Let’s engage in dialogue that moves global health forward.

Last week I attended a meeting in Brussels called by the European Union on Global Health. These high-level meetings seem largely ceremonial but obtaining consensus and inter-governmental agreement is key to enabling large organizations to move forward. So, they are frustrating but necessary.

I attended two sessions focused on research. Although important topics surfaced and some novel ideas were proposed to address them, two of my least favorite “false debates” predictably came up. The first is the idea that we invest in innovation OR access. The second is that product-related innovations are at odds with social innovations. I have been enduring these discussions for my 20 years in global health and feel the time has come to ask this question:

Can we all focus on the end game, understand what is needed to gain successful outcomes, and if our ‘solution’ is not needed to solve a given problem, can we let it go in favor of those that are needed?

If we look at global health as collective problem solving, then maybe we could get somewhere. Innovation and access are inextricably linked and if you try to do one without the other you will fail in your goals. We have learned the lessons of developing technologies and throwing them over the fence for the implementers to deal with. The Malaria Vaccine Initiative under the direction of Alan Brooks has been working with policy makers and implementers to prepare for the rollout of a malaria vaccine for about 5 years! This is based on lessons learned from current vaccines and the difficulties in getting them to the children who need them most. The lessons about preparing for the roll-out of new technologies are being learned.

Though we would like to believe that all human behavior is evidence based and rational, sometimes people want the shiny new technology even if the dull technology gets the job done (think Mac vs. PC and pneumococcal vaccine vs. measles). In my many years of being a grantee of the Gates Foundation, I have had one 1-hour meeting with Bill Gates, shared with five other groups. I used this time to make the case for a revolution in health systems that mirrors the technological revolution that is well underway. Social innovation, including the vitally important role of health promotion, is key to behavior change and to finding issues that appeal to the communities. Programs in microfinance, education, and agriculture may be the keys that open the door to new health programs. Why would anyone argue against social innovation?

The simple but profound truth is that we need the players from multiple disciplines to understand the value that each brings to solving the problems of global health and to find creative ways to work together to improve the health and well being of poor people. Spending more time in meetings engaging in false debates or paradoxes that will never be ‘solved’ may be intellectually stimulating for some, but I would encourage us to separate the academic debate from the real debate, and organize our meetings with those ready to move forward or who will allow others to move forward if they are not needed to solve a specific problem.

I would like to single out MSF at the Brussels meeting for a proposal to separate the cost of developing a new drug from trying to recover the R&D costs through the sale of the drug. Although I would not want to put my efforts into most aspects of this proposal because I rarely agree with proposals that seek to overthrow a system (beware the law of unintended consequences), at least MSF came to the table with a new idea aimed at moving the debate forward.

This is not a “global health architecture issue.” The harshest and most helpful advice I ever received is when someone close to me said, “Melinda you are a great problem spotter…the problem is that most people want to work with problem solvers.” This is a question of personal reflection. Can we all come to meetings ready to lay down our preconceived solutions, really listen to each other’s ideas, and aim ourselves toward identifying and solving the problem? I’ll set this as a personal goal and you can feel free to hold me accountable.

Melinda Moree is the CEO of BIO Ventures for Global Health.