Q&A: What Washington state can teach DC about public health collaboration

At a moment when U.S. politics have rarely felt so divided, Washington state — not Washington, D.C. — might offer a model worth watching. That’s according to Lisa Cohen, founder and executive director of the Washington Global Health Alliance, a coalition of leading global health organizations in the state. Their work building partnerships in the sector has won champions on both sides of the political aisle.

WGHA’s model brings diverse and at times unexpected groups together to collaborate on global health challenges. “It’s tempting to get competitive about hanging on to our specific areas of funding,” she told Devex this week ahead of the annual Global Washington conference in Seattle. “Alliances help us keep a longer-term view and expose us to new ways of approaching problems, and can help us reach those audacious goals like the SDGs more efficiently and more creatively.”

It’s the collaborative environment that sets Washington apart. After last month’s U.S. presidential election, Cohen wrote to members and supporters to argue that her state is “in a unique position to illuminate a course forward” for public health under the next administration.

“We simply don't know what the ramifications [of the election] will be, and we won't for a while,” Cohen wrote to supporters. “It is incumbent upon our global health community … to thoughtfully and compellingly educate and advocate for continued support on behalf of global health issues,” she wrote.

Devex caught up with Cohen about the incoming Donald Trump administration, how the WGHA model is spreading to other states and global cities, and why collaboration is more important now than ever before. Here are the highlights from our conversation, edited for length and clarity.

After the U.S. election, you wrote that in the absence of information, there is speculation. What have we learned since then with regard to global health and development under the next administration, and what remains stuck in speculation?

We simply don't have enough information yet to draw any firm conclusions about the future for global health following the election. It's in our nature as human beings to fill any void where we don't have answers with speculation. It’s also important to remember that there wasn’t a lot of turnover in Congress.

Why should Washington, D.C., pay attention to what’s happening here in Seattle, Washington?

In Washington state, we've been able to effectively open lines of communication on both sides of the aisle and have advocates in every congressional seat, because we believe very strongly that global health is not a partisan issue. Washington, D.C., can get caught up in the same old narratives, talking to the same people using the same language rather than thinking about what's going to make the case for broad support, considering the audience with a fresh perspective. When we look at the holistic approach [that is] essential to making greater gains toward health equity, when we include agriculture and animal health and environmental impacts, we widen the net and give more lawmakers more reasons to support the work.

When we make the connection between low-cost and culturally appropriate access to health for those most in need — both overseas and in our own backyards — we make a much stronger case.

Why is the role you play essential now? What is your call to action for those looking to do similar work in cities that might not have the same level of global health and development activity as Seattle, but which could still benefit from more collaboration?

It's more important than ever for policymakers to hear directly from constituents in their cities, counties and states about the huge return on investment from global health. And it is our job to develop cohesive messages that educate policymakers about the role they play in saving lives around the world, which includes our backyard. Washington state has 168 global health organizations and WGHA has had the opportunity to work with many of them to develop those shared messages.

I think an opportunity for any city or region, regardless of the number of global health or development organizations they have, is to make the connection between global work and local health outcomes. Ultimately global public health work is about equity, whether it be in Kinshasa [in the Democratic Republic of the Congo], Bangladesh or a small town in eastern Washington state. Lessons we learn, technologies we create and programs we design have the potential to be applied in any setting. Ultimately, where appropriate, I think that's going to help make a strong case to our elected officials for support. If we can demonstrate that federal and state investments in global health have real payoff in lessons, technology and programs we can use back home, then I believe we’ll stand a much greater chance of winning bipartisan support.

You helped support a Malaria No More reporting fellowship that introduced fellows, myself included, to some of the individuals and organizations that make Seattle an epicenter of global health innovation. What do you think sets Seattle apart as a hub and what are some transferable lessons?

We are fortunate in Seattle to have organizations working on malaria that hit all elements of the spectrum from discovery to development to delivery, as well as advocacy and education. They are working on everything from vaccine development to new low-cost diagnostics and countrywide malaria control programs.

Of course not every region is going to have a Gates Foundation or an international advocacy organization like Malaria No More, and most states aren’t lucky enough to have more than 150 organizations working in global health. I think what can be replicated, however, is an emphasis and an intention to share lessons learned and leverage each other's skills and expertise. But this has to be done deliberately.

Typically organizations work within their particular area of expertise, so researchers focus on the basic research and if they don't meet other people at a conference or co-author papers, they're not going to generally think to get together with one other to discuss collaborating. And often partnerships might be unexpected. For example, recently we brought people together to talk about data storage and analysis. We had PATH and Fred Hutchinson Cancer Research Center in the room with the Gates Foundation. But we also had Amazon. We’re talking with Microsoft and Tableau. That’s where this can get really interesting.

You have to make a concerted effort to bring people together, and then you have to do the hard work to keep the momentum to facilitate conversations to drive next steps. It isn't enough just to get together; you want to develop outcomes and attach milestones.

Another example of collaboration in Washington is a very exciting statewide antimicrobial resistance coalition, which developed over this past year. This is really groundbreaking because we have brought together experts from animal health, environmental health, human health, and organizations ranging from funders to NGOs to local hospitals to military researchers and state and county officials to come up with ideas to develop a surveillance system that will have global and local impact. It is coalitions like this that are going to be game changers in the next pandemics or systems strengthening or maternal and child health. We think this collective approach breaks down silos.

You were recently in the San Francisco Bay Area meeting with a range of people interested in learning more about how they might replicate what you have done. Can you share more details about how the Washington Global Health Alliance model is expanding beyond Seattle?

We've had the great privilege, over the past year and a half, to work with several regions around the country and the world that are interested in replicating the global health alliance model. For example in Atlanta, leaders have talked about creating a regional alliance for more than 20 years, but for various reasons it had run into roadblocks. We were able to draw on our experience to help them identify key stakeholders to bring into the room and focus their efforts on collective outcomes as opposed to the individual needs of organizations. As a result, they were able to develop a mission that’s additive for all stakeholders. They've now launched the Georgia Global Health Alliance.

We had a similar experience in Melbourne, Australia. We were able to advise them about what could realistically be achieved in the short term and then help make the case to a very diverse group of leaders and organizations.

Both of these Alliances are launched and have staff and missions and strategies in place. This strengthens not only their local communities but also the global health ecosystem internationally. As part of the process, we developed a resource called “The Blueprint for Building a Regional Global Health Alliance.” I am delighted that the Blueprint has been downloaded in countries like China, Belgium, Gambia and Korea. The Blueprint includes WGHA’s approach to collaboration as well as lessons we've learned along the way. We’ve been very transparent about some of the mistakes we've made, and hopefully this will help other regions avoid some of those pitfalls.

We've also been working with California and there's a terrific group there. These alliances can be launched with a relatively small amount of investment but, to be very candid, that's the biggest challenge. Funders say they want organizations to partner and an alliance provides a framework to realize those potential partnerships. But the reality is they don't invest in the time and talent essential to creating those partnerships. I hope that funders rethink this approach, because the return on investment in terms of impact can be enormous.

For more Devex coverage on global health, visit Focus On: Global Health