Monday, July 26, 2010

Jim and Karen Ansara: Not giving up on Haiti

We had dinner over the weekend with Jim and Karen Ansara, and the talk turned to Haiti, to which he will be returning tomorrow as he has every 7-10 days since the earthquake last January.

Ground has been broken in Mirebelais for the hospital whose construction Jim is overseeing. The cornerstone will be laid on September 10 with completion hoped for in 15 months. Jim has spent almost as much time in the Dominican Republic where he searches for contractors, though most of the labor will be Haitian. The hospital is one of the largest construction projects underway since the quake and may be impressive enough to draw some Haitian away from Port au Prince to the more welcoming Central Plateau. Meanwhile Karen has just announced a first round of grants from the Boston Foundation where she and Jim put up the money but gave Haitians living in Boston the decision making responsibility.

The massive tarp and tent camps of homeless Haitians in Port au Prince have turned dangerous and the expectation is that they will be there for years. The cash for work programs are rumored to be riddled with fraud. Most of the aid workers are gone. There are a thousand reasons for giving up. The Ansara’s haven’t. Their continuing commitment inspires. They are true heroes of Haiti.

Tuesday, July 20, 2010

Behind Share Our Strength's growth: talent, imagination, stubbornness

Thanks to Paul Shoemaker, the visionary founder and leader of Social Venture Partners whom I greatly admire, for an e-mail yesterday asking if I could pinpoint the 2-3 most vital factors in Share Our Strength’s journey from start-up to more established national organization. He kindly suggested that I spend no more than 10 minutes on what could otherwise have been a months-long task.

In response, I shared the following: First, to state the obvious, we still have a long way to go at Share Our Strength. There is of course no secret sauce, but I would say that for an organization like ours it is all about talent and at several major junctures we very pro-actively set about upgrading our team, acknowledging the difficult truth that good was not good enough, and at least searching for great people with a wide variety of experience, often from the business community, that was different from our own. It made a big difference.

I also think that writing and publishing books about our learnings helped us to reach a larger audience. But probably most important, and this may seem at first like a “softer” answer than is helpful, I’ve really come to believe that most failures are not failures of money or strategy or planning or even of execution, but rather failures of imagination. At every critical turn for Share Our Strength we forced ourselves to imagine something that hadn’t been done before – whether it was a nationwide Taste of the Nation comprised of nearly a hundred events taking place at the same time or building a consensus to not only feed kids but actually end childhood hunger. Notwithstanding how unrealistic it might have seemed, we went for it. Even when we fell short it inspired people to do more than they thought they could.

Finally we are just plain stubborn. We keep at it. There are always some points to be had for that I guess.

Monday, July 19, 2010

"Battles big enough to matter, small enough to win" - hunger and malaria in Maryland and Moheli

Moheli is a small east African island thousands of miles from Maryland and as different as can be politically, economically and culturally. But Moheli and Maryland have something in common that is critically important to children, and also to Share Our Strength. Both have been chosen to demonstrate proof of concept for bold strategies once thought so ambitious as to be unrealistic: Maryland for eradicating childhood hunger, Moheli for eradicating malaria.
Both were chosen for the three same interrelated reasons: (a) they meet author Jonathan Kozol’s criteria of being battles big enough to matter but small enough to win; (b) each has sufficient political will to get the job done; and (c) the caseload and outcomes are manageable enough to actually measure.
Over the weekend MSNBC and other news services carried a Reuters report about malaria being eradicated on the small East African island of Moheli (population 36,000). Moheli is one of the Comoros group of islands at the northern mouth of the Mozambique channel in East Africa. In 2007 a Chinese professor working with a company called Artepharm Global, launched a mass drug administration in which the entire population of 36,000 had to take two courses of anti-malarial drugs to flush the parasites from their bodies. The malaria infection rate dropped from 22% to 2% before disappearing entirely. Now Comoros bars anyone from entering Moheli unless they take a course of the anti- malarial drug, called Artequick.
In 2008 there were more than 243 million cases of malaria worldwide and 863,000 deaths from the disease. So Moheli’s case load or lack thereof is too small to even register as a blip on the global totals. And the procedures used there – such as compulsory administration of the drug, could not be used in many societies. But it did serve as a proving ground for scientists desperate to prove that eradication is a possibility. The Comoros government now hopes to work with China to roll out the program to two of its larger islands with a combined population of 760,000.
Maryland is our Moheli. As became clear when Governor Martin O’Malley spoke about increased summer feeding enrollment at the National Governors Conference in Boston earlier this month, other states will be looking to Maryland’s results to decide how much political capital and financial support to put behind a campaign to end childhood hunger in their states.
Ending childhood hunger in Maryland, like ending malaria in Moheli, is just small first step. But it will send a very large message that the only failure that can stand in our way is failure of imagination.

Friday, July 16, 2010

Another Major Milestone Toward Ending Childhood Hunger

Yesterday the House Education and Labor Committee approved the Child Nutrition Reauthorization and sent it to the full House where it will await action. ( Many organizations like the Food Research and Action Committee, the Center on Budget and Policy Priorities, Feeding America, and Bread For the World deserve credit for helping to create the political will that made this possible. A big focus of the legislation is increasing access to existing programs – like school breakfast and summer feeding - which has been particular area of importance to Share Our Strength.

The legislation represents a critical milestone in our nation’s commitment to ending childhood hunger. It also represents a major evolution in Share Our Strength’s role from grant maker to other local, state, and national anti-hunger organizations – a role we continue to play – to one of policy advocate as well. The two are mutually reinforcing because it was in the course of making grants to hundreds of other hunger fighting champions that we began to see the gaps in program participation and the challenges of affording full access that are addressed in the House bill.
The legislation still needs to get to both the House and Senate floor and with the Congressional session nearing an end before the November elections, and much unfinished business remaining, there are no guarantees. But if Congress and the President want to ensure that those suffering the most unnecessarily from the recession and unemployment, they will move swiftly to take the final steps needed to ensure that programs proven to work are accessible to all of our children who are eligible.

Tuesday, July 13, 2010

Partners in Health provides transparency and health care

One of Share Our Strength's major grant recipients since the earthquake in Haiti has been Partners In Health. Yesterday, on the 6 month anniversary of the earthquake they released a report detailing their impact so far, as well as the $26.6 million in expenditures made in 2010 and projected spending through FY 2012. A summary can be found at Partners in Health has always set the standard when it comes to health care in Haiti and the other developing countries where they work. Now it is setting an impressive standard for financial transparency as well.
As you’ve seen from news accounts, conditions in Haiti remain desperate. The media has temporarily brought Haiti back onto the front page and into national awareness. Unfortunately it now only does so to mark major anniversaries of the earthquake, though the suffering of course is year round.

Monday, July 12, 2010

Last week the Gates Foundation announced a $10 million grant to the Institute for One World Health (IOWH) to increase the supply of semisynthetic artemisinin that can be used in the treatment of malaria. (Puget Sound Business Journal @ The grant furthers the work of synthetic biologist Jay Keasling and advances the efforts of the Institute of One World Health and sanofi-aventis to begin commercializing production in about two years.
The grant is also a reminder of one of the great triumphs of imagination that has transformed global health. The IOWH was the brainchild of Victoria Hale who believed that a pharmaceutical firm could exist as a nonprofit and thereby address the needs and diseases of those so vulnerable and voiceless that there are no markets for solving them. 

 We tend to think of science and medicine as being advanced by breakthrough discoveries from experts in the field. But sometimes it is the breakthrough thinking of social entrepreneurs, like Victoria Hale, that really changes everything.

Thursday, July 8, 2010

THE FEVER, a courageous book bears witness to the drama of man's struggle to end malaria

Yesterday the Boston Globe ( reviewed a new book called The Fever, by Sonia Shaw, about the impact malaria has had on the world over the last half a million years. I went out and bought the book and was glad I did. Shaw frames the drama in the books first pages:
“We’ve had plenty of time – our entire evolutionary history, in fact – to adapt to malaria, and it to us. Or, at least, to devise tools and strategies to blunt its appetite. And yet, despite the millennia-long battles between us, malaria still manages to infect at least 300 million of us – that is one out of twenty-one human beings on the planet – and kills nearly one million, year after year. As an extinguisher of human lives, write the malariologists Richard Carter and Kamini Mendis, malaria historically and to this day ‘has few rivals’. It remains essentially wild and untamed, despite its great antiquity.”

The book is a well researched and well written account of the ferocity of the disease and our long struggle to conquer it. But Shaw’s most important attributes are the courage and commitment it took to personally bear witness to the impact of malaria in Africa, India and elsewhere around the world, and to write about something to which most people are otherwise content to remain oblivious.
It’s tempting to describe malaria’s toll as senseless, but in the most tragic of ways it makes perfect sense because malaria affects people so vulnerable and voiceless that there have been no markets – economic or political – for solving this problem. Shaw gives a sense of how that is beginning to change as well. Having read her book from the perspective of having just finished writing an account of the race to develop the world’s first malaria vaccine – my new book, THE IMAGINATIONS OF UNREASONABLE MEN to be published in November by PublicAffairs ( – I had a renewed appreciation for just how formidable is the challenge ahead.

Wednesday, July 7, 2010

Imagining a National School of Tropical Medicine and Neglected Infections of Poverty for North America

Thanks to the Gates Foundation and others there has been a surge of interest in global health issues like malaria as well as what have come to be known as neglected tropical diseases. These include parasitic infections like schistosomiasis or leishmaniasis. Peter Hotez, who is president of the Sabin Vaccine Institute and editor-in-chief of PLoS Neglected Tropical Diseases, has been making the case that while we may not have neglected tropical diseases here in North America, we do have neglected infections of poverty that disproportionately impact African American and Hispanic minority populations.

A few days ago ,using the Liverpool School of Tropical Medicine and the London School of Hygiene and Tropical Medicines as models, Hotez published an editorial ( calling for a National School of Tropical Medicine and Neglected Infections of Poverty in North America.

Based on the conviction that training is not keeping up with advances in technology, Hotez makes the case for a new national school to train the next generation of global public health experts. It is an innovative and inspiring idea, characteristic of the ingenuity of Hotez who I write about in my new book The Imaginations of Unreasonable Men (to be published in November by PublicAffairs)