Free Global Health from “Living with Darth Vader”

MBA student Grace Lam gives us a vivid account of “Closing the Gap:Tackling Global Health Challenges, health ” a panel at the Skoll World Forum.

Peggy Clark, Peter Drobac, Pamela Collins, Tapela Neo, Chris Underhill

With an audience filled with seasoned global health experts, there’s not much the “Closing the Gap: Tackling Global Health Challenges” panelists could say to shock their audience. Non-communicable diseases (NCDs) and mental disorders have been underfunded and largely neglected due to the widespread focus on malaria, TB, and AIDS. Sure. Less than 25 cents per person per day is spent on mental health. Unfortunate but familiar. There have been huge successes in the millennium development goals, especially since the country with the biggest improvement, Rwanda, was measured with its pre-genocide 1990 baseline. Impressive and noted.

What did garner a response, however, was Chris Underhill’s candid memory of his own childhood experience with mental health. As a 12-year-old boy, he had a mental health episode that required treatment. The British hospital naively thought the illness could be transmissible, so they placed Chris in a ward where the only other patient was one with an iron lung. The six month recovery period “was like living with Darth Vader”, recounts Chris. Though Chris’ jocular comment evoked a lively chuckle from the audience, his unfortunate treatment reminded us of the perils of erroneous healthcare decisions and our own responsibility to deliver not only efficacious but also ethical care. Anything less could become another’s Darth Vader.

Closing the Gap: Tackling Global Health Challenges

Chris’ story provided the perfect segway into a discussion of the shortcomings of today’s global health delivery systems. While most agreed more resources should be devoted to the treatment of NCDs and mental health, one critic questioned whether the disease-centric approach was appropriate or whether this approach only treated the symptoms while neglecting the underlying pathology of an inadequate organizational structure for delivering care. Regardless of the opinions of the feasibility of such an approach, all agreed that the structure need to expand diagonally to integrate more disease states and delivery personnel such as community health workers. As if anticipatory of the audience’s call for improved systematic change, Peter Drobac distributed copies of “Delivering Health. Care Redefined.” – a working paper on current successful expanded healthcare business models, and encouraged us to improve and expand on it. And so, with celebration of some successes and the weight of ever more challenges, we disbanded, each renewed with their own campaign to free global health from the grips of Darth Vader.

Shifting the Paradigm: Social Entrepreneurs and the Art of Fiction Film

MBA student Natasha Garcha reports on the Skoll World Forum panel, ambulance “Shifting the Paradigm: Social Entrepreneurs and the Art of Fiction Film.

Natasha Garcha

Natasha Garcha

Storytelling must not be peripheral to social movements – it must be at the center of revolutions. Cara Mertes, sale director at Just Films, ampoule begun the session by delving into the art of fiction. Quoting non-fiction author, Peter Matthiessen, who ironically said “(non-fiction is) captive to facts or predetermined forms- it cannot fly,” Cara elucidated how non-fiction can sometimes leave its audience feeling powerless, acting as a disincentive to civic engagement. Fiction, on the contrary, allows us to be embedded in someone else’s reality. Research shows fiction readers are inclined to believe the world is more just than it really is. As someone who spent majority of her childhood in a library devouring novels and grew up to be an irrepressible optimist, this deeply resonated with me! The session introduced us to two revolutionary fiction films, Difret and Under the Same Sun. Both epitomize why there is such great power in the art of storytelling. Movements are built around emotional connections and the immersive experience of fiction film is the perfect medium.

Cara Mertes, John Marks, and Mehret Mandefro in their session "Shifting the Paradigm" at Saïd Business School

Difret has a double-entendre. In its widest use, the word means courage. But in Amharic, it also means “the act of being raped.” The film showcases the story of 14 year Hirut Assefa’s act of defiance against the dominant narrative. Abducted while walking home from school by her 29-year-old would-be husband (as is customary in Ethiopia), in an instance she is robbed of her childhood, her innocence, her freedom. In a desperate attempt to escape and return to the sanctity of her home, she manages to shoot her captor, killing him with his own rifle. Charged with murder, Hirut’s pleas of self-defense fall on deaf ears. Here unfolds the core story of a tenacious struggle against the status quo. Meaza, a human rights lawyer inspired by Hirut’s relentless courage, embarks on an epic legal battle to save the young girl from facing the death penalty. Based on a true story, the cast and crew went through extraordinary lengths to ensure minimal deviation from the real chain of events. During the snippets of the film that we had the privilege of viewing, audible gasps of shock echoed through Seminar Room A – a symbol of the deep impact that fiction films can have on its audience. Having the producer of such a powerful movie with us was a HUGE honor. Mehret Mandefro gave us an inside peek into the making of Difret, emphasizing the utmost importance of authenticity in a movie which hopes to represent the Ethiopian culture, giving its unsung heroes a voice in the world. Difret is not a tale of tragedy, but one of hope. Difret does not seek to demonize Ethiopian men, but to change the social norms around cultural violence by telling a story that does not judge or dismiss. I believe it will act as catalyst for change, making these men think, question and reflect rather than view this as a critique. Mehret also shared the struggles as a filmmaker to remain true to the soul of the story, defending her decision to not cast Halle Berry as the lawyer in a bold attempt to maintain the authenticity of the film at the cost of blocking out mainstream funders. She described how Hollywood is “dying for a revolution” that will challenge these artificial assumptions about the relationship between commerce and art. Mehret eloquently pointed out that disruptive movies require disruptive distribution channels – despite meriting the audience award at Sundance, commercial theatres (especially in the US) were still weary about screening a potentially controversial and un-conventional film. Difret in my opinion is nothing short of a work of art and I hope it is embraced and celebrated across the world.

Under the Same Sun is a movie based “sometime in the near future.” Producer John Marks gave us the pleasure of a candid discussion about his journey to create a movie of how an unexpected alliance develops between an Israeli and a Palestinian who “set out to make money and wind up making peace.” Old antagonisms, new technologies and two hopeful entrepreneurs live ‘under the same sun.’ They unite to develop a solar energy project to bring electricity to Palestine, risking their lives and burying old hostilities. The perils the duo encounter and how they overcome artificial divisions by recognizing the importance of being invested in something that is meaningful, exposes the audience to the crux of how cultures shift. Shot in three different languages, the film in John’s words is “the most scrupulously accurate film” possible which endeavors to fulfill his “über objective” of peacebuilding. In my opinion, by putting hope on the screen Under the Same Sun will help overcome the current cynicism by illustrating how ordinary people can create huge waves of disruption and truly enable shifting the paradigm.

 

Getting the impact jackpot through networking and communities’ involvement

MBA student Tanja Collavo tells us what she learned at the Skoll World Forum session, viagra “The Impact Jackpot: Service Delivery to the Very Poor.”

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Tanja Collavo

There are no easy ways to make the difference when tackling the poorest of the poor. Many talks and seminars during the Skoll World Forum have aimed at facilitating the sharing of ideas among entrepreneurs, investors, facilitators and representatives of governments and public bodies on how to best operate in areas where nothing can be taken for granted. However, the session “The Impact Jackpot: Service Delivery Innovation for the Very Poor” was especially effective in exploring the topic. The panel featured Christine Mwelwa Kaseba, first lady of Zambia and champion of several projects in her country for the improvement of women’s health; Kristin Gilliss, associate portfolio director of Mulago foundation, investing in high impact organisations tackling the very poor with a scalable model;  Neal Keny-Guyer, CEO of Mercy Crops, an international development organisation operating in areas of conflicts such as Syria to transform crises in opportunities; Steve Davis, CEO of Path, a non-profitspecialised in innovation for healthcare; and Andrew Youn, co-founder and director of One Acre Fund, an NGO improving the productivity of the poorest farmers through support along their whole value chain.

 

Kristin Gillis, Neal Keny-Guyer, H.E. Christine, M. Kaseba-Sata, Andrew Youn, Steve Davis

The panellists discussed very openly about their projects, the difficulties they encountered and how they innovated in order to reach the bottom of the pyramid. The passion and commitment they showed for their companies and causes generated a strong involvement in the audience, which was clear from the many faces nodding during the session and from the questions and feedbacks expressed during the Q&A part. Most importantly, the discussion revealed a common theme emerging from each experience reported regarding effective serving of the poorest of the poor: the necessity of creating strong partnerships across sectors. The topic was brought up in his very first answer by Neal Keny-Guyer, who mentioned partnerships as the fundamental element to innovate and reach populations facing crises and lack of any kind of resource. His statement was then reinforced by all following interventions, that even went beyond it by explicitly mentioning the necessity to co-operate with local governments in order to have different stakeholders coming together and understanding each other and to connect different countries and players engaged in different programs in order to share best practices and uncover new ways to employ existing tools and resources. Similarly, the panel highlighted the potential of partnerships between NGOs and social enterprises allowing to fully exploit and combine the reach and connections of the former with the innovativeness of the latter.

Additional suggestions that social entrepreneurs as well as governments, funders and NGOs might find interesting were those of Andrew Youn and Steve Davies, who both focused on the necessity to redesign the whole distribution chain and to think about the whole ecosystem when planning to deliver something to forgotten communities. Indeed, in order to reach such populations and to really make the difference, it is necessary to trigger behavioural changes, to make recipients understand the products offered and how to use them, to reach people where they are, and to develop products and services keeping in mind from the very beginning the money, mobility and information constraints that these populations face. The importance of connecting with and providing detailed information to target recipients was confirmed by Zambia’s first lady Christina Mwelwa Kaseba, who recalled how important information sharing had been in the projects she championed in order to make poor women aware of their rights, opportunities and of the services that were available to them. In this regard, she mentioned the relevance of new technologies in engaging with people in a visual and easy-to-understand way, another theme clearly emerging in many sessions held during the Skoll World Forum.

 

The Impact Jackpot: Service Delivery Innovation for the Very Poor

Overall, for me the key take-away from this session was panellists’ conviction, supported by the Skoll foundation’s belief and from similar conclusions reached in other seminars, that no real impact can be generated if a project does not trigger systemic change and does not go beyond the delivery of a mere service or product. What the poor need is a chance to speak up, to develop themselves in the way they need and want through products and services configured around them and with their contributions, to hope in a better future thanks to someone helping them in reducing inequalities, that are one of the main barriers of economic and, most importantly, social development. Partnerships and connections are the key to succeed in this important mission. After three days of networking, it feels like we all should be in a better position now to go reach the bottom of the pyramid and make even more the difference.

BEYOND THE PIONEER: FROM BUILDING FIRMS TO BUILDING MARKETS – a report from the Skoll world forum

Austin Harris

Austin Harris

Skoll Scholar and MBA student Austin Harris gave us this update from Day 3 of the Skoll World Forum.


SPEAKERS: ALEX SLOAN, JUDITH POLLOCK, CAMILLE SAADE, LIZ PATTERSON, HARVEY KOH

When pioneer firms attempt to introduce new innovations into bottom of the pyramid markets, they often face barriers to scaling the business models. Alex Sloan with the Skoll Foundation moderated our panel of speakers who highlighted these barriers and addressed ways to overcome them.  The focus was impact through successful scalability, from the individual firm to the entire market. 

Harvey Koh with Monitor Deloitte is a coauthor of From Blueprint to Scale, a report on the role of philanthropy in impact investing.  Making reference to this report, Harvey discussed the “pioneer gap” in investment and how philanthropic money can be used to create inclusive businesses.    

Harvey illustrated that introducing a working product into a market is not enough.  Three essential criteria for firms to succeed:

·         Impact

·         Sustainable

·         Scalable

Of these, scalability is the “hardest to crack.”  He emphasized that scale needs to focus on solutions rather than the number of companies.  Instead of simply focusing on the firm, you must extend to include external elements, such as government and supply chains.  

What has become informally known as the “Easter Egg Model”, Harvey showed the links between the firm, value chain, public goods, and government to display all components involved in scaling a business model. 

 

More than One Firm to Make a Market

Judith Pollock with the Shell Foundation added that scaling should be should not just be limited to the firm, but also the industry to expand the total market size.  To scale an industry, it is helpful to have your product and service replicated by other firms.  She shared the experience of the Shell Foundation in doing clean cook stoves in Asia.  One firm was insufficient to tackle the total problem.  The foundation sought to reduce the barriers to all firms in the industry, enabling them to get to market.  The effort was on lowering barriers in the value chain, using existing distribution as an enabling mechanism, and dealing with financial constraints that limited inventory for merchants.  Tackling all these elements enabled Shell Foundation to increase clean cooking stoves in the market from 100,000 to 1,000,000. 

Camille Saade with FHI360 discussed his organization’s experience with treating Diarrhea, the second leading cause of death in children after pneumonia.  The program in Uttar Pradesh delivered oral rehydration salts and zinc to children suffering from diarrhea.  However, after 18 months, they found less than 1% use of zinc in the slums.  Though subsidization, the program was able to incentivize distributors, starting at 70% subsidization and waning to 0% over time. They ultimately found 54% of doctors prescribing zinc.  Now that the distribution barriers to market were addressed, other brands of zinc followed into the market, totaling 42 brands in the region.
  

Important Factors for Scaling

Scaling for a firm often entails more than increased production of product.  The panelists offered other, often overlooked, factors for successful scaling.  Camille emphasized the determination of the entrepreneurs and the long-term vision.  Judith stressed the importance of establishing partners with common views and goals, and for reducing barriers of distribution and trade finance.  Liz Patterson with DFID focused on the importance of establishing strong relationships between firms and local government.

Where are All the Impact Investors?

Developing markets, otherwise known as global growth markets, have incredible upside potential.  However, the investment money is not following this potential.  Harvey stressed that many investors want opportunities that already exist.  Most investors are not interested in the risk and time in creating markets, which is often necessary in less developed countries.

Liz highlighted that regulations in government have also presented a barrier to investment.  Judith emphasized that more success has come with philanthropic investment that is willing to tolerate the high risk space.  She stressed that this investment needs to gain scope beyond the firm, and extend to the supply chain to achieve returns. 

Difficulties with Push Products

How does one know if consumers in the developing world needs a particular product?  Judith stated that there can be different reasons why a consumer does not connect with a product: she does not see a need, she is unaware of the product, or the new product does not fully meet her needs.  Judith emphasized the need to get feedback from the target audience to ensure your product is meeting the necessary consumer criteria.  Camille added that a focus on ease of access and proper pricing are also crucial when pushing products to consumers. 

What Lies Ahead?

Looking towards the next year, the panelists offered how to continue closing the pioneer gap and building firms to build markets.  Harvey noted the need to focus on industry facilitation. Camille concentrated on potential partnerships to form inclusive markets and work with competitors to grow the overall size of markets. Judith stated the need to use philanthropic money in high-risk areas to find what needs to be done to gain impact. Liz stressed the need to build investor confidence.

We extend a warm thank you to the moderator and panelists for illuminating difficulties for pioneer firms to get to market and scale.  They all provided wonderful insight on the issues currently faced and offered promising methods to narrow the pioneer gap.    

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Campaign Models & Engaging Audiences – Report from the Skoll World Forum

MBA student Holden Bonwit provides an update from this morning’s session at the Skoll World Forum in Oxford, which was moderated by Cathy Galvin of the United Nations Foundation.

Holden Bonwit

In just six days, a 29 minute video had been viewed by more than 100 million people around the world. Bucking the trend for youtube videos, these viewers had watched the long video all the way through.  How did the Kony 2012 video, created by film makers Invisible Children accomplish this?

Ben Keesey,  Invisible Children’s CEO, shared a few reasons he thinks they were able to achieve such success:

1. Recognize that nobody really cares right at the beginning – you must start with a simple, single human, and use them as the cipher to tell an engaging story.

2. Take risks – let people take control, both in developing content before release, and in supporting you after release.

3. Avoid the greatest sin: to be boring – put in the energy to make something engaging and shareable.

4. Show the young people agency – give them a way to help, and the belief that they can make a difference.

5. Remember that building advocacy takes time. Kony 2012 seemed like an “instant success” – but its powerful community of young advocates was eight years in the making. The team travelled to 10,000 high schools and colleges to promote similar films, and engage young audiences. When Kony 2012 was made, these advocates spread the film locally and then nationally via social media. They embraced it and took it to heart. For them, it was personal.

campaign models panel

Cathy Galvin, Ben Keesey, Ido Leffler and Gabrielle Fitzgerald: Campaign Models: Driving Your Audience to Engage

The result of the media campaign was undeniable. (On the ground, effects are harder to measure: though Kony himself was not captured, the effects of the film and movement seem to be real: a 93% reduction in killings.) As Ben posted on his twitter feed: “For every single one that comes out, the war is over- at least for them.”

Ido Leffler of Yes To Carrots used a “buy one, give one” type program to multiply resources and engage consumers of ‘flu vaccines in the “Get a shot, Give a Shot” program with Walgreens.  In just six weeks, the result was three million gifted polio and measles vaccines.  Ido echoed that these projects take a massive amount of work behind the scenes and lots of promotion of your vision. Online campaigns are their lifeblood at “Yes To” –  recently, with a hashtag campaign on Facebook, the company gave away 50,000 meals – but there remain questions around the efficacy of “click activism” or “clicktivism”.

The direct link between hashtags and improved nutrition is tenuous. Ben chimed in that in themselves, the clicks don’t do anything on their own, but on aggregate the big numbers are meaningful, and the Invisible Children team has influenced policy makers with reams of printed online petitions. Further, Invisible Children mines their 3 million followers to find the best of them, to act as community leaders and make a difference in the real world (IRL).

Gabrielle Fitzgerald at the Gates Foundation followed on regarding the “Get a shot, Give a shot” initiative – there are only a few hundred cases of Polio currently, and there is a goal of elimination by 2018. That achievement can only be reached through system building – even the Gates Foundation with its funding can’t achieve this alone, and has formed what Gabrielle calls “catalytic coalitions” including the WHO, CDC, the government of Abu Dhabi, and others at the Global Vaccine Summit. Another strategy she shared was to tie in the joining of “grass top” campaigns with “grass roots” campaigns – funding initiatives that others wish to do, but need assistance to take forward. An example of these “grass tops” were the joining of ministers of sport and ministers of health for the malaria campaign “Nothing But Nets” during the FIFA World Cup tournament of 2010 in South Africa. Although Gabrielle definitely realizes there is more to malaria eradication than simply bed nets, creating a message that was tangible for sports fans was the key to engaging them. To excite fans, they got local sports teams involved from all the participating regions.

Gabrielle shared the three ‘M’s that are a prerequisite for any successful campaign: Money, Motivation and Momentum.

Chris Gebhard at Participant Media  added a fourth factor: serendipity. He stressed that you don’t just need an audience, but rather you need to form a community, and then give them a mission. His latest initiative, TAG was born when people said “we love these films, how can we work with you?”

Questions remain.  Ben is struggling with how to reach a truly international audience through one pipe – his followers are ready to take activism advice, but is that appropriate given that some do not live in democracies? Would that endanger them? How can Ben suggest concrete steps to take when he doesn’t know the intricacies of each system?  — Reach out if you have some ideas to Ben Keesey on Twitter: @BenKeesey

To close up the session, our moderator Cathy Calvin shared a final quote, from Eleanor Roosevelt:

“It is more intelligent to hope rather than to fear, to try rather than not to try. For one thing we know beyond all doubt: Nothing has ever been achieved by the person who says, `It can’t be done.’ ”

 – You Learn By Living (1960); Eleanor Roosevelt

A career in the social enterprise sector you say?

An MBA and Skoll Centre Ecosystem Awardee, viagra dosage Tamer Azer is also an On Purpose Associate and the Co-Editor of The Renegade Times. You can reach Tamer at tame.azer@onpurpose.uk.com 

Tamer AzerWalk into the Skoll Centre for Social Entrepreneurship at the Saïd Business School on any given day or attend any of their events and you will be greeted with young and inspired students from a variety of backgrounds who are keen on being part of the Social Enterprise sector. Since the sector is still very nascent, stomach the most popular question is, discount how do you become part of this sector when you don’t have any experience working with social enterprises?

The standard response is that the social enterprise sector is just like any sector. To succeed you require very much the same commercial skills and emotional intelligence you would require working in the private sector; because much like the private sector, any organization in the social enterprise sector needs to be financially viable and sustainable. Essentially, this makes the skills and experiences you’ve acquired throughout your career not only transferrable but also immensely valuable for this growing sector. However, there are a few more things you should keep in mind if you are considering a career in the social enterprise sector.

Experience and skills aside, most people think it’s enough to express their passion for the sector and all the good that it does in order to get in on all that good stuff. Well, it’s not enough. It’s not enough to show social enterprises you want to work with, how passionate you are about them; you need to give them reasons to be passionate about you. Here is how you do that.

1. Understand the sector well and understand where you can add value

Understanding the sector in relation to your skills and experiences gives you the ability to position yourself not just from the perspective of your passion and interests but also from the perspective of where you can add the most value to the sector and to the organization you want to work with. So while you think an organization like Aduna is really cool and you want to work with them to grow their sales, your experience might be best suited to working with a sector support organization like NESTA or Unltd where you can help develop the ecosystem.

2. Be brave

If you know you really want to work with social enterprises, then just do it, take that leap of faith and don’t look back. It’s much harder to make a career with social enterprises your priority from the start and it takes a lot more courage and dedication to take that leap of faith early. Want to show passion? Then show faith in the sector and make it your priority.

3. Prove it

Show on paper that you understand the sector and that you’re making that leap of faith. Sign up to an internship with a social enterprise, do a fellowship program like On Purpose, Acumen or the Shell Foundation Fellowship. You can also participate in one of NESTA’s many projects, just put a team together and submit an expression of interest. Attend social sector conferences, tweet and blog about the sector and show that you know what you’re talking about.

In the end, because the sector is still nascent, most people coming into the sector don’t really have any experience working with social enterprises. This is a great opportunity for people truly interested in careers in the sector to distinguish themselves from the pack. Especially since there is no shortage of opportunities out there to experiment and really show that you are keen on being a part of this growing and thriving community.