Map the System: Youth Suicide Crisis in India

On 15-17 June 2020, the Skoll Centre’s Map the System Competition held its Global Final virtually. The team from Amani Institute competed against 30 other finalists from institutions around the world. Team members Bhairavi Prakash, Maya Narayan, Anshul Agrawal, Neeraja Kulkarni and Tushara Ravindranath tell us how they mapped the system for addressing youth suicide crisis in India.

In February this year, when India had still not experienced the gravity of the COVID19 pandemic, five of us got together and decided to participate in the Map the System 2020 challenge. Although we come from diverse backgrounds, Bhairavi (Psychology), Anshul and Maya (Systems Thinking), Neeraja (Design Thinking) and Tushara (Academic Research), the common thread which connects us together is that we are all young professionals who have spent at least two decades of our lives, being a part of the Indian education system, and have been witness to some of the challenges it exposes students to. The situation has only gotten from bad to worse in the past decade, where roughly one Indian student dies by suicide every hour. Given the alarming rate of deaths by suicide among Indian youth, we chose to explore the various factors that contribute to this crisis.

Secondary Research

We undertook extensive literature review and realised that death by suicide is a complex biopsychosocial phenomenon, requiring a multi-sectoral approach for tackling. We particularly looked at Higher Education Institutions (HEIs) as spaces, where psychosocial determinants play out in myriad ways.

Primary Research

We created an online survey (436 student participants) across different HEIs in India to understand this issue. The survey had questions on factors that impacted student wellbeing, and on coping mechanisms that they used to deal with emotional distress. In addition to the survey, we also conducted 10 in-depth interviews of experts working in the fields of education, mental health policy and practice, funding ecosystem, etc.

Following were the findings from our research:

  1. Complex bio-psycho-social factors can contribute to emotional distress, which can lead to death by suicide.
  2. Young people are open about their struggles with mental health, however, usage of services is low.
  3. Deaths by suicide are found across the spectrum of HEIs in India, not just engineering and medical institutions.
  4. There are barriers to both seeking and providing help, which widens the treatment gap among young people.

Problem Landscape

We used system mapping tools to further analyse the data collected. We identified four major systems that interact to have an impact on one’s mental wellbeing. Interconnections between these systems, further exacerbate the challenges faced by youth, affecting their mental wellbeing.

We also classified the existing solutions in three categories: Knowledge and Awareness, Services and Skills.

Shifting the Burden Archetype

Analysing the current solutions landscape, we found an overwhelming focus on short-term remedial solutions that are easier to formulate and less expensive. This consequently, acts as a barrier to implementing restorative solutions that address the root causes and could have a long-term impact on reducing emotional distress.

Gaps & Levers

We observed multiple political, social, cultural, and economic factors, possibly acting as tipping points that contribute to suicidal ideation amongst young people. Based on these factors, we identified four overarching gaps in the system and 22 levers for systemic change.

Key Learnings from Systems Mapping

  1. Deaths by suicide are symptomatic of larger structural and systemic challenges and completely preventable.
  2. Preventive interventions for youth suicide need to be prioritised in schools, colleges, families, communities, and society at large.
  3. Contextualisation and scalability are important factors for proper understanding of the problem space, and require adequate human and financial capital.
  4. Visualisation of the system by diverse stakeholders can help build a comprehensive narrative that is key to determine the success of interventions.

Way Forward

Being one among the top 31 global finalists at Map the System 2020, was a wonderful opportunity to connect with systems thinkers across the globe, and learn about the complex problems they are working upon.

To further our study and alleviate this challenge, we have applied for a Think Tank Grant. Our goal is to organise an immersive conference and introduce contemplative practices (traditional forms including yoga and meditation, and expressive forms including art, theatre, and movement therapy) for building resilience and emotional regulation in young people.

What’s coming up this year?

The Skoll Centre for Social Entrepreneurship is heading into a new era. Over the summer months, we’ve been busy planning our future. Our main aim, as always, will focus on cultivating the next generation of social entrepreneurs, and the leaders who support them through a complementary set of activities. These activities will aim to strengthen the ecosystem for social entrepreneurs, including academic initiatives that advance the field.

What’s new?

We are excited to launch our brand-new Impact Lab onto the Oxford MBA – a set of complimentary co-curricular programmes for students pursuing careers as socially entrepreneurial leaders. We have developed initial modules for the course which includes topics such as; impact measurement, systems change, and design thinking.

Emerge conference – a fallow year

With a busy term ahead, we’ve decided to take a break from running our annual Emerge conference this year. After ten years of delivery we’re letting Emerge go fallow for 2018, but we hope to be back next year with a bountiful crop of content to excite and inspire!

Skoll Speaker Series

Although Emerge is not running this year, we do have been hosting inspiring lunchtime talks, with more to come this term. These are open to all, so please sign up if you wish to attend.

Events for 2019

We will be partnering with our friends at the Entrepreneurship Centre on the Oxford Saïd Entrepreneurship Forum (OSEF) on Saturday, 2 March. OSEF is for anyone interested in all things entrepreneurial – from pursuing start-up ideas or leading change within an organisation. Register your interest in attending.

Of course, the Skoll World Forum will be back from 9-12 April. We will be hosting several ecosystem events during the week, not to mention the abundance of other Skoll Week activities going on including the public plenaries. Stay tuned for more detail in the coming year.

Follow us for updates

For regular updates, follow us on Twitter, LinkedIn, and Facebook.

You can also sign up to our newsletter to get updates sent direct to your inbox throughout the term!



Meet the Finalists – Map the System Global Final

Montage of all the finalist's institutions

In its third year, the Map the System competition’s Global Final is set to be the biggest yet; with 15 competing teams arriving here in Oxford from six continents.

This competition is a chance for students and recent graduates, of participating educational institutions, to learn more about the issues they care about and present their findings to the world.

We believe that tackling global challenges starts with understanding a problem and its wider context, rather than jumping straight into a business plan or an idea for a quick fix. Participants are asked to demonstrate a deep understanding of a pressing social or environmental issue by mapping out the landscape of the current solutions and identifying missing opportunities for positive change.

27 educational institutions took part in the 2018 competition, with over 470 applications from teams within them. Australia, Canada, Chile, China, South Africa, U.K, and U.S.A are the seven countries represented in the Global Final from 1-3 June.

How will it work?

Each finalist team is made up of students or recent graduates working in teams of up to five, who have chosen a social or environmental issue to “map”. Prior to the presentations, finalists have each submitted three documents as part of the competition: a visual map or chart, a report summarising their research analysis, and a bibliography. Each of these has been reviewed by the judges.

On the day, students will have 10 minutes to deliver their presentation, followed by approximately 5-10 minutes of Q&A from a panel of judges. The purpose of the presentation is to highlight the key insights and learnings from the students’ research of their chosen issue. Each presentation will focus on four key areas:

  • Problem landscape
  • Solutions landscape
  • Identification of gaps and levers of change
  • Lessons learned

After all 15 finalists have presented on Saturday, the judges will select just six to present again in front of an audience on the Sunday afternoon. Then from those final six teams, just three winners will be selected as the 2018 winners, with each team awarded cash prizes of £4,000, £3,000 and £2,000. .

Meet the finalists

Hainan University EYE OF THE AUTISM


Hainan University, China

Humanistic Concern. The team from Hainan University have focused their research on the current situation of social workers involved in autistic families, specifically those living in Haikou City. Their research investigates how to have a positive impact on them, for example, how to improve the child’s condition and family’s economic situation.



Henan University of Urban Construction, China

Environmental Sustainability. This team have researched the urgent needs of mining area reconstruction and urban transformation in Pingdingshan, Henan Province. Pingdingshan is the third largest coal producing base and coking coal production base in China, and hence is causing mass pollution and damage in the surrounding areas.



Mount Royal University, Canada

Healthcare. Roisin has focused her research on the opioid epidemic in Canada, with a particular focus on fentanyl. Many Canadians have passed away as a result of taking illicit substances whilst unaware they are laced with fentanyl, and this research investigates solutions aimed at educating and disseminating information on this topic.



Kellogg School of Management, Northwestern University USA

Peace & Human Rights. The Kellogg-Northwestern team have conducted their research about Colombian child soldier reintegration. Several team members are connected with Colombia or have attended an entrepreneurship course there, and are passionate about children’s rights and the implications on similar global uses of child soldiers.



Royal Roads University, Canada

Environmental Sustainability. Canada has one of the highest rates of food waste annually, and while other countries make policies to prevent and combat food waste issue, Canada remains complacent. The Royal Roads team’s presentation will shed light on these inadequacies and outline the opportunities for impact in this area.



Shanghai Institute of Visual Arts, China

Environmental Sustainability. Team IDEAL have explored ecological co-living residential design in Shanghai. Due to the close proximity of the residential properties to the main industrial area, problems with the environment and health issues in this area are prominent, and so IDEAL have mapped and designed a ventilation solution to help with this problem.



Simon Fraser University, Canada

Healthcare. Bridging the Gap has explored the mental health and mental wellness outcomes of Second-generation Asian immigrant youth aged 14-25 in the Greater Vancouver region. This group experience unique mental health challenges due to the mental stressors imposed by processes of acculturation.


+Chilenas en STEM

Teach for All, Chile

Education and Gender. Evidence has shown significant gender disparities in maths subjects at school where girls tend to get lower results, leading to fewer women participating in STEM careers. The +Chilenas en STEM team posit that part of this gap is produced by gender stereotypes, which can be unconsciously reproduced in the household and in the classroom. This team have therefore investigated a new initiative to work with teachers on gender-stereotype awareness.



Graduate School of Business, University of Cape Town, South Africa

Water and Sanitation. FemWash have looked at menstrual hygiene management and the barriers that women face with respect to water, hygiene and sanitation. They have focused their research on South Africa, particularly the rural areas, such as townships that often lack infrastructure, sanitation and water – but have also examined developing countries with similar geographies to the South African landscape.



The University of Melbourne, Australia

Healthcare. Team Luna Baby have researched the issue of premature birth, specifically looking into supporting parent and infant well-being in Australia. Due to the powerful role that parents play in the development of their premature infants, the team have focused their research on the support given to these parents in neonatal nurseries and how it can be improved.



University of Oxford, UK

Gender Equality. Team Daughters has focused on gender inequality in the U.S. State of Utah. With a team that have deep Utah roots, they have witnessed first hand the impact on gender disparity in their own families and in the community. Their research maps solutions to educate communities and reduce the impact of gender inequalities in this state.



University of San Diego, USA

Emergency Response, Health and Wellbeing. After one team member’s direct experience of working in Thai refugee camps, the University of San Diego team were motivated to examine the issue of fire disasters in Thailand’s refugee camps. Based on their frustration at this seemingly intractable issue, they have endeavoured to understand the system so that potential solutions come from an informed perspective.



Utah Valley University, USA

Environmental Sustainability and Healthcare. Team Lakeridge has researched Utah’s Ogden-Salt Lake-Provo area (the Wasatch Front), and its unique geography that creates ‘inversion’ –  a lid that traps cooler air in the valleys. This layer traps toxic air particles released by natural sources and human activity, which leads to health issues, stifled economic growth, and the general deterioration of quality of life in the region.



Vanderbilt University, USA

Healthcare. The team from Vanderbilt University have focused their research on the healthcare provided to incarcerated persons in Tennessee, United States. The team’s mix of disciplinary backgrounds in law, business, and community psychology has enabled them to recognise the need for a better understanding of the correctional healthcare system, in the hopes of increasing the health of incarcerated individuals and benefitting the overall state of health in the United States.



Watson University, USA

Mental Health. This team has researched the issue of depression and anxiety in American colleges. Motivated by first hand personal experiences of this issue, the team has examined the lack of resources in the current system and has mapped the solutions landscape with a view to positively impact this area.

On the judging panel will be;

Jasmine Lau, a social entrepreneur and educator from Hong Kong, Jasmine is also the Founder and Executive Director of Philanthropy In Motion (PIM).

Odin Mühlenbein, a Partner at Ashoka Germany and Lead of Advisory at Ashoka Globalizer.

Daniela Papi-Thornton, former Deputy Director of the Skoll Centre, and thought-leader in systems change education.

Darian Stibbe, Executive Director, The Partnering Initiative.

Annelies Tjebbes, a biomedical engineer and social innovator.

Chintal Barot, Founder and Director of CoSustain Consulting Limited.

Please join us if you would like to watch the concluding part of our Global Final to Map the System, on Sunday, 3 June. Learn about complex issues facing people and planet, and understand how taking a systems approach to tackling them can identify gaps and levers for positive change.

Register for the Global Final on Sunday, 3 June 12:00 – 5:30pm mapthesystemfinal2018.eventbrite.com

Emerge 2017

This weekend, we welcomed 400+ attendees across two days at the Saïd Business School for our 9th annual Emerge Conference.

People from across the globe came together for what was a jam-packed event, dedicated to showcasing innovation across a variety of trends within the social impact space.

We invited four writers to join us as our Communications Champions to capture the event in real-time using #Emerge17. And guess what? As per infectious disease specialist, Peter Drobac’s welcome speech and corny pun intended, we made it #GoViral!

Here are our four writers’ insights from Emerge 2017:

Claud Williams

Claud WilliamsClaud Williams is a brand consultant, public speaker, and social entrepreneur. He currently serves as the Executive Chairman of the social enterprise Dream Nation, which is re-inventing personal development for millennials.

“We cannot predict the future, but we can invent it”

I had the pleasure of spending my weekend at Emerge 2017. A conference created by the Skoll Centre and the Saïd Business School at University of Oxford, focused on exploring big ideas that are disrupting and challenging unjust systems and practices.

Each session I attended has laid out a blueprint of what is needed to ‘invent’ the future. Although, we cannot say for sure which particular idea or business will eventually become the status quo, these principles should still be universally applicable. The four themes which stood out most to me are:

  1. Leveling the playing field
  2. Useful innovations
  3. Measuring Impact
  4. Building relationships


Katherine Li

Katherine LiKatherine Li is a current MBA student at the University of Oxford – Saïd Business School. Prior to Oxford, she worked with early stage Bay Area, San Francisco, start-ups to enable future growth and is passionate about innovation, technology, and healthcare.

How Virtual Reality is Helping Grow Africa’s New World Wonder

What do global decision makers and an 8-year old Senegalese girl have in common? It turns out that they can inhabit the same space despite the many miles between them.

The initiative in question is an ambitious 8000 km long natural wonder termed “The Great Green Wall.” Their shared experience comes from a VR film entitled “Growing a World Wonder” led by the United Nations Convention to Combat Desertification (UNCCD) in partnership with Surround Vision. But they’re also the first to tell you that VR isn’t the answer to everything. “I know many people talk about VR as the ultimate empathy machine – but for us it wasn’t so much about empathy but about inspiration to see and hear the world from another human’s perspective. I think in that sense. VR breaks the square frame of traditional narratives,” says Alexander Asen, Communications Officer at UNCCD. To craft a compelling narrative, Alex and his team decided to place people at the center of the action, rather than simply speaking to the story through reports and visuals.


Khadeja Ramali

Khadeja RamaliKhadeja is currently an MA student at Soas University of London. She co-founded Project Silphium, which was launched to create a digital space for Libyan women to share their stories and have their voices heard. She is also a Geophysics Graduate from Imperial College London and worked as a Geophysicist in Libya for 5 years.

Shaping the systems and practices surrounding us

We live in a time where we have the tools necessary to make a difference and impact the many systems surrounding us but sometimes we fall short of tackling the big challenges. Through discussions, conversations and exploration, the Emerge conference facilitates the sharing of knowledge and inspiration between members who are already part of the social impact drive in their own communities and participants who want to get involved. At the same time, remembering that we have a responsibility towards the environments that get affected.

“What would you do if you couldn’t fail”

 Andy Middleton set the tone and started off the opening plenary highlighting the need to create networks of people in diverse places and be more focused on the real challenges affecting us. His work at Project Slipstream focused on preparing future generations to be more aware of their environment and food consumption, while teaching them the tools to be able to take on big goals to change the world.


Solene van der Wielen

Solene van der WielenSolene is a History graduate from the Universities of Warwick and Oxford. She uses her research and writing skills to help social enterprises better understand, address, and communicate human needs in the United Kingdom and internationally.

Conversation: An Untapped Resource?

Over the weekend, the halls of Saïd Business School were flooded with entrepreneurs, technologists, journalists, performers, and students for Emerge, the Skoll Centre’s annual conference on social innovation. As could be expected from such an eclectic mix, many quickly found themselves making new and unexpected connections, often an eco-cup of coffee. However the question of conversation was far from confined to the conference hall or corridors of the Business School. Several sessions addressed the importance of connecting with others be it across the social, economic, geographic, or political divide.


, , , ,

The rise and challenges of social entrepreneurship

Skoll Centre Early Career Research Fellow Tanja Collavo hosted a workshop at Marmalade 2017 on the strengths and weaknesses of the social entrepreneurship sector in England… and where next.  

The State of Social Entrepreneurship in England – Strengths, Issues, and Solutions.

What is the state of social entrepreneurship in England? In the course of my DPhil research at Saïd Business School I interviewed key people at social entrepreneurship organisations, revealing a snapshot of strengths, weaknesses, worries and ambitions for the future development of the sector. At this workshop I presented some of my findings and asked participants to give their thoughts and elaborate actionable proposals around the issues most important to them.

The debate was lively! The overall agreement was that the sector is growing, vibrant, diverse, exciting, and constantly changing thanks to the very low barriers to entry. Its core strengths are its ability to break silos across sectors and organisations, and its democratic nature, encouraging bottom-up solutions to social problems and the retention of the wealth produced at the local level. Additionally, the perception is that the quality of products and services delivered by social enterprises is constantly improving and that this is a great business card to increase their market penetration both in the business-to-business and business-to-consumer markets. In this sense, many workshop participants welcomed the shift of the sector towards business and believe that more and more social enterprises should aim to become business-savvy and competitive.

But participants also agreed that there are still many key issues holding back the growth and success of the social entrepreneurship sector:

  1. No one talks about failures

There is very little learning inside the sector because media, intermediaries, social entrepreneurs and enterprises talk a lot about successes but hardly ever about failures.

  1. The passion paradox

Most ventures start because of founder’s personal experience with or passion for the problem they are trying to tackle. This has obvious positives but also can lead to a “do something now” mindset promoting easy solutions and immediate action more than the elaboration of long-term strategies. Further consequences can be the lack of professional sectoral knowledge and lower inclination towards collaboration due to high levels of personal ownership and commitment, also associated with stress and burnout.

  1. Difficulty accessing supply chains

A third issue present in the sector is the low presence of social entrepreneurial organisations in supply chains, both in the business and in the public sectors. In fact, in most cases, social ventures are too small to bid for contracts and too young to have a proven track record that would facilitate their winning supply or service contracts.

  1. Too dependent on government and poor finance

Participants described the sector as still too reliant on government and as lacking appropriate financial support matching its funding requirements and specificities. Financial support was described as particularly scarce at regional and local level, with core sector and financial intermediaries being based in London and mostly focusing on organisations and areas geographically close to them.

  1. Lack of collaboration amongst support organisations

Finally, the group agreed on one of the main findings of my research projects: the lack of collaboration among sector intermediaries. This leads to a duplication of efforts and to a degree of confusion among social entrepreneurs and enterprises about where to look for support and how to reconcile the different messages they hear from the different intermediaries they are affiliated with.

Out of this list of issues, the workshop participants picked two areas that they thought were especially relevant in order for the sector to keep on thriving: the access of social enterprises supply chains in private and public sectors, and the low collaboration among sector intermediaries.

Social entrepreneurship in supply chains

The group tackling the issue “access to supply chains” found several core causes for this issue. Some causes can be attributed to failings of social enterprises themselves:

  • a lack of transparency and metrics that would lower the perceived risk of social ventures;
  • a low understanding of tender processes;
  • and the inability of social enterprises to scale and integrate or collaborate in order to bid for big projects and commissions.

Other challenges are created by the surrounding ecosystem:

  • procurement practices and contracts that do not favour the involvement of social enterprises and small organisations in supply chains of corporations and public bodies;
  • the existing regulatory environment;
  • and the still low recognition of the value and specifies of social enterprises outside of the sector.

Proposed solutions to improve the situation relied on the involvement of social entrepreneurs and enterprises and/or in that of sector intermediaries. Social entrepreneurs and enterprises should, with the help of intermediaries, lobby both the government for changes in legislation regarding tendering processes, and private companies to convince them about the possibility to collaborate with social enterprises to enhance the sustainability and credibility/effectiveness of their CSR practices. Furthermore, on their own, social entrepreneurs and enterprises should collaborate to win contracts and present stronger evidence about their performance and competitiveness, which would reduce the perceived risk for procuring organisations. Finally, sector intermediaries and research bodies should: analyse where the Social Value Act has worked; prove the benefits of values-based supply chains; and ensure social ventures involvement in supplier network platforms like Ariba.

Increasing collaboration amongst intermediaries

The second group of participants decided instead to work on the problem of low collaboration among social entrepreneurship sector intermediaries. The origins of this situation can be found in the presence in the sector of multiple umbrella bodies and intermediaries that publicly state that they are cooperating and collaborating with one another but in reality are very territorial and not interested in what other intermediaries do because “they occupy a separate niche in the sector”. In addition, many intermediaries have very specific views and beliefs about the definition of social entrepreneurship, about what the sector should look like, or about its role in society. This makes it difficult for them to really collaborate beyond sporadic cooperation for specific projects and events.

In this case, the proposed solution was to start from existing successful platforms involving several intermediaries (such as the Social Economy Alliance) and create a “network of networks”. This would have shared ownership and governance, would avoid exclusive definitions, and would initiate collaborations among different organisations around specific projects, such as “improving the access to supply chains for organisations in the social economy”. Cooperation on specific projects could be a starting point to create trust and a mutual understanding. At the same time, this “network of networks” should map out all the different intermediaries present in the sector and develop an online list differentiating organisations according to their core competences and easily accessible for organisations interested in obtaining support from the ecosystem. The creation of such a database would simplify the research process for individuals and organisations in need of help and would create the opportunity for intermediaries to understand where their respective strengths are and, thus, for sharing best practices and outsourcing to each other non-core activities.

What’s next?

The meeting finished with some networking and the hope that these solutions could lead to some concrete initiatives in the sector as well as to other opportunities to meet and discuss also the other issues present in the sector and ways to solve them in a collaborative way. Is anyone there up for the challenge? From my side, the door is open to anyone willing to know more or to jointly organise something along these lines to help the social entrepreneurship sector as well as other parts of the social economy grow and thrive even more.

Want to learn more about the interconnected networks within social entrepreneurship and social enterprise? Come along to Tanja’s talk ‘Networks in social entrepreneurship – how to support the sector while mobilising it‘ on Wednesday 17 May, at the Saïd Business School, Oxford.

, ,

Who wants to be sexy, anyway? How ignoring the boring bits of global health costs lives

Global Health: Getting from Innovation to Implementation panel

Forging Common Ground – Series of Oxford Student Insights to the Skoll World Forum 2017.

Oxford DPhil candidate in Philosophy, Michael Plant, gives his perspective on the  Skoll World Forum session “Global Health: Getting from Innovation to Implementation”.

As you start the marathon, crowds cheer you on. They’re with you for the first mile. And the second mile. Now you’re at the 15th mile. You hit the wall. You need support to keep you going –  a glass of water, a single cheer – but no one’s there. Who wants to watch the middle of a long race? You know they’ll be crowds to cheer you across the line, but that seems very far away.

This, argued Barbara Bush, founder of Global Health Corps, is an uncomfortably apt analogy for the problems facing global health as it tries to move from innovation to implementation. People get excited about the start: creating a new vaccine. And people can get excited about the end: making sure that vaccine travels the last mile and gets to the child who needs it.

Yet, in the long distance between those two, cheerleaders are thin on the ground. It’s very hard to get people interested in improving health systems, scaling up interventions and finding better ways to distribute medicines around the world.

Why? Systems simply aren’t sexy, unsexy things get ignored, and so millions of people die or suffer from health conditions we already have the technology to solve.

Hence the question Barbara posed to the three experts on her discussion panel: if we want to improve the ‘unsexy middle’ of global health, what should we do?

Steve Davis, CEO of PATH, argued healthcare innovators should be designing with scale in mind and the road to scale is mostly clearly through health ministers, rather than patients or funders. For instance, there’s little point creating a new drug so expensive developing countries can’t afford it.

Yap Boum of MSF added progress is often slow because locals aren’t invited to be part of the innovation process. How much better could NGOs be if they had locals on their boards who understood the country?

Surgeon and public health researcher Atul Gawande agreed going from ‘zero to one’ – inventing something – was valued much more by funders than taking discoveries and bringing them into the existing systems. At least in part, this is because discoveries feel much more tangible. He suggested a way around this is for funders to focus on scaling an innovation by one order of magnitude at a time, seeing each as a serious and independent goal. Pioneering a new procedure in one clinic should be thought of as a victory. Getting that procedure from 1 to 10 clinics is different second achievement requiring different methods, getting it from 10 clinics to 100 a third, and so on.

As panel discussion moved to questions, the audience wanted to understand why there wasn’t more collaboration between all the different organisations. If so much of global health is just a co-ordination problem, why haven’t we solved it yet?

The problem, it seems, is people having priorities. If, as Atul shrewdly noted, the US can’t even agree on whether to provide subsistence healthcare in their own country, how could we reasonably expect NGOs, governments and donors to all be effectively pulling in the same direction on global health? He suggested we need a unified metric, or yardstick, to compare different potential health priorities and reveal the top priorities.

Two things struck me from the conversation today. The first was: if we’re worried we’re overlooking things because they’re not sexy, what else are we ignoring?

As someone who’s interested in how best to increase happiness – or put another way, how best to reduce misery – I had hoped mental illness would have been a bigger part of the discussion. Research suggests mental pain can, and often does, have a bigger effect on self-reported happiness scores than physical pain does. What’s more the way standard health metrics, such as ‘QALYs’ (Quality-Adjusted Life Years), are constructed fails to adequately capture the badness of mental illness (see Dolan and Metcalfe 2012). Perhaps due to the stigma, measurement issues, or the complexity of treating them, mental illness is the marathon almost no one is even watching.

Second, if we need to agree on a single metric so we can prioritise resources in global health, it seems obvious to me the right metric is happiness. I take it we don’t value health just for its own sake, but because it helps us live longer and enjoy our lives more. Not all health conditions make people unhappy and, where there’s a choice between reducing unhappiness or ill-heath, we should target misery. Whilst some may worry happiness is too ‘fluffy’, the evidence suggests ‘subjective well-being’, as it’s often called, can be reliable measured. The OECD now recommends countries collect data on it.

Neither improving healthcare systems or mental health care are particularly sexy, which is why they’ve been overlooked. However, as Steve Davis said at the close to the session: our outrage at avoidable deaths and suffering should drive us to do better.

Michael Plant is a DPhil Candidate in Philosophy, CEO and Co-Founder of Hippo. Read more from Michael at www.plantinghappiness.co.uk.

Follow Michael: @michaeldplant