Leading Towards the Finish Lines in Global Health: A Conversation with Dr. Muhammad Pate
By Renzo Guinto
Nearly 40 years ago, the global health community triumphed over smallpox, one of the biggest scourges in human health. Today, Dr. Muhammad Pate is finishing the race towards eradicating another major infectious disease that has claimed millions of lives — polio. To discuss the challenges and triumphs of his pursuit, the Voices in Leadership series put the spotlight on Dr. Pate at the Harvard T.H. Chan School of Public Health on September 8, 2016.
An American Board-Certified MD in Internal Medicine and Infectious Diseases, Dr. Pate held several positions at the World Bank prior to being appointed the Executive Director of Nigeria’s National Primary Health Care Development Agency (NPHCDA), eventually serving as the Minister of State for Health for Nigeria from 2011 to 2013. As a Menschel Senior Leadership Fellow at the Harvard T.H. Chan School of Public Health, Dr. Pate teaches a course entitled “Leadership Development in Global Health: Building Community Trust Networks.”
Running the race without losing the big picture
During Dr. Pate’s term in the Nigerian government, the country was on the precipice of a polio-free future. Though the global health community promoted a disease-focused campaign, Dr. Pate understood the needs of his country.
“Polio was more a symptom of an underlying dysfunction in the basic health service delivery,” he said. Keeping this perspective on health systems in mind, he was determined to finish the polio race and strengthen the primary health care system. Not only did Dr. Pate confront the tension between global agenda and local needs, he also had to assess competing domestic demands. Though some may have believed Dr. Pate’s ‘diagonal’ approach to polio ran counter to an intense concentration on disease eradication, he strongly believed that there had to be a balance between globally-agreed priorities and locally-expressed needs.
“You can’t also just go to your community and say you have to deal with it when they have other issues that people consider unattended,” Dr. Pate remarked. “It’s the role of leader to arbitrate that, to frame it in such a way that the local context also appreciates the value of finishing it for the global imperative but also for the felt needs of those community members. That can be lost if you just go purely from a vertical perspective.”
Building coalitions, forging trust
Dr. Pate also emphasized the value of forging trust within communities where health initiatives were taking place. To resolve the “trust deficit” between the community and government, Dr. Pate and his ministry partnered with leaders of what he called “traditional institutions.” These institutions were trusted by local people, and ensured that the populace was involved in the planning and execution of the polio elimination campaign. He also partnered with private businesses.
“Finding a way of taking what is good from the private sector capabilities and resources and complement it with what the public sector has” is doable, Dr. Pate said.
He emphasized the importance of “protecting the public mission, protecting the vulnerable, ensuring it’s governed properly.”
New ways of doing things
Dr. Pate also reflected upon the West African Ebola outbreak. Though Dr. Pate was no longer the health minister when Ebola hit Nigeria, he co-chaired the Independent Panel on the Global Response to Ebola convened in 2015 by the Harvard Global Health Institute and the London School of Hygiene & Tropical Medicine. He shared how the initial structures adopted for eliminating polio have been useful in mounting an immediate response to fighting Ebola, and highlighted that vertical programs should, through “deliberate action,” find their way through the horizontal public health system.
As the global health community confronts emerging threats, Dr. Pate believed that there is a need to stop solving problems in hierarchical manner. “When people look at the global governance today…we’re looking at a single institution, a single leader that actually will solve all the problems in a hierarchical manner,” Dr. Pate remarked. “I think that’s the past.” As a future public health leader, I shall take Dr. Pate’s advice, and embrace “non-traditional and non-hierarchical ways to come together and respond to a dynamic problem that threatens everybody.”
Story by Renzo Guinto, a physician trained in the Philippines and a first year Doctor of Public Health student at the Harvard T.H. Chan School of Public Health.
Story edited by Sohini Mukherjee, a first year Master of Science student studying Global Health and Population at the Harvard T.H. Chan School of Public Health.