Stepping away, looking forward

This past October, on a blistering hot day in western Kenya’s Kakamega County, I gathered with PATH’s local partners in the busy courtyard of the county health ministry for a bittersweet farewell. The scene was development at its best: with the generous support of USAID over more than a decade, PATH and our partners had been providing technical assistance and building capacity for much-needed HIV/AIDS prevention and treatment programs. Working tirelessly, we had engaged more than 1,000 health workers, provided services to more than 800 survivors of gender-based sexual violence, and screened more than 58,000 HIV-positive clients for tuberculosis. Our collaborative success and USAID’s changing policies supporting the journey to self-reliance meant that PATH’s help was no longer required; we had done our bit, and the local public and nonprofit health organizations were ready to fly solo.

In celebration of our shared accomplishments, we transferred to the county ministry of health and other local health organizations some of the equipment that we had purchased for this program. Standing under a makeshift tent, I handed over laptops, as well as keys to motorcycles and cars, to help the program continue after our departure. We also had to make the difficult decisions to terminate the employment of more than 50 Kenya staff who had given great passion and energy to this work (thankfully, most found new roles with the local organizations). While the emotions of our teams were mixed and the journey ahead uncertain, that didn’t dampen the shared feelings of joy, accomplishment, and gratitude in Kakamega that day.

This month, I’m handing off another set of keys—those to PATH itself. After seven and one-half years as CEO, and almost 20 years deeply engaged with PATH (first as a board member, then as interim India country director), I’ve decided to make way for a new CEO, Nikolaj Gilbert. As in Kakamega County, it’s a bittersweet moment, but overall I’m full of gratitude for the immense privilege I’ve enjoyed to lead this great organization, work with such amazing colleagues and partners, support our important mission, and help shape the global health innovation agenda over the past decade. But the time has come for me to turn over the keys and keep moving forward in my activist journey.

From Montana cowtown to committed activism

I was drawn to PATH two decades ago because its mission aligned with my most deeply held values. Values shaped, in part, by my experience growing up gay in a 1960's Montana cowtown. Despite the fact I’m a white American male with enormous privilege, I’ve faced my share of discrimination. As a young man, isolated and in the closet, I channeled my energy into my studies, leaving Montana for an undergraduate degree at Princeton and then on to Taiwan and China. Maybe my early experience of being an outsider in my own culture accounts, in some part, for my desire to make things right in the world. It helped propel me into decades of social activism, including work on refugee resettlement and policies in the US and globally, national gay and lesbian legal activism, and human rights law in multiple contexts and countries. In Seattle, I served on and chaired nonprofit boards, including the United Way of King County, Fred Hutchinson Cancer Research Center, PATH, and others.

All of these experiences tied together my commitment to activism and social change, with my belief in the transformative power of technologies, innovation, and large system change. I became what I call a “practical activist”—working more and more behind the scenes, leading and connecting programs, ideas, and institutions, and building coalitions and organizations to make the world better.

Along the way, I was also extremely fortunate to snag a front-row seat to the nascent digital revolution, back when we were still calling the internet the “information superhighway.” My early experience in digital technology fueled my passion for innovation and a penchant for problem-solving. I spent a couple decades building a pioneering digital media company and working at the intersection of technology and social issues, including as McKinsey’s director of social innovation. In the midst of that wonderful phase of my life, I co-founded an organization that brought technology training and strategy to local nonprofits. When a friend asked me to get involved with PATH, I jumped at the chance to marry new health technologies with my abiding passion for social justice.

Helping to move humanity forward

I joined the PATH board in 2002 and never looked back. The organization turbo-charged my exposure to global issues and opened up a world of new ideas, innovations, and relationships that continually impress and excite me. It’s been a master class in practical activism that continues to deliver new lessons every day: How to create the conditions for great social innovation. How to scale up great ideas that work. How to be responsive to country needs and support their agendas. How to create global teams that are agile, motivated, evidence driven, and focused on real impact. How to navigate a dynamic world of political changes, evolving business models, new technologies, and community dynamics, while raising tons of money and executing on thousands of projects over these past almost eight years. 

Most important, I’ve relished the chance to work with teams of passionate, committed people, and will especially miss working with our teams around the world. Over the past two decades, they’ve consistently inspired me with their skills, energy, sophistication, and can-do spirit.

Together with our partners in dozens of countries, PATH has leveraged sustainable approaches to health innovation and systems to make a direct, positive impact on the health of hundreds of millions of people. We’ve helped chart real progress toward the UN’s Sustainable Development Goal of health and well-being for everyone on several fronts, including the need for universal health coverage. In 1990, just more than half of the world’s people could reliably access essential health services without incurring financial hardship. That figure has risen to almost 70 percent. Worldwide, plummeting malaria rates tell another success story: Forty years ago, there were roughly 37 new cases of the disease in every 1,000 people. Today, that number is 29. We’ve also made huge strides in immunization rates, because no one should die of an easily prevented illness. When we look at measles specifically, the worldwide immunization rate has risen from 72 percent in 1990 to 86 percent today.

Huge health inequities remain, even within individual countries, and plenty of work remains to be done. But life—as measured by health and education levels—is getting better, even for the poorest people on Earth.

A single PATH emerges

I’m enormously proud of PATH’s contributions to this progress, and humbled to think of the millions of lives we touch. During my tenure as CEO, we’ve come together as a single organization united by a mission to move humanity forward. We call it “One PATH.” It’s much more than a streamlined way of working and a more coherent brand and operating model. A unified PATH has driven greater impact and visibility, such as our centers of excellence in programs in malaria, digital and data excellence, and vaccines and immunization. A single PATH lends us an enhanced presence at the global leadership table. And, vital to our mission, this approach generates more collaboration and more partnerships around the world.

My lasting memories of PATH will always be anchored in joy and gratitude. For the privilege of getting to do this work. For amazing colleagues around the globe. And for working at the intersection of innovation and social justice. As I transition out of my CEO duties at PATH and explore ideas for the future, my immediate tasks are clear: I’m writing a book, expanding the social innovation class I teach at Stanford University, taking on the co-chairmanship of the WHO Digital Health Technical Advisory Group, and dusting off my long-neglected skis.   

In the coming year, I’ll take some time to reflect on the broader form my passion will take. But a few things are certain: I’ll continue to translate my outrage and concerns to optimism and activism, and I’ll remain deeply engaged in social innovation and global development. It’s good to hand off the keys of PATH to a great team and new leader, but I will always remain PATH’s biggest champion.