, I call on philanthropic organisations to please help us ensure sustained investment in primary healthcare and emergency preparedness.
Third, our aim is to make WHO a learning organisation. We have a transformation implementation unit which we want to drive continuous improvement, because change is a constant, so helping us strengthen that unit would be really great. We need support from philanthropists to implement these chances and to help prepare better for the future, so what happened never happens again.
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1 December 2020
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NEXT SPECIAL FEATURE TO READ
Applying the lessons of Ebola to Covid
Dr Charlie Weller
1 December 2020
15 Prescott Place
Tel: +44 207 062 8920
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Design and Built by The Idea Bureau
Giftadeed has been designed as a digital mobile platform for organisations which are invovled in csr /volunteer /any kind of humanitarian work, by bringing in transparency, collaboration and verification of on-ground projects.
It assists in pin-pointing, tracking and verifying last – mile needs & resources, on a map combining automated big data reports and collaboration between different stakeholders in a community which is being served.
Here is our 3min promtional video
BBC News feature on click broadcast in April’20 :
-please get in touch with charities in around Pune who are trying to helo the needy /weaker sections of the society –
Children in dog cages: Covid-19 puts Asia’s most vulnerable at greater risk https://www.scmp.com/week-asia/health-environment/article/3078395/children-dog-cage-how-coronavirus-puts-asias-most
Allowing people to come together as a team, divide different functions of giving, 1.needs identification ; 2.resource collection; 3.logistics to connect
Utilise the built in chat function?
Overlay an automated chatbot to assist?
A. Needs mapping – how we qualify? Needs based / means tested.
To start we will narrow our focus to 3 functions:
Safety/Anxiety – self help groups
BBC News – Coronavirus: Domestic abuse victims ‘still allowed to leave home’
Problem of safety of women and children, in a neighbourhood, by anyone in distress /abused calling for help via the SOS tag of our App. Self help groups can be formed in a neighbourhood who can respond immediately to someone needing help.
B. Resource mapping – households in a community /residents welfare / organisations. Restaurants and Grocery stores
C. Logistics /delivery services.
Mumbai dhabawallas per month or random location. Who pays for it?
Links to other platforms for good. What services and which area do we want to cover?
Partnership with logistics provider like Dunzo
What can we learn?
2. Following hyperlocal startups in logistics, charge 30-50-100 Rs. per delivery. Utensils for carrying food.
People to people direct giving via volunteers
Met RK Jain on 5th August, who came recommended by Mr harsh l mehta in chennai.
Brief take aways were:
1) What is the capacity max. peeople who can use the app
2) Blood donation drive, how app can benefit
3) Roti Bank pilot wanted to see stats about,
What radius of location and distance is roti Bank serving
How many people are being served
Where is the pick up location and drop off location
How many people impacted with what kind of meals.
One person’s charity is another person’s loss-absorbing capital –
Earlier this month, we pointed to an emerging American trend where philanthropists provide “first loss” capital for private investments.
The idea works as follows. Investment ideas that pursue political outcomes — such as education, or environmental sustainability — don’t usually achieve high enough returns to entice private capital. But if philanthropic capital takes the bulk of the risk, then private money will flow in.
Here’s the latest example of the emerging complexity of philanthropic capital structures, in an article earlier this week from Impact Alpha. It describes a new fund, backed by the Chan Zuckerberg Initiative, to provide affordable housing in San Francisco.
The Facebook-linked organisation will provide $40m, which effectively “serves as equity”, and is “given with no expectation of a financial return”. Here’s the key line:
The big slug of concessionary capital — effectively a grant — makes it possible for the new fund to both provide affordable housing developers with lower-cost loans and other attractive terms — and attract additional investors with competitive returns.
The investment fund has raised $260m out of a total of $500m. It has attracted capital from Morgan Stanley, according to a press release last week. That release also mentions the Ford Foundation, which we pointed to in our last post, as well as a host of other foundations that are involved in the broader project, including the San Francisco foundation and the William and Flora Hewlett Foundation.
For US foundations, losses themselves have a kind of value, because they count towards requirements to distribute (or “lose”) 5 per cent of their holdings each year, so as to remain tax-exempt. At a high level, you can see a conceptual substitution between tax “losses” on the one hand and charitable “first losses” on the other.
The investment fund is already lending $6.5m to the East Bay Asian Local Development Corporation. The ultimate logic is that the concessionary capital (also known as “catalytic capital”, also known, as above, as “first-loss capital”) allows the loans provided by the fund to be cheaper than the market would provide. These loans, to developers, will allow them in turn to provide more affordable housing in developments that “also include market-rate units”.
As you may have noticed, the entire principle is analogous to what a range of government subsidies aim to do. As the Impact Alpha article notes, those earning 60 per cent of the average median income are eligible for federal Low Income Housing Tax Credits. The philanthropic approach targets those who earn more, but are still struggling to find affordable housing.
When the government provides subsidies, it potentially benefits private businesses or investors as much as it benefits the targeted political demographic which it intends to subsidise in some way. This is why private interests try to influence or capture the government’s decision-making process.
The same thing is also true of charity. Or, as we should now start referring to it, “loss-absorbing capital”. We’ll be closely following the development of these new capital structures.
Gift-a-deed app – Science and Inspiration
Background of Gift -a-Deed
Gift of a basic necessity of food, water, clothing, shelter et all, to a Needy anywhere anytime.
Gift of a platform to enable you do a Good-Deed today, without depending on any one organization or gov’t. This is as they say in sharing economy, “Democratization of Charity”.
Deed of doing good, or simply a Good Deed of helping a fellow human being for basic necessities of life, which nature out to have made it free for everyone.
Even Birds and Animals get the basic necessities of life free from nature, be it a wild Jungle or in vastness of the Oceans; a nest for bird in a Tree, or the wild grass lands for Herbivores animals to graze on or for that matter for a Fish in an Ocean of water.
Why then in a Human civilized world Jungle we have extreme Have & Have-nots.
If we show compassion and share these basic necessities, which Animals have no problem sharing, wouldn’t the world be a better place?
We believe it will be, thus was born the seed of this idea. Do a Good Deed today by Gifting a Need.
Download giftadeed app from your Google Android Play Store now. IOS version coming soon.
Motivational quotes on Giving
1. A Chinese proverb:
“If you want happiness for an hour, take a nap. If you want happiness for a day, go fishing. If you want happiness for a year, inherit a fortune. If you want happiness for a lifetime, help somebody.” For centuries, the greatest thinkers have suggested the same thing: Happiness is found in helping others.
2. For it is in giving that we receive — Saint Francis of Assisi
3. The sole meaning of life is to serve humanity — Leo Tolstoy
4. We make a living by what we get; we make a life by what we give — Winston Churchill
5. Making money is a happiness; making other people happy is a super happiness — Nobel Peace Prize recipient Muhammad Yunus
6. Giving back is as good for you as it is for those you are helping, because giving gives you purpose. When you have a purpose-driven life, you’re a happier person — Goldie Hawn
7. According to Harvard scientist Michael Norton, “Giving to a cause that specifies what they’re going to do with your money leads to more happiness than giving to an umbrella cause where you’re not so sure where your money is going.”
Scientific Research on giving
Scientific research provides compelling data to support the anecdotal evidence that giving is a powerful pathway to personal growth and lasting happiness. Through fMRI technology, we now know that giving activates the same parts of the brain that are stimulated by food and sex. Experiments show evidence that altruism is hardwired in the brain—and it’s pleasurable. Helping others may just be the secret to living a life that is not only happier but also healthier, wealthier, more productive, and meaningful.
Tips on Giving
Here are some tips to that will help you give not until it hurts, but until it feels great:
1. Find your passion – choose what is right for you
2. Give your time – time is better than material things
3. Align your passion and interests
4. Give to organizations with transparent aims and results
5. Be pro-active, not reactive.
The key is to find the approach that fits us. When we do, then the more we give, the more we stand to gain purpose, meaning and happiness—all of the things that we look for in life but are so hard to find.
(Adapted from http://time.com/4070299/secret-to-happiness/
Original article appeared in Time magazine dated 4August 2017 authored by Jenny Santi, a philanthropy advisor and author of The Giving Way to Happiness: Stories & Science Behind the Life-Changing Power of Giving)
Where does “Gift-a-Deed” fit in ‘Giving’
Connecting Resources to Needs
To Connect Needy and Donors
To be the platform of choice for Charities linked to Food, Clothes and Shelter by providing a location based mobile app
To raise awareness of Food resource planning and avoid Food wastage to ensure long-term providence of food for everyone
Any Corporation with excess Food, Water, Clothes
Any household with excess Food, Water, Clothes
Retailers with food, clothes
Charities with excess donations
Target Beneficiaries (Members)
Restaurants , Hotel establishments
Food charities like Soup kitchens, Feeding Hong Kong
Marriage and other catering social events with excess food
Other charity/ NGOs
How does giftadeed app work
Taggers – doing a Good deed is as easy now- by just Tag & Post a Need anywhere anytime, using the Camera icon of the app, choosing the need & writing few words about the need. Just click on submit to post the need.
Tagging uses location based technology on Google maps, similar to the one used by any Car ride hailing app.
Fulfillers/Donors – can Gift a Need by simply using the app to find a Need they want to give.
To find a Need simply by opening the app and finding need icons (for food, water, clothes, shelter ) closest to their location. Just select the need by gently tapping the icon and then simply click on the Map icon on bottom right corner of the Map to take you to the location of the need.
You may choose to display the picture of your gift by clicking on picture icon or by browse through your pictures.
Once a Need is gifted, you may click on the Gift now button. This will send a message to the Tagger that the Tagged need has been fulfilled. The system will also then show the need as fulfilled on the app.
There are 3 winners at the end of every donation of a Gift:-
1. Tagger, who did a Good deed by tagging the needy location.
2. Fulfillers, who did a Good deed by using the Tagged need location to fulfill the need.
3. Needy person who receives the Tagged need directly from the Fulfillers.