Q&A with Devex: MSH's new CEO on her transition from the private sector

Marian Wentworth

In a recent conversation with global development media platform Devex, MSH’s President and CEO Marian Wentworth talked about her new role, her transition from the private sector, and her overall views on the challenges and opportunities facing global health. The following are excerpts from the article originally published on Devex on March 27, 2017, by Amy Lieberman.

What do you hope to bring to MSH, and what changes would you like to see in the organization?

I've thought about it a bit and I'm not ready to land [with particular strategies on change]. I would like to learn from employees. I want to engage with staff and understand what drives the organization. It's very broad in terms of size and scope, and there are different levels of the health care system it works under. [It's about] those kinds of questions: What more can they do? Where, when does it make a difference versus other reputable areas that are out there? I'd like to hear from staff first.

I'm aware that the environment continues to shift for a whole set of reasons, and the things that we learn while working with the people we serve help to inform us ... as we move into new geographies, new technologies, changing health care environments. There are so many levels of change, that I think an organization [like this] needs to continue to reinvent itself to move into the future. I will make sure that things happen with an eye toward creating greater impact.

This is your first job outside the private sector. Why did you make the transition?

It's a big shift for me. I've been in global health for some time and one of the things that has been extremely exciting for me in recent years was working on the global stage on issues of public-private partnerships and collaboration. I ran the vaccine strategy at Merck and was also looking at other private sector companies and what arrangements we were making with them. We started to fall into certain patterns, and after spending a fair amount of time looking at things like HPV and Ebola, [I concluded that] we actually need new models — we need more models. I would like to think about those from outside the private sector.

Why are you keen to explore these issues from outside the private sector?

Affordability is always an enormous concern for global health. In the vaccines arena, and this applies to others as well, many of the public-private partnership models are meant to address this question of affordability. Some models depend on market forces to drive costs down, while others depend on volume. However, neither market forces nor volume can solve the challenges of emerging infectious diseases or episodic infectious diseases such as Ebola. For some of these diseases, there is not likely to be a consistent enough market, nor enough volume, to cover the enormous capital investments that are required over long periods of time. Clearly, we need new models — and maybe even new technological approaches — to address these issues.

I have been aware for some time that affordability is as much, or more, about the money and resources required to deliver care as it is about the cost of products. What I am learning now is a great deal more about how to think about and impact delivery of care. I am pretty sure there is no silver bullet to solve healthcare problems, but I think that we can still learn a lot about how we can add even more value — that is certainly what I am going to try to do.

What strategies do you think might translate well from the private to the public sector?

I think there is a certain discipline associated with running a business and with having the tools for looking at investments over a short and long period, as well as with running a fairly hierarchical organization where there are different motivations for employees to work there. I mostly want to make the world a healthier place and to think about it in different terms. Coming in fresh, from a different angle, could actually add some value. It's not that I want to turn MSH into a forprofit business — that would be a crazy thing. But coming in from outside means you can ask fresh questions.

We want to maximize the impact and be the driver of efficiency, and I have not found all organizations do this in a highly quantitative way. In the forprofit space, we do have quantitative measures — [but] you can have precision without accuracy. That is, you can calculate how many Cheerios you had for breakfast to the fifth decimal place, but it won't tell you about your nutrition intake. There are times when numbers can give people a false comfort, and I do want to be careful about that. On the other hand, some things are worth figuring out — you can actually measure and set goals around your metrics if you are passionate about them.

What types of questions are you asking now to guide the organization’s direction?

In the few days that I have been in my role, we have already had a lot of discussions about this with my team and with the board of directors. The purpose of an organization is to deliver on its mission; in our case that is to strengthen health care systems in very low income settings. That is a tremendous responsibility and opportunity to make an impact. However, our resources are quite limited, so I am looking for ways to help us clarify how our investments connect to impact. It is as important to measure impact on investment for MSH as it is to measure return on investment in the business world. So the question I already ask every day is: what is the impact, is it needed, are we best positioned to deliver? MSH is full of very skilled people who really care about the impact that they make on the world. My job as a leader is to cherish that and cultivate it.

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