Africa: New Gates Foundation CEO Mark Suzman Plots to Increase Poverty-Reduction Impact

Mark Suzman, CEO of the Bill and Melinda Gates Foundation
17 February 2020
interview

Cape Town — AllAfrica's Juanita Williams quizzed South African native Mark Suzman <@msuzman>, leader of the Bill and Melinda Gates Foundation. the world's largest philanthropy, who assumed the position this month. She asked him what will stay the same and what will change under his leadership. Part 1. (Read Part 2)

How have your past positions at the Gates Foundation prepared you for your new role of CEO?

They've prepared me very well, I hope. I've been exposed both to our extensive external partnerships - a lot of which I built in previous roles running our policy and advocacy programmes - which is essentially how we work with others like governments; multilateral agencies like the United Nations or the World Bank; private philanthropists; the private sector. And that's a huge part of how we're successful and how we operate anywhere. Whether it is domestically in the United States, in education, or globally, in areas like HIV or TB in South Africa.

But a second role I've had over the last three years as chief strategy officer (CSO) has really had me go deep in every part of the work we do as a foundation - trying to assess how do we think about the best way to get impact in each of the areas we work. Our mission and our role as the Gates Foundation is that we want to help the poorest and neediest all over the world. We have this on our office wall in Seattle: "Every person deserves the chance to a happy and productive life." And then we try to measure that.

Measuring effectiveness in core goal: helping the poorest and neediest

First, you to need live. To live you need to reduce child mortality and maternal mortality. To be productive, you need adequate nutrition, adequate tools like financial services; you need access to good sanitation. In each of these areas as CSO (strategy officer), I was trying to think through how we assess what the highest-impact interventions will be -because you always have choices. And now those have all come together and my job as CEO - to actually help implement that and be true to the vision of Bill and Melinda Gates, and Warren Buffet who also supports us: to make sure that as a foundation we stay always focused on our core role, which is are we helping people.

And how do you measure the impact of the work the foundation has been involved in with governments and organisations?

There are several levels to it. At its most basic, you need to look at some of the overarching goals. These are ones where we try and align with where the world is trying to achieve impact. The [United Nations] Sustainable Development Goals today include specific targets around access to family planning products, continued reduction to child mortality, maternal mortality, how can you double agricultural productivity. These are all measurable things and that, in the end, is the ultimate impact. And then what we decide to do is say what are the intermediate steps that need to take place for that to happen. You need [such tools as] strong, cheap, widely available vaccines. Is the vaccine developed, does the supply chain work, does it reach the child?

You need to think about all the resources that are available.

 "You always have choices."

Another measurement of impact is adequate financing - is there political will, is the right legislative framework in place? There needs to be something tangible. One of the challenges you constantly face in philanthropy is - because your mission is so important - it's just so easy to say 'Well, we should just do X!'.Because it is important, let's put some money into this - because it is important, there's need. And we know that's not a good enough reason. The challenge is always to say "how much money". How are we going to be sure it's being spent well? How are we going to know if we need to make course correction? That is the constant challenge we have to work on.

As former managing director of the country offices, which includes the Africa offices, what do you consider your greatest success?

I would take a step back globally first and say that, when I joined the foundation 13 years ago, we did not actually have an international presence outside of the United States. We worked on some HIV prevention programs in India and China, but we did not have a set of country offices.

One of the changes that I made in that role was saying even though we're based in Seattle, which is very far away from south Asia and sub-Saharan Africa - which are the two primary geographies we work in - we simply cannot be effective unless we have a presence on the ground in the places where we work. To talk to our partners in real time and to be able to engage. To be able to assess what we are doing.

AllAfrica's Juanita Williams interviewing Mark Suzman, CEO of the Bill and Melinda Gates Foundation.

That led not just to offices in Africa. We built out our Beijing office in China, our New Delhi offices. We built out our partner offices in Europe - London and Berlin. And then in Africa, we set up offices in Addis Abba, Ethiopia and Abuja in Nigeria, and then here [in South Africa] in Johannesburg.

At the time they were very small. We were experimenting whether that would work, and now it's become very clear that we are far more impactful when we do have a strong, robust, local presence. And in fact only last night I was doing the formal opening, which I was very proud to do, of our regional office in Johannesburg. We did a ribbon cutting ceremony and a partner reception. Now that is the office which is now servicing not only South Africa but is becoming the regional headquarters for our work across Africa, because we work in nearly every country on the continent.

Are there any changes afoot, as you take up your role as CEO, considering the focus on agriculture in Ethiopia and polio in Nigeria, for example.

I don't think that's going to be a change in our specific objectives and focus. One of the things we pride ourselves on is, when we pick our issues, we're going to be in it for the long haul. Hopefully, with the exception of polio, because we hope we will eradicate polio completely sometime in the next few years, and then that program will go away.

We hope to eradicate polio completely in the next few years.

But in the other areas, we are going to work in agricultural development as long as we are a foundation because we believe there is going to be need. We're going to work in sanitation, we're going to work in global education.Those focuses won't change - but deepen.

Aligning with local priorities

It's about making sure what we do is aligned with the national priorities of the countries we're working in. There's always a risk with foreign aid and philanthropy that people are coming in and they think they're doing good, that they're funding this great project, but it's completely divorced from everything else. It's not sustainable and it doesn't have lasting impact.

And so one of the things I want us to be very sensitive to, and will be a key part of my tenure as CEO, is always checking what we're doing is aligned to where the government is trying to go, where other partners are trying to go. Can we help support the data to ensure that it works well.

I've just come out of a meeting with the [South African] health to make sure that our work in TB and HIV is actually going to support the wider health program.

Gender equality – the basis for everything

The second area which I'm planning to make a very, very high priority as CEO - which is also a deepening rather than a shift – is a focus on gender equality. It has become increasingly clear in everything we do, whether it is agriculture, financial services for the poor or healthcare, unless you take a deeper, much more focused look at the needs of women and girls you simply cannot succeed.

If you take an area like agriculture, we know that 70% of the people living on the continent are still rural poor, and they are very dependent on subsistence agriculture for both the food they eat and income they generate.

Around 50% of that labor is women and we also know that women are less likely to have land tenure and less likely to have access to extension services, which is the support from government to train you to be a better farmer. They're less likely to have access to credit. They're less likely to have time available to farm, because they're more likely to have other household duties of childcare-related activities.

And so it's a simple fact that unless you address their needs much more deliberately, we cannot collectively meet the goal of doubling agricultural productivity and halving poverty. Everywhere we look, one of the things I'll be pushing our teams on is: have you thought about when and where we should be giving special attention to the needs of women in order to meet our overall goals?

Gender equality is being discussed by everyone at the moment, and most of the donor money is going in that direction. Some have called the funding of sexual and reproductive health projects a trend. I interviewed Jaha Dukureh, who has been running a campaign to end FGM in Gambia. The global campaign to end FGM has run for 15 years now - and she says international donors are more likely to fund bigger organisations and not the ones on the ground who know what is happening in the villages and understand the sensitivies of some issues.

Ghanaian women don traditional dress for an African conference on gender and reproductive health rights.

Historically there's a lot of truth to that, that donors have tilted towards big, traditional partners. That's often been true of some of the resources that we provide as the Gates Foundation. And I don't want to paint all partners with the same brush. Some of those big partners are actually very thoughtful about building local community partners and what it means to understand those issues on the ground - and some less so.

Again, go back to my point about why I care so strongly that we have regional officers and teams on the ground able to work. It's clear, if you're thinking in the long term, if you want success over 5, 10, 15, 20 years - and we certainly expect to be working in the African continent for the lifetime of this foundation, which should be at least 40 to 50 years - is you have to have that strong local capacity on the ground. Even if there might be some short-term benefits to working with the biggest national partners, that has to be linked very intentionally to be building strong, on-the-ground, local domestic capacity. So, it's a 'both/and'.

When you say it's very fashionable for donors to talk about gender, I would say: very fashionable for donors to talk about gender as a priority. I think the result and track record on the ground is much more mixed.

Data in the field of gender equality is atrocious.

I worked in the UN before I worked at the Gates Foundation. It's very rare to find a project proposal that doesn't have a beautifully written first paragraph about why this project is going to be gender-sensitive and think about all these issues. And then when you actually track the implementation, have they actually monitored? Where's the data? One of the biggest weaknesses in the whole field of gender equality is that data is atrocious. People do not do proper gender dis-aggregation.

Investments in data to measure effectiveness

We're the largest funders of this tool called Globalfindex, which looks at financial inclusion globally. We make sure that that tool is gender disaggregated. It shows you massive gaps in access to financial services for men and women, which vary heavily by geography. You will have more challenges in parts of southeast Asia than there might be in parts of east Africa. West Africa might be more challenging than southern Africa.

You need that data. So when I talk about the focus on gender equality, it is not about it as a slogan. It's about making sure the investments are making material and measurable differences. That's why we've recently made a major set of investments in improving the quality of gender data in Africa and around the world.

We have a partnership with UN women, for example, which works across several African counties and helps the national statistical agencies with how can you actually better track issue like women's economic empowerment.

Taking a step back and looking at [UN] Millennium Development Goals 20 years ago, we saw a lot of progress in poverty, child and maternal mortality. But it was actually very weak on gender - there was a gender goal, but its indicators were really about getting the same number of boys and girls and more women in as members of parliament. They're both important but that's not comprehensive.

Then in 2015 there was a new goal - Sustainable Development Goal 5, covering areas like child marriage and gender-based violence, women's access to financial resources and women's empowerment. But when statisticians went to look at the outcomes it was found that most countries do not have the databases to try and track - in any credible way - if we're making progress or not.

So if I say we're making investments in gender data, it's with partners like UN Women, to help governments put in place the statistical capacity to track whether you're making progress or not. Because that's got to be your baseline, and then. what are the policies that allow you to make progress? So that's that balance.

It's great to see the momentum and energy coming into it as a field and we welcome and encourage that.

(Read Part 2 of the interview with Gates Foundation CEO Mark Suzman)

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