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Financing Change: Collaborative Approaches to Philanthropy | SkollWF 2018

Financing Change: Collaborative Approaches to Philanthropy | SkollWF 2018

– Good afternoon, everyone. Hopefully we’re well rested. Welcome to the Financing
Change, Collaborative Approaches to Philanthropy session. I’ve got a couple housekeeping remarks. And then I’m gonna turn it
over to our fearless moderator. Please, everyone, silence your cell phones if you could be so kind. We’re going to have an
opportunity for some question and answers from the audience. For that part of the session, please wait for the microphone before speaking. We are filming this session, and so, they won’t be able to hear
you without the microphone. And then, if you look in front of you, you have, sort of, square papers and pencils. After this session, if you
could please just take a few seconds to complete the session survey and hand it to a steward
on your way out the door. I’d like to kick us off,
if you would allow me, with a reference back to 2008, and an MIT article that Sally Osberg, Skoll Foundation’s
president and CEO wrote, entitled Framing the Change,
and Changing the Frame. In this, she spoke to the power
of strategic partnerships, calling them the coalitions
that take the solutions social entrepreneurs envision,
and bring them to scale. And she called for a new
model for social change, one which values the
power of the ecosystem and smarter, broader collaborations. It won’t come to any surprise to you that social entrepreneurs agreed, and, in fact, were already
sort of working towards this ecosystem oriented approach and working in partnerships
and coalitions. And, today, we’re here to
talk about how philanthropy can catch up with those fearless leaders. So I’m gonna turn it
over to Heather Grady, the Vice President of
Rockefeller Philanthropy advisers to moderate the session. – Thank you, Liz. And good afternoon,
everyone, it’s wonderful to have you all here. I know there’s a lot of competition from other sessions that
are also really excellent, but I think you’ll find our panelists are an amazing group. Let me just introduce them, I think, to start with. First is Neera Nundy in the middle, in that beautiful, orange outfit. She is the founder and a partner at Dasra, which is a leading
strategic philanthropy organization in India
that shapes the process of social change by forming partnerships with funders and social enterprises. She has also incubated
something called the Dasra Social Impact program,
enabling over 500 social organizations to receive
over 40 million dollars US in funding over the past 14 years. And every one of them that
I introduce has a long, long list of accomplishments. I’m just choosing a couple. To my immediate left, is Rukmini Banerji. She is the CEO of Pratham,
which is a world famous organization in India. She has extensive field experience in program implementation
in rural and urban areas and is also very strong in research. She has been there since 1996, I believe, so over 20 years. She also led something called ASER, Annual Status of Education Report, that effort for 10 years in India. On the far, next over, is Olivia. Olivia Leland is the founder and CEO of Co-Impact. She has spent the last
three years building that. It’s a global collaborative
to align philanthropy, social change leaders,
and large scale change. And she also serves as a managing director at the Rockefeller Foundation, focusing on bringing collaborative approaches to the foundation’s initiative. Olivia was also one of the creators of the giving pledge with
Bill and Melinda Gates and Warren Buffett. And finally, on the far
left, is Rebecca Onie. She is the co-founder and CEO Amerita of an organization called Health Leads. It’s a social enterprise that was designed to address a blind spot in
the US healthcare system, which is that so many people
who have health problems, it stems from environmental
and social causes. She also, by the way, received
a MacArthur Genius Award. So you can see we have just a very
distinguished panel today. I wanna just start by
saying, talking a little bit about the title of this
session, Financing Change Collaborative Approaches to Philanthropy. It’s got a bit of a sub-theme
around systems change. We want to see what happens when funders of different sizes combine their funds and their efforts, their
non-monetary support as well, to advance
positive systems change. We’re going to hear, not
only about the opportunities, but about many of the
barriers and challenges that these organizations have faced, and also hear about nascent collaborations that some of you may be interested in joining. I also want to just read the definition that the Skoll Foundation uses. They talk about the
term equilibrium change to describe their approach. They support social
entrepreneurs who are creating innovative models to
drive equilibrium change. The disruption of social, economic, and political forces
that enable inequality, injustice, and other thorny problems to persist. And I wanna mention that a report that my organization,
Rockefeller Philanthropy advisers and the Skoll Foundation put out last year with a group of others. The Ford Foundation, Draper
Richards Kaplan, and Porticus. Working with many different organizations to see what really can
help funders work more collaboratively together
to help scale impact and create real systems change. So without further ado, I think I’ll start with the questions. I’m going to start with Rukmini. So Pratham, as I mentioned,
it’s a world-renowned organization. You’ve stood the test of time. You’ve both scaled your impact and I think you remained
very close to communities. I think everyone knows
there’s a theme here this week at this forum about proximity. So sometimes organizations might be at risk of losing that proximity as they scale. So can you tell us a little bit about how you think
about shifting systems. What kind of systems change
Pratham has been involved in and what has been the role of funders, either in a positive or negative way in causing that? – I think the word systems change is a word that’s used a
lot in forums like this, and-, that’s a good thing. And for the last two
days, I’ve been thinking about, you know, what we do. Is it systems change, or is
it just we do what we do? When you work with kids in primary school, although we’ve spent 20 years, I think, working on only one or two issues, having children in school
and having them learn at least, building their foundations. Basic reading, basic math. But I think once you do that or anything, you’re going to have
effects on a whole set of other things. Some of which are
intended and some of which may not be intended. And I think that the more we have pushed on the edge of how can we do this? How can we do this faster? Because if kids don’t have
their basic foundations in place quickly, they’re losing time. Their families are losing opportunity, and the system, this
amorphous thing called system is in danger of becoming stuck. And I think that in the process of trying to do these things, you know, maybe faster, maybe deeper, maybe better, you are hitting on different parts of, you know, what makes all of this work. And so people talk about systems change as, I think, you know, the
way, let’s say a school system works. But I think of that as more
as how do you changing norms in a society? And I think we’ve seen a lot of examples of norms changing. Today, in India, as compared
to maybe even 15 years ago, you don’t have to talk
to people about the need to go to school. The whole thing has changed such that now, if somebody doesn’t go to
school, it’s an anomaly. And that involves, I
think, a large scale shift in mindset and in priorities of people. Now, I don’t know if
that is systems change or not, but I think
that’s a necessary part of really shifting a big-, So for us, we feel that
every child in the world has a very good chance to learn how to read and to do basic math,
and which is also a short form for being able to stand on their own feet and take the next step towards learning, and I think you have
to move everything else out of the way to make this happen. – Great. Now, one of the aspects people talk about in systems change is that their has to be collaboration. Collaboration across institutional sectors and silos, collaboration between funders and grantees, can you
say just a little more about how collaborative it’s been? Do you have your funders collaborating with each other? – So I would say, bef- Let me first talk about collaboration and then about financing. So the biggest changes, I think, at least in the world that I know, which is education or
schooling or learning, is when parents and
teachers can actually work in the same direction in
favor of the children. And that’s the kind of
collaboration that needs to exist in, you know,
wherever you’re working with kids. Very often, school systems have high walls and illiterate parents
can’t really engage. So how do you create platforms? How do you create places where people who care about these
children can come together? So that’s at, I would
say, at a community level. Very often, I find now
when people talk to us about schooling, they just assume that everything needs to
happen inside the school. I think the big things happen, actually, in the community, in the environment, in the air, and then they move into this tight thing
called an institution, which is a school. In terms of financing, you know, we’ve- we are supported, and have been supported, over time by many people. Some have come together to support us, and some will support us,
you know, independently. So we have, for example, a big pool of funds that we have-, we get and we’ve gotten for a long time from people of Indian
origin who live in the US. Now, is that collaborative,
or is that independent? But it’s people who are
putting their individual money into a big pool. And some of that money could be $100, and some of it could be a million dollars. But I think that this coming together to support a bigger cause, to me, is a very big, you know, is a big model of collaboration. And the way that they raise
the money also is quite collaborative. There’s a large number of volunteers in different parts of the US who, you know, mobilize their friends, their community to put money in. So, to me, it looks like while, you know, two big foundations coming
together is collaboration, and, you know, maybe that’s hard to do, but this building of a platform on which many people can come together to support a common cause, I think is, you know, an even more
sustainable collaboration. – Great. Thank you. And I think that leads very well into my next question to Neera. Dasra was formed, I think, specifically, because you saw a lot
of fragmented efforts in India, a lot of
different philanthropists, a lot of different types of funding, a lot of great
organizations, but not enough of a maybe connective
tissue that was really able to help organizations scale
the way they needed to. So just talk a little bit, not everyone in the audience will know what Dasra is. So talk a little bit about
it and then how you did that. – Sure, sure. So we started 18 years ago when it-, I wasn’t as insightful at the time. And it was very simply, I felt like I didn’t have a whole lot of skills, necessarily, to
do the great kind of work that Rukmini and Pratham do to be in the community
or actually have enough of a pile of cash to actually give to the non-profits. So we ended up situating ourselves in the middle between where the funding is and what the non-profits needed. But very much being driven
by how could we support these organizations in achieving scale? And impact is still at
the core of what we try to do. And so with that mission, we realized, you know, A, there isn’t enough funding that’s funding these organizations
in an unrestricted way. So how do they invest in themselves to actually be able to
scale and how do we provide that kind of flexibility? Because we realized
that for them to scale, they’ll need some support
around basic management kinds of things, and
that was really kind of the perspective that we were coming from having been in investment banking for a few years. It was just more of that perspective. And then very quickly, we realized you can give all the advice to the organizations,
which if you don’t provide that flexible funding,
then what’s the point? And so that’s when we, about 15 years ago, started what are called giving circles. And in the simplest way,
we created a mechanism for philanthropists to pool funds, and we realized to be research led. So in India, we have
three million non-profits, so it’s very difficult to navigate through and so it ended up being a bit of an excuse as to why philanthropists, or people with wealth,
or people who wanna give, who didn’t wanna give
saying, everyone’s corrupt and there’s no good NGOs, and so we said, well, here are some great NGOs. But also, the context
of how they’re situated in that particular issue, and then pooling funds and then supporting that organization and
then we take, you know, a little bit of fundings to sort of, provide that capacity building. So we did that for, you
know, about 15 years, and then realized about
three or four years ago that you can support a non-profit and help that non-profit scale, but ultimately, how are you gonna move on a sector. And how, in an aggregated way, do we collaborate with, sort of, a sense of urgency that Rukmini was talking about. And that’s why, about last year, about a year and a half ago,
we launched what’s called a 10 to 19 adolescent collaborative, and there were a couple of learnings from having pooled this fund. We call it an outcome led fund. And what we wanted to do here was we found that NGOs labeled themselves, right? Like, education, I’m
a health organization, I’m an education organization. And so not only NGOs label themselves, but funders label themselves,
and so how are you gonna actually have systemic change, you know, as you’ve described it. Or holistic change if you
can’t bring the different kinds of funding together. Give the flexibility to the organization to have comprehensive
programming, allow them to innovate to ultimately, sort
of, achieve these outcomes. And so starting to think about, initially, with adolescent girls, what
could be systems change for that. We realize to empower an adolescent girl. And we did a bit of
research with Bridgespan. And what really helps in
some of the systems change, and bringing about collaboration is really focusing on a few outcomes. And so in the 10 to 19 collaborative, through some research, we realized that actually if you
focus on four outcomes for adolescent girls, one
is delaying child marriage, delaying first pregnancy, keeping girls in secondary school and increasing agency, you can really be transformational for the girl. But then you have non-profits
who actually don’t have the flexibility to innovate
across different pathways. So what we created was a mechanism where health money comes
in, education money comes in, and then
Dasra, as a facilitator, supports a group of
organizations, and really invests in them to really be able to scale is some way that we’re thinking
you can kind of overcome some of the challenges around being able to have systems change
when the funding side actually doesn’t quite
see or call themselves that. But I thought I’d leave you with a couple of other aspects that I
think are really important if we want to achieve
collaboration and sort of move on systems change is I
think you need a facilitator. It’s not just to promote Dasra. But, you know, you do need
something that sits in between because collaboration
needs to be facilitated, whether it’s, you know,
supporting the non-profits because it takes time out,
or building a common agenda with funders, you do need to have that sort of facilitation aspect to it. So that’s one thing that I
think is really important. A couple of other things,
and Rukmini also spoke to this, is we just have
to work towards changing the narrative. So although we may be
funding organizations, if in mainstream, for example, with adolescents, you don’t change some of the mindset in the community, but also through all the way through
at different levels, all the way up to the government. You’re really not gonna see a lot of change if we don’t invest in mindset, in awareness, how the media sees this. So I think starting to invest in some of that is really important. And then, ultimately, and you know, this seems obvious,
but it’s very important in India, is you cannot
achieve this without engaging with the government. And so, although philanthropy
in the grand scheme of the funding out there, is quite small, definitely compared to
the Indian government, there has to be a way to engage with the government where they
see you more than just money, but they see you actually being able to see if policies are
working, how you tweak this, and ultimately, how you integrate into the government systems. And then, finally, the last piece, and, you know, everybody talks about this, but I think it’s important as well, is measurement. And also of what not- doesn’t work. And so, giving an opportunity to measure, not just for the funders themselves, but actually moreso for the organizations, and investing in capability
for organizations to kind of have that
feedback loop will ultimately help us sort of achieve those outcomes that I said are upward of the North Star in systems change. – Thank you.
– Yeah. – Olivia, you launched Co-Impact last year to great fanfare. I think it really struck a chord with so many organizations. It struck a chord with funders. I think even more with
organizations looking for funding because it was a commitment to large scale funding to being in it for a bit of the long term. I don’t think you’re going
to be giving one year grants. I think you’re looking for the long term. But tell us about, so again, not everyone will know about Co-Impact, so tell us a bit about the genesis and then what you’re
working on now in 2018, and maybe some of the
opportunities, but any constraints that you’ve had as well. – Really? Well, first I just want to
say how incredibly excited I am to be here with this amazing panel, all of whom have influenced our thinking at Co-Impact, so it’s a real privilege and honor to get to be
here with all of you. Also, this has been
incredibly inspiring few days. The Skoll Foundation, and Jeff Skoll, have been an incredible
partner to Co-Impact. And our whole reason for being is actually to support the efforts that are here and are talking up at work here. So I’m feeling after these few days is just a huge amount of inspiration. So why Co-Impact and
why did this come about? So I had been hearing, repeatedly, from philanthropists around the world that there’s a desire to
drive large scale change. And yet, the mechanisms
out there to be able to do so are still quite limited. That’s not to say they don’t exist. They absolutely do. But it’s limited. And so, if you’re looking to drive large scale change, often
that means you’ll need to go and develop your
own large foundation, and oftentimes the efforts
are really quite separate and siloed. And so I’d been hearing
this, through my experience, with the giving pledge,
and then was interested in going and actually listening to the social entrepreneurs
and the non-profit leaders as well to hear what more
philanthropy really could do to drive impact. And so I spent a year
doing that and talking to about 250 people around the world. And what kept coming out
is exactly what Liz spoke about in her opening, which was really, people have moved, and
actually what Rukmini talked about as well, of there’s
a lot of discussion of systems change. There’s a real hunger to really work on systems change. And yet, funding isn’t
there in adequate supply to really work in this way,
which requires a sort of longer term funding, but also, the kind of partnership of not just, you know, a here, you can go and scale, but really saying, okay, how can we help you to bridge the kinds of partnerships in order to drive this sort of change, and also really kind of throughout the journey, be with you over the longer term. And so that’s how Co-Impact came about, and the-, what it is,
is it’s a global collaborative that’s focused on driving systems change in the areas of education, health, and economic opportunity around the world. Where we are now is, as Heather said, we launched in November. So its early days were still very much in the mode of, you know, big ambition, and at the same time, there’s a lot that we still have to learn. But we’re-, so our plans
for 2018 is to start working with some of the amazing initiatives that are doing this work with the goal of, then, making our first round of systems change
rounds, which are grounds of-, that are, in five years in duration between 10 and 15 million dollars each. With-, in the fall. And the other thing that
we’re doing is continuing to build out our donor community. We have five incredible core partners. And we’re continuing
to build out that group as well as engage with others
around Co-Impact as well. And then the other thing that we’re doing is talking with efforts like Dasra and learning from what are
some of the other efforts that are trying to do
some of the same things that we’re trying to do and learning and exchanging and seeing how
we can actually have more. Because we will only be really one piece of this question, and there’s a movement. And it’s so incredibly
exciting that I think we are at a moment where funding can move in this direction. I think there’s real appetite all around to do that, and the way that we’ll make that happen is by coming together, realizing what we can
learn from each other, what we don’t know, so that we don’t all make the
same mistakes, but also, then, we really can come together to have more impact, and then
so that we see more kinds of efforts that really are
around driving systems change in a really meaningful way. – Thank you. Rebecca, your organization
that you founded was one of the organizations featured in our scaling solutions report last year, and I certainly learned a lot from interviewing you and
from your experiences. So you jumped into the
US healthcare field, which everyone has to
admit is very fraught with problems, can you talk about how-, a little bit more about that process, and I know you want to show us one slide that kind of illustrates that. And maybe some of the funder experiences that you had, and then also,
with what you’re doing now, and how does that relate
to this conversation today? – Sure, thank you. You know, before I talk
about Health Leads, and I think we’ve had some
really powerful learning about when this goes
well and when it doesn’t. I was actually thinking about some of the photographs that
Sally Osberg showed, can’t remember, yesterday
or the day before. And, you know, those are, like, some of my favorite photographs, right? The photograph of Rosa Parks looking out the bus window, Martin Luther King at the march on Washington, and, you know, I was thinking
about how little time we have, how, you know, Martin
Luther King began his work in 1955 and, within 13
years, would be assassinated. And yet still, in that time, did more around issues of racial equality in the United States than probably the prior three centuries. And I was also thinking about, you know, what if King had spent 18
months every three years in due diligence. But I actually think this
is a really important point because I’ve spent 18
months every three years in due diligence, and I’m sure a lot of us in the room have done this, and I was thinking about, you know, what if that had meant
that he had spent 50% of those 13 years proving to people that he would have an impact instead of having an impact. And, you know, what would
due diligence look like on Martin Luther King and Rosa Parks? Like, what would have
funders asked to see? What would the metrics have been? How would they have been-, how would they have structured their grant or porting requirements, right? And, you know, it’s both kind of like an
absurd thought experiment but, you know, I’m not MLK,
and I’m not Rosa Parks, but I dream of having
the impact that they had. And I want to bring health injustice to communities in the United States, and I think about how,
you know, in this room, there are just, like, there
are the revolutionaries of our generation, and, you know, these folks are my heroes, my mentors, my colleagues, my co-conspirators, and, you know, and I’ve just been, I’ve been thinking about how, like, with really a heavy heart, if our current funding norms continue to shape the way we do our work, what is possible around
fundamental change? And– (applause) You know, and I say this
from the perspective of my time with Health
Leads where I think I’m on this panel because I
have had the privilege of watching funders literally
throw away the playbook, and I’ve also witnessed funders, like, clutch it. I think, even tighter
when I come in the room. And I just wanted to share a little bit of what that arc has looked like. So Health Leads work is,
you know, as Heather said, is fundamentally about how do
we reimagine the boundaries of what counts as healthcare. You know, why is it that
we have a healthcare system in the United States that doesn’t account for access to food or heat or housing, these fundamentals that we
know drive health outcomes. And, you know, so, for the first phase of Health Leads work, it was really kind of the
brutal operational work of proving that you could
integrate social needs into care delivery. What are the clinical work flows? What are the technology platforms? Who are the workforces? And we were privileged to be able to raise 11 million dollars
to really get the model right. And that’s this, basically, a period between 2010 and 2014, and
when we got the model right, and, you know, by getting it right, we began to scale, and you can see this, like, very sharp trajectory here, basically, from 2010 to 2014. And at the tail end of that period, there was a-, like, a really
profound ecosystem shift in the US healthcare landscape where there was the first hints that our healthcare system would shift for-, from, basically, paying
for bad health outcomes like ER visits, to paying for health. And our phones were literally
ringing off the hook. And so we, like, rallied,
and we put together a very-, what we thought was a very
ambitious growth plan, which meant we would go
from 24 implementations to 80 implementations, basically, like a breakneck growth speed. And the plan was to
raise 35 million dollars to enable this growth, and we went out and raised 20 million of it, and the idea is we’d raise the last, like, leg in the first year of the plan. So, and 16 million of that came from Robert Wood Johnson Foundation in a, like, really kind of mind-boggling, unrestricted grant. So we’re two months into the plan in fall of 2014, and we have this, like, massive oh crap
moment where we realize that the market is actually, like, starting to move so fast that, like, replication of our model is
totally irrelevant, right? What the market really needs is for us to liberate all of the tools and insights and technologies,
hard one learnings, in order to be able to
enable this whole ecosystem. All of these health system actors to actually make this work their own. And they wanted to. And so I had the opportunity to go back to those funders and tell them, like, we got the whole thing wrong. So your 18 months of due diligence, like, poring over our
financial projections, like, everything about it was wrong. Like, and our work structure wasn’t right, and by the way, this isn’t really gonna be about earned revenue,
and there was just this, like, you know, it’s
like freeze frame moment where those funders had the choice to do two things. They could totally held us to our plan, or they could, like,
abandon the whole thing with us and understand
what was truly required for change. And I think it really required us to ask each other, are we really committed to the same vision? Because if we are, we
know what we need to do. But, like, or are we
committed to the stuff we put in like a 60 slide deck? And, you know, I give, like, Robert Wood Johnson
Foundation enormous credit. And they moved their
whole 16 million over. And with them, came everybody else, and we ended up raising
an additional 15 million. But I think, you know, you can see one of the interesting results of this, which is that the blue
line here is the number of patients we serve directly. And we looked awesome, right? This is what every funder wants. The line is going up. And then, in 2015, when
we made this shift, you see the number of folks
we’re reaching directly begins to plummet, but the
yellow line is the number of healthcare institutions
we were engaging, right? This is the ecosystem change. And, basically, now our
entire 20 year US history, we basically worked with
two dozen institutions. And last year, we were able to work with 2,300 institutions. So just, you know, what I always say is, like– (applause) You know, what I always say is, like, if Health Leads were
to liberate its model, our funders needed to liberate us, and they chose to do that at that moment, and this is what was made possible. The last thing I’ll just quickly say, ’cause Heather asked, is, you know, the next phase of the work,
I actually left Health Leads about three months ago, I was recognizing that we actually have to
shift the public discourse, the policy making, the politics, in order for that institutional trajectory to really stick in a meaningful way, and that’s the next phase
of this systems work from our perspective. – Thank you. So I wanna pull out a couple of strands from all of you and add
to some of the thinking that we and others have been doing. We’re-, we have the
urgency of the problems, and all of us are sitting here, enjoying each other’s company for three or four days, but then we go back to the reality of the enormous challenges, whether it’s climate change, or lack of education, or gender inequality, whatever, so the urgency, and then we have the
typical funder behavior and what we’re trying to get to. So we’re trying to get shifting the system of funding itself. Looking at things like, can funders streamline their processes to make it easier to-,
for grantees and investees to get funding? Can we get funders to
do the collaboration, not just funders asking organizations to do the collaboration? Can we get people to think
in more systemic ways? Which requires longer term funding and also allowing the
kind of strategy pivots that Rebecca and others have talked about, and can we change the power dynamics? Between those who are
providing the funding and those who are taking it. We’ve heard about different methods of scaling impact from our four speakers. They’re scaling direct impact when an organization
gets larger and larger and reaches more individuals
or offers more products and services, but there are also things
like influencing public policy in governments, shifting market behavior
and investment behavior, maybe using technological innovations, or changing social norms, and
building social movements. So these are the tools
that organizations use. So can the four of you, can
each of you say something about, what have you seen, what do you think changes the mindset and actually makes funders
think about what’s needed, the urgency of the problem,
and they actually act on that. Is it that you’re taking them on trips? Is it that you are using peer influencing and getting good funders
to learn from each other? What has ever made a real difference? Rebecca, let’s start with you. You actually gave an example, but you, I think were a very empowered NGO leader who got, was it luck that
Robert Wood Johnson did what they did, or is there any, what can we learn from that example that we can apply to our other work? – Yeah, I mean, I think, you know, one of the things that Health
Leads was always really clear on was that our work, that our goal was to change the system, and so, you know, what we would always say,
internally, externally, funders, everybody,
was the only two things that are sacred are the
vision and the values. You should expect that
everything else is gonna change. And, you know, and I
think with that clarity, you know, building relationships with funders like the
conversation is really about, are we committed to this vision? And, you know, there was this really, like, Crucible moment, the one that actually changed our trajectory, where, you know, Health Leads
had had its best year ever, we had served something
like 14,000 patients, we had, like, a 29% growth rate. Like, you know, everything
that funders traditionally want to see, and, but the problem is, that one in five people in
the United States get care through public insurance, right? Through Medicaid. And we actually visualized this. And our dot on the map was so small as to be invisible. And I think, like, that kind of speaks for itself, right? I mean, is this about the incremental
next 14,000 human beings, or is this about redefining what our healthcare’s
delivery system does, right? This is 19% of GDP. And I think one of the things that we just learned really early on is, you know, we ask our funders to commit with us to the ultimate impact around systems change, and we contract that we have a working hypothesis of the pathway to achieve that impact. But if that pathway adjusts, we, Health Leads, will adjust, and, you know, the question is is that, I mean, I just think this is
about being fully transparent that that’s the way we
think about our work and our impact and really asking folks to come with us on that. – Thanks. So not every funder’s going to care about systems change, but I think a lot of funders who come to
the Skoll World Forum do. So is there something in that, there’s been a debate over
the last few days here, is this just another fad and more jargon and it’s a bandwagon, and it will come and go like so many other things have, or is this something that can
really change funding behavior if we hold ourselves to
a different standard? So, Olivia, what do you think? You’ve started out with that. Can you confirm or,
maybe it’s not clear yet. The funders that have come in earliest to your work, are they going to allow
this kind of strategy pivot if it’s needed with the grantees that you put your weight behind? – [Rebecca] It’s kind
of renegade behavior. – I mean, I think it’s really all about the impact that can be had. I think that’s the key
thing is what is the impact on people’s lives through this work? And, so, as I’ve had conversations, both with funders and
with social entrepreneurs, there’s something that’s constant across all of those conversations, which is, the desire to
really have a lasting impact. However you want to call it. And this is the thing
that Rebecca’s talking about, which is, what does that mean in terms of whether it’s the 14,000 or what that means in terms
of sort of transforming the system over the longer term. So I think, in answer, just
from your other question there. I think it is about being
able to see these examples. So see the examples of
other funders, also, who are doing this work
from around the world, which I think is also a
really important piece. And also to be able to see the examples of where the sort of support has led to results for millions of people. And then I think that’s
what will actually mean whether it’s something that’s a fad or not. I mean, I think this point of where we are in philanthropy now is, there’s a real appetite to have more ways for funders to engage in the kind of work that, yes, of course,
there will always be a need for also supporting, also
smaller scale efforts and direct service and throughout. But I think the other piece is saying, okay, if we’re bringing
together these kinds of collaborations that
really can drive impact at a really significant scale, and you see that funding those actually
really can be effective. I think that’s what will end up meaning that it will stay. – Thanks. Neera, in your work, so your work, you have giving circles,
and you have funders that are already working together. Do you see something? Is there peer leadership there? Are there funders that have, maybe, better practices? And, also, you mentioned
measurement earlier. Is there a difference in what’s measured? – So I don’t actually think
this systems change is a fad. I think that the complexity
of solving the problems that we’re all facing are multi-sectoral, and there is an inherent convergence of spaces that we’ve tried to separate that I think we’re recognizing the need for all of that to somehow come together to ultimately move on these results. So I do think it’s important. I think funders have a herd mentality, so absolutely. Like, if Co-Impact comes
in, you’re gonna see lots of people wanting to come in, right? If people are funding Pratham, lots of other people will also want to fund Pratham. So absolutely. Peers in the funding space love it. And high net worth individuals want to see the richest people and hobnob with them to feel
that they can kind of be in that club. But I also think there needs to be, and it’s a bit too, what I was thinking when Rebecca was speaking, is there needs to be a sense of collaboration
and a collective voice from the leadership and the non-profits on-, for lack of a better
word, the demand side. And it takes a lot to be as confident as you are, to say screw you I’m not gonna
take your funding, right? And there are defi– – I didn’t frame it that way. – No, no! – You are paraphrasing. – You were way more articulate. And I was feeling kind of
guilty to tell you the truth. But ultimately, I think what funders bet on is the leadership. And so, the more we can, as an ecosystem or sector, invest in leadership, to have a voice like Rebecca’s, and to push and say
we’re not gonna be able to solve this problem, I’m not necessarily an
education organization, this is how, you know, we’re
approaching the problem. I think giving that voice to the leadership is really important, and I think funders are
looking to be educated. So coming with research, coming with understanding the root cause of the problem, what are you learning in the communities? What’s working, what’s not? I feel like there is
more than ever a sense of openness for funders to really figure out how do they get to
kind of the root cause of the problem. And that’s part of why I’m
saying measurement is important. I want to be careful
because I think we’re all so in this crazy evaluation world, and then we spend ridiculous amounts, and then funders don’t
really want to fund it, or they fund it for themselves, and so, what’s the point of it? I would encourage us to just measure for our own learning and
to just be comfortable and confident that you’re
making a difference, and to, ultimately,
are you changing lives? And don’t get confused by,
you know, these big numbers and, necessarily, aggregation. But if you can really be able to say that this kind of an intervention
ultimately changes lives, then that can help government, that can help policy, that in and of itself, I think, has ability to scale. – Thanks. Rukmini, what about you? What are your reflections on this question and are your funders the way– – I’m sorry, I’m listening
to all kinds of strategies. So when I go back and people say, what was the impact of the Skoll forum, I can say at least a
couple of things here. I think the-, you know, as I’m listening to, I mean, I keep thinking that this
funder isn’t some other kind of creature. I mean, yes, she or he has a lot of money, but, no, they’re people too. And so. And so I think the
fundamental question is, how do you carry people along? How do you convince a broad
cross section of people about what you’re doing is so important that they need to jump into it as well? And I think we’ve learned a lot, and, you know, what is it? I’ve heard this word here, chatter mouse. Don’t quote me outside this. Money is a very good
thing, and you can do a lot of things with money, but
you don’t always have money. So what is it that you really wanted to do? What is it that Martin Luther King wanted to do? What is it that Gandhi wanted to do that they would do anyway? And you have to have the power of that idea to carry people along. And so, I think that, you know, when money is available, it allows a lot of things that, perhaps,
you couldn’t do otherwise. But the goal has to be such that a lot of people think it’s
important and can participate. And I think we’ve learned quite a bit, both from failures as well as, you know, things that have gone well. Is that the simplicity of what-, And also, I’m in education. I’m in primary education, a
bit different than health, or in climate change, so
I’m not sure this cuts across sectors, but if I keep things, what you have to do simple, if
it’s a totally different way of tackling a problem
that wasn’t done before, then the absorption of
that into different types of settings is easier. So in about, 10, 15 years ago, we could see our tagline is every child in school and learning well. And more and more children in school were in school in India. But everybody had this discomfort that things aren’t as good as they ought to be now that all children are in school. But you didn’t quite know what that was. And we could see that, unless, and, you know, when you
worked in communities, you worked with kids,
you worked in schools, you could see that it was really
some fundamental obstacles. If you can’t read for example, you really can’t do anything else. And so, it is important for kids that are by a certain age, to learn how to read because that then
unlocks a big potential to do more. And, you know, teaching children to read is not like some
major health problem. I mean, many people can help to do this if they know what to do. So I think that we did
two things simultaneously. And I’m not sure how self consciously-, you know, how strategically
we were doing it then. They just seemed like
two obvious things to do. One was, how do you make this problem, that children are in school
but they’re not learning, very obvious to many people? So we did-, we have this
very simple assessment, and, unfortunately, my bag is over there, otherwise, I’d show it to you right now, and it’s incredible how, no matter where you are, at a bus stop in India or in the stage and Skoll forum, you always need that little piece of paper to show what you do. So it’s a simple assessment. It’s a simple assessment of can you read? Few letters, words, a little paragraph and a story. And we use this, it’s
called the Annual Status of Education Report, but what it is, is helping everyone uncover the problem. And right from the first day, and, I remember that we decided to just-, it’s a good story now, really, it so happened we did it that day. The second of October, when we decided as an organization, that
we should do something across the country to help uncover this. Second of October happens
to be Gandhi’s birthday. It’s also a holiday in India,
which is why you had time to think. But it’s a good story now, and you know, it makes you
feel Gandhi in our soul. And it was October. We didn’t have any money put aside to do a survey across
600 districts of India. But we thought it was a
really important thing to do at that time. And so, what do you do
when you don’t have money but you have a big
ambition and a big desire? You have to convert people
in whatever way you can to participate. And I think that was one of the things that really helped. We understood the problem, we had a kind of a estimate of it. But that was not enough for us. It needed everybody in
India, and it needed, we’ve done this thing over and over again, 10 years, 12 years, for the problem, really, to settle down. And that one survey that we do every year can’t
be too expensive ’cause what if there’s no one to fund it next year? You know, this is showing a country that we are not doing as well as we think. It’s sometimes not popular. You know, understandably. And so, I think that was one thing. And then coming up with a solution to solve the problem that we will see in a way that, you know, volunteers in the community could
do it, moms could do it, teachers could do it, was
also equally important. So I would say I’m not aware
of which funder we took to show what, but I think when
you do something like this, and it seems like, you
know, the right thing to do at the right moment,
you know, many people come on board. And, you know, governments
will come on board. They sometimes don’t like your assessment, but they like the solution. Sometimes people like, you know, but I think that investing
in understanding the problems from a different angles and making sure that what you’re doing
is not so complicated that you know, you need a pagee to explain it to anybody. So I think keeping things simple, keeping things straightforward, keeping things non-expensive, allows, according to me, allows
scale in the context in which we are. I don’t know what scale would mean in America, but at least
that’s what I think. – Thanks. – Can I add just one
quick thing on this point? And I think there’s this
really interesting kind of dialogue here around
the chicken and the egg of the funders and those doing the work and how do we mutually commit to this. So that chart that I showed
actually got published about two months ago in Health Affairs, which is the, like, main
health policy journal in the United States. And one of the things that I wanted to do was publish it
with one of our funders to really have memorialized this is what it looks like when you
enact this kind of throw out the playbook funding. So the article got published, and, you know, it’s a 20 year case study of the sort of triangulation
between Health Leads, the market, the healthcare sector, and the role of philanthropy,
which has been clutch. And, you know, it’s like, you know, it’s gotten some
attention, but I was like, why isn’t this being
tol-, like systems change, philanthropy. Why isn’t this getting talked about more? So I called, you know, one of the folks who, you know, had been
kind of a thought partner to me on the article, and, you know, who’s been in philanthropy for a long time and said, like, what’s the deal? Like, it’s not getting tweeted, no one’s talking about this. And she was like, as
though I was a small child, was like, see, nobody wants to talk about this, Rebecca, because
you are the exception. Health Leads was the exception. And, like, no funder wants people showing up being like, we got the wrong strategy. Like, shift your, you
know, 20 million this way. And I think it was just a really-, like, I think I had genuinely believed that if we documented the story of systems change philanthropy
and really showed the chart, right, that that would
be catalytic, in a way. And to hear, like, no. Like, this is actually, like,
this is high risk behavior on the funder’s side,
that we actually want to, like, tamp down this documentation. I think, at least sobered me around, you know, what are the dynamics in this ecosystem and how do we think about unlocking them. – So we have sort of varying levels of optimism across the panel. I think we’re all optimistic but maybe more cautious than one another. Okay, we have time for some questions. So raise your hands high. We have some mics. It’s hard for us to see up here. Okay, how about this person, one, two, three, in the
fourth row with the suit. – Thank you. I’m Tim (Wain-hart) from Monterey. I thought it was a really
interesting discussion, and I don’t think it’s
a fad, actually, either. And in other sectors, they talk about adjunct program, which is similar. And Rebecca, right? I loved your story and slide. So I work in water sanitation and hygiene. Long term sustainable,
systemic change is impossible without full engagement of government. Local government, national government, high level political leadership. So I just wondered if
any of you had any words of wisdom to offer on how philanthropic funding can be, can
help to enter that mix. Where government engagement is essential to long term change. – Thank you. And we’re going to take three questions at a time. I know there’s a question down here at the front row. The woman with the blue scarf. – Hi, thank you all so much. Melissa Stevens from the Milcom Institute. So when you think about philanthropy, it’s a mechanism for families to leave their legacy in this world. And so, my question is for Olivia. If you have, have you found
yourself having a hurdle, or expect to have a hurdle
in bringing funders together to be collaborative. Do they have a sense of
losing their identity or still, how do they balance wanting to have a unique identity and footprint to leave that, and do
they ever have a sense of, you know, being diluted, I guess, by being more collaborative with others. – Okay, and how about one from this side. Any questions over here? Well, we’ll take from you. The gentleman with the suit. – Thanks for this. Incredibly enlightening. Can I ask whether it matters
where the money comes from? The global fund recently disengaged from Heineken a rather large partnership that was being forged in the wake of backlash as to what Heineken represents in the face of global health. Does it matter to organizations
where their money comes from, how clean it is. And are there intermediaries
that can help, quote, unquote, launder this reputation. – Okay, let’s see. How about if the first question about words of wisdom
of philanthropy working with the government, maybe Neera and Rebecca, can you answer that one? – Sure. So I think there’s many ways in India, because you can’t, also, unfortunately, I can only speak from
the Indian perspective, is that you can’t achieve scale without working with the government. There’s, it’s as simple as sometimes
just funding non-profits. So, in India, a lot of
non-profits that are working to achieve scale will be working, either through government systems or aligning with policies or a veiling of some sort of government scheme. So you can inherently fund organizations that have a model that already engages with the government. Interestingly enough,
in the sanitation space, where we’re also focused
in urban sanitation, there actually weren’t enough policies, whether at the city level or even at a government central level
on equal sludge management. And that’s one of the biggest problems in India is sort of, 70% to 80% of fecal sludge, or shit, basically, goes into the drinking
water, into the water system. And so, what we did is we brought a group of organizations together as being able to advise the government on the policy, draft the policy, and do consultations. And I know they do that quite a lot in India, with engaging the non-profits on that, but what we did was build that alliance and facilitate that alliance and bring folks from
different perspectives to be able to do that. The challenge with working with the government is the
government is as siloed, if not more siloed, than the funding. And so to actually achieve some of these issues, they’re cross ministry as well. And so what we’re seeing is helpful, potentially, for philanthropy
to fund are these missions which bring different ministries together, whether it’s the women
and child fare ministry or water and drinking. And so, creating some of these areas of convergence within the
government system is also where we’ve seen philanthropy work. – Thanks. Rukmini said she wanted to answer this one as well. – Yeah, so I think, again, you know, unfortunately, you have, or fortunately, you have a lot of Indian voices here. – [Neera] We do have
billions of people, so. – Yeah. I think that, you know, obviously, without working with government, it’s difficult to really benefit into some of the norms
that we’re talking about. And I wanted to mention that, for example, the grant, we have a grant
from the Skoll Foundation. And what we use it for is to be able to categorize what happens
in government systems. So that grant is, you know, compared to what the government is spending, it’s a very, very small amount. We use it to spend on people
who will work very closely with the government. So you can think about a state in India, which has, maybe, 50 districts, and all that this philanthropic money, which is coming to us, helps to fund, is two people per district. But even that, in a well designed, collaborative program with the government, can lead to quite big results. So I would say that the way that we look upon it is that that
helps us cover our costs. We are very mindful that
in each successive wave with the government, how
do you keep your costs, either at the same level while
you’re expanding the work of the government is going to do, or, you know, if you are
mainly at the same scale, then how do you reduce your cost. But playing with some of this, and I think the governments
in India look forward to some of these things. I think that time, ideas that need to be injected into a system,
I think there is openness in different places for
how you bring that in, and I think that’s where, you know, collaboration’s working, you know, implementers, or innovators, working with some funds of their
own, can certainly help. – Rebecca, I want you to add, briefly, but then I’m gonna also, I’m
gonna switch the question for you to ask about bad money. Would you take money
from a tainted source? You can start with the government answer. – Why do I get, like, the
money laundering question? Well, I mean, I think I can just answer that latter question very simply, which is no. I think it’s a more complicated question of, like, what’s a tainted source, right? So just on this government point, just to make this really crisp, and, like, very concrete, so, basically, you know, I started Health Leads in 1996, and in 2016, the centers for Medicare and Medicaid services
in the United States, which is the largest
purchaser of healthcare in the entire world. For the first time in history, created a pilot called the accountable health communities pilot that actually paid to screen patients for their unmet social
needs and navigate them to resources. But that was 20 years, right? And so, you know, I was
presenting the paper at a healthcare event, you know, with all these pairs in the room and health systems providers, and, you know, they’re like, yeah, yeah, yeah, you know, addressing the broader notion of health, yes. But, of course, like, none
of them were gonna pay for the 20 years that we spend, like, refining the model, testing it, failing, going back again and again, and like, I just think it’s
a very crisp case study of if we had not had flexible philanthropy over a 20 year period, there
would have been no bridge to government involvement. And, you know, that’s the
critical inflection point, and what’s so critical is not just that, you know, the US
government said okay, we’re gonna commit 157 million dollars to pilot this approach and to really understand the economics of addressing social needs. It was the market signal
that that created. So as soon as CMS said
it was gonna do that, you know, literally, for the first time in 20 years, we have the
largest commercial payers in the United States, insurers, calling us saying, how do we
address patients’ social needs, right? So that catalytic effect of, like, true venture philanthropy, bridging to government, and then governments market
signaling causing a set of private actors to begin
to behave differently, like, we just saw that play out directly. – Thanks. I don’t want to gloss over that question about the source of money. I think it’s important because we talk about philanthropy collaborating. So I guess let me reframe the question. If, bearing in mind that it’s hard to judge, what money one
might consider tainted. But let’s say there were. So in philanthropy collaborations, do you think we have the mechanisms in our sector that if you are wor-, that we have, we are able to say to funders, who we don’t
want to partner with, no? I mean, Olivia, this could come up for you very concretely. And Neera, it could come
up for you very concretely. Is it something we need
to think about more? Or– – I think we all do think about it. I mean, we’ve certainly had lots of conversations on our team
about this very question as well as with many of the donors that we’ve been engaging with because, especially when it does come to collaboration, it’s really important to think about who you’re engaging with. So both for, sort of,
us as the Co-Impact team as well as for all the donors
who already are involved. And I think I would broaden it beyond, sort of, the tainted, but
it’s also just thinking about how can you insure, especially when it comes to collaboration,
that people are aligned, because that’s sort of
one of the key points of collaboration is to be able to provide that kind of aligned support. So I think that’s also really important. – I think we have-, I do think we have to be careful. I think that it’s difficult to know who’s out there with dirty money and not. I think Ruchir Sharma
wrote an interesting book about bad billionaires
and good billionaires and bad billionaires are the mining and oil and gas and all
of that kind of stuff, and the good billionaires, apparently, are the technology and,
you know, the pretty ones. You know, it’s-, a lot of
the wealthiest families in foundations didn’t make money in the cleanest of ways, right? The Tata Trust did opium, Rockefeller had oil and gas, I mean. So if it’s enough generations far away, it seems to be fine. If it’s newer wealth, then you question, but I think it also has to do with, at least in a high net worth individual, the individual. And you really do need to
make sure you’re aligned on basic values and, to the extent of even behaviors, and
how they come together, to your question, like,
when they’re all sitting around the table, so, in our
adolescence collaborative, we have USAID, Packard Foundation, SIFF, a UK family based foundation,
and we have Bank of America. So we have a lot of different kinds of folks, if you want to call them that, coming to the table. And you do a lot behind the door. Because we got brutally screwed once where we were like,
we’re all happy, happy, let’s all come together, and then this entire meeting exploded where people were
misaligned, they were like, what’s Dasra doing anyway,
so we had to take a time out. So you do a lot of behind
the door alignment. And so not only values and behaviors, but it’s also that individual with whom you’re collaborating. So you might have an
institution behind them, but that person that’s gonna be engaged on the relationship is actually extremely, extremely important. And you also, ultimately, go by gut feel and trust, so I’m not
sure we’ve talked enough about this, but ultimately,
you’re investing, or you’re bringing that person, and you all trust that what you’re trying to achieve, you know,
together is really something that you want to do. And the thing that’s really helped us in terms of building the alignment, are the outcomes. And so, if you can have that North Star, everybody’s bought into that North Star, you really try and work
through the conflict of the how, I think is a lot easier. – Right. Olivia, I don’t want to
overlook the question about families that come together and maybe lose their identity
through the collaborative. Is that something that
you’ve thought about? Well, you must have in
the last many years. – So, yes. I’ve definitely thought about it. So I think it’s quite
striking that there are lots of jokes in philanthropy
about collaboration. Right, so, there’s sort of the, okay, collaboration philanthropy
is I do this, you do this, and this is collaboration. I won’t go through them. Jokes are not necessarily my strong suit. But, basically, there are many. And as I was talking with
funders in the early days of getting Co-Impact off the
ground, one in particular, said to me something which
really stuck with me, which was the challenge with a lot of philanthropic collaboration is that you feel like the pimple
on the tail of the dog. I think that’s very evocative. So the pimple on the tail of the dog means that you don’t feel like
your, sort of, full self. I guess, is there, but also,
it’s because oftentimes, what it means is if
you need to go and give to a much larger funder, which
is often the model, right? Where you actually go, and
there’s another funder, and then you would go give alongside that you can’t bring your full self. And I think that’s where Neera’s point of, what role can you play where, actually, you do have an intermediary that can then, it’s not just about the funding. So what you need to do, I
think, with collaboration, is actually have it so
it’s not just about kind of everybody pools and then walks away, but really that you try to think about, in the collaborative, what
are the different things that each funder brings to the table. So it could be, and this
gets the piece of, again, some of the other themes of, sort of, then encouraging others, right? If you, of course, it’s
not going to be everyone who sees this, but then if you have a few that really do see the
power of coming together and can then demonstrate
that it isn’t just about the funding, what
does each funder bring, then others can see that, and we can start to see more collaboration
and philanthropy. I think one of the other
things that I saw a lot through my conversations
was there is a lot of push on non-profits to collaborate,
and in order for us, and we went through a lot of
different names with Co-Impact, and at some point, we called
it a donor collaborative, and we felt very strongly that it’s not a donor collaborative, it really has to be about,
not just donors collaborating. If you create the space
for true collaboration, it’s about the donors coming together with the organizations with
government, with really sort of all the factors coming
together towards a similar goal, or towards the same goal. And that that’s, really,
what you need to do in order to then see. It goes back to then being
able to see the impact and actually seeing,
also, what you can bring. I mean, I do think it is challenging. The systems change both
for the organizations that are involved as well
as for the funders sometimes to be able to see that,
to figure out what is-, what you can sort of attribute
in terms of when it comes to measurement. And I think that’s gonna be
something we’re all going to need to learn more about
so that we can really look at kind of what are some of the practices that various organizations
have used around this as we think about impact
across an entire system. – Thanks. Yeah, I think we need to recognize that collaboration is not easy. People talk about having to have trust, but sometimes people have to collaborate in cases where there is no trust. There’s a book that came out
recently called Collaborating With the Enemy. How to collaborate with
people you don’t trust, like, or agree with. – [Olivia] Okay. – And I think that’s important. And also, there’s a saying- – The fact that I’m writing
it down doesn’t mean anything, I’m just– – It’s by Adam Kahane,
so there you have it. There’s also a saying
by the, I think the US, the former US surgeon general that says collaboration
is an unnatural act between non-consenting adults. And I am sure that all of us have been in that situation. Okay, we have time, I think,
for maybe one more question or two, depending on how long they are. Okay, the gentleman here. And I’d like to get someone up there, but it’s hard for us to see. Okay. – Hi, thank you for
extremely interesting session over here. My name is Amir Fancy. I’m from Pakistan. I run a not-for-profit
trust, which is 70 years old. My question to philanthropy over here is do the funders
also think about sustainability? Is it just giving grants
to organizations which may or may not survive the long run? We’ve had an opportunity, after 70 years, to partner with the Acumen
Fund to set up a for-profit but for-purpose enterprise
for local private schools. So our collaboration and
philanthropy has been with not-for-profit and
for-profit but for-purpose. Is the world moving towards social finance and patient capital
from just giving grants from large funders? Is that something that
you look at, in terms of keeping organizations sustainable and letting them grow on their own? – Okay. And a question over here. – Rebecca, I’ve got a question. You got your very large support
from Robert Wood Johnson. When you transitioned
from scaling programs to scaling impact, what
did your more traditional, or your older line funders,
how did they react? And was it good for you
or a problem for you? – Okay, why don’t we stop there, I think, with the questions. Rebecca, why don’t you answer that and then all of us have a chance to answer that last question. – Yeah, it’s a great question. So, what to say. I mean, I think that, I think there’s, at that pivot moment, I
think there’s multiple ways that folks can struggle,
funders can struggle to, like, cross the
chasm from scaling impact to really beginning to
invest in an organization or set of organizations to be able to really move systems. And I think, so three of those that were most omnipresent
was, of course, first, what do we measure? Right? Like, number of patients,
number of deaths, number of implementations,
number of clinics, super easy, right? And when we started, you know,
the real thing we’re trying to do is, like, reimagine the use of 19% of GDP in the United States. Like, how do you think about measurement in the context of systems change? We’ve all talked about that. But, I think, what was critical was
those funders did commit, and this was important, to wor- Instead of pulling their
funding and waiting for us to miraculously come back with metrics, they actually committed to work with us on the creation of a new set of metrics. So that was really game changing. I think the second challenge was around, which got alluded to,
this issue of attribution or contribution. Right? So the funny thing is, right, so, like, the US government says, like, okay, we’re gonna launch this
157 million dollar pilot. Health Leads had nothing to
do with it to be super clear. Other than we were, like, the model that was cited in
the funding announcement. Every funder calls, did you do that? And it’s like, I don’t know
how to answer that question. Like, sort of, right? And so just like, what’s the way that we actually talk about what our impact has been? You know, and then I
think the final piece, which has to be said, is
around risk tolerance. So, like, scaling an organization, like, there’s a way to think
about risk tolerance and to mitigate risk. And I actually think funders are like, increasingly practiced at
risk mitigation in the context of scaling impact, right? And partly because they’re
pulling from, like, their venture capital days
and other ways of thinking about due diligence but also
tracking progress over time. We just have to say systems change work
is extremely high risk work, period. And we have to re-evaluate
the way we manage risk because it’s not gonna be
because the chart, like, goes up and up and up over time. And so, I think, you know, all three of those were things that we had to spend a lot of- And I think appropriately. Like, a good amount of
time really engaging with our funding partners around. None of them were resolved
before they made this commitment, but what I did appreciate
was that the commitment was to be with us in working
to understand those issues. – [Audience] Just, my
question was, carrying through with that, was
your board supportive as well? – Yeah. I think, I mean, we had just,
again, been always religious about this point of, like,
it’s about ultimate impact, and you have to let go of all kinds of stuff. Board members cry when we
cut programs, blah blah blah. But, like, bottom line is are we trying to transform the healthcare system or not? And we’re not gonna do it in increments of, like, 14,000 human beings. So, you know, we kind of had to be honest about that. – So we all now know
working with Rebecca is not for the faint of heart. Okay, can I ask our other three panelists, we each have a minute
to answer the question about sustainability. And let me just say I think we all know we
support organizations that can absorb grant
capital, and that’s all. Some that are- Can take fully commercial capital and some that are somewhere in the middle on the spectrum. So can you think about sustainability in the context of donor collaboration? What are any lessons about that? Or is that a good opportunity? To mix them within one
donor collaborative? – I’ll say two things. One is that I think the key thing in what we’ve been seeing through many of the partners that we’ve been working with is that the sustainability of impact is crucial and that that might also mean the
organization shifting what it’s doing. Similar to the story that Rebecca told. Or, potentially, actually
no longer existing, 10, 15 years if, actually,
the goals are accomplished. So, I think, when we were thinking about systems change, I
think that’s really important from a sustainability lens. The second thing I would
say is that similar to the question about the
role that philanthropy has with government, I think we do need to be more thoughtful about the role that grant funding has as well as looking at other forms of financing. And that’s something
I’m particularly excited to see, sort of, more discussion about. I think in some settings,
we’ve really moved very far in the direction of saying impact investing
is really the way to go. And the other- ‘Cause we say it’s only grant funding. There needs to be somewhere
where we actually really do look at when is grant funding playing a role and how can we think about blended models when it makes sense? And I think that is something
around collaboration as well. And also that that is a
chance to then leverage. I mean, a piece we haven’t talked about is this incredibly important part that philanthropy is only a
tiny, tiny piece of the picture. And so, if we think about
leveraging other funding, that’s so crucial. – Thanks. Neera, briefly. – Yeah, I mean, I think it sounds like
your question largely came from financial sustainability,
which is why, maybe, you were talking a bit about for-profits. I really believe that we have to look at the actual business
model and then match it with the right kind of financing. And so, you know, if you are a non-profit, you are a non-profit because products and services cannot be paid for by the ultimate consumer. And so, looking at these business models and then matching it
with can it take equity, can it take debt, can
it take grant funding, I don’t think we do actually enough of that. And so, for everyone to start to gravitate that the answer to sustainability
are all for-profit models, we’ve got way too many
problems, in Pakistan and India, that won’t be solved with, you know, just that. The Acumen Fund or funds. – Thanks. Rukmini, last words for you. – So you know the work
(bra-that’s) means first. So I’m really happy you’re
giving me the last word. I just want to talk about
the word sustainability. It’s another word that
is talked about a lot. And, you know, I think you already talked about, I think he meant
financial sustainability. But as I look ahead, I
think about sustainability as sustainability of the
idea that you’re trying to push. Obviously of impact as well. And another thing that I’m beginning to increasingly be aware of, and that maybe others who
are far wiser and smarter, who’ve been aware of it all
along, is that, you know, we run a big organization. I
mean, 6,000 full-time people, almost an equal amount of, almost an equal number
of part-time people. And what I’m seeing is that
this is a training ground for people who have
this kind of mentality. And I’m not sure that we do
enough to sustain, to build, the fact that these are all
long-run players in this game. Today, if I look around in India, many of the education people who are doing other organizations
who are doing good work, have had some roots in Pratham. And I’m not sure that I’m- We are doing enough about, you know, kind of creating this
garden of can-do people, will-do regardless, love funders, but if they don’t come along,
we’ll still do it anyway, kind of mentality. Don’t get me wrong, by
the way, everyone here. There must be lots of
funders in the audience. We love money. But I think that this stuff we
are working on has, you know, needs to be pushed in many different ways and many different settings. And, to me, sustaining
the pressure on, you know, our families, our
communities, and our systems to make sure that this is
not a problem for some time. Needs, I think, a broader look
about what sustainability is. So. – Thanks. Okay, well, that brings us to the end. I think– (applause) Our panelists have been, not only amazing and thoughtful and experienced, they’re also very entertaining, so thank you all so much. Enjoy the rest of the forum.

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