Podcast: UNGA Decoded #3 – Chelsea Clinton on health's human resources

Listen to "Chelsea Clinton on health's human resources" on Spreaker.

The United Nations General Assembly is back, and so is the Clinton Global Initiative. Devex Editor-in-Chief Raj Kumar talks with Chelsea Clinton about what the future holds for her family's signature convening — and what she wants to see happen in global health.

Chelsea Clinton is vice chair of the Clinton Foundation, where she focuses on the organization’s global health programs. She is also an adjunct professor at Columbia University’s Mailman School of Public Health.

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TRANSCRIPT

Michael Igoe

Welcome to “UNGA Decoded.” I'm Michael Igoe, Senior Reporter at Devex. For the next couple of weeks, my colleagues and I are going to bring you inside the biggest global development gathering of the year. Skip the travel, the traffic, and the security lines, and join us for candid conversations with people at the leading edge of global development, global health, and humanitarian assistance. This is “UNGA Decoded.”

Chelsea Clinton

I think it's an experiment. So hopefully we continue to learn and get better. And then yes, I hope that we learn a lot and it's effective, and we're able to do it again.

Michael Igoe

There's a strong sense of reunion in the air at the 77th United Nations General Assembly. This is the first time in three years that this unrivaled fixture on the global development calendar is back in person. And while the COVID-19 pandemic is not over, it has been kind of amazing to see the resilience of the little rituals, behaviors, and peculiarities that make up the UNGA experience. The street protests, the heads of state running late for their speaking engagements, the strange combination of really dire headlines with an almost celebratory atmosphere in some places. I sometimes felt, while rushing from side event to side event or trying to elbow up to a world leader to ask them a question, like we've all been transported back in time. And maybe nowhere was that more the case than at the Clinton Global Initiatives annual meeting, which sprung back into action this year after a full six-year hiatus, brought on not by COVID, but by concerns about politics, influencem and optics during Hillary Clinton's 2016 presidential run. Devex Editor-in-Chief Raj Kumar sat down with Chelsea Clinton to ask why the Clintons decided to reboot CGI in 2022, and to hear what she's focused on as a prominent public health advocate. Here's their conversation.

Raj Kumar

Nice to see you.

Chelsea Clinton

Nice to see you.

Raj Kumar

How does it feel to be back at CGI? We did this six years ago.

Chelsea Clinton

Yes, it feels just like this is what we need to be doing because there's so much work to do.

Raj Kumar

Was it a tough decision or like a no-brainer to bring back the Clinton Global Initiative?

Chelsea Clinton 

It was both, I would say. It was a no-brainer insofar as it felt like there was such a need to get people back together on purpose, focused on what problems we could solve together. And also challenging to think about, well, how do we ensure that that problem-solving ethos is maintained and also make adjustments to ensure that we are more inclusive and more bold because we have just so many challenges, and we really need to ensure that the communities most affected by those challenges are at the center of talking about them and trying to tackle them.

Raj Kumar 

You can definitely feel that vibe in the room, that people are desperate to see each other to get together to talk about issues, which is, I think, a sense that this was needed. But thinking about your second point there, about we need a new way of thinking about these problems, that there's so many overlapping issues. Take it a little further on that point, what do you think is required from this community of doers?

Chelsea Clinton

I do think, Raj, we have more than 2,300 people. And you know, it's our youngest and most diverse CGI ever. I think we also have tried very hard to ensure, and I think we have done this, that people who are most affected by the challenges and also most prime to hopefully be part of articulating the opportunities are front and center in every conversation. I think that's hugely important. I also think that in this phase of COVID we're in now because we're not past COVID, despite what I know many people would like to believe, that we really have — and this is hugely important to me — really have tried to kind think boldly around what we need to do to help ensure that we are answering the challenges that COVID exacerbated, and also kind of doing a better job of building kind of public health infrastructure from here forward. And I think that that wasn't necessarily an obvious design choice for CGI because there are so many people who are like, “Oh, I just I really, of course it's important, but I want to talk about climate change. Of course, it's important but I want to talk about food security.” Climate change and food security also relate to whether or not we are increasing our pandemic risk or whether or not we're building real meaningful community resilience.

Raj Kumar 

Yeah. You know, I'm sure just about everybody here knows about your role in the foundation, but maybe not everyone knows your global health role and the work you do on things like the Global Fund replenishment. I understand you played a key behind the scenes role in some of the private sector funds and that have been put together. Tell us a little bit about that because that's this week, right?

Chelsea Clinton

The Global Fund replenishment, yes, set for Wednesday. And, you know, the Global Fund has been very clear since the launch of the replenishment in February, literally Feb. 24th, so for people paying attention that night was when Russia invaded Ukraine. So unfortunately, you know, I think the replenishment’s bold articulation of $18 billion, helping to save 20 million more lives, you may not have, for understandable reasons, it may not have gotten the attention that it merited because there's a lot of kind of evidence and data from the Global Fund’s last almost 20 years that really kind of went into that figure, it wasn't kind of plucked from the sky. And while the United States has made a commitment of $6 billion, that commitment can only be realized if we also raise the other $12 billion because of the way the US commitment to the Global Fund is structured, it can never be more than one-third of the Global Fund’s overall budget. And so, you know, I would hope that people understand both to maximize the American contribution and also, you know, to really realize in practice the promise of saving 20 million more lives, we do need the full tranche of funding. Very encouraged that today Project Red, sorry, Red — they've rebranded — Red announced their $150 million commitment, which while I know very bold, like they would not have said, did they not have confidence that even if they stretch to new and heretofore unexperienced extremes, that they won't be able to secure those dollars. But we need others to really step forward, too, over the next couple of days.

Raj Kumar

It's tough to get the private sector, I think when they see governments and they say, well, the U.S. is doing $6 billion, what’s my $10 million going to do? How do you think about that? And what are you doing to try to get some of the private sector players to participate?

Chelsea Clinton 

I think every dollar matters. And I think, too, that what has worked historically for the Global Fund and for some other private-public partnerships is really when companies recognize that yes, you can make — and this is actually how Red, when it was Project Red started — yes, you can make your commitments in totality or you can make commitments to stop mother-to-child transmission. Or you can, you can make commitments to ensure that insecticide-treated bed nets for children are where your dollars will go towards in a purchasing power capacity. And I think that is important because I think private sector entities, you know, hopefully do have a broader sense of who their stakeholders are, and also a real world understanding of how increasingly consumers, customers, partners, employees want to see their company stand for something and standing for helping the world finally end malaria is a pretty good thing to stand for. Helping to end mother-to-child transmission everywhere, which we are so close to doing, is a really great thing to stand for. Just two small examples.

Raj Kumar

It is kind of a tough moment because we're actually backsliding on a lot of these things, right?

Chelsea Clinton 

You either can think, “Oh, my gosh, that's so depressing.” Which is understandable. Or you could think alongside, “Wow, that is depressing that we've allowed that to happen, we know what is possible because look at all the progress we did make when we had clear-eyed, relentless focus.”

Raj Kumar

Not everyone in our audience may know that you actually did your doctoral thesis on the Global Fund.

Chelsea Clinton

… You too can read it online at the Bodleian Library.

Raj Kumar

You have been nerding out on global health architecture for a long time.

Chelsea Clinton

I have. That’s true.

Raj Kumar

I wonder what you think of the architecture. I mean, we've got so many new acronyms out there. CEPI, relatively new, obviously ACT-A during the COVID crisis. But just in general, when you look at the architecture, and you think about what you just described, some of the challenges we're facing. Do you think we're sort of set up the way you would want us to be set up? Or do you have any thoughts about global health broadly?

Chelsea Clinton

You know, Raj, I think that the answer to that question is: yes, if, in some ways. I do think that, clearly, we have seen the real utility of vertical focused funds in not only the Global Fund, but in Gavi as well, and particularly for the Global Fund, admittedly, how often it was a Trojan horse to investing in building real health systems capacity. So I think that is important to recognize, and also that we need kind of more investment in kind of building robust and flexible health care capacity, both to meet the needs of people as they are today, whether you're pregnant or facing cancer, or you have an injury, and also to help us all be better prepared for the inevitable kind of next time.

Raj Kumar

Which may not be that far off in the future, right?

Chelsea Clinton 

Which may not be that far off in the future. And I don't think that we have resourced or equipped WHO sufficiently to be able to have its real role fully realized as not only a kind of normative leader, but also through technical assistance and partnership. And I don't think that the World Bank — which actually contributes even more dollars into global health concerns than WHO does — is as yet able to move kind of quickly enough. And so I think that we have amazing people, more than I even know — many, many more than I even know — in many of these institutions, who are so mission oriented. And we have amazing people in health ministries around the world, and in regional health organizations around the world. And yet, we’re not yet appropriately resourcing or appropriately matching urgency, I think, to need. So I think a lot of the pieces are there, but we are not yet doing what we need to do to really try to help protect lives and livelihoods everywhere.

Raj Kumar 

Yeah, it felt like at the beginning of COVID, we saw that there is a new gear, right, like we could work faster.

Chelsea Clinton

Completely.

Raj Kumar

But in general, it does feel like we're not at the pace of the challenges as they’re growing around the world. What are some things you're particularly excited about this CGI? Just give people a flavor [for those] who aren't here.

Chelsea Clinton 

So I think Raj in some ways, it's a good segue from the last conversation. I'm particularly excited about the real focus on human resources for health, which is something that the Clinton Access Initiative has been focused on for a long time, that we've had a focus on at CGI in the past, but a real focus, and a focus on health resources, you know, human resources for health, excuse me, here in the United States, even here locally in New York City, as well as globally, a focus on not only kind of training capacity, but the need to appropriately pay and protect health care workers, that that needs to happen at kind of every level of care. So from community health care workers and kind of, you know, people engaged in disease surveillance and kind of laboratory infrastructure, as health care techs, you know, as nurses, as doctors, as health care leaders. That I really think is so kind of desperately needed, not only because we have, you know, a health workforce shortage in the millions around the world; also, because we know there's enormous health care workforce burnout, and that we're not doing a good enough job really anywhere, including here, of taking care of the people that we expect to take care of us. So that to me is really meaningful, that there are so many people who are focused on these related challenges and trying to solve them.

Raj Kumar 

Yeah, that is, and there's so much focus on innovation and technology and health, but health workforce, you have to have a long-term plan, you’ve got to work toward it. It's not going to happen overnight with a new whiz bang technology. So it's important you're bringing that discussion here. Thank you for taking the time. Is this an experiment bringing back CGI or do you think like, we're gonna be doing this every year?

Chelsea Clinton 

I mean, I think both, right? I mean, I think it's an experiment because hopefully we continue to learn and get better, and then yes, I hope that we learn a lot and it's effective and we're able to do it again.

Raj Kumar 

I hope to see you here next year. Thank you so much, Chelsea.

Michael Igoe

Thanks for listening to “UNGA Decoded.” We'll be bringing you more interviews from the U.N. General Assembly throughout the next week. If you enjoyed today's episode, please do share it with friends, family, and colleagues. And you can also leave us a rating or a review on Apple podcasts. If you've been to UNGA and have some thoughts, or if you just want to share some feedback on this episode, we'd love to hear from you. You can find us on social media @devex and @AlterIgoe.