Leadership in Uncertain Times

Dr. Rajiv J. Shah, The Rockefeller Foundation

Dr. Rajiv J. Shah

One Health

Editors’ Note

Dr. Rajiv Shah brings over 20 years of experience in business, government, and philanthropy to The Rockefeller Foundation. In 2009, he was appointed to serve as USAID Administrator by President Obama and unanimously confirmed by the U.S. Senate. Dr. Shah was charged with reshaping the $20 billion agency’s operations to provide greater assistance to pressing development challenges around the globe. In this role he also led the U.S. response to the Haiti earthquake and the West African Ebola crisis, and served on the National Security Council. By elevating innovation and public-private partnerships, and shifting how dollars were spent to deliver stronger results, Dr. Shah secured bipartisan support that enabled USAID to dramatically accelerate its work to end extreme poverty, including the passage of significant Presidential priorities – Feed the Future and Power Africa and the Global Food Security Act, which is the second largest global development legislation after PEPFAR. When Dr. Shah left USAID in 2015, he continued to follow his passion for creating opportunities for communities to thrive in the developing world by founding Latitude Capital, a private equity firm focused on power and infrastructure projects in Africa and Asia. He was also appointed a Distinguished Fellow in Residence at Georgetown University. Earlier in his career, Dr. Shah served as Chief Scientist and Undersecretary for Research, Education and Economics at the United States Department of Agriculture. He also served in a number of leadership roles at the Bill & Melinda Gates Foundation, where he helped launch the Alliance for a Green Revolution in Africa (a joint venture by the Gates and Rockefeller foundations) and the International Financing Facility for Immunization (credited with raising more than $5 billion for childhood immunizations worldwide) and where he supported the creation of the Global Development Program. Dr. Shah is a graduate of the University of Michigan at Ann Arbor, the University of Pennsylvania School of Medicine, and the Wharton School of Business, and has been awarded honorary degrees from Tuskegee University, American University, and Colby College.

Institution Brief

The Rockefeller Foundation (rockefellerfoundation.org) is a global institution with an unparalleled track record of success carrying out its founding mission to promote the well-being of humanity around the world. Over its century long history, The Rockefeller Foundation has embraced scientific frontiers to lift up vulnerable children and families. Today, The Rockefeller Foundation seeks to apply science, technology, and innovation to this task and end preventable child and maternal mortality, transform food systems to reduce the global burden of disease, end energy poverty for millions in Africa and Asia, and enable meaningful economic mobility in the United States and around the world.

Rockefeller Foundation CORE Sean Penn LAFD

The Rockefeller Foundation partnered with CORE.
It’s Founder Sean Penn and CEO Ann Lee meeting with
first responders at the Los Angeles Fire Department.

The world is facing an unprecedented crisis that is impacting all countries and their citizens. The pandemic is being fought on the front lines by healthcare workers, first responders, those providing supplies and meals, transportation workers and all other essential workers. What do you say to these true leaders and heroes that are risking their lives to protect others?

First and foremost, they have my deepest gratitude. We are all staying safe at home while they are running towards the fire. They are the heroes among us. Second, I want to reassure them that, at The Rockefeller Foundation, we are doing everything we can to help create a safer work situation for them and other front line workers – partnering with state and local governments, industries, health officials, scientists, economists, and more to scale testing and contact tracing in this country up to a level where front line workers can come to work and be confident in their safety.

As of May 31, the United States was conducting approximately 2.7 million coronavirus tests per week and starting to trace contacts, which is an improvement from the 1 million tests per week America was at when we released our National COVID-19 Testing Action Plan in late April. Still, we have a long way to go to reach the 30 million tests per week and expansive contact tracing that the country needs to more safely reopen workplaces and communities, which is why we continue to engage policymakers, medical experts, and industry and government leaders to accelerate access to testing, contact tracing, and the guidance that defines how data should be gathered. Only then can we suppress this pandemic.

How is The Rockefeller Foundation confronting the COVID-19 pandemic based on the Foundation’s unique position and ability to make a major impact with its expertise, history and heritage?

The Rockefeller Foundation has a long history of advancing the frontiers of science and innovation to positively transform lives around the world, beginning with its very first grant in 1913 to the American Red Cross. From creating the field of public health to stopping the spread of disease, to catalyzing the Green Revolution that prevented starvation for one billion people, to supporting the Committee on Social Security in the depths of the Great Depression, the Foundation has been a bedrock institution in the United States and globally, providing the necessary leadership when it mattered most.

The COVID-19 pandemic has brought us to another critical juncture at home and abroad. This time, our 21st century global goals of achieving health for all, nourishing the world, and expanding economic opportunity are both center stage and under siege. COVID-19 is both an unprecedented challenge for humanity and an equally powerful opportunity for our institution to act with urgency and deliver lasting results for vulnerable people in the United States, Sub-Saharan Africa, and South and Southeast Asia.

So when we saw the devastation being caused by this pandemic, we immediately began pivoting our portfolios to meet this moment by accelerating the global COVID-19 response and recovery and driving structural reforms to help vulnerable families survive this pandemic and thrive afterward. We set clear goals: to accelerate the response to this pandemic and prevent the next one; to fight the existing and emerging crisis of hunger and malnutrition that we see rising at home and around the world; and to help workers, families, and vulnerable communities get through this moment and emerge with greater opportunity than they had before. In order to achieve these goals, we’ve committed at least $50 million over two years, because the time to act is now.

What role can The Rockefeller Foundation have in addressing the needs of low-wage workers in America who have been so hurt by this crisis?

This is an issue our team was working on prior to the pandemic, allowing us to really ramp up our work during the crisis. Even before COVID-19, 40 percent of Americans didn’t have enough in savings to handle a $400 emergency payment – and now the emergency is here. These are working families who are barely making ends meet, so the loss of income on top of that makes all their hard work seem to count for nothing.

The situation that millions of Americans find themselves in today is no accident. Since the early 1980s, corporate profits as a share of the economy have nearly doubled while wages and salaries for working families have fallen by the same amount as a share of GDP. Despite significant improvements in labor productivity, American workers have not gotten a raise in four decades. Today, nearly 90 million Americans live in families headed by someone who works but can’t pay their bills each month. Many of these are the low-wage workers who were always essential to American life, but who we now recognize as a lifeline. Those who haven’t lost jobs are currently enabling millions of Americans to stay safely in their homes, but they are still not getting paid enough to provide for their families – let alone give their kids a better future.

This is not only a result of globalization and technology. It is what happens when you have a system that for over 40 years has created preferences for those who possess capital over those who provide labor. That’s why we recently launched an initiative on Equity and Economic Opportunity to widen the path to economic stability and mobility for millions of low-wage workers and their families.

Through this initiative, we’re working to help low-wage families access the benefits and capital they are entitled to while rebuilding a more equitable economy. We’re working with partners like Benefits Data Trust, Code for America, and the United Way to expand, improve, and accelerate access to unemployment and other benefits including direct cash payments such as the Earned Income Tax Credit and CARES Act stimulus checks, and programs like supplemental nutrition assistance (formerly known as food stamps), Medicaid, and others. We’re supporting advocacy efforts for evidence-based national and state tax and budget decisions to rebuild a more inclusive, equitable economy. We’re demonstrating and scaling solutions to increase access to capital for minority-owned small businesses – which represent 30 percent of all U.S. businesses, but received only 10 percent of recent stimulus loans from the Paycheck Protection Program and others.

Rockefeller Foundation CORE COVID-19 Test Site

CORE Staff at a drive-thru COVID-19 testing site in Los Angeles

What do you see as the role that philanthropy needs to play to meet this moment?

This is an unprecedented crisis. For the first time since 1998, global poverty will increase. At least a half billion people could slip into destitution by the end of the year. We’re on the verge of the worst hunger crisis in 30 years, with the number of people facing acute hunger projected to double by the end of the year. Across the health, food, and economic challenges, the people who will pay for these catastrophic outcomes will be the world’s bottom billion – the hundreds of millions of people living in extreme poverty. We have to do better than that.

The Rockefeller Foundation has worked for more than 100 years to lift people out of poverty and unlock human potential, but philanthropy cannot fill the gap alone. We can never replace government – even if you combine the country’s largest foundations, we just don’t have the scale or the mandate to do so.

What philanthropy can do is identify solutions when others are not doing so. We can take on unique risks that others can’t or won’t. We can bring together different parts of society – serving as a bridge between public and private, between non-profits and investors, between communities and government officials, bringing everyone to the table to help create solutions to some of the biggest problems we face – to create plans, programs, and innovations that others can follow. That’s what a number of us in philanthropy are doing right now.

Over the long term, I think COVID-19 is going to dramatically change the way people perceive the connectivity and risks that we face together, and I think it’s going to dramatically change the economic trajectory of 50 or 60 countries around the world that are going to be stuck in a longer-term global recession, or something worse. Now more than ever, philanthropy needs to work together with business and government to offer a new vision of how the world can cooperate.

How critical is real time data in order to stop the spread of the virus and has an effective data platform been created to track the pandemic disease cases in real time?

It’s essential – knowing who is infected and who they have been in contact with is key to controlling a pandemic. I saw that firsthand in West Africa during the Ebola outbreak, when I led the U.S. response as the head of the U.S. Agency for International Development (USAID). Then, we were flying blind until we got the technology in place to see where the virus was. That required getting tests that could give results in minutes, not days. We hired community health workers to work with people living in the communities to find those who had come into contact with someone infected so we could isolate them and protect others. Finally, we worked with partners to develop a data platform to not only tell us where the virus was, but also based on all the information coming in, where it would likely go.

We call for those same measures in our National COVID-19 Testing Action Plan: scaling up testing so it can be done anywhere and give quick results, working with partners to build up a community health corps to find people when they have come into contact with someone who was infected so they can protect others, and building a data platform that pulls all the available information together so we can get in front of the virus and help people everywhere return to work safely.

Rockefeller Foundation CORE Sean Penn Direct Relief

CORE Founder Sean Penn and a Direct Relief Volunteer
unload PPE supplies

Does there need to be a coordinated response globally and do countries need to work more closely together to address this pandemic?

We live in a global community and it is a very interconnected world, intertwining our cultures, our food, our work, our lives. Because of modern air transportation, we can wake up in Hong Kong and be home with our families in Washington, D.C. at day’s end. The advantages of this global convenience and global livelihoods is also a risk when it comes to disease outbreaks. Viruses and diseases do not respect national borders. Human beings in the 21st century move fast around the world and we can unknowingly carry diseases with us. International coordination and information sharing is the only way to beat disease outbreaks like this.

We’ve already seen this with COVID-19. The World Health Organization declared this disease outbreak a “public health emergency of international concern” on January 30, 2020. One of the defining criteria of that declaration is that the disease outbreak is large enough and concerning enough that it requires a globally coordinated response – and less than six weeks later it became a global pandemic. The only way we come out ahead of this virus is if we all work together.

As you look to the future, does there need to be a holistic approach that takes into account global health issues, climate change, migration, poverty, racism and other factors when preparing for future crises? Do you feel that these factors are interrelated?

Absolutely. In public health this is called “one health,” and it’s the concept that the health of humans is intricately connected with the health of the environment and the health of animals. Let me give you an example. In the forest region of Guinea in late 2013, a village had moved into land that was previously purely forest. As the village used more land, animals were pushed further into the forest. A bat that had been living in a tree defecated in the dead tree. A child from the village was playing in the tree and came into contact with the bat excrement. The bat had been carrying the virus that causes Ebola, and the child became infected. The disease then spread from person to person – starting in that village and traveling with the people as they sought help – until more than 11,000 people were dead across three West African countries. That Ebola outbreak, like every Ebola outbreak, shows us what happens when humans move into areas that belong to animals and they interact in ways that spread disease.

Many disease outbreaks are caused by zoonotic pathogens that can jump from animals to humans. What we do to the environment affects us, whether it’s through climate change, overpopulation, migration, or any other reason that can bring animals and humans together in detrimental ways and allow diseases to jump between animals and humans. We really need to understand this concept and take all these aspects into consideration as we work to protect the health of people, animals, and the environment.

There is a great deal of discussion about the future and the “new normal.” What do you feel that this new normal may look like?

It’s hard to know what the “new normal” will be after COVID-19 and all the disparities it has uncovered, which is understandably causing distrust of institutions. We need to have a normal that gives everyone opportunity. As for the disease, until we have a vaccine it will undoubtedly involve testing and probably looking proactively for symptoms of disease by taking our temperatures. But people are adaptable, we have been here before and adjusted and I am confident that once we get some of the tools we need in place, we will adapt to the lifestyle that keeps us safe.

I will say that even as the death toll began climbing, I started to hear sentences starting with the phrase, “When things go back to normal.” If we learn anything from this crisis, it should be that the old “normal” is unsustainable for the vast majority of people in the world. It’s unsustainable for the billions of people who live in poverty, in countries where social distancing guidelines are laughably unrealistic. It’s unsustainable for the tens of millions of Americans who work full-time only to fall further behind every month, and the tens of millions of children at home and around the world without access to nutritious meals. And it is unsustainable for those who have been disproportionately affected not just by this virus, but overall, because of the color of their skin.

After we respond and recover from this crisis, we’ll have a chance to rebuild. In that moment, we should remember that the best antibody against future threats is a world where we protect and support our most vulnerable: where workers can earn enough to meet their needs and save for emergencies, where remote areas have access to economic prosperity, where we end energy poverty in a way that also fights climate change, and where innovation, cooperation, and collaboration across countries and sectors are not the exception but the norm. Let’s channel our energy into building that more hopeful, more humane world, together.

You are a leader who has always focused on your people and believed that talent makes great organizations. What do you say to your team about their perseverance and resilience?

While an organization can be defined by its leader, its success depends on the whole team – every single one of its people. I couldn’t be prouder of our global team at The Rockefeller Foundation. They’re incredibly strong and they have all stepped up to meet this moment.

I’ve watched our people put in 12- and 14-hour days, while somehow still finding the time to care for themselves and their families. Many are based in New York City and northern Italy, two of the COVID-19 hot zones, while those in Bangkok, New Delhi, and Nairobi have been bracing for the pandemic to spread more widely in South Asia and sub-Saharan Africa. Some colleagues are building public-private partnerships with technology companies, gig workers, and school districts to help feed kids who would otherwise go hungry. Others are working to make safety net benefits more accessible, supporting efforts to keep fresh food markets from closing in East Africa, or crafting innovative policies that could hire and train millions of newly unemployed workers to help fight the pandemic by providing the testing that will allow our economy to reopen. Our team in Asia is helping doctors and public health professionals in China share lessons learned fighting the coronavirus with millions around the world, and in Africa, Italy, and New York, our teams are helping procure and donate personal protective equipment for local health agencies, paramedics, and hospitals. Our team at Rockefeller is as passionate about helping others as I am, they work tirelessly and I am extremely fortunate to work alongside them.

You served in the Obama administration and helped lead efforts in West Africa during the Ebola epidemic. Do you feel that to most effectively address global health issues it is critical to have a strong partnership between the public sector, private sector and non-profits?

It’s tremendously critical. We benefitted from this kind of close partnership when we were fighting Ebola in West Africa. When our lack of data had us flying blind, we were able to put in place modern diagnostics and send epidemiologists from Sweden and Johns Hopkins who were able to build a real-time data system that showed us where the cases were as soon as we knew they were laboratory-confirmed positives. Once we started to get transparent, location-specific, real-time data, we could target prevention and response efforts much more precisely. Another outcome of public-private partnership was that we were able to redesign the protective equipment suits that healthcare workers wore in the Ebola Treatment Units. Often when they took it off, they would infect themselves – I tried it myself in Sierra Leone, and if I had been treating patients in the hot zone I would’ve infected myself despite being trained properly. So we worked with partners to redesign the suit with a safer doffing process, and also bigger face shields so patients could see who was treating them.

Today public-private partnerships have to be even stronger than they are right now. One thing about Rockefeller is we work with the public sector very closely, but I think we’re pretty proficient at being a bridge between the public and private sector. We’ve seen that several times in the fight against COVID-19. There isn’t a single CEO I’ve spoken to who doesn’t fully appreciate the need to have a more active testing protocol for asymptomatic employees as part of a strategy to enable them to work and be confident they’re safe. It applies to people in the food services industry, to folks in telecommunications and infrastructure maintenance. There’s a lot of innovation happening in large private companies, and we can always do more to connect public institutions with the dynamism and innovation that’s happening in the private sector.

You are known to be an optimistic person. During this difficult and uncertain time, what are you telling your people and what would you say to young people across the country who are deeply concerned and fearful about the future?

We are in unchartered waters right now. Anxiety is running high in many places. Anger at injustice is understandably spilling forth. We need to listen to each other and help people realize the change we need. The uncertainty is real – none of us have been here before. At The Rockefeller Foundation, we are grateful that we have the ability to respond to help people. I tell young people to look for opportunity in times of crisis. If anything, how we’re meeting this moment is an affirmation of the power of science and technology combined with human ingenuity, and an opportunity to drastically expand our concept of what is possible to achieve and how quickly.

Since we started working remotely, I’ve been doing “Ask Raj” video calls with our global team every other week, where they can ask me whatever questions they want, and recently I was asked what keeps me up at night. After I acknowledged the realities of parenting during a pandemic – especially after more than two months of all our kids being at home and trying to learn – I shared that if anything, I’m up at night because I’m enthusiastic about the opportunity we and our partners have to make a difference.

In India and Tanzania, one of our energy partners, Husk Power Systems, has been going to extraordinary lengths to protect and provide for their field workers, who are in turn making sure groceries, clinics, pharmacies, and other essential services have steady electricity during this pandemic. In African countries, our co-impact partner, Last Mile Health, has been working with health ministries to mobilize and equip front line health workers with essential training and supplies to combat the coronavirus – starting in Liberia, with 4,000 health workers who serve nearly 80 percent of the rural population. And in the United States, teams from our partner FoodCorps are supporting school nutrition professionals from coast to coast as they work to prepare, pack, and deliver meals to hungry kids at home. At a time when we need to support our communities and deliver results quickly, it’s our people and our partners like these that give me hope and keep me optimistic.