Charles Stokes: Faces of Public Health

Aug 21, 2012, 8:06 PM

Charles Stokes, CDC Foundation Charles Stokes, CDC Foundation

Faces of Public Health is a recurring editorial series on NewPublicHealth featuring individuals working on the front lines of public health and helping keep people healthy and safe.

The CDC Foundation, established by Congress in 1995, connects the Centers for Disease Control and Prevention (CDC) with private-sector foundations, corporations, organizations and individuals to help build public health programs. Since its inception, the CDC Foundation has provided $350 million to support CDC’s work and launched more than 600 programs around the world. The support is typically financial, but also can include expertise, information or leadership.

One key initiative from the Foundation, in partnership with CDC and the Robert Wood Johnson Foundation, was the Meta-Leadership Summit for Preparedness—a model approach for bringing communities together to improve emergency preparedness and build community resilience. From 2006 through 2011, initiative partners organized and hosted 36 Summits across the country, training 5,000 business, government and nonprofit leaders in meta-leadership concepts. While the initiative has concluded, the Meta-Leadership Summit Resource Centerprovides resources to help communities initiate or continue meta-leadership activities.

NewPublicHealth spoke with Charles Stokes, president and CEO of the CDC Foundation, about the Foundation’s partnerships and successes, including those around meta-leadership and more.

NewPublicHealth: What kind of work did you do before becoming president and CEO of the CDC Foundation?

Charles Stokes: For the prior 22 years, I worked with the Missouri state department of health. The last 10 of those I was deputy director or acting director of the state health agency. In that role I had the opportunity to chair an American Public Health Association workgroup that developed Healthy Communities 2000: Model Standards where we set model goals and objectives for state and local health departments to use in reaching the national goals ofHealthy People 2000. That connected me with CDC.

NPH: What was the impetus behind the creation of the CDC Foundation?

Charles Stokes: The impetus really goes back to Dr. Bill Foege, a former CDC director who recently retired as a senior fellow in the Bill & Melinda Gates Foundation Global Health Program. Dr. Foege and several CDC directors after him realized that CDC could more effectively address the complex health issues facing America and the world through partnerships with the private sector. And so they worked with Congress to create this nonprofit organization to serve as a bridge to the private sector—a difficult thing to do from within the government. For me, the idea of being part of bridging sectors with an agency as important as CDC was a golden opportunity. And so I started with the Foundation 17 years ago and I’ve been here ever since.

NPH: What were some of the high points from 1995 to now that the CDC Foundation has been able to accomplish that hadn’t been done before?

Charles Stokes: Most of the work has been about building partnerships that have brought money to CDC to do things that they desperately wanted to do but just simply never could. Over 17 years we’ve actually raised about $350 million to implement over 600 programs in more than 30 countries around the world. Over the years we’ve moved more and more into tobacco, and one of the real highlights now is a program funded by Bloomberg Philanthropies to help CDC work with the World Health Organization and ministries of health around the world to collect data on tobacco use and the effectiveness of tobacco control measures in more than 30 countries.

Another program, supported in part by the Robert Wood Johnson Foundation, was in the area of intimate partner violence, helping coalitions at the state level focus more on preventing violence before it ever occurs. Through grants we’ve also helped CDC investigate what works best to fight obesity, what’s being tried out there that works and how do we get that information out, so that scarce dollars are being used effectively.

NPH: Why are partnerships so important for improving public health?

Charles Stokes: I’ve become convinced that we need to get away from segregating government from business and from the nonprofit sector. If we’re going to continue to be a leader in the world and do as much as we’ve gotten used to doing, it’s going to be through partnerships, and that takes a change in culture.

NPH: The CDC Foundation and RWJF partnered on a meta-leadership program that recently ended. How did it come about, and what has been achieved?

Charles Stokes: The origin of that program was a flight organized by the American Red Cross to the front lines of the response after Hurricane Katrina. All of us remember as Americans watching the television, scratching our heads and saying, ‘Why are we so disorganized?’ You know, people throwing money at different problems, nothing quite coming together. Our thought was: we’ve got to get better prepared for the next time, and being prepared means working outside of our individual sectors in partnership. The result was that the board of the CDC Foundation sat down with the CDC director at the time, Dr. Julie Gerberding, and said, ‘What can we do differently?’ Dr. Gerberding thought we should take the concept of meta-leadership across the country. Meta-leadership, a concept developed by Harvard professors Dr. Lenny Marcus and Dr. Barry Dorn, is a new model of leadership, encouraging leaders to reach across organizations and sectors to build cross-cutting strategies. Before, during and after an emergency, meta-leaders use their influence and connections to guide a cooperative course of action to protect their communities.

At Harvard Dr. Marcus and Dr. Dorn were teaching a course on meta-leadership to federal government leaders. At our request, they converted that week long course to a one-day summit. We organized 36 summits in communities across the country, and we focused on bringing together equal numbers of government, business and nonprofit leaders, including nonprofit philanthropic leaders. At each summit, leaders learned about the principles of meta-leadership and then discussed local preparedness gaps. Leaders from each sector were asked what they could do to fill those gaps, and what they needed from the other sectors. For example, putting the owner of a fleet of buses together with city government in case of an evacuation order. That lets the fleet owner address concerns such as asking about liability in terms of accidents in an emergency situation, and is likely to say that ‘if government can do that for us, we can help government.’

NPH: What results can you show from the meta-leadership program?

Charles Stokes: We evaluated the program immediately after each summit. In total there were 36 summits across the country. Did people learn something? Did it feel like they could apply it? And we went back six months later with a follow-up meeting and there were different examples in every community of how people had come together. Among the feedback: some leaders said, we’re talking to other people we never would have picked up the phone and called before, or we’re forming cross-sector planning councils. We had local and state governments who had emergency response centers with nobody from business, nobody from philanthropy connected in any way, and now they were creating seats in their emergency operation centers for folks from these other sectors so that in a crisis people were talking. In North Carolina they had created a database of resources, but the Summit led them to add private sector resources to it.

NPH: What is the status of the meta-leadership program now?

Charles Stokes: The Meta-Leadership initiative concluded in June 2012. During the five-year initiative, more than 5,000 leaders attended a Meta-Leadership for Preparedness Summit, and almost 3,000 people joined a Meta-Leadership online community. We also developed an online meta-leadership summit resource center that builds on the meta-leadership summit model. The online resource center provides templates, sample documents, idea starters and videos that may help initiate or continue meta-leadership activities in communities.

NPH: What was the most important thing you learned from the initiative?

Charles Stokes: The Meta-Leadership Summit initiative confirmed for us the importance and value of bringing all three sectors to the table to address complex issues. I think the Summit also reminded us of the unique role corporate America can play in building cross-cutting solutions. The evolution for the CDC Foundation over time has been a focus that has broadened to include business. All of our initial partnerships were with private foundations and philanthropies, and a lot of opportunities for CDC to improve health came out of that. But as we have continued to grow, there’s been a realization of the importance of business in this equation. They care about the health of their employees. They are looking more and more at the health of their communities and understanding that they’re inextricably connected.

NPH: Can you share an example of a critical partnership CDC has with a corporation?

Charles Stokes: A good example is a partnership we have with Amgen, a pharmaceutical firm. One of their focus areas is cancer treatment. They were finding that while their products were being used effectively to save lives from cancer, many patients were dying from institutionally acquired infections. At the same time, CDC had ongoing programs aimed at educating institutions and providers, and patients and their families, on how to prevent these kinds of infections. So, through a partnership with the CDC Foundation, Amgen provided funding to enable CDC experts in cancer and  health care quality to apply their expertise specifically to preventing infections in cancer patients.

CDC often has the science but is not funded to get their messages out, and this partnership enabled CDC to launch an interactive website for patients and their caregivers and develop new tools for outpatient oncology clinics—and then market both through the media and direct outreach to  health care providers and patients. I think it’s a great example of a win-win, and a great example of the intersection of clinical health and public health.

NPH:  What is the incentive for businesses to get involved in public health?

Charles Stokes: I think we can bring more corporate partners to the table if more corporate leaders are aware of the impact of public health problems and solutions on their businesses. As someone who’s been on both sides of the table as a budget analyst listening to public health talk about itself and then as someone involved in selling public health, I think prevention and public health are terms that do not sell well. Nobody understands, and we in public health tend to bemoan the fact that nobody understands us. I think we’ve got to get over that, and we’ve got to begin to look at how do we take what CDC does and talk about that in a language that not just philanthropy, but, equally important, business understands and appreciates.

So a new key focus area for the CDC Foundation is to demonstrate how the health of our nation impacts the health of American businesses and our national economy. CDC [and public health] is vital to a healthy economy, helping employers and families reduce  health care spending; fighting disease outbreaks that disrupt continuity of operations and reduce productivity; and providing proven guidelines and health data to help protect workers’ health and safety. At the CDC Foundation, we are working to identify opportunities to educate corporate leaders about how CDC keeps American communities—and American businesses—healthy, safe and secure. And about how they, as corporate leaders, can help. I think that’s extremely important.

This commentary originally appeared on the RWJF New Public Health blog.