From Farms to Forests: Land Rights as an Impact Multiplier

Each year the Skoll Centre invites a small number of Oxford students to the annual Skoll World Forum on Social Entrepreneurship. Each year they share their unique perspectives of the sessions and events that unfold during this magical time in Oxford.

In a social enterprise space dominated by philanthropic or investment dollars that are often chasing the latest innovation, it is easy to overlook a time-tested conservation strategy that costs close to zero – supporting indigenous land rights.

Panellist José de los Santos Sauna Limaco is a tribal leader and governor of the Kogui Arhuaco indigenous reserve in Colombia. He could hardly have appeared more different from your typical social entrepreneur, but his community and others like it are on the front lines of conserving some of the world’s most biodiverse ecosystems.

José de los Santos Sauna Limaco

As other panellists pointed out, indigenous reserves often produce better results than national parks, drastically reducing deforestation while costing governments and the international community virtually nothing.

Kogui Arhuaco Indigenous Reserve in the Sierra Nevada of Colombia

As the spread of technology and consumerism accelerate and rainforests disappear, the traditional livelihoods of tribal communities may seem like a thing of the past. However, this largely depends on indigenous people’s land titles and tenancy laws, even if these laws do not fully reflect the cultural and spiritual importance of the land. Gaia Amazonas CEO Francisco von Hildebrand has worked for 30 years to protect an indigenous reserve the size of Greece in the rainforests of Colombia, ensuring that nations such as the Kogui Arhuaco will have a future. Hildebrand remembers that “Indigenous leaders didn’t understand how a piece of paper could mean ownership of the land if it belongs to birds, trees, and flowers.”

Protected Lands have grown in Colombia from 2009 – 2019

Chris Jochnick, CEO of Landesa, pointed out that most of the poorest people in the world are rural, depend on the land for their livelihoods, and don’t have secure rights to the land. For first world audiences, it can be hard to understand the full damage done to indigenous people whose land is routinely damaged or taken away by governments and business interests such as mining and oil. “Would you put a new roof on your house if it might be taken away? Once you give the land a title, it changes the incentive structure. It changes the whole cycle of development outcomes.” said Jochnick.

However, truly recognizing indigenous voices can sometimes mean questioning the paradigm of development itself. Ralph Regenvanu, who has served as a member of Parlament and Minister of Lands of the pacific island Republic of Vanuatu, helped restore the customary rights of indigenous people in his country. He has also been involved in efforts to decolonize development indicators in order to better reflect the quality of life in a non-cash traditional economy. Although international organizations can use their own metrics, Vanuatu demands that they also include 3 measures in their analysis: Free access to land and resources, traditional knowledge and practice, and vitality of communities. Vanuatu is also studying Bhutan’s Gross National Happiness Index.

Even as the world faces critical new threats to rainforests and indigenous lands, persistence and certain victories by indigenous organizers are still a reason for hope. Panellist Jennifer Corpuz described the struggle of her community of Kankana-ey Igorot people in the Philippines against a dam funded by the World Bank in the 1970s – 1980s. The project was successfully blocked by years of activism, but new Chinese investment has reignited the struggle to protect Karinga lands and homes. Jennifer said that this project is arrogant because “The land will outlive us. We are just borrowing it from future generations.”

Jennifer Corpuz

The clash of cultures was on full display when José de Los Santos was asked how he measures the wellbeing of his people. He replied that although he is aware that scientific tests demonstrate that his community has clean water and pure air, for his community these tests are not necessary because they have their own ways of knowing the territory that is their spiritual home. He said “The very water itself will speak to us. The earth will speak to us.” 

About the Author

Alexander Wankel

As founder of Kai Pacha Foods, Alex launched the first plant-base milk made with native quinoa and tarwi – two climate-smart miracle crops scalably produced by smallholder farmers in Peru using regenerative agriculture practices. As a current Skoll Scholar, Alex hopes to use his MBA to support a more biodiverse food system while supporting local land rights in Andean communities.

The Promise and Peril of ‘Tech for Good’

Each year the Skoll Centre invites a small number of Oxford students to the annual Skoll World Forum on Social Entrepreneurship. Each year they share their unique perspectives of the sessions and events that unfold during this magical time in Oxford. Our fellow, Grace Mzumara recounts the Skoll World Forum Debate where six panellists argued for and against the motion, “This house beleives that ‘Tech for Good’ is a false promise”.

How would you explain the world today, to the world that was, a hundred years ago? I imagine my wide-eyed self, sharing the marvels of modern day transportation and music from the little box in my hand that also, buzzes with ‘likes’ from humans I don’t know.

Well, in the chambers of the nearly 200 year old Oxford Union debating society, hosting the 2nd debate of the 16th annual Skoll World Forum on Social Entrepreneurship, the conversation is easy to picture. On the other hand, what would the world a hundred years from now, make of the world we are creating? With technology at the core of how we industrialise, will we have delivered on the promise of ‘good’?

While acknowledging that technology is here to stay, and shape the world we know, the proposition built their case around the powers that drive it, and the inequalities it creates or sustains. Tanya O’Carroll, co-founder of Amnesty International’s global technology and human rights programme, opened with her confession of a ‘failed’ mobile application. She made her case on the public trust that technology has taken away. With examples of private companies like Amazon and Facebook, compromising our information and privacy, Tanya described how little is done to protect people from the powers that exploit the industry.  

Additionally, the second proposition speaker, Dr Mariarosaria Taddeo from the Oxford Internet Institute, made her case on the unintended consequences of technology. She described the malleable nature of technology, to be used for bad even when intended for good. She adapted a Winston Churchill quote to mean that ‘we build technology, and technology builds us’. Dr Taddeos’ analysis showed that the promise of good depends on the ability of the society to provide it. She warned against wishfully thinking that technology generates a good in isolation of its drivers.

Tom Adams, the co-founder of 60 Decibels led an equally compelling case for the opposition. He argued that the loss and benefit scale of technology favours the benefit, even more so, for marginalised populations. He called for leveraging the ability and responsibility of societies to transform technology to become a tool for public trust. Toms analysis looked at transforming capitalism with impact investing and social accounting to meet public needs.

Chi Nnadi of Sela Technologies speaking for the opposition

Public needs being met in all parts of the world, by facilitating communications across socially or economically divided groups was the central argument for the second opposition speaker, Chi Nnadi, founder and CEO of Sela Technologies. He shared the story of how a WhatsApp group and mobile phone pictures were central to managing oil pollution in the Niger delta. Chi argues that technology has harnessed the power of information and communication to re-organise ourselves. This reflects our evolution as a society and our ability to make technology evolve for us as well.

In Oxford fashion, the first four debates were followed by six audience speeches for and against the motion, in what is called the ‘floor debate’. The audience was clearly invested in the motion, with propositions tackling issues from romanticizing technology in thinking apps can solve everything, to discussing the inequality of money as a need for and driver of technology. The opposing participants fought back. They argued that technology has become an extension of ourselves and advocated for social ethics to curb what ‘bad’ technology.

Oxford alumnus, Tarun Varma of Lego Foundation, was one of the speakers from the floor.

With two speeches remaining to the vote, the closing speakers were set to draw the split audience, each to their side. Closing Proposition speaker, Sean Hinton from Open Society Foundations, focused on the increasing inequalities caused by technologies. He argues against the technology utopia saying, ‘our belief in the promise of technology, can undermine our strife to understand societal concerns’.  Sean concluded with a powerful argument, stating that the economic arc of technology disproportionally excludes the poor and the old, and that these were the central failures, on the promise of good.

Sean Hinton of Open Society Foundations closed the argument for the proposition side.

I couldn’t imagine a better rebuttal from the propositions points than when Shashi Buluswar, CEO of the Institute for Transformative Technologies, took the stage with a seed, a vaccine vial, a DNA reader, and well, a ‘pretend’ bag of mosquitoes. He showed how each one of these objects represented a promise of good, that was kept. From sustainable agricultural technologies, vaccines saving millions of lives, to technologies combating drug resistance by accurately detecting bacteria. Shashi Buluswar made an unexpected speech, using existing technologies for good, as evidence of the good in upcoming technologies.

Shashi Buluswar of the Institute for Transformative Technologies gave a powerful closing argument for the opposition.

With such a compelling presentation, it is perhaps no surprise that the opposition, the ‘noes’ had the day for the 2019 Skoll World Forum Debate. It displays the understanding that technology is central to how we operate in the world today, and the hope we have, in generating public good in these operations. This year, all Skoll Awardees are technology-based, with one even solving problems created by technology. It shows our willingness to participate in this form of industrialisation, and our eagerness to harness our intrinsic power, to fight for the good in our era of development. I believe that this good will span centuries of generations to come.

About the Author

Grace Mzumara

Grace Mzumara is a Malawian medical doctor reading International Health and Tropical Medicine at the University of Oxford as a Weidenfeld and Hoffmann Scholar.

Follow Grace on Twitter.

Fighting for Fairness: Investing in Local Solutions

Each year the Skoll Centre invites a small number of Oxford students to the annual Skoll World Forum on Social Entrepreneurship. Each year they share their unique perspectives of the sessions and events that unfold during this magical time in Oxford.

The problem: How to make donor-grantee relationships more equitable?

The solution: We don’t need to keep talking about it, we just need to do it

The “Fighting for fairness: investing in local solutions” panel is the most practical event I attended at the Skoll World Forum, and given who was in the room, it could very well be the most actionable. Nothing I heard was new, but how I heard it, and whom I heard it from was both humbling and hope-inducing.  

The session was facilitated by Andy Bryant, Executive Director of the Segal Family Foundation, Atti Worku, founder and CEO of Seeds of Africa, and Solomon Benge King, Founder and CEO of Fundi Bots. They spoke very little, a few words to open and close, framing an hour long workshop to address the uncomfortable question of the relationship between donors and grantees, or ‘doers’ as they were referred to throughout the session.

The audience, a mixed bag of donors, doers and “others”, broke into small groups, utilizing this safe space to share their perspective on:

  1. The challenges to initiating partnerships between local organisations and donors
  2. Balancing the power dynamics between donors and doers
  3. Feedback mechanisms in partnerships

Post-its, flipcharts and designated group spokespeople made it all feel very actionable. A useful ruse to keep us from fading, post lunch on day 3 of the Forum.

Blurring the line between donor and doer

My group had two doers, five donors and three ‘others’ (yours truly included), but most interesting of all, many amongst us were mixed -persons who had long been doers and recently became donors, or straddled both identities in some way or another. Seeing that the line between doer and donor is, (and should be), blurred was one of the most important takeaways. Whilst acknowledging the asymmetrical nature of the donor-grantee relationship is necessary, this barrier could be diluted by changing how both sides communicate with, and posture vis-à-vis each other. Andy Bryant summed up the rationale quite simply: “it’s all about the math:  how to reach more problem solvers, who can solve more problems, more effectively?”. Changing power dynamics then, is about shifting mindset; both for donors, who could do more to valorize the expertise that grantees bring, and for doers, who must themselves muster the courage to stand their ground and view themselves as experts.

The quest for ‘trust’ by way of flexible criteria and networks

Inevitably, ‘trust’ was cited frequently in a session like this one. Having worked in peacebuilding for the biggest part of my life, the ‘T’ word tends to give me chills, as I anticipate the empty rhetoric that can accompany such an emblematic, yet abstract concept. It was a pleasant surprise then, to come out of the session with a list of tangible ways in which trust could be fostered between donors and doers. Two simple yet powerful recommendations were for donors to create flexibility in their criteria for partner selection, and for stakeholders to find ways to share information.

Recommendation 1: “Just fix your criteria, we actually have the power to do that!”.

Many of the doers in the room recounted situations in which they had become frustrated by the fact that potential donors would applaud their work but hold back on funding because the organization did not meet all the grant criteria, whether in terms of organizational structure or areas of intervention. Donors too, especially those from larger organizations, pointed to the rigidity of criteria or complexity of decision making processes as a key barrier to identifying new partners or more locally embedded partners. As a result, grants tend to get distributed to a band of “usual suspects” who often go on to act as gatekeepers to other organisations or entrepreneurs in their communities. A genuine commitment to local solutions requires some appetite for risk: gambling on unknowns and allowing some margin of initial failure.

Recommendation 2: Opt for a  collaborative, rather than silos-inducing competitive organizational culture

Donors with positive experiences of local partnerships emphasized initial, and continued investments in learning about the context and most importantly of its actors. That process is often costly, and as contexts become more remote, the cost and unreliability of information tends to increase. Working through geography or sector specific networks of doers and donors provides a means of sharing information but also of creating rapport beyond the confines of the donor-grantee relationship. These networks also create opportunities for interactions which in turn cultivate the types of relationships needed to build trust.

Ready, set.. Go

These would have been good, but merely aspirational thoughts, had we been a group of students in a classroom, or even just a group of social entrepreneurs speaking amongst ourselves. But we were not. The people in the room were the ones with the decision-making power, and so, there is a great opportunity to enact the expert knowledge of our facilitator (and doer), Solomon King, who shared his life mantra to “talk little, and just move on to action.”

About the Author

Anupah Makoond

Anupah Makoond is pursuing an Msc. in Evidence Based Social Intervention and Policy Evaluation at the University of Oxford. She has spent the last five years supporting peacebuilding and humanitarian initiatives in East and West Africa, Central America and South East Asia.

Confronting the hard truths of impact investing

Each year the Skoll Centre invites a small number of Oxford students to the annual Skoll World Forum on Social Entrepreneurship. Each year they share their unique perspectives of the sessions and events that unfold during this magical time in Oxford.

As a young impact investor, I was introduced to a strange new lingo that included “additionality”, “doing well by doing good”, “patient capital” and the “triple bottom line”. I was excited by the possibilities of social enterprise and investing money for good, but also exposed to some of the contradictions and challenges of impact investing that these opaque terms and phrases can conceal. How can I support the most impactful projects and businesses when my capital provider demands a “market return”? Must I accept a tradeoff between impact and returns? When does capital need to take extra risk? And what should entrepreneurs do when their business is too small for larger funds, and too large for early-stage venture capital, falling in the so called “missing middle”? These were among the thorny questions that a brilliant panel of investors and entrepreneurs wrestled with at the 2019 Skoll World Forum’s “Unleashing Conscious Capital” session.

The session brought together some of the brightest lights in impact investing:

  • Jacqueline Novogratz (@jnovogratz), the founder of Acumen and a legendary figure in the impact investing space, brought to the discussion a sense of optimism backed by decades of results and experience.
  • Sean Hinton (@seanjhinton), a Director of the Economic Advancement Program at the Open Society Foundations, brought a mix of levity and honesty, challenging the panel to think critically about the tradeoffs inherent in impact investing.
  • Michelle Arévalo-Carpenter (@michelleAC1), founder of IMPAQTO, shared stories of the many Ecuadorian companies she supports who have struggled to find willing investors.
  • Perry Chen (@perrychen), founder of Kickstarter, was direct and honest about the perceived absence of impact investors willing to take risks on unique, multi-bottom line businesses like his.
  • Bart Houlahan (@BCorporatio), co-founder of B Lab, moderated the panel, interspersing it with the wisdom he’s accrued as a leader of the benefit corporation movement.

Is the market working for entrepreneurs?

First, the panelists delved into the state of play for social entrepreneurs who seek impact investment. To the question “is the market working for entrepreneurs,” we heard a resounding “no” from Kickstarter founder Perry Chen. He’s built a high-profile, highly impactful business – over $3.5 billion raised and distributed to over 150,000 creator-led projects – but says he struggles to get investors to support the lean entity that facilitates this impact, the Kickstarter platform itself. Why, he wondered, is there no middle ground between trying to be a high-growth unicorn, and remaining eligible for grant funding? He was essentially describing a tradeoff for entrepreneurs – if you want to be something other than maximize profit, it will make selling yourself to investors trickier.

Michelle echoed some of the same concerns. Entrepreneurs in small markets like Ecuador, where IMPAQTO works, can’t sell a grand vision of rapid scaling to investors and grantors, and capital is often not interested in making small deals. She sees 90% of startups she works with as sitting in this “missing middle”, too small for the smallest ticket size available from Latin American funds (companies with $150k in revenue), but too large for early-stage funding.

Perry Chen also sees a lot of “conscious capital” going to what he calls “harm mitigators” or “green dry-cleaners”. That is, enterprises that target established industries where they can make a lot of money, but do so in a more sustainable, less harmful way.

Sean Hinton essentially agreed, facetiously referring to the time “when Bono and TPG invented [impact investing] a few years ago.” Essentially, new entrants to the space are still enamored with the idea that you can have your cake and eat it too. Not so, he claimed. There is often an inherent tradeoff between impact and returns, and that’s where philanthropy and patient, risk-tolerant impact investment capital is necessary to get certain industries and enterprises off the ground. Just as the film industry often produces sequels as guaranteed hits, so too do investors of all stripes like to follow in others’ footsteps rather than be the first person to fund something creative and risky. This can also lead to well-intentioned investors doing bad deals. The Economic Advancement Program he leads has therefore made the decision to fund high-risk sectors with little prospect of a commercial business model or massive exit, investments that a pension fund investor could never even look at.

Jacqueline concluded with a call for a new definition of what makes a “real” investor. It’s no longer enough to only validate those who obtain the highest returns. We need to acknowledge those who have the most impact. Some are concerned that this amounts to donors subsidizing capitalists. But Jacqueline was adamant that there is a role for those willing to take a first loss position, and there are some sectors (e.g. smallholder farmer venture capital fund for sub-Saharan Africa) where overall returns may be in the negative double digits, and we simply need someone to pave the way for more impact (and eventual better returns) down the line.

Hard truths of impact investing

From the investors on the panel, we heard some refreshingly forthright insights into the challenges of investing for good, addressing some of those tricky questions that are too often avoided.

Both Sean and Jacqueline were open about the fact that they do see a tradeoff between impact and return for some high-risk, highly-impactful sectors. Second, they alluded to the difficulties of investing “patient capital”. With very long time horizons required to realize returns in some high-impact deals, it becomes difficult to motivate talented investment teams who have their personal investment track records and career arc to consider. Sean also highlighted some other difficulties investors face, from the lack of proximity between decision makers and impact, to the vested interests lobbying against DFIs and impact investors investing in any concessional way in the name of not crowding out private investors. These same private investors have themselves failed to fill key gaps, whether that’s funding clean drinking water or basic medical services.

This brings us to the final hard truth about impact investing, which the panel didn’t discuss explicitly but which must be acknowledged at a Forum dedicated to social entrepreneurship. These enterprises are often plugging holes and providing services that governments should be providing, and that don’t lend themselves to a profit-driven model. This is common both in the developing world, where weaker institutions have failed to provide basic services required for a healthy life, and in OECD countries where conservative activists have gutted public services through waves of privatization. The impact investor faces a tricky dilemma: are there times when they shouldn’t invest in social enterprises, because doing so absolves governments of upholding basic elements of their social contract?

What did we learn?

From Michelle Arévalo-Carpenter and Perry Chen’s firsthand accounts, it was clear that the “missing middle” is real. Sean also pointed out that it can be a moving target: “the ‘middle’ has been following me around my whole career”. But an audience member aired the fact that inside the impact investing community, you might be forgiven for thinking that the problem was exactly the opposite: a dearth of investable deals, not a lack of willing capital! Why do entrepreneurs think there’s no capital, and investors think there are no deals? Who is right?

Jacqueline Novogratz left us with a positive conclusion: if capitalism is a religion, we don’t have to be atheists to push systems change in the way capital flows to good ideas with impact. She thinks a moral revolution, in which we redefine investing success to include impact, is possible. It starts with communicating the stories of what deep impact can achieve and being honest with investors about what it means for conscious capital to seek to create it. What shone through the panel was an optimism that capital can in fact be “conscious”, supporting breakthrough social enterprises and projects with a range of grants, investments, and hybrid forms. However, the challenges and contradictions of impact investing haven’t gone away. The panelists were unanimous in recognizing that some brave philanthropists and impact investors need to take on the extra risks (and potentially extra losses) that come with supporting some of the cutting edge impactful work of social entrepreneurs.

About the Author

Eli Mitchell-Larson

Eli is a social entrepreneur and impact investor working to achieve a negative carbon future. He is currently a candidate for an MSc in Environmental Change & Management and an MBA at the University of Oxford.

Photo credit: Skoll Foundation

Yes, and…

Each year the Skoll Centre invites a small number of Oxford students to the annual Skoll World Forum on Social Entrepreneurship. Each year they share their unique perspectives of the sessions and events that unfold during this magical time in Oxford.

The promises and limitations of using comedy as a tool for social change

What do you get when you cross social impact with jokes? At the risk of burying the punch line – some good things! But it’s complicated…

This morning, participants at the Skoll World Forum explored the power that comedy has to highlight social issues and drive behavior change. Caty Borum Chatto, Omri Marcus, Erika Soto Lamb, and Fenella Kernebone led us in a discussion of when comedy has supercharged social movements, but also touched on challenges that merit further attention.

Comedy is a foundational element of drama, and as we all know, drama captures public attention and imagination. While activism has long highlighted the tragedies around us, the panel showed us that comedy is an underutilized tool. In fact, it’s a tool that allows us as changemakers to stir some of the most important emotions for action – hope and optimism – in our target audiences. Comedy also serves as a gateway to talk about serious, and sometimes taboo, topics. In an age where there are ever increasing demands on our attention, comedy holds real potential for getting people to pay attention to the most important issues.

Yet like with any tool, comedy must be deployed carefully and strategically. As the panel pointed out, using comedy effectively in social change work requires a collaborative give and take between comedians and activists. Lean too heavily on the comedy, and while the result may be entertaining, it won’t help solve a social problem. Lean too heavily on the social problem, and what’s supposed to be comedy will no longer be funny.

However, I think there’s an even more important consideration changemakers must keep in mind with using comedy, and that’s clarity on target outcomes. The panel touched on the point that there are different genres of comedy that are best suited to different outcomes. For example, Borum Chatto pointed out that satire has been very successfully used to coalesce identity and solidify a base. Political satires like the Colbert Report immediately comes to mind, but here’s the thing: in a world of increasing divisions and identity politics, is solidifying into separate bases really the outcome we need to create change?

In contrast, Borum Chatto lifted up episodic narratives as a more effective genre for changing people’s hearts and minds. She pointed to the example of Modern Family and other sitcoms featuring gay characters playing a role in changing mainstream social opinion about gay marriage in the US. Such “edutainment” is a powerful contributor to behavior change, but I think it can also magnify differences that already exist; according to the New York Times, people in American cities, where gay marriage is generally more accepted, watch Modern Family, while Duck Dynasty, whose star is vehemently against gay marriage, is far more popular in rural areas.

As an enthusiastic (amateur) improv actress, and an aspiring social entrepreneur, I found myself shouting “yes, and!” in my head at the end of the panel discussion. Comedy is powerful, and it is underutilized in social justice work. And…we need to do more experimenting with comedy, to make sure we’re not solidifying a base, but also connecting with the people whom we find incredibly hard to convince. 

About the Author

Laura White

An aspiring early child education social entrepreneur, Laura’s career has focused on empowering young children and their families. Before joining the MBA programme at Saïd Business School, “Ms. Laura” taught three and four year-old students as a preschool teacher for the District of Columbia Public School.

Photo source: Skoll Foundation


Accelerating Global Health Delivery

Each year the Skoll Centre invites a small number of Oxford students to the annual Skoll World Forum on Social Entrepreneurship. Each year they share their unique perspectives of the sessions and events that unfold during this magical time in Oxford.

This session conducted by the leadership team of Partners in Health was scheduled for 7 am on the 10th of April. Hence by design it self-selected for individuals who were extremely motivated to learn from the experience of Partners in Health in Global Health Delivery.

Partners in Health (PIH) is a Boston-based nonprofit health care organization founded in 1987 by Paul Farmer, Ophelia Dahl, Thomas J. White, Todd McCormack, and Jim Yong Kim.

The organization’s goals are “to bring the benefits of modern medical science to those most in need of them and to serve as an antidote to despair.” It provides healthcare in the poorest areas of developing countries. It builds hospitals and other medical facilities, hires and trains local staff, and delivers a range of healthcare, from in-home consultations to cancer treatments.

The session was led by Dr. Joia Mukherjee, and was facilitated by her colleagues Dr. Gary GottliebDr. Abera Lotha

The session delved into a nuance in global health delivery which are often ignored. Dr. Mukherjee asserted that the successful delivery of healthcare ought to be reviewed through three lenses.

  1. A justice framework
  2. Human rights framework
  3. Social determinants of health framework

The first two are not given their due share of discussion since perhaps as healthcare professionals we feel this is beyond our scope of work however, they are essential to an equitable delivery of good health for all.

The justice framework requires retrospective reflection. Many of the inequities we observe as global health delivery agents are not just because people who we aim to benefit do not know better or that there is lack of will to correct the structural problems that exist. Instead, the source of these issues come from a history of colonization, practices of slavery and exploitation of certain regions by others. The damage from these unfortunate parts of our collective history is immense. While these chapters of history cannot be undone, it would not be prudent to completely forget about these issues as important causative factors towards why certain regions struggle to this day with diseases that the developed world has long overcome. Hence, keeping them in our purview as we think about global health would ensure such injustices are never repeated.

The second framework is the human rights framework. Today we live in a world where almost everything we do, any service we receive or any item we own has input from many different regions. This is especially more applicable to the socioeconomic strata attending this forum or can read this narrative that I write today. When we live in a globalized world of commerce then a question that arises is why our human rights are different depending on national borders. What would be considered exploitation in one country would be considered fair trading practices in another. The world is much more comfortable with utilitarian notions of healthcare service delivery for the poor but not the same yardstick is applied to the wealthy. These are deep-seated, class-based biases that ought to be brought out in the fore and the repercussions of these biases need to be corrected or else the inequities we wish to overcome will always plague us in some way or form. This philosophy of healthcare delivery is reflected in the work of Partners in Health throughout the world. They believe all that they interact within their ecosystems are owed a similar chance towards healthcare services.

Finally, the social determinants of health were also discussed. This is an area quite often discussed and debated on in Global Health conversations. The impact of where you are born, your gender, your education and such all impact health outcomes. This has been researched and well documented. Dr. Mukherjee added a nuance to this conversation though. She proposed that instead of calling it social determinants of health we should label this effect the social forces of health since these socioeconomic markers are not just a correlation but have vector component to them as well hence the relabeling to a “force” would more accurately depict the relationship.

One of the key takeaways from this session was that healthcare is clearly a political and a social issue. And in our respective communities, to enable meaningful healthcare change we must interact deeply with the social and political forces. Meaningful change requires mobilization and that’s only possible once we put our skin in the game by operating beyond our healthcare facilities and embed ourselves intimately with the wider community.

About the Author

Mohsin Mustafa

Mohsin Mustafa is an Oxford MBA candidate, a Skoll Scholar and Weidenfeld-Hoffmann Trust Scholar. He is also an entrepreneur who is passionate about the provision of quality primary healthcare. He sees the provision of quality healthcare as a way of enabling social justice and that’s what fuels his passion for work. Mohsin is the co-founder and managing director of Clinic5, an affordable healthcare delivery service for communities in Pakistan. He is currently a Skoll Scholar, Weidenfeld-Hoffman Scholar and MBA candidate at the Saïd Business School.