GHLI Partners with Uganda to Treat NCDs

Mike Skonieczny, 

Executive Director, GHLI

The global burden of non-communicable diseases (NCDs) like diabetes, cardiovascular disease and cancer is staggering. According to the World Health Organization, NCDs represent 43% of the burden of disease and are expected to be responsible for 73% of deaths worldwide by 2020. Most of this increase will be accounted for by emerging NCD epidemics in developing countries. In Uganda, NCDs have become a pressing issue, and the leadership of the country is determined to act.

Stemming from a relationship with the Yale School of Medicine that began in 2006 with Mulago Hospital, the teaching hospital of Makerere University in Kampala, I recently visited Uganda to meet with key stakeholders to understand the landscape of NCDs in that country and prepare for a Ugandan delegation to attend the GHLI Conference at Yale in June.  During the Conference, health practitioners, policymakers and researchers from around the world convene to facilitate collaborative, locally-driven solutions to improve health.

GHLI’s work with Uganda will focus on developing a strategy to address NCDs. Student and staff support will be offered at all phases to help organize and implement their plan —including sending student fellows back home with the delegates to begin work on the ground in their country. In addition to NCDs, delegations from Brazil, Ghana, and Trinidad and Tobago will also attend the GHLI Conference to share challenges, insights and develop strategies to address mental health and early childhood development.

Our work with colleagues in the School of Medicine and in Uganda is central to our interest in developing strong collaborations that lead to sustainable solutions.  We look forward to working with them and our other delegations to develop new strategies to address growing health issues like NCDs. 

Why We Do What We Do: Patrick Geoghegan

Patrick Geoghegan, OBE, is the first to say that he had no career plan. “I was driven by my passion to do something different,” he proclaims. “And, I looked for every opportunity to actually make that difference.”

In the field of health care for more than 40 years, Patrick has pushed for system reform and transformed mental health services. He currently serves as chief executive for the South Essex Partnership University NHS Foundation Trust (SEPT) – a partner of GHLI. SEPT provides integrated care to local communities including mental health, learning disability and social care services.

Growing up in Ireland, Patrick went to school to become an accountant but quickly realized that wasn’t his calling. He then joined the priesthood, where he assisted mentally ill people and underprivileged communities. He saw that persons with mental health issues are more likely to die 20 years sooner than others because of neglect to their health. The exposure to the daily lives of these disadvantaged groups fueled his desire to help in everyway he could. Though his work with the church was rewarding, Patrick could not make the type of change he wanted behind the walls of a monastery.

To become more directly involved with health care, Patrick moved to England to work at a hospital. He quickly worked his way up from porter to nurse to senior manager to director to chief executive. “I strive to make sure services are available to people and reach out to vulnerable groups -- those who may not know how to access services,” adds Patrick. To help ensure patients receive quality care, he helped establish a feedback system where random patients review their experiences. Both the community and staff praised this initiative for improving doctor patient interactions.

Throughout his career, Patrick always pushed boundaries, questioned policy and stood up to defend those at the corners of his community. He aims to be the voice of the smaller groups who tend to go without because they don’t know how to be heard in the system. 

Patrick is excited to continue working with GHLI and thrilled about the progress the organizations have made in Ghana, but he also looks forward to training the next generation of leaders and passing the torch to future visionaries.

The Power of Public/Private Partnerships

Erika Linnander, Director of Field Programs

Partners join together to discuss Project Last Mile.

Collaboration across sectors is essential to positive advancements in global health. One loud and relentless champion of this idea is former Secretary of State, Hilary Clinton. During a speech honoring the Department of State's Public/Private Partnerships, Clinton noted the importance of partnerships that span across sectors, industries and geographic regions.

Our experience at GHLI shows that while well-developed partnerships can have a great impact, they also can be difficult to create and maintain as partners navigate competing priorities and objectives, develop relationships, bridge gaps created by cultural and technical jargon, and identify and articulate their strategic advantages.  That said, with the right approach, potential return on investment in partnership can be well worth any challenges we may face.

As evidence of our belief in partnerships, GHLI joined The Coca-Cola Company, the Global Fund, the Medical Stores Department in Tanzania, and other key partners in Project Last Mile. With the goal of improving access to medicines in remote areas of Tanzania, Coke offers expertise related to global distribution systems while GHLI focuses on identifying how private and public sectors can collaborate effectively to benefit populations.

As the Former Secretary of State has so often asserted, our global interdependence compels us to act on behalf of the most needy among us.  Global health can no longer be a profession of charity, and traditional models of corporate social responsibility are proving inadequate for addressing today's complex development challenges.  Lessons learned from Project Last Mile can be applied to other public-private partnerships in the future to positively shape the global health landscape.

For a description of key factors associated with successful partnership development and to read a complete teaching case study describing Project Last Mile, click here.

Equipping Rwandan Hospitals to Address Shared Challenges

Dana Karen Ciccone,
GHLI Project Manager

As part of GHLI’s participation in the USAID-funded Leadership, Management and Governance Project, I recently traveled to Kigali, Rwanda, to launch our first Senior Leadership Program (SLP). GHLI staff teamed up with Lourdes de la Peza of Management Sciences for Health and three local facilitators to teach strategic problem solving and accountable, gender-sensitive governance.  

My first impression of Rwanda was that it was refreshingly clean. I had heard how impressively litter-free the country is, but it took seeing it myself to fully appreciate the manicured sidewalks, the landscaped medians, and the striking absence of plastic bags.

Our students were 30 of the country’s 44 district hospital directors, as well as five professors from the National University of Rwanda’s School of Public Health. Participants were divided into teams based on the primary hospital challenges identified prior to our visit, they included: staff motivation, staff supervision, equipment management, procurement and maternal/newborn health and family planning.

Though these directors convene monthly for staff meetings, it seems they rarely have an opportunity to work together. One of the most important things the SLP does is create a space in which participants can learn from the struggles and achievements of their peers – comments and concerns included frequent stock-outs of essential medicines and no inventory for medical equipment.  As one person would divulge a problem they would all nod their heads in somber agreement. They seemed both surprised and relieved to hear how many challenges they had in common.

Despite steaming hot afternoons in a room with no fans, the SLP participants sat eagerly through lectures, debated passionately with their team members in work sessions, and engaged enthusiastically with us throughout to ascertain whether we were fully enjoying our visit to their stunning country.

Participants seemed to walk away feeling empowered to improve their workplaces, leveraging both the tools we shared as well as the relationships they built throughout the session that will hopefully endure long after this program has closed.

World Leaders Meet to Encourage Global Collaborations

Elizabeth Bradley, Ph.D.
Faculty Director, GHLI/GHI
Master, Branford College

I was warned about the long train ride from Zurich and the icy walks in Davos, but nothing truly prepared me for the World Economic Forum. As a professor accustomed to more limited signs of power, I had never seen so many prime ministers, CEOs of mega-corporations, and global influencers in one place as last week nestled in the Alps.

The week was full of optimism. Nothing seemed too daunting, and the group tackled massive global problems with confidence. Dialogue about even grim challenges – the war on drugs, global climate change, and obesity – reflected a firm determination, guided by the silent and sure mantra, “We can do it!”

The Congress Center in Davos was pulsating with new ideas. Art and leadership are the same thing. We need a GPS for the soul. An eleven-year old in Pakistan knocking off straight A’s in advanced MIT physics courses online. You have to see this to believe it.

The Yale Global Health Leadership Institute (GHLI) presented its work on improving the supply chain in Tanzania for essential medicines, an endeavor of a public-private partnership between The Global Fund for AIDS, TB, and Malaria, The Coca Cola Company, The Gates Foundation, Accenture Development Partners, and Yale. As I watched academics, public health, big business, and high finance all in one space working on a common problem, I thought I was in a rarified environment of great hope and commitment.

The most exceptional session discussed the development of Sustainability Development Goals (SDGs) to replace the Millennium Development Goals. The General Secretary of the UN, Ban Ki-Moon, moderated the session with the great and beautiful – the likes of David Cameron, Bill Gates, Queen Rainia Al Abdullah. They asked for input on the SDGs, so I crowd sourced Branford College at Yale.

Here is the view from the 18-20 years old Yalies, who will someday populate the World Economic Forum themselves: 1) increase global internet access, 2) liberalize food trade policies, 3) redesign global power structures to be anti-fragile, 4) decrease global violence, 5) decrease rates of human and sex trafficking, 6) increase global response to natural disasters and climate change, 7) increase primary care, 8) improve early childhood care and education, 9) create sustainable living and urban environments, and 10) decrease corruption through increasing transparency. Selection of the SDGs will be hammered out by 2015. In the meantime with vision like this from the next generation, we should be optimistic.