Since your appointment as special envoy for Malaria, over US$4 billion has been raised to combat the disease. To what do you attribute that success?
I do not think there is a single thing to which to attribute the success in combatting malaria. Most important in making the case for funding is the simple fact that combatting malaria is an exceptionally good investment. It has been shown that the return on investment approaches 40 to 1. That is incredible by any measure—certainly the highest I have seen in my 20 plus years building a career in business. According to the Copenhagen Consensus, which has been ranking activities in terms of return on investment for the post-2015 Global Goals, malaria control delivers $36 USD in social and economic benefits for every dollar spent. Meaning, for a $5 USD bed net, $180 USD is returned to the economy. We need to make sure that going forward, we shift the discussion from one of costs to one of return on investment and value for money when contributing to combatting malaria. Health comes before wealth. If nations invest in health, as they have with malaria, economies will grow.
We also had so many other essential elements for fund-raising success. It has been important to have a time-bound and measurable plan that holds people accountable and makes sure that there are benchmarks for measuring success. There has also been an excellent team including The Global Fund, Roll Back Malaria, Malaria No More, Medicines for Malaria Venture, The African Leaders Malaria Alliance, and the Asia Pacific Leaders Malaria Alliance. Many of the NGOs that work on the issue of malaria have been incredibly effective advocates for financing, exemplified by the work of Malaria No More. There have also been great media partnerships such as American Idol’s“Idol Gives Back”event. And the compelling message of “$10 USD buys a net, saves a life” has had a large impact on fundraising efforts.
There have also been political changes that have helped in the fight against malaria. There has been the emergence of strong political will to combat malaria, evidenced by support from leaders such as former US President George W. Bush and former UK Prime Minister Gordon Brown. And African heads of state have come together to create the African Leaders Malaria Alliance to take ownership of the malaria effort.
More broadly, the public doesn’t hear much about the fundraising side of the MDGs. Can you elaborate on the role of funding in achieving these goals?
Simply speaking, funding is necessary in order to achieve these goals. And we would not have been able to make the progress we have made without the commitment of many leaders who provided funding—both directly and indirectly-to achieve these goals. In the case of malaria and other health goals, this has been achieved through a historic public-private partnership, including support from donor nations such as the United States, the United Kingdom, and Norway; partnerships with global financial institutions, especially the Global Fund and the World Bank; increasing domestic support from affected countries; grassroots support from local communities in donor nations; the work of private sector partners who develop or distribute the tools, influence, and know-how to battle health challenges; and the work of philanthropies, first and foremost the Bill & Melinda Gates Foundation.
With just months to go until the deadline of the MDGs, what is your estimation of their success? Feel free to speak both about Goal 6, combatting malaria and other diseases, as well as the goals in general.
The MDGs are, quite simply, the most successful, broad-based international development effort in history. Every nation in the world agreed to this set of eight international development goals which is, in and of itself, a historic alignment around a commitment to reduce poverty and human suffering. The goals have been as successful as they have been because the specificity and time-bound nature of the initiative have enabled global leaders to create plans and determine the funding needed to achieve them.
In terms of Goal 6 specifically, the achievements made by the malaria community during the MDG era have been unprecedented in global health. Our collective efforts have: reduced malaria deaths in children in Africa (the epicenter of the malaria challenge) by 69 percent; prevented 670 million malaria cases overall; helped avert more than 4 million deaths since 2001; and returned billions back to economies and brought incalculable joy to families and communities that have not experienced outbreaks.
What do you think will happen after the 2015 deadline for the MDGs expires? How will the United Nations continue to work on these issues?
The unmet MDGs will be folded into a new and even more ambitious set of 17 global goals for sustainable de- velopment (the SDGs). This year’s annual gathering of the world’s leaders at the United Nations General Assembly in New York in September will include a summit to ratify an even more ambitious set of priorities for the next 15 years. The General Assembly will be an opportunity to look at the progress of the MDGs and determine what still needs to be done to make progress on these issues.
Health is really a front-runner issue for so many of the historic public-private partnership, including support from donor nations such as the United States, the United Kingdom, and Norway; partnerships with global financial institutions, especially the Global Fund and the World Bank; increasing domestic support from affected countries; grassroots support from local communities in donor nations; the work of private sector partners who develop or distribute the tools, influence, and know-how to battle health challenges; and the work of philanthropies, first and foremost the Bill & Melinda Gates Foundation.
I am optimistic about our work on a bigger set of goals, but achieving them will require a fundamental shift in funding the global development agenda. Some of these changes include the fact that countries must begin to cover more of their costs in achieving these objectives, that the private sector must have the opportunity and obligation to play a bigger role, and that we must get more creative about how we leverage existing funding to unlock new sources of financing.
Worldwide public health received a huge shock with the recent Ebola outbreak. What do you think we the greatest successes as well as areas for improvement in how that crisis was handled?
Ebola has been a wake-up call, not just for Africa, but for the world. Personally, I think that there are improvements that could have been made on all levels in how the outbreak was handled. But despite the devastation wrought, the world ultimately came together with the money and resources needed to fight this outbreak. In particular I was impressed and moved by the thousands of community health workers who did such valiant work on a community level. We are not out of the woods yet, but we can acknowledge a superhuman effort on so many people’s parts to halt a major global threat, and this fact, at least, is encouraging.
To ensure that such an outbreak does not happen again, we must invest in building resilient communities and well-performing health systems that integrate public health and primary health care. Ideally, health systems should aim for universal health coverage, so that the poor are not left behind. This requires new thinking and a new approach to health development. One critical area requiring more investment is the training and deployment of community health workers. If we can build an army of health workers poised to engage in harder-to-reach communities across Africa, we will greatly improve our chances of preventing, detecting and more successfully addressing outbreaks like this one. We also must develop the systems, capacities, and financing mechanisms needed to build surge capacity for responding to outbreaks and humanitarian emergencies. There is a high level committee of esteemed leaders that is currently developing recommendations. And lastly, we must create incentives for research and development for new medical products for diseases that primarily affect the poor. A fair and just world should not let people die for what is essentially market failure and poverty.
You have spent a large part of your career working with at-risk youth. Can you speak about the transition to the United Nations and the MDGs? What are some similarities and differences between the two types of work?
For me, these two roles are really one—helping children in need, whether that be in Newark, New Jersey or in Central Africa. It is also important to emphasize that working with children is a continuous process. It is not a mission that I have had for a couple years; it has been a project that has absorbed much of my life. I have had one mentee for 27 years.
The work that I did on mentoring has grown into a national movement, which can be seen in the work of organizations such as the National Mentoring Partnership, the Points of Light Foundation, and America’s Promise.
The transition from mentoring to malaria can be attributed to several things. But a seminal event that turned my attention to malaria was Jeff Sachs’ photo of “sleeping” children and then learning that the tools to prevent and treat malaria were available, affordable, and effective. The fact that such a devastating worldwide problem had achievable solutions served as a call to action for me and motivated me to start working on the issue.
Ultimately however, whether it be through mentoring, working to combat malaria, or any other issue, there is no better return on investment than investing in a child.