Remarks by Dr. Rajiv J. Shah, President of The Rockefeller Foundation: Announcing The Rockefeller Foundation’s Precision Public Health Initiative
September 25, 2019
As delivered on Wednesday, September 25, 2019 at the Grand Hyatt, New York City
Good evening. How are you?
Thank you Naveen, for your extraordinary leadership and convincing everyone to come out here, and thank you to your team. Many of you may not know our full Health team – some of our members are new – but Nana, Manisha, David, and the rest of the crew, thank you so much for your hard work and your leadership.
We do gather tonight at a pivotal time in the fight to achieve health for all. Four years ago – how many of you were here four years ago, at the UNGA event? So you know – and, frankly, for many years before that, we came together as a global community to set goals that represented the future we wanted for our children: where no child dies of simple diseases; where every mother survives childbirth; where all of humanity has an equal chance at a full and hopeful life.
Yet on multiple counts, the arc of progress has plateaued. Despite overall gains in reducing deaths for children under the age of five, the needle is moving much slower for babies surviving their first month of life. And the same is true for mothers. Across sub-Saharan Africa, progress is stagnating, while in some places – including here in the United States of America – maternal deaths are actually on the rise.
So here’s the bottom line: we are not on the path we hoped to be on four years ago – and it’s not because we lack knowhow. It’s because we have not done enough to extend the knowledge and resources we have to the front lines of health in the very poorest communities.
But now we have a chance to change that. In the last five to seven years, we’ve seen incredible advances in data science and other technologies that can help us achieve our goals. And we’re betting that deploying these tools to frontline health care workers – putting data-driven insights in the hands of a global community health workforce that is more than 5 million people strong – will in fact be transformative.
I saw the power and promise of data for health during the 2014 Ebola crisis in West Africa, when I was in a different role. At first we were struggling – most community health workers on the front line of that response were in fact flying blind. But once we started to get transparent, location-specific, real-time data on where someone had perished from Ebola, and who their relatives and other contacts were, we could target prevention and response efforts much more precisely.
The data really do tell the story: we stopped the epidemic more quickly and more effectively than anyone thought possible. It was a powerful example of how investing in the health of those least fortunate helps us all. And it convinced me that if we’re going to achieve our goals in global health, we need to use these data tools more broadly to make public health efforts much more precise.
That’s why we are launching The Rockefeller Foundation’s new Precision Public Health initiative, which will take this concept to scale for high-risk families in vulnerable communities around the world. Together with our amazing partners, we’re committing $100 million dollars to this initiative, with a goal of saving at least 6 million lives in 10 countries by 2030.
We’re starting in Uganda and India – which combined have more than 2 million community health workers. These individuals spend their days going door-to-door. This initiative will seek to empower them with better data and predictive analytics, so they can precisely target proven community health interventions to those families with the greatest needs.
Doing so will help save millions of lives – and doing so will also harness the frontiers of science and technology to build a more equitable world.
Think about it: less than five minutes away is the Apple Store Grand Central, where you can buy – if you have enough money – a watch with an ECG monitor that assesses your heart beat and tells you if something is wrong. And that’s just one example of how data, science, and technology are revolutionizing human health.
But here’s the problem: when it comes to data science and technology and health, most of the brightest minds, most of the largest investments, and many of the best innovations tend to come from, and be designed for, the parts of the world that are healthiest and wealthiest.
The result is health for some, not health for all. And it’s only deepening the extraordinary inequalities in our world today. Almost everyone else is being left out and left behind – like this mother in Burundi, Mama Fidès, and her 11-month-old son, who has a high fever and anemia caused by severe malaria.
So at The Rockefeller Foundation we’ve been asking a fundamental question: as data, science, and technology increasingly make it possible to live longer, healthier, and more prosperous lives, will this happen equitably? Will it lift up all of humanity? Or will more and more be gained by fewer and fewer people?
You all know the truth: right now we’re facing a future where some people who have money and access to cutting-edge innovations are likely to live to and beyond 100 years of age – while on the same planet a baby girl born in Chad, born into poverty, is 55 times more likely to die as a child, a number so high it’s morally outrageous.
Tomorrow approximately 14,000 children worldwide will suffer a similar fate. Most will die from preventable, treatable causes of disease, such as malaria, pneumonia, diarrheal dehydration – even though we have simple, proven primary care interventions, like treated bed nets, vaccines, and oral rehydration solutions, that we know can save these lives, and that frontline health workers can deliver effectively if given the chance and the tools.
Precision Public health can bridge this gap. Let me show you.
We’ve had these kinds of maps for years, showing where child mortality is highest. Today we can even model it down to a 5-kilometer resolution, which is extraordinary progress. This is great for high-level reporting, or if you’re managing resources at a global, regional, or national level. But if you’re a frontline health worker trying to save lives door-to-door in a community, you need something very different.
Put yourself in the shoes of a frontline health worker in the field, like Deborah here on the left. You work countless hours trying to save the lives of mothers and children – often your very friends and neighbors. You’ve watched babies die in their mothers’ arms. You’ve had people survive one day but perish the next, because there wasn’t enough medication or supplies on hand. It’s easy in that context to feel powerless. And you can’t solve what you can’t see. Top-down population estimates of health risk, like the ones I just showed you, really don’t help you very much. You need data that is much, much more precise.
The good news is that this capability is finally emerging. I’m glad Uganda’s health minister, Dr. Jane Aceng, is here with us today. Thank you for your partnership and commitment to innovation.
Today the Ugandan government and its partners have the ability to create detailed datasets with information gathered by frontline health workers. If you match it with location data, you can see where women and children are dying, and why, precisely at the household level. And if you integrate non-health data, you can take this to a whole new level.
In the health world we call these ‘social determinants of health’ – things like income, infrastructure, access to electricity, and proximity to health clinics. When we plug in those datasets – showing the main power grid and the nearest clinics – we believe we can generate predictive insights that let us target health risks with even more pinpoint accuracy. It means we can act with more precision, and more efficiency, than ever before.
Imagine if a frontline health worker was empowered with the right information, at her fingertips, that can help her make the right decisions. She could pull out her phone or tablet, and see in real-time who, when, and where the health risks are greatest in her community, and what it’s coming from: a disease outbreak, a homebirth, or an impending flood. Then she can stock up on supplies, arrive early, and provide the care, resources, knowledge, and connectivity that can help save lives.
That’s the power of Precision Public Health. And not only is it key to unlocking health for all – we believe it will help save at least 6 million lives between now and 2030, in 10 countries, starting with India and Uganda.
Over time, Precision Public Health can be a strategy to address other major health challenges: from chronic diseases like diabetes, to mental health, to preventing the next pandemic. And because we all believe in data – otherwise we wouldn’t be here today – we will of course measure our progress: starting with how many frontline health workers are able to use these analytic insights, and whether it’s made them more effective at doing their job.
Tonight you’ll hear from many of our extraordinary partners – including Henrietta Fore of UNICEF, an innovative and demanding leader who is absolutely on the frontiers of innovation in this space. You’ll hear from Dr. Tedros from the World Health Organization, who understands community health perhaps better than any other former health minister on the planet. You’ll hear from Dr. Seth Berkley, a former Rockefeller alum, but now the leader of GAVI, who is putting resources and detailed measurement in practice all around the world. You’ll hear from Peter Sands of the Global Fund, who believes in data analytics empowering those who are trying to reach the most vulnerable. And you’ll hear from Dr. Muhammad Pate, from the Global Financing Facility supported by and hosted by the World Bank.
It’s rare for so many different and diverse global health organizations to stand on stage together and join hands for this common purpose, and for this common goal. Forging committed partnerships has long been a hallmark of The Rockefeller Foundation, and we’re proud to continue that tradition with you all today.
We’ll also hear tonight from private-sector technology companies, whose capabilities and resources could really help accelerate this work even more.
This initiative will be the central focus of Rockefeller’s health work over the next decade. Having shaped the field of modern public health more than 106 years ago, we’re now attempting to bring public health into this century, together with our extremely innovative and courageous partners. It’s a cornerstone of our commitment at the Foundation, in this new era, to make sure innovation empowers all of humanity to rise.
If you remember nothing else tonight, please remember these three women – a frontline health worker, a mother – actually a grandmother – and a baby girl. Because the actions we take today on behalf of them speak volumes about our values.
Thank you, all, for being here. Some of us together have been working together at this task for decades. But all of us are here in this room because we’re committed to a very simple idea: that we are all connected to each other and should work together to extend the reach of human dignity to every single person on this planet.
I know this week, in this town, we’ve heard some different visions of the future. One in particular that says our purpose should be to look out only for ourselves, and elevate our differences over our common aspirations.
Against the backdrop of that competing vision, I know those of us in the room here tonight will look back on this work together, and take pride in how our actions made clear where we stood at this moment. Because they also make clear what we value:
A health worker’s desire to serve her community.
A mother’s love.
A child’s future.
That is what we’re fighting for, who we’re fighting for, and why I hope all of you will join us and our partners in this mission forward.
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