World Health Day Keynote Address

Center for Global Health, University of Chicago

John Palfrey, April 7, 2021

Thank you, Dr. Olopade, for your kind introduction. Thanks to Dean Gorman-Smith and all of you at the University of Chicago Center for Global Health for inviting me to speak this morning in honor of World Health Day.

1.

It is such a pleasure to serve alongside Dr. Olopade—a member of the MacArthur Foundation’s Board of Directors and therefore my boss. As you would no doubt imagine, she brings deep experience and a unique perspective to our work—which I know many of you get to experience on a daily basis at the University of Chicago. Dr. Olopade’s relationship with MacArthur goes back further: among the many honors she has received during her career, she was named a MacArthur Fellow in 2005 for her work to change the way doctors screen and treat African and African American women for breast cancer.

Dr. Olopade’s influence is felt locally here in Chicago, her current home, and all around the world, including in Nigeria where she was born, and where we at MacArthur Foundation have had an office for decades. On a personal level, she has been such a generous and kind guide to the City of Chicago as my family arrived here a few years ago from Boston. As we have often said at MacArthur Foundation, Dr. Olopade has the biggest heart of any of us on the Board. When she asked me to speak today, I jumped at the chance.

The Center for Global Health at the University of Chicago is leading the way in advancing the field. Your center is addressing health inequities and their root causes through an interdisciplinary lens, in partnership with communities in Chicago and abroad—both of which are especially critical in this moment. Thank you for hosting this day of conversation and commemoration and for all the work you do, every day, to advance global health.

I am excited to kick off World Health Day with you today. Despite all the harm that the COVID-19 virus has caused this past year-plus, I am excited about what this day can mean for us. Never has it been more important than it is this year, more than a year into a global pandemic and the end far from in sight. I am excited because we need to frame and address problems that touch each person in the world—and because the University of Chicago and places like yours make that thinking and doing, big and at scale, seem entirely possible, here in Chicago and all over the world.

2.

Global Health Day has personal resonance for me. I grew up as the child of two parents who were and are devoted to public health. My mother and father are both pediatricians and medical educators in Boston. My parents often talked about the health disparities and the kinds of issues that the pandemic has laid bare. The topics you are studying and dissecting today were dinner table conversation for me and my sister Katy and brother Quentin. My parents have dedicated their lives to taking care of others and instilled in me and my siblings a sense of community consciousness and social justice. As it turns out, the three of us have all ended up in the non-profit and government sectors. At one moment recently, we were all CEOs of non-profit organizations.

One thing I’ll always think of when I think of my parents and their respective careers is that each morning, they got on a city bus and rode down Massachusetts Avenue from the community in which they lived to the hospitals and community health centers where they served. Every day, they gave their best in service of communities in Boston that have been and are underserved. They have at the same time had a clear sense of global interconnection. In my mom’s case, for instance, she started her career focused on neighborhood health in Boston and she is today focused on global health, with projects from Chile to China. I am proud and grateful for my parents’ fine example, and it informs the thinking that I bring to my work every day as president of MacArthur Foundation.

3.

Each year, the World Health Organization designates a theme for World Health Day. It seems fitting that this year’s theme is “Building a Fairer, Healthier World.”

World Health Day is a moment for us to come together and recognize the opportunity for fundamental and systemic change. This inflection point has lessons for the future. We must realize the promise of the moment—to take this opportunity to recommit to racial and ethnic equity, diversity, and inclusion as we recover from a global pandemic that has impacted every corner of the world.

A year ago, none of us could have foreseen the extraordinary death toll we would experience from the COVID-19 pandemic. We must acknowledge the deaths of more than 550,000 people in the United States and the more than 2.7 million lives lost around the world due to COVID-19.

We must also acknowledge the disproportionate harm, felt as a matter of health, job loss, and much more, in historically marginalized communities in Chicago, the U.S., and globally.

Certainly, we have been experiencing dual crises—the twin pandemics of COVID-19 and racism, which are very much intertwined. They have wreaked economic devastation and disastrous health impacts for African American, Latino, and Native American individuals. In communities of color, rates of COVID-19 exposure, illness, hospitalization and death are all higher. Native American, Black, and Latinx people twice as likely to die from COVID-19 infections.

Meanwhile, racial disparities in police killings have remained unchanged over the past five years, with 164 Black people suffering fatal police violence in the first eight months of 2020, alone. The American Public Health Association has declared police and law enforcement violence as a public health crisis. We have also seen a rise in xenophobia and violence directed against individuals of Asian descent across the nation, culminating in the senseless killings in Atlanta last month.

Police brutality and violence is not limited to the United States. In Nigeria, over the past few years, mass demonstrations have taken place through the #EndSARS movement to protest the corruption and abuse of power by the SARS (Special Anti-Robbery Squad), a branch of the Nigeria Police Force. MacArthur Fellow and writer Chimamanda Ngozi Adichie has written extensively about this topic on how the police force has terrorized its own citizens.

While these are unprecedented times, the problems we are confronting are not new. Racism is a contagion that existed long before COVID-19.

White people, myself included, have an essential role to play in dismantling the structures and practices that uphold systemic racism. We have to deconstruct our thinking and our practices that have brought us to this point of reckoning, and we have to reconstruct new systems in their place—that goes for individuals and institutions. It is clear that we need new directions in philanthropy to respond to urgent needs and to help communities recover.

If money is medicine, as Edgar Villanueva has written in his book Decolonizing Wealth, how do we ensure that we are using and distributing it to heal the people we seek to serve?  For decades, situational privilege has reinforced grantmaking methods in philanthropy that do not center the leadership of Black, Brown, and Indigenous people.

Again, these inequities play out not just in the United States but in fact around the world. The gap between wealthy nations and those with fewer economic resources presented a renewed crisis, as the availability of life-saving vaccines, medicines, and practices has been spread unevenly across the globe. Within countries where the MacArthur Foundation makes grants, including the United Staes, Nigeria and India, we have seen similar disparities play out along lines of gender, social class, and abilities.

4.

As a non-profit institution and as a funder of other non-profits, we at MacArthur Foundation are committed to doing our part to help bring about an equitable, inclusive recovery, with the individuals most affected in the lead to determine priorities and what is best for communities seeking to recover. We have much to learn from Black, Indigenous, and People of Color (BIPOC) leaders—in all the places we operate—about how to organize and consolidate our collective resources to meet the moment and fund a movement.

MacArthur has had a long-standing commitment to Chicago, our home city, where we invest in people, places, and partnerships to advance racial equity and build a more inclusive Chicago. Over 40 years we have invested $1.4 billion in more than 1,600 local organizations and individuals—more than any other place in the world.

There are times when those of us with the power and resources are called on to do more. This past year, 2020, was such a year.

Last summer, MacArthur issued “social bonds” to make $125 million in additional grants and investments in people, organizations, and communities. Our goal is to put these funds to work in an intentional, transparent, and accountable fashion toward the reconstruction of new, more equitable systems and structures.

We are taking advantage of historically low interest rates to be able to give out more money in a time of great need. Our first $25 million in grants addressed anti-Black racism, supported Native Americans impacted by COVID-19, strengthened voter education and mobilization, and combatted voter suppression. We also awarded grants to organizations based in India, Mexico, and Nigeria to respond to increased gender-based violence, reduced access to healthcare, fewer safe spaces, and unequal workloads.

The remaining funds will be allocated in support of organizations that can advance an overarching goal of racial and ethnic justice. One area of focus is health equity and access, which includes issues ranging from the disparate views of the safety and efficacy of COVID vaccines by race to the mental health and wellness of Black, Indigenous, and other youth of color.

In Nigeria, where we have worked for over 30 years, we are using a gender equity and social inclusion lens with our grantmaking, which aims to reduce corruption by supporting Nigerian-led efforts to strengthen accountability, transparency, and participation.

That means we are looking at everything from:

-Supporting women-led and youth-led organizations with our grantmaking;

-Ensuring that our anti-corruption programming is informed by and reaches people from historically and contemporary marginalized groups such as young people, people with disabilities, women, and people in hard-to-reach communities. We have a particular focus on individuals who have intersecting identities, such as disabled women in hard-to-reach places;

-Offering Gender Equity and Social Inclusion training support to grantees; and

-Setting markers in how we evaluate our grantmaking to hold ourselves and grantees accountable to this priority.

The substance of our grantmaking and investing is as important as our mode of operating. Within the organization, we have embraced the Just Imperative, which is grounded in the values of diversity, equity, and inclusion as we strive to become an anti-racist organization.

Our aspiration is for each member of the MacArthur Foundation—all 180 Staff members around the globe—to feel a sense of belonging and a profound recognition that the Just Imperative is a part of all of our work. We continue to become more diverse as a Foundation and attempt to do the same with the organizations and people we support. We are also a learning organization, devoted to the work of evaluation and holding ourselves accountable for our progress as well as our failures.

This commitment we have made—this Just Imperative—calls upon us to look at everything we do. While some of the obvious steps have been to look at hiring and procurement practices, we are also looking across all our grantmaking, our impact investing, and our approach to investing the endowment itself.

Now is the time to fundamentally transform our systems, structures, and practices and reconstruct something better. Later today, we will announce the award recipient of 100&Change, our global competition for a single $100 million grant to solve a critical problem of our time. The six bold ideas will accelerate social change by ending homelessness, providing oxygen therapy to patients worldwide, restoring our oceans, democratizing life-saving medical knowledge and care, eliminating news deserts, and combating mosquito-borne disease.

5.

What does this have to do with World Health Day? One of the many lessons of COVID-19 is our interconnectedness and our interdependence. We have missed this lesson in the past and we miss it again at our peril. The transmission of disease across geographic boundaries is just the most obvious dimension. The ravages of racism cross geographic boundaries, just as the slave trade joined Europe, Africa, and North and South America—and touched every corner of the world, as one example. Colonialism had and has today the same interconnected qualities. Information systems, trade, economic policy, security—each of these areas and more show us the deep and now permanent forms of interconnection. We cannot ignore these forms of interconnection; we cannot pull back from seeing our common humanity, acting locally, acting regionally, and both thinking and acting globally as we seek to define and solve the biggest problems.

As I close, let me harken back to Dr. Olopade and to my parents and to the approach they all take to their work. The public health leaders I most admire both act and think locally and act and think globally. They take care of people in their own communities and they never lose sight of our shared humanity, our deep interconnectedness with every other person on the planet.

The many learnings and types of reckonings of this past year give me hope for the future. To realize this future, we need to take stock now and understand what lessons we can learn from this once-in-a-lifetime moment—what we hope will be a once-in-a-lifetime moment, anyway. We must deepen our understanding of racial justice in an enduring way. The MacArthur Foundation is committed to realizing the promise of the moment—in solidarity with those whom we invest in and whom we partner with—towards a fairer and healthier world. I look forward to partnering with many of you, shoulder to shoulder with Dr. Olopade, in that work. Thank you.