Aug 6 2013
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Thinking Globally: A Q&A with Kathy Calvin of the UN Foundation

Kathy Calvin, President and Chief Executive Officer of the United Nations Foundation

The United Nations Foundation believes that, for the biggest public health obstacles facing the world, it will take all nations and all sectors working toward solutions to succeed. So the Foundation works to make that a reality, bringing together partnerships, growing constituencies, mobilizing resources and advocating policies that can help everyone—in both the developing and developed world.

NewPublicHealth recently spoke with Kathy Calvin, President and Chief Executive Officer of the United Nations Foundation, about the organization’s many efforts to improve health both globally and locally—and how these two goals can support each other.

NewPublicHealth: What changes have you seen in global health during your time in the field?

Kathy Calvin: The number of nonprofits dedicated to health issues has quadrupled it seems, and real progress has been made, which is the most important point—that we’re actually seeing a reduction in maternal deaths and newborn deaths and preventable diseases such as measles and diarrhea and pneumonia. I mean, there’s just been enormous progress, with still much more to happen. But it’s been an exciting time after what I think has been a pretty discouraging period where no amounts of foreign aid seemed to be making a difference. I attribute that partly to some innovations in research and financing, but also to the fact that a lot of governments in Africa actually have prioritized women and prioritized health in some pretty significant ways. And I think we’ve had a very enlightened government in the last five years here, too, in terms of what we’re doing overseas.

So, it’s been exciting to see it. Health is not my background. I’ve really been privileged to see both how serious and significant the challenges are, but also how much good can be done with just a little bit of organized effort.

NPH: When you talk about enlightened government, what are some examples? What is making the difference now?

Calvin: Well ironically it isn’t all that political. In fact, some of the biggest shifts took place under President George W. Bush’s administration with his creation of the President’s Malaria Initiative—until then, there had been zero real depth of interest and progress on malaria—as well as PEPFAR, which some people criticized because it was so bilateral, but it had a huge impact in allowing the current administration to really set some ambitious goals for reducing and eliminating parent-to-child transmission and setting that audacious goal of an AIDS-free generation.

I think the things that influenced politicians around these policies were the embrace of the religious community of all our collective responsibility for global health. They took on AIDS, which until then had been fairly controversial. And then second, the desire to have some impact in showing America’s contribution to the world. I was involved pretty heavily with the creation of the President’s Malaria Initiative, and it was wonderful. It made a huge difference, and then at the same time, I think there were innovations in things such as bed nets. Finally, instead of having nets that had to be dipped every year, we had long-lasting nets, and you could really start to see a difference that when you provided a net and provided training, you could really prevent malaria deaths in a fairly major way. That allowed us also to talk to Americans in a new way because there was a tangible solution that didn’t cost a lot of money—$10 funds a net, saves a life—and you could show people that global health dollars and global aid dollars really were making a difference around the world.

So, we watched Americans who had zero interest or awareness 10 years ago in global health, suddenly realize, one, that there were issues such as malaria or polio, and two, that solutions were exciting to support. So we’ve been really gratified that we’ve had the Nothing But Nets campaign that started in 2006 and it’s rallied I think close to $45 million and hundreds of thousands of donors, and mostly young people because they really got excited that they could individually in their own communities have an impact globally, and there was that growing recognition that global health actually is something that affects all of us. It’s not just what happens to people over there, and I think that’s the other thing that happened in this period as we started to hear news about how health issues don’t have borders, and that people will bring tuberculosis into our country, various flu episodes and SARS and all those things I think were a wakeup call that we actually live in a very small community.

NPH: What are some of the UN Foundation’s other global health initiatives?

Calvin: We also run a campaign called Shot@Life, which is aimed at reinforcing in America the value of vaccines globally as a very cost-effective solution to ensure mothers around the world have the same ability as mothers here to vaccinate their children and keep them alive, but also to ensure that if funding support starts to wane, we have a built-in cadre of Americans who prioritize this very important, life-saving solution that, again, is not that expensive but has genuine impact around the world. And so the interesting thing is that Nothing But Nets really appealed to young people. Shot@Life has really become a mommy blogger phenomenon, and tons of women have learned about vaccines, and this doesn’t even touch the somewhat controversial issue of vaccinating our own children or how often or at what rate.

This really is just a kind of simple human rights issue that every mother has the ability to have that simple opportunity to keep her child alive and make sure that child has the right to go on to school and everything else. So, we’ve been excited to see how this has become a mother-to-mother issue around the world. It’s another, to me, example of that phenomenon of “think global, act global.” And we work really closely with the American Pediatrics Association. They’ve been awesome at really understanding that they need to be champions of good health, not only in their own communities, but around the world, and it’s been great to watch them take this on.

NPH: In what ways can global health efforts have an impact on Americans?

Calvin: That’s a great question. This will be a big topic in the next couple years as we look toward the creation of the next millennium’s sustainable development goals. (Editor’s Note: The eight Millennium Development Goals, or MDGs, form a blueprint agreed on by countries and leading development institutions to improve world health by 2015. The goals include halving extreme poverty rates, stopping the spread of HIV/AIDS and providing universal primary education.) The first set of goals spanned from 2000 to 2015, and they had some pretty good public health metrics about reducing child mortality, maternal mortality, offering access to family planning, and more. We’re now looking at what those goals should be for the future, and I think one thing that’s clear is they will have a broader definition of public health or longevity. There are a lot of different ways being talked about it that will encompass a lot of issues that are not the diseases of the developing world—that are diseases and health issues for the whole world, whether it’s obesity or smoking or diabetes or heart issues, the so-called non-communicable [chronic] diseases. And I think that ties it back into the United States a lot more because we have challenges right here in our own country on all of those, and increasingly they are the problems that we’re seeing around the world. So, solutions will have to be truly global and not just local.

Second, I love the notion that we’re seeing some learning from the global community in some interesting ways. I mean, we see much greater use of mobile phones for health and development and the use of phones overseas than we see here, and there’s clearly learning that can come here from our experiences around the world. When I was in Russia last week, I met with Text4Baby, which is a product of Johnson & Johnson USAID and BabyCenter, and they provide information for pregnant women about their pregnancy—when they should see a doctor, what they should be experiencing, reminders about checkups and all that on the phone. And, there’s a version of Text4Baby in the United States, and it is clear to me that the Russian version is teaching the U.S. version a lot about the different ways to communicate—when to use voice in some low-literacy areas, when to use texting, and when to use Webinars, which have been incredibly popular in Russia.

So we’re seeing greater uptake in some of these other regions of the world and some experimentation with using mobile phones for very important health data, very important diagnostics in the future, very important after-the-fact reporting. I mean, we see a lot of use of mobile phones in various places on knowing when they’re out of a particular vaccine or condoms at a clinic, stuff that used to take months to be communicated on paper and in lots of different ways that were very unsuccessful. That innovation in and of itself to me is one that we will benefit from in this country, from the experimentation and innovations being tried around the world.

And then, I think a third area is that we’re seeing empowerment in some new ways and that girls and women are speaking up and taking action on their own rights for health information, particularly in the area of reproductive services and family planning. And of course, that’s one that I think to our surprise maybe turns out to be less of an obvious public service in this country than it should be. So watching how that issue plays out around the world and then how women and girls in this country respond to it is another area that I think could be really interesting, where the two come together and the United States could benefit from what is being done around the world.

NPH: How successful has the Girl Up program been and what kind of an impact has it had?

Calvin: Everybody I talk to is excited by this one, and I think it is because what we are seeing is the fact that this is a for-girls, by-girls campaign and that the girls themselves are really the bosses. So, it’s got a teen advisory board that kind of chooses the issues. Girls have self-selected into Girl Up clubs nationwide and in about 30 other countries. It’s been incredibly popular in social media, and that’s one of the ways we try to tap into talking to girls where they are and using a tool that they really like. We did a lot of research before we launched that campaign to understand how to talk to girls and how to keep them engaged. It was highly impactful because they wanted to be part of something global. It wasn’t just an online campaign.

Second, the term the girls used as they would learn about the fact that one in seven girls around the world is married before 15 against her will, that many girls can’t stay in school because of family issues or social pressures or the fact that they’re married and pregnant, their term was it’s “not fair.” That’s a rallying cry for young people and one that they then wanted to do something about, so this event is not about philanthropy or charity—it’s about change, and they want to be part of change that’s fair to everyone around the world. I feel like we’re creating global citizens in the process of educating them about what it’s like to be a girl anywhere else around the world and then helping them recognize the privileges that they have, the chance to go to school, the chance to see doctors, to stay safe from violence. All the things that they might take for granted or had been taking for granted, they suddenly are mindful of and want to be helping somebody else.

NPH: Are there other UN Foundation programs that have helped create synergy between people in the United States and people in the rest of the world?

Calvin: We host three initiatives that I think are worth mentioning. One is Family Planning 2020. It just started this year. It came out of a large summit in London hosted last year by the Gates Foundation and the UK aid agency, DFID, with the goal of getting family planning supplies and services to 120 million more women, and which would effectively reduce by half the number of women around the world who do not currently have access. I think it’s going to create a lot of buzz, and the fact that Melinda Gates herself has made this her passion and cause has really changed some of the dialogue and given air cover to a broader number of organizations and people and corporations that we hope are thinking about this issue in a new way. We just issued a document called “The Return on Investment on Family Planning” that basically argues to companies that if you’re concerned about workforce diversity or if you’re concerned about the environment or you’re concerned about an educated workforce, you need to be concerned about family planning, because if a woman can plan the timing and number of children, she will be healthier. She’ll be more able to earn a livelihood. The number of people on the planet will be reduced, and there are a lot of just side benefits, so that’s one that I think is exciting.

A second is the Mobile Health Alliance, which does all this interesting innovative work with mobile phones. That’s a hot topic that you’re going to be seeing more and more of. Third, we run something called the Global Alliance for Clean Cookstoves. Four million people a year die from the effects—primarily pneumonia and other respiratory causes—of cooking in an enclosed, small environment over what’s essentially a hibachi in their house. These stoves are incredibly dirty. The fuel is often wood and inappropriate for being in a house, and the time women spend collecting the fuel, the risks they take collecting the fuel, the health impacts—I mean, this is just one of these amazing issues that cuts across gender issues, health issues, environmental issues and economic issues. So, I think that one’s a very exciting one that’s taking off in a pretty big way.

And then just one last thing on child marriage. I think that issue has really become one that has legs. There’s a new organization called Girls Not Brides. Malawi is one country we’re lobbying in right now through our girl advocacy program. They’re likely to pass the bill setting a higher age limit and real enforcement backup against child marriage, and I just feel like the world has come to recognize that’s a very big one in terms of both health and girls’ rights, so it’s exciting to me to see that there’s real stuff happening.

Tags: AIDS, Access to Health Care, Global Health, Prevention, Public policy, Q&A