Let Go the Reins: On Investing in Young Leaders

Global health leadership is too male… and too old (and too white)

In her recent editorial, Nina Schwalbe boldly points out the unfortunate normalcy that many of us in global health have lived with for so long: though the workforce is largely female, the leadership is overwhelmingly male. While a gaping gender gap is by no means unique to the health sector (sadly), calling it out in the world’s preeminent public health journal The Lancet — which has, in fact, never had a female editor-in-chief — is, as the kids would say, a boss move.

It’s already helping to spark a healthy call out. Last week, World Health Organization’s newest leader, Dr. Tedros Adhanom, blithely Tweeted a photo of a successful brainstorm with World Bank head Dr. Jim Kim and his team.

He was quickly admonished by dozens for an all-male photo. It was an unfortunate gaffe in the day and age of Tumblr’s “Congrats, you have an all male panel,” but shows just how easy it is to rest on the status quo.

The largest and most prominent global health institutions in the world — with more access and resources than anyone — should be leading the charge for gender parity, not trailing behind. Dr. Adhanon handled it gracefully, quickly acknowledging that this is something to be fixed, though it would be near impossible to admit otherwise. So, here we are (still) at the “admit there’s a problem” stage.

But the problem isn’t that simple. Embedded in Schwalbe’s editorial, but not explicit, are the additional layers of inequity within global health leadership. Humans contain multitudes and inequity is always intersectional. Yes, global health leadership is mostly male (with important exceptions, like the rad-as-hell Dr. Sue Desmond-Hellman who runs The Bill & Melinda Gates Foundation and is actually not their first female CEO — hooray!). But global health leadership is also mostly old and white.

Important side note: The whiteness of global health and development — and its eerie mimic of colonialism — deserves more in-depth discussion than I can devote here. But I will say: in the face of historic and ongoing oppression at all levels of people of color, to be an effective and ethical global health leader who is white requires crystalline self-reflection. It demands humility and realism about one’s privilege within systems, and the impact of one’s actions and words. It demands additional systems change skills. It requires of us to pass the mic, give up a seat at the table, and certainly let go the reins.

We need more women at the helm. YES. We also need younger folks, including and especially young women. We need new faces, voices, and visions at the helm in global health and pouring from the pipeline. That doesn’t often happen. That’s not because there aren’t hundreds of badass, creative, and highly talented emerging health professionals just waiting for the opportunity to lead like a boss.

It’s that we, as a field, don’t value mentorship and the investment in a leadership bench the way we should.

Instead, we create excuses, bottlenecks, and obstacles. We don’t make way. We cling to what we know and to our security. There is an important correlation between age and experience, certainly. Unless you’re Doogie Houser, M.D. (a reference that belies I’m not that young myself), it takes time to earn the credentials and the credibility that are often required for the highest posts. But why are they required? The assumption that lack of experience = lack of ability means we miss out on the opportunity to have creative and fresh perspectives at the table. We rob high-potential emerging leaders of opportunities to test their mettle and to rise to the occasion. How many countless “youth” panels at conferences and meetings have kept emerging giants tokenized at the “kids” table? Why don’t we have more young leaders on our boards, our high-level plenaries, and deputized to run our organizations?

They aren’t ready, you may say. And sometimes you’re right. But what are you doing to change that?

Strong management as part of visionary leadership has only relatively recently become valued as a priority within global health, a field which has focused on policies and interventions as primary “wins” for so long. Strong management should be measured by how well we invest in and develop others around and “behind” us. Great leadership hinges on the ability to envision and serve the greater good — a future you may not be in charge of or even part of.

In global health and development, we often use the rhetoric of wanting to “work ourselves out of a job.” We serve others until others no longer need or want that. But there are other ways we can think of working ourselves out of a job: investing in someone’s development so that they can step into big shoes, and letting go to give them the chance to lead. This is particularly critical if we want to expand the number of badass women leaders in global health.

“Life Each Other Up,” Libby Vanderploeg (libbyvanderploeg.com)

Investing in young leaders is certainly easier said than done. Anyone who’s ever managed or mentored someone knows it might possibly be the most challenging (and most awesome) thing ever. You never get it perfect (dang!). It’s a dynamic equilibrium. It’s an adventure in trust and a wisdom exchange. It’s a continuous growth pattern. It’s also a hefty time and energy commitment. The road between where someone is and where they want to go is likely long and circuitous. Are you there for it?

I want to give all due respect to the giants of global health and still say… you should be investing in your successors and then please consider moving on when the time comes. Asking female global health leaders to “make way” is complex given the ageism exhibited toward women in particular in the US, and the dearth of female leaders in global health to begin with. But if we want to erase the gender gap in global health leadership, even the most brilliant minds will retire one day. Every leader in the field, male, female, or otherwise, should invest in an emerging female global health leader.

Here is what I mean by “make way”: 1) Say yes. Invest in (ideally) multiple emerging leaders and bright stars, and not just young white men. 2) Be generous: with your time and your patience, but especially your learnings. 3) Affirm that failure is not to be feared and always at our heels. We can work with and through it. It isn’t a mark of weakness. 4) Show, don’t tell, your values. Strive to walk your walk and own up when you don’t. 5) Let go: of what you want someone to become, and let them walk their own path. 6) Pass the mic: Let go of your clutch on the opportunities you’ve “earned” and ask yourself if you really need them anymore. Do you need to sit on that panel (again)? 7) Root for them: Support young leaders to step into big shoes and have their back when they do.

Every single leader should have at least one, if not more, mentees under his or her wing. If we want to change the face of global health leadership, which I think we must, mentor a young woman. Mentor a young person of color. If you are reading this and you aren’t mentoring someone, email or text me. I know hundreds of gangbusters young leaders who could use a chance, a contact, or a piece of advice.

The world is more global and connected than it’s ever been. We’ve been working away at mammoth challenges like needless child mortality and hunger for decades. We’ve seen some progress, but not nearly enough. We need new construction, not stasis. Turning our intention to the development of emerging leaders, and opening our minds to the possibility that they are, already, ready to lead is a bold step toward this. If we can do that, we’re really building something!