New Job: Country Support Analyst at the Clinton Health Access Initiative

I was lucky to have a little break in Thailand between my last job at PwC in Tokyo working on sustainable international business deals, in particular inclusive busine feasibility studies, and my new job at the Clinton Health Access Initiative (CHAI). For self-promotion purposes and those that want to know, my understanding of the job is described below.


My title is Country Support Analyst for the Labratory Services Team with the Clinton Health Access Initiative (CHAI). CHAI is an arm of the Clinton Foundation. Within CHAI I’m working on a Multi Drug Resistant Turbeculosis program that aims to reduce deaths caused by TB and MDR-TB in Africa, which when combined with HIV is the biggest killer in sub-saharan Africa.

TB treatments have been around for a long time but have never been accessible enough to eradicate TB completely or even reduce the problem to a manageable level. Making matters worse the TB bacteria has evolved and there is a growing number of cases where the best drugs are no longer effective. They call this new bacteria Multiple Drug Resistant TB (MDR-TB).

The MDR-TB program at CHAI aims to save lives by increasing sustainable access to diagnosis and treatment. How?

MDR-TB Strategy

Firstly through improved information and data on TB cases, leading to greater visibility of demand for Diagnostics, leading to lower prices for diagnostic machines and greater procurement and then use. More diagnosis will lead to greater visibility of infection rates, more stable demand and ordering process and reduced drug prices, reinforcing greater access to treatment and diagnosis. Essentially, once diagnosis is improved, treatment is a circular process that gets cheaper and cheaper as the number of patients increases. The problem to be addressed is therefore identifying the patients in the first place, providing some financing to assist with initial drug procurement and then helping improve the processes as it starts to repeat. Perhaps an analogy that would work is that we are push-starting a car that has a flat battery, once it is going, the battery will charge via the alternator and keep the car going. In the analogy the car is the diagnosis, the battery is the treatment and the passengers are the patients.

The program currently covers South Africa, Swaziland, Lesotho, Ethiopia, Ukraine, India and Vietnam, for various reasons. its likely other countries will be added, possibly Uganda, Zimbabwe and Mozambique. Being in the lab services team my focus for the first few months is going to be on helping countries use the data to determine procurement and roll-out strategies for diagnostics. As a country support analyst it seems it will be my role to ensure that countries are kept up-to date with findings from other teams in CHAI (e.g., procurement details, new diagnostic tool development updates, scientific advice, etc) as well as sharing information on each country between countries where relevant. It involves a lot of travel.

Book Review: “The diary of Bua Geow” by JC Shaw

“The diary of Bua Geow” is a heartfelt and enlightening read about the simple pleasures Bua, a northern Thailand country girl, finds in her home town and how they supersede all the desires of the bright lights of Bangkok. It serves as testament to the intelligence, wisdom, beauty and depth all people are capable of, regardless of their education  or social status. For me personally, it is a reminder that language is not a barrier to intelligence, it is only a barrier to communication.

The story is beautiful. One of the most touching I have ever read. The diary deals with atrocities that befall Bua and how she acts with bravery beyond her means to save herself and others and finds hope and love in the process. Reading the diary and experiencing northen Thailand at the same time, I feel that Bua’s life must be similar to many other Thai girls and I can’t help but think that the wisdom that is behind the diary is also behind many of the beautiful smiles I see on the road.

Bua’s brave actions are not without cost, as she is disabled from the waist down after her leap to freedom, which saves not only herself but a roomful of girls. In an amazing way, she casts aside any righteous anger and with the help of family and friends, she finds a purpose and starts on a path to hers and many others salvation. A salvation, which many knitters and sewers will appreciate, begins with a needle and thread and traditional hill-tribe costumes.

The reinforcing lesson here for development folk is that sometimes helping someone find the path to dignity and purpose is enough, if not more valuable, than the path to economic success.

The book is unfortunately in limited print, however it is apparently available from Amazon sellers and Google Books. I read the copy available in Gins Maekhong Resort and Spa reading room in Chiang Saen.

Book Review: “The age of reason” by Jean-Paul Sartre

“The age of reason” is a haunting account of Philosophy professor Mathieu’s own battle with identity and freedom when he learns that his girlfriend, of whom he had no intention of marrying, is pregnant.

The story follows Mathieu over two days of anguish as he tries to raise the money needed for an abortion and debates if an abortion is the right thing to do, if it will really bring him his strongest desire – freedom. During these two days Mathieu juggles a bourgeois background, strong moral convictions and opinions upholding his bohemian personal philosophy, a streak of cowardice, love, poverty and mostly narcissistic friends. Eventually balls begin to fall and at the end of the story, Mathieu is left with nothing, not a single commitment and also no freedom.

Sartre somehow fills the pages with surreal characters that can still be admired, despised and empathised with, sometimes on successive pages. For example the indecisiveness of Mathieu is pathetic yet his dedication to making the right decision is admirable. In the introduction to the version I read David Caute describes Sartre as a ‘master cartographer of the landscape of evasion, the flight from responsibility’ and this is very evident in Mathieu and this story.

Much of the book is beyond me, indeed the introduction itself reminded me far to much of high-school English class, but despite this and the warnings in the introduction, I found “The age of reason” a pleasant, compelling read. it is a book that you can think about a lot, or a little and still enjoy.

One of the lessons I take from this book that be applied to development is the need for adaptability and decisiveness in dealing with difficult, morally challenging situations. Mathieu was a rigid character, jailed by his ideals and reasoning into a life of nothing. In development, the outcome is rarely questionable, it is the process that is debated, as it should be.  Mathieu failed to make a choice, he lost nothing and gained nothing. In development, this would be considered a failure. Adaptation to the situation and finding the best possible outcome is necessary, but as “Poor Economics” taught us, we should be careful where possible to test the assumptions we make in determining the best possible outcome.

Book review: “Poor Economics”

“Poor Economics” is a pertinent reminder that our assumptions and preconceived perceptions are often wrong and frequently create unintended and undesirable consequences*.  However, “Poor Economics” is not a nagging, accusatory reminder, it is a pleading reminder, a reminder that seeks cooperation and cohesion within the development field. It is also a reminder backed by random sampling and behavioral economics – the two biggest introductions to financial academia since regression analysis.

If you read the same books I do (Or Liesbeth Geerligs honours thesis!), than you will know a good story will actually be more persuasive then a set of statistics**. Thankfully Abhjit Banerjee and Esther Duflo know that, and they have peppered “Poor Economics” with examples and anecdotes to help communicate their message, their reminder.  Here is hoping that the reminder is heard and the small arsenal of positive examples they have documented in the book and on helps convince the development world that they need to continue evolving, adapting and improving, especially by discarding preconceived assumptions and perceptions about what poor people need, want and what is best for them.

Adaptation and change is always necessary. Without it, we would still be carbon molecules. Perhaps the change is not the hard part, and as one infamous organisation puts it, perhaps the hard part is recognising there is a problem.



*Interestingly, on a side note a few smart people at Yale have found that the erroneous use of preconceived ideas in economic policy extends beyond development and developing countries. Their paper discusses the preconceived ideas conceptualised in Japanese economic policy and is available here. Whilst it is an interesting paper, don’t ask me how they determined that the ideas were preconceived or erroneous as my reading of the article failed to find an explanation.

** For example, books such as:

“27 Powers of persuasion” by Christ St Hilaire. Undoubtedly not the original source and original source not cited. Review coming soon, in the mean-time don’t bother buying it.

“Mindfield” by Lone Frank will have cited the original source, as it was one of the first books to make brain science understandable for common folk. Read it if you haven’t already, even though some of the science is probably outdated now.

*** Many thanks to Scott for the extended loan on this book – it shall be returned. Whilst the book is an interesting read it is not exactly cover-cover reading. It requires a little dedication, which I have been lacking.

Book review: “Rigged”

“Rigged” is a wild ride of strategy, oil, energy, ambition, girls and money based on the true story of John D’Agostino, written by Ben Mezrich.

The story relates a very brief period in Johns life when, at 26 he became the youngest ever vice president of the New York Mercantile Exchange (NYMEX), which at the time was the US leading energy (mostly oil) trading exchange. The Mercantile is also the focus of other wall-street pop-fiction such as the Eddie Murphy / Dan Akroyd movie “Trading places”.

John was sponsored by the then chairmen of the NYMEX to work directly with the chairman and CEO of the NYMEX. John establishes the trust of the trading floor by demonstrating he is ‘one of the boys’ and also the trust of the chairman and CEO by delivering high quality work under pressure. This lands him the VP of Strategy position in an environment where the traders and the management are pitted against each other in a race against the clock to modernize the trading floor. The traders like what they have and do not want to change, the management face globalisation and increasing competition and know they need to modernize to survive.

With one foot on the trading floor and one foot in management, a very serendipitous meeting with some very wealthy and influential people in Dubai takes place. In that meeting, John is matched with an equally ambitious, young and well supported protege who proposes a partnership scheme between the NYMEX and a future Dubai Mercantile Exchange. John and his Dubai ally face down the opposition to the merger and manage to swing the board into supporting the deal by showing them all that Dubai has to offer.

A great story that demonstrates how ambition, a desire to make a change and wealthy strategic supporters can up-end established institutions. Recommended reading for anyone that desires to make a change.

Incidentally, in 2006 the board of the NYMEX agreed to sell-off the NYMEX, with an IPO on the NY stock exchange and independent sales to private equity and the Chicago Mercantile Exchange, garnering significant wealth for themselves. The pit traders, who were mostly independent operators, were left with little to show for their time with NYMEX, which is now a shadow of its former self . No doubt that management won that round too. The Dubai mercantile exchange is going from strength to strength.

Review: “The curious incident of the dog in the night-time”

“The curious incident of the dog in the night time” is written by Mark Haddon and helped changed my opinion on fiction books.

For a while now I have been reading more and more non-fiction books. Autobiography, biography, essay dissertations, DIY and other books that defy categorisation such as “Mind-Field” by Lone Frank and “Purple Cows” by Sascha Dichter. I found these books more stimulating, they challenged me to think about concepts and ideas that novels did not.

I was wrong to apply that assumption to all fiction novels. In this book Haddon re-awakened me to the world of fiction and how important story-telling is in defining history, education and society. The story is told through the diary of Christopher John Francis Boone, a mildly autistic 15 year old who is attempting to sit his A-Lvel maths exam. His regulated and orderly world is threatened by the messy, emotional and seemingly illogical events of life in his small village. Especially his parents struggle to support him as best they can whilst dealing with their own problems.

Haddons story telling had me empathizing with Chistopher and really understanding what life in his situation might be like. I think of it as learned empathy. Plus it served as a reminder to just how silly humans can be some times.

Thanks to the Timor crew for putting me onto this book.

Review: “The satanic verses” by Salman Rushdie

Literature is an art. In art, there is no right or wrong answers. There is only the impact, the resulting inspiration, the feelings and emotions created by the art. In terms of impact, this book created a storm.

If you’re looking for a technical review that sheds light on that storm, your reading the wrong review. If you want to know why Muslims considered it insulting you can read this post from the Islamic Centre. Be warned, it’s hardly objective.   This review on  Goodreads by Riku Sayuji probably does a better job of saying what I’m trying to say but you need to know a little Shakespeare to understand it, and probably to have read the book already!

Enough caveats. This book is hard to read, yet strangely hard to let go. Even if it is a struggle it seems many people try, try and try again to read it. It is compelling and rewarding. Once I got past about pg 60 it become hard to ignore. The mix of dark and light, evil and goodness is obvious enough after a while for a layperson like me to understand. And yet, that same battle of hero and villain is sufficiently convoluted and complicated by the doubts, transformations and schizophrenia in its characters to represent reality, to have application in today’s morally complicated world. This is one of my favorite topics and has been covered before in the travel blog in such posts as a Guiding Light and the Genealogy of morals.

There was once a time that I thought it was possible to keep light and dark separate in this world. No doubt the definition of naïve. No doubt also, at that point, when on the moral high horse, we all have the capacity to be  “the cussed, bloody-minded, ramrod-backed type of damnfool notion that would rather break than sway with the breeze?”. The kind of notion that would not permit integration, that would never be grey.

Rushdie goes on to show us that we need to accept that everyone, including ourselves, has the capacity for evil inside them. It is one of our challenges as conscious, empathetic beings to recognise when “Something [is] badly amiss with the spiritual life of the planet…Too many demons inside people claiming to believe in God.” Where God represents strict moral righteousness. The 10+ commandments of your choice, your cultures choice, your societies choice.

Whats the message for sustainability and development? Societal values and morals are influenced by culture. When working in unfamiliar cultures we need to take care to ensure our programs benefit from values that are consistent with the local societal values, where appropriate. And they wont always be appropriate – there are lots of grey areas out there and change is just as certain as death and taxes.

Idea: how to make people happy

Take them outside, into the sunshine, the greenery and the flowers.

That’s what we did today for our monthly team meeting and it worked a treat. Although team members were discussing deep personal commitments each had made to the team, they did it with smiles and laughter.

Beautiful places, like Hamarikyu Gardens  where we had our meeting, demonstrate to staff that they are trusted, valued and respected. Beautiful places give people dignity and therefore bring out the best in them.

The smiles and laughter at todays meeting after a tough week was enough evidence for me, if you want further proof just ask Bill Strickland onTED to show you his box of slides on how his beautiful school, with beautiful music, sunlight and flowers is transforming peoples lives in dull and dark Detroit.



SUS Team away day at Yamanakako Lake

My role here is very diverse and I was lucky to recently propose and organize the Sustainability team away day with the assistance of a good team and HC. The event took place at PICA village on Yamanakako lake at the base of Mt Fuji. The message for me was that work can be fun, should be fun and that its only when it is that people will share, care and succeed.

There was a surprising amount of nervousness, anxiety, stress and uncertainty exhibited by the team prior to the event. They were really worried about it and seemed to me to be not very interested and actively trying to avoid the event. This was an interesting and very different response than what you would expect in Australia, where such an event would be perceived as a reward – a 2 day corporate sponsored party or holiday. It was also personally frustrating at time!  Turns out that only one or two of them have actually ever participated in anything like a team building event in their whole career! I felt lucky and continually appreciate the fun and open corporate culture I experienced in PwC Australia.

The events aim was to address some of the behavioral concerns that the team has and which are under our control. Whilst corporate culture in Japan maybe a certain way and the structure of PwC Japan may encourage certain behaviours, every individual within the team acts and behaves as they choose. An organizations culture has many facets and some of them are often rusted, stuck in tradition or worn into a path from repetitive use – they are difficult to change. Whilst personnel change at the top is a recognized way of breaking the holds of bad habits, mass movement from the bottom is another. Whilst our team leaders are attacking the structural issues at the top to enable us all to succeed our team can create change for themselves which may help create a movement of change throughout the organisation. The intention of the event was to kick-start the change.

The event was a success in that everybody enjoyed themselves, learned more about each other and identified and committed to behavioral change. Long-term success will need a much more comprehensive program of promotion and reinforcement. The kick-start has worked, now to keep the momentum rolling.


Strategic Sustainable Value

Need to develop a strategic plan and struggling with scary concepts such as weak macro-economic outlooks, high energy prices, impending raw material resource constraints and unstable global financial markets? Not to mention weak OECD consumer demand and a changing world order where the emerging markets and their rapidly developing domestic demand are at the forefront?

Fear not. The following frameworks take you back to basics, looking first to the capacity, constraints and readiness of the business before turning the focus outward and forward so that you can develop a strategy that captures sustainable value and positions the business to compete today and prepare for the future.

The Sustainable Value Framework was developed by Hart and Milstein in 2003. The first of its kind, it has been criticised for being a little narrow in its definitions and applicability. Good if your focused on pollution control.

The Strategic Sustainability Framework was developed by Graham and Bertels and expands on the shortcomings of the Sustainable Value Framework. Good if you want to consider a broader definition of sustainability.

I recommend reading about both to inform your work and using the latter when researching, discussing or presenting your work due to its broader applicability.

Remember to take into account The Next 4 Billion at the BoP when you’re preparing a business for the future. When you’re trying to figure out just how to do that, I suggest checking out what the IFC’s Inclusive Business Team have done and what kind of business models they have financed.


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