“A Mighty Purpose:” How individuals can impact global health
Like a lot of folks in global health, most of my reading is from boring, dense, and dry journals. I don’t get a ton of sunlight and at the end of most days; my eyes are tired from looking at a computer screen. However, every once in a while, a book will come along that reminds me that global health is ultimately about people and our shared experience. The academic in me wants to believe that history is a story of structural factors, but one book this year showed how a single person’s personality and sheer force of will can help bend the trajectory of life of millions for the better.
That’s why A Mighty Purpose: How Jim Grant Sold the World on Saving Its Children resonated with me so deeply. The most fundamental injustice that I see in our world is that we have the technology, knowledge, and wealth to prevent massive amounts of suffering in our world, but we largely choose not to. Jim Grant’s career as Executive Director of UNICEF is about how the world, collectively, began to reverse that decision and value the lives of children.
What’s most amazing about Grant’s work is his singular focus on results. A Mighty Purpose conveys how Grant, through sheer force of personality and will, pushed ministers and presidents to focus on children and the most effective health interventions. Towards the beginning of his helm at UNICEF, Grant focused his efforts on a narrow set of interventions called GOBI (Growth monitoring, Oral rehydration therapy, Breastfeeding, and Immunization).
As Grant put it, this mission was “doable” — he could convince political leaders to support these simple, proven interventions. Grant’s insistence on GOBI has many legitimate criticisms, but what they miss is that it’s exactly this laser-focus on just a few interventions that allowed him to successfully make the case to political leaders that child health matters. Even aid critics like Bill Easterly praise Grant’s top-down approach as successful.
Moreover, Grant deliberately advocated for some of the most effective interventions we have — there is no “magic bullet” that will end all disease burden in the developing world, but we can focus on using our resources to maximize impact. In any case, the results speak for themselves: the child survival revolution that Grant helped spur is credited with moving 129 countries on earth to immunization rates of at least 80%, expanding oral rehydration therapy to nearly ⅔ of families in the developing world, and saving nearly 12 million lives.
Throughout his career, Grant maintained that UNICEF should put most of its efforts into the “silent crisis” of preventable deaths that claims millions of lives every year, rather than disasters that inevitably spring up. However, some of A Mighty Purpose’s most incredible anecdotes happen in the middle of warzones, shaky ceasefires, and brutal regimes.
In one meeting with Syrian dictator Hafez al-Assad — father of Syria’s current dictator, Bashar al-Assad — Grant asked, “how would you like to beat the Turks?” Grant told al-Assad that Syria’s former colonial master during the Ottoman Empire, Turkey, had successfully immunized a majority of its children, unlike Syria — a massive gamble to say to a dictator. Al-Assad was intrigued and listened to Grant, eventually calling several ministers, who appeared within minutes. After just three months, Syria launched an immunization campaign that caused coverage for most vaccines to skyrocket. Grant applied this tactic of playing dictators’ sense of jealousy and rivalry wherever he could, orchestrating successful ceasefires and health campaigns in Syria, El Salvador, Sudan, and Bosnia.
Many questioned Grant’s eagerness to work alongside some of the world’s most reprehensible characters, but his response was always defiant: “We don’t like the President so the kids don’t get immunized? You want to wait to launch the campaign until all governments are respectable?”
Certainly, Grant was no perfect character and many of his decisions deserve more critical reception than provided in the book. However, I struggle to think of many people who have had as positive an impact on the world when judged for the entirety of their work. I’ll save you another story about Grant and instead, encourage you to just read the book in its entirety. There is probably no better book to bring you to see the urgency of our work in global health. Although there was very strong competition last year, A Mighty Purpose is my favorite global health book of 2015.
Scott T. Weathers is a 2015–2016 Global Health Corps fellow at IntraHealth International in Washington, D.C. All GHC fellows, partners and supporters are united in a common belief: health is a human right. There is a role for everyone in the movement for health equity. Join the movement today.
