The global health community was left bewildered when the Global Health Council suddenly announced last April that it was closing.
Members of the prestigious, decades-old organization were not warned in advance, participants in the upcoming annual meeting had to abruptly cancel their plans and the GHC’s cryptic explanation (scroll down to April) just left everyone scratching their heads:
“Times have changed… Funding that once existed to promote a broad-based health agenda is now focused on specific health issues. The fundamental shifts in the health landscape have led the Board to revisit the relevance of the organization and determine that the Council’s current operating model is no longer sustainable.”
But times have changed again, apparently.
The organization is being resurrected with a new board, a slightly new name (Global Health Coalition) and with purportedly a new and more relevant strategy.
Along with the resurrection of the GHC has come more detailed explanations of the previous collapse and what is intended to distinguish this new iteration. A Seattle-based organization, the Washington Global Health Alliance, is playing a leading role in this revival (and also serving as a model for strategy) as well as a DC-based aid and development organization, Global Impact, which is acting as the interim administration and secretariat.
But first, a bit of history and a description of how too much dependency upon another Seattle organization, a fairly well known philanthropy run by two former Microsoft executives, led to the demise of the GHC.
Global Health Leader
In 1972, the National Council of International Health was formed to provide a space for global health practitioners, researchers and organizations to collaborate, connect and share information. Doing so would support the collective goal of improving health around the world.
The organization changed to its present name, the Global Health Council (GHC), in 1998. The GHC’s flagship event was the annual International Conference on Global Health. It brought together the global health community each year for 39 years. By 2010, GHC boasted having 600 organizational members and a diverse set of 5,400 individual members hailing from more than 100 countries.
While the conference was the GHC’s more visible event, its additional value was serving as a convener and advocate for the global health community in Washington DC.
“Historically, the Global Health Council played an important role in organizing the global health community,” said Erin Hohlfelder, Global Health Policy Director, for the ONE Campaign. “They were a consistent, go-to resource for Members of Congress, their staff, and the Administration and they also played key facilitating and convening roles for the global health community.”
The GHC provided influential support in the re-authorization of of President George W Bush’s President’s Emergency Plan for AIDS Relief (PEPFAR), a program that has garnered praise from both political parties and global health professionals alike. By helping to coordinate the International AIDS Candlelight Memorial since 1999, the GHC helped to bring the grassroots campaign to over 1000 communities worldwide.
One of the most significant achievements for the organization, in terms of its policy influence, was its leading role in assisting the Obama administration’s aim of better coordinating the government’s various global health programs.
That partnership led to the administration’s Global Health Initiative, which though lauded in concept never really came into clear focus and was eventually shelved. Many said it did, however, change US global health policy to expand its focus from high-visibility infectious diseases like malaria, AIDS and TB to include woman’s health, nutrition and more.
Structural Problems Plague Council
The beginning of the end can be traced back to the growing reliance on member fees that made up only a small part of the budget and an increasingly fewer number of grants.
The Bill & Melinda Gates Foundation evolved into a vital donor for the GHC. From 2000 to 2008, the Gates Foundation provided grants to the GHC totaling $36,419,516. During that same period, the GHC spent roughly $7 million a year in its final three full years. The Gates Foundation grant disbursed in 2008 to the GHC accounted for more than 40% of the organization’s budget during that period.
With its relatively high budget, the GHC needed to either change its funding structure or reduce its costs to ensure that it was not vulnerable to the sudden loss of funds from Gates. “GHC staff was very aware of this problem and trying to rectify it but, in my opinion, did not do enough to make that happen,” argues former GHC staffer David Olson.
Despite the awareness, little was done to address the problem, Olson said. When the only staff member dedicated to fund-raising left in 2010, the development position was not filled. Olson contends the GHC did not do enough to nurture its relationship with the Gates Foundation and it went beyond simply having fundraising staff.
“Our reports to Gates should have included more quantifiable data,” said Olson. “For example, how many congressional staffers attended our Capitol Hill events and how did it change from year to year? The Gates Foundation is understandably data-driven, and we could have done a better job of providing relevant data.” As a result of staffing issues and a lack of communication the vital relationship with the Gates Foundation went neglected.
When the GHC was to make an appeal for funding from Gates in September 2011, there was still no fundraising staff. The grant was lost. Discussions were made to get funding from USAID, but that failed as well. Having become so reliant upon a single source for funds, the GHC was left with no other option than to close in early 2012.
Members Push Back
It came as a shock when the 40 year-old Global Health Council announced its closing in April 2012. The vague letter to members citing a lack of funding and “fundamental shifts in the health landscape” left many unsatisfied, frustrated.
The decision to close the GHC was sudden and unilateral. Neither the board nor the staff of the GHC consulted with the membership. “Since GHC is, at its heart, a membership organization that is there to serve the needs of the members, the membership should have been consulted on such a monumental decision,” says Olson.
Member organizations felt that the GHC was an important convener and many continued discussions to explore how to go forward.
“What everyone felt was needed was an organization that, instead of advocating for a particular cause, represented the interests of global health in its entirety,” said Lisa Cohen, executive director of the Washington Global Health Alliance.
Scott Jackson, chief executive officer of Global Impact, which is serving as the working headquarters for the reforming GHC, said the global health and development community sent a very strong message expressing a need for a single organization to advocate on their behalf to government officials, donors and the public.
“Basically, they said we all need to pull together to make the case for continuing to make progress in the fight against diseases of poverty,” Jackson said.
Given the fact that the GHC was already an established organization, it was agreed upon to reform under the already-existing organization, but make significant changes to the structure. A new board was elected in October 2012 and working groups were established to assist in the development of the GHC.
“We are revitalizing and reimaging it as a new organization,” explained the new GHC Board President Jono Quick. “It is not the same and it won’t be the same.” 45 members have committed to this new vision and the board is working with the 1,000 members in good standing to create an organization that contains many of the core elements as the previous GHC, but avoids some of the previous mistakes.
Quick said that the new GHC will put a greater focus on a network model as opposed to a staff model. That means there will be fewer staff and it will be cheaper to run. Decisions will be made by the membership rather than the staff and board alone.
A New and Better Coalition?
There are hopes that the new Global Health Coalition will be able to expand its network. For example, the new organization is already speaking with the Washington Global Health Alliance to better align with its work. Further, Quick said that the GHC hopes to look beyond Western nations as a source for membership and coordination. He hopes that the new GHC can support similar networks in the global south “We can have a global health network of civil society organizations,” said Quick. Such a set up would mean that there could be a greater alignment of ideas and policies with inputs from the groups on the ground and the people affected.
“However, a new Global Health Council will need to find a better way of representing global health needs to leaders in Washington. The old model of simply adding up a disease-specific roundtable ask for each issue no longer resonates in this economic environment,” explains Hohlfelder. “Deciding how and when to discuss sensitive budgetary and programmatic trade-offs will be a major challenge moving forward.”