What’s the Key to Building Sustainable Global Healthcare Systems?

Physicians for Peace CEO Lisa Arfaa talks with veteran Global Health leader, Erin Thornton, about how to end health disparity

For the first stop on my Learning Tour, I sat down with Erin Thornton, a consultant I brought on in November to work with PFP’s programs team. Erin is a seasoned leader in global health, one of Devex’s Top 40 Leaders in Global Development Under 40 in 2010, and a super-bright woman hired to help determine the most efficient, effective and sustainable way forward for Physicians for Peace.

Lisa: Hi Erin. First off, I’m thrilled to have you on board with all of your amazing expertise in global health. I hoped you could just fill people in a little bit on who you are, and your background, both personally and in global health.

Erin: Hi Lisa. Sure, happy to. Like you, I grew up in a medical family and always thought I was going to go into medicine. I also had the bug to travel internationally, but I thought that would just be a hobby. But then in my junior year of college I spent a summer in Zimbabwe, and put medicine on the back burner to go into development. After grad school, I worked for both the Export-Import Bank and the U.S. State Dept. in the International Health Affairs office, trying to piece things together to work on the overlapping issues of trade, health and debt cancellation. I have such tremendous respect for those who work within the government system to change things, but I was young and passionate and the opportunity to be a bit of an activist on the outside was too tough to resist.

In 2002, I was lucky enough to join forces with the team that was putting together a new advocacy organization called DATA (debt, AIDS, trade, Africa). The precursor to the current ONE campaign, it was an advocacy and campaigning organization co-founded by Bono and Bobby Shriver. I was the Global Policy Director, trying to understand what the public needed to know to help drive policy and what the policymakers needed to hear to push the agenda. One of the first things we really focused our work on was the HIV/AIDS crisis, but we always did so in the context of the broader development agenda and all its components, be it education, trade, water, sanitation or its impact on specific groups, like women. From ONE, I went to work with Christy Turlington Burns as the Executive Director of Every Mother Counts, a campaign she co-founded to engage the public on global maternal health. I was inspired to work on maternal health as I came to recognize the inordinate burden that women face in terms of so many development challenges but also the opportunity to positively impact entire families and communities by supporting the women.

Lisa: Such amazing work. What inspires you to stay committed to global health? Why do you think this work matters so much?

Erin: I think that looking at healthcare around the world, it is such a demonstration of inequality. There are people dying of things they absolutely don’t have to die from simply because of a lack of access to care. What’s unbelievable about global health is that where you live is such a determination of how you fare. There are people still dying of diarrheal diseases and in labor. The injustice of those deaths, when we have the means to do something about it, motivates me to keep on working.

Lisa: A lot of people, especially in government, talk about how health disparities are rampant domestically, with plenty of unnecessary illnesses and deaths here in the States. Why do you believe that global efforts are so important to focus on?

Erin: There are definitely inequalities here in the U.S., but the magnitude of health disparities in developing countries is just different. And we live in a connected world now, where disease knows no borders. There is no Us and Them anymore. It is in everyone’s self interest to protect against illness and epidemics around the world.

Lisa: Looking back, what would you say was your greatest accomplishments in global health?

Erin: Well I’m not writing the memoir just yet- there’s a lot still to do I hope! But I do remember one moment where I really realized how lucky I was to get to work in this field. Back in 2002, when the U.S. decided to invest in the HIV crisis and created the President’s Emergency Plan for AIDS Relief (PEPFAR), the question arose about whether or not countries were equipped to absorb the aid that we were talking about mobilizing. At the time I remember feeling infuriated by the question even though in time, you realize it was exactly the right one to ask. Regardless, we rolled up our sleeves and started calling around, talking to the experts and those who we knew would be implementers. I remember asking them, “what could you do tomorrow and what would you need?” and then putting together this 10-page spreadsheet listing partners and countries and their potential to scale up over certain time frames. We used that to keep momentum building. It was a very real debate and it really sticks with me as I continue to think about the need to build infrastructure alongside any global health intervention, but it was also just a very unique moment to get to be a real-time part of the debate.

Lisa: What do you attribute your success to?

Erin: I’ve been crazy lucky to have crossed paths with the sort of people I have and to get to build up such unique partnerships with people who have common passions and goals but different talents for making a difference. Great opportunities presented themselves, and I was at the right place at the right time. But I’ve also tried to stay true to knowing myself and knowing what it is that I can do uniquely well. While I’ll always be rooted in the substance and the policy side of things, I find great joy in building bridges so that information can get into the hands of those who can use it to make a change. I feel very deeply that there are great opportunities for individuals, corporations and nonprofits to come together to make a difference. We each have a unique set of assets to use and sometimes it’s just a matter of identifying those and navigating the right path forward.

Lisa: What are the global health priorities that the world needs to be focused on?

Erin: While headlines will continue to compete over the latest and greatest threat, or immunizations or the not-yet-finished-fight against HIV/AIDS, the truth is that we need to build up the capacity of countries to address all of these. That is a complicated thing because health systems are complex, expensive and time consuming, so the key right now is to find the most efficient way to help countries build their own capacity to serve their citizens. That way, they’ll be better able to improve overall health and mount a response to the next global health challenge that we don’t even know about yet.

Lisa: In our lifetime will we see quality healthcare reach a majority of communities in the world?

Erin: I’m not sure. I think it’s important to reflect on just how much progress our generation has seen and to really celebrate that fact. The statistics on improved child mortality, on the fight against HIV/AIDS, on diseases like polio…people get numb to them, but they are truly amazing success stories that the generation before ours probably thought impossible. So I don’t want to say anything is impossible. We’ve ridden this great wave since the turn of the Millennium with attention increasing for the poorer people on the planet, and we’ve done a lot of good with that. But the advocacy side of me knows there are windows of opportunity where people pay attention, and sometimes those windows will close. If this generation doesn’t seize its chance to build on the successes we’ve had so far and further build something that can deliver for all the health challenges still outstanding, then we’ll have really missed a great opportunity.

Lisa: How have you seen the global health landscape change between when you started with DATA in 2002 and now?

Erin: There have been huge strides made. There has been a turnaround in child mortality, we now talk about an ‘AIDS-free generation’…it’s amazing how far we’ve come in terms of our ability to say ‘yes, we can do this.’ How we take those gains that will help weather the storms we don’t know about, and actually help deliver truly equal access to quality healthcare? That will still take much more innovation in technology, much more in-kind building and sharing…we still have a long way to go.

Lisa: Was Physicians for Peace founder Dr. Charles Horton innovative in starting a global health nonprofit?

Erin: Absolutely. What’s great about PFP is that it’s authentic and uniquely has remained committed to capacity building whether it was the “in” thing to do or not. I have always found that individuals who are uniquely passionate and willing to truly commit to ‘walk the walk’ can make a tremendous difference. Charlie Horton recognized the need to build capacity and has put that first and foremost into his work as does PFP today. What needs to happen now is to build on that vision, with various organizations determining what they can bring toward the solution, because so many single organizations working independently is grossly inefficient.

Lisa: That said, what appealed to you specifically about PFP?

Erin: I was really drawn to the opportunity to work with a small organization that was wrestling with these huge questions of capacity building. Meaningful capacity building is tough. It’s not about what we want to deliver- it’s about what a community, a country needs and what will work within their environment to deliver for their population. In meeting with the team here I was impressed by the commitment to really understand what was needed and what PFP could uniquely do to help and that’s a very rewarding challenge.

Lisa: Thank you. Now, what’s your first order of business?

Erin: Having identified increasing surgical capacity in some key regions as our immediate mission, we are in the process of identifying exactly what we should be doing on the ground. That’s an exciting and daunting task to determine what’s needed and what we uniquely can do, but with our laser focus, I feel confident we can make some exciting strides.

Lisa: Thank you, Erin.

Erin: Thanks Lisa.