225 posts categorized "Health"

Health justice and participatory democracy: An interview with Hanh Cao Yu, Chief Learning Officer, California Endowment

October 27, 2021

Headshot_Hanh_Cao_Yu_TCEEven before the COVID-19 pandemic struck, the California Endowment (TCE) had been working to move from Building Healthy Communities, its place-based initiative, to an effort that provides more flexible funding to the organizations and communities it works with to build power across California. For example, TCE increased the share of grant dollars awarded in general operating support from 3 percent in 2010 to 20 percent by 2020.The foundation is on track to further increase flexible funding so that communities and grantees have more freedom to determine how best to use those funds.

Hanh Cao Yu is TCE's chief learning officer, in which role she is responsible for learning, evaluation, and impact activities and ensures that local communities, local and state grantees, board members, and staff understand the results and lessons of the foundation's investments.

PND's Matt Sinclair spoke with Yu about the foundation's effort to promote "People Power" and how the pandemic has affected its relationships with grantees.

Philanthropy News Digest: What does "health equity" mean? How is it different from "health justice," and to what extent has the foundation's idea of "health justice" changed in the wake of the pandemic and its impact, especially on communities of color?

Hanh Cao Yu: For us at the California Endowment, health equity has three parts: We want to achieve the highest level of health for all Californians, improve the systems and conditions of health for all groups, and make sure that those who've experienced racism and socioeconomic and historic injustices are helped and supported — because health equity helps advance social justice.

In terms of health justice, which is also a North Star of ours, the focus is on outcomes, whereas health equity is focused on the process of how we got to where we are today. At the heart of equity is the ability to meaningfully participate, to have a voice, to be heard, and to help set the agenda of the priorities for your community.

Even before the pandemic, TCE was working to achieve health equity in a major initiative called Building Healthy Communities, which is about investing in groups that are serving and led by Black, Indigenous, and people of color fighting for health systems reforms and the transformation of our justice system, as well as equitable public education and more inclusive community economic development.

Health justice is also about robust, participatory democracy, and it's good for equitable community health.

Read the full interview with Hanh Cao Yu.

'Tips for rapid grantmaking during a global pandemic': A commentary by Sierra Fox-Woods

October 18, 2021

News_mental_health.2Five tips for rapid grantmaking during a global pandemic: Lessons learned supporting adolescent mental health organizations during COVID-19

In the face of the COVID-19 pandemic and the widespread losses people have suffered — of loved ones, jobs, safety, and a sense of normalcy — community-based organizations are stepping up to bridge the gaps in social services. While government agencies are slower to move resources in response to real-time and evolving needs, philanthropy can act quickly and mobilize resources through rapid-response grantmaking.

At the Upswing Fund for Adolescent Mental Health, we've seen firsthand the challenges of reviewing high-volume, short-turnaround proposals. The initial concept for the fund was proposed in July 2020 as a collaborative COVID-relief fund at Panorama to focus on adolescent mental health and well-being, and was seeded by Melinda French Gates' Pivotal Ventures with additional support from the Klarman Family Foundation. Over the course of three months, we developed a grantmaking and implementation strategy supported by an advisory committee of practitioners, policy experts, and researchers, and issued a request for proposals in late October, with applications open for six weeks. The fund received 485 proposals from forty states and the District of Columbia, and to date has awarded more than $11 million to ninety-two organizations.

We'd like to share five considerations for rapid grantmaking that were critical to our process and designed in the spirit of advancing trust-based philanthropy. Some validated our own grantmaking principles at Panorama, such as the importance of giving general operating support grants, while others were unique to processes required to execute on an expedited timeline....

Read the full commentary by Sierra Fox-Woods, a program officer for Panorama's Upswing Fund for Adolescent Mental Health.

 

'A roadmap for how to respond to and provide funding for addressing collective traumas': A commentary by Stephanie Berkowitz

September 09, 2021

Headshot_Stephanie_Berkowitz_2_NVFSTwenty years after 9/11: Prioritizing trauma-informed mental health care

Twenty years after the September 11 attacks, lessons from that experience continue to inform the most effective ways to provide mental health support to individuals, families, and communities in crisis. At the same time, new lessons have emerged as a result of the COVID-19 pandemic and ongoing demand for racial justice. Together, these insights provide a roadmap for how to respond to and provide funding for addressing collective traumas for families as diverse as refugees arriving in this country from Afghanistan to those displaced by hurricanes. 

In 2001, the Greater Washington Community Foundation tapped Northern Virginia Family Service (NVFS) to provide trauma recovery services to survivors of the attack on the Pentagon. The September 11 Survivors' Fund was intentionally set up to be flexible and broadly focused. While we provided services to survivors most obviously impacted — those who were physically injured in the attack — we also supported a flight attendant who lost colleagues on the plane that flew into the Pentagon, a firefighter who saw the unimaginable and chose to change professions, and anguished family members who lost loved ones, among others. In all, the $25 million fund helped 1,051 people.

Years later, we learned of a group of construction workers from El Salvador who participated in clean-up efforts at the Pentagon but did not receive Survivors' Fund services. Only then did we recognize a significant shortcoming on our part. Since then, we have come to understand that targeted outreach to underserved populations in multiple languages by professionals with fluency in a variety of cultural traditions is the most effective way to reach neighbors who are frequently overlooked and disproportionately impacted by communitywide crises....

Read the full commentary by Stephanie Berkowitz, president and CEO of Northern Virginia Family Service.

'We have to infuse equity into every part of the system': A Q&A with Priti Krishtel

September 02, 2021

Headshot_Priti Krishtel_I-MAKlPriti Krishtel is a health justice lawyer who has spent nearly two decades exposing structural inequities that limit access to medicines and vaccines across the Global South and the United States. She is the co-founder and co-executive director of I-MAK (Initiative for Medicines, Access & Knowledge), a nonprofit organization building a more just and equitable medicines system. An Echoing Green Global Fellow, TED speaker, Presidential Leadership Scholar, and Ashoka Fellow, she is a frequent contributor to leading international and national news outlets on issues of domestic and global health equity.

PND asked Krishtel about inequity across the globe as it relates to COVID-19 vaccines, challenges in the United States of ensuring an equitable medicines system, the drug pricing crisis, and what funders can do to bring about change. Here is an excerpt:

Philanthropy News Digest: I-MAK states that a global pandemic, economic and racial awakening, and skyrocketing costs of medicine have created a crucial mandate for equity in the drug development system, especially with growing inequity across the globe as it relates to COVID-19 vaccines. What action do you believe leaders of national governments should be engaged in to mitigate those disparities? And what are the most significant barriers to improving vaccine access worldwide?                       

Priti Krishtel: I cannot stress this point enough: In a pandemic, no country is safe until every country is safe. Today, vaccinations are readily available in wealthy countries like the U.S. However, it's a completely different situation for most of the world's population: so far, less than 2 percent of residents in low-income countries have been vaccinated. Until we employ an equitable system to make sure that vaccines are available everywhere, that all countries have access to the vaccine, and that everyone who is willing and able is vaccinated, variants will not stop. Governments — and wealthy nations in particular — have to stop taking a country-by-country, nationalistic approach to pandemic responses and instead start looking at the system holistically. With every passing day, the risk of a mutated COVID-19 variant that is resistant to vaccines grows.

The Delta variant teaches us that we have to radically and rapidly rethink our approach to recover from this pandemic and adequately prepare for the next. We can't do this by relying on market incentives alone. Right now, pharmaceutical companies are incentivized to lock up knowledge to maximize profits to serve shareholder interests rather than share that knowledge and bring this pandemic to an end.

Philanthropy can play a catalytic role in this moment. Philanthropy is the only sector with the resources, capacity, and global connections to resource organizations and individuals leading the fight for a globally more just and equitable medicines system. It can and must play a connective and transformative role in stemming the gap in places where countries, communities, and individuals are being left behind....

Read the full Q&A with Priti Krishtel.

The Sustainable Nonprofit: 'Lessons from a successful merger'

August 17, 2021

Handshake_two_suitsHow nonprofit mergers can energize donors and accelerate progress

While nonprofit and for-profit organizations differ in that nonprofits are mission-driven and for-profits are profit-driven, both seek to provide value to their constituents or customers, so it's critical to maximize efficiencies to increase capacity, value, and impact. Consolidation or mergers are an important way to maximize efficiencies — an area where nonprofits could learn valuable lessons from for-profits.

Although mergers occasionally occur in the nonprofit space, particularly among larger organizations, the tendency is toward proliferation, which is almost always driven by the best of motives. Individuals personally affected by a disease or cause are moved to action and often set up a nonprofit to do work that is already being done by other organizations. This can dilute available resources, create inefficiencies, and confuse donors. Consolidation, by contrast, creates opportunities for existing nonprofits to expand mission and achieve results that simply aren't possible when resources are fragmented....

Read the full column article by John L. Lehr, CEO of the Parkinson's Foundation....

How nonprofits are navigating the real estate market in an almost-post-COVID-19 New York City

August 06, 2021

New_york_city_Katie Haugland BowenBefore the COVID-19 pandemic, the real estate landscape had always been a challenge for New York City nonprofits, with rent-related cost often being the second-largest expense of a nonprofit's budget and venue-dependent organizations allocating an even greater portion of their budgets to real estate. The pandemic's unprecedented impact on companies and organizations across the world varied by sector; for nonprofits, the effects were compounded by increased uncertainty around funding, physical closures, and, for many, the inability to fully transition to remote work while continuing to serve their missions.

Some organizations could not transition to remote work because in-person services were essential to their programmatic offerings, while others continued to work in physical offices because they faced low funding or technology barriers that prevented them from switching to remote work or elected not to do so because of the impact on work culture and productivity. For example, nonprofits committed to advocacy work, many of which rely on dynamic brainstorming sessions to analyze issues and advance strategies, found Zoom meetings a poor substitute. Those organizations eagerly returned to their offices as soon as they could, implementing safety protocols while getting "back to business." Nonprofits that work to address food insecurity also had personnel who were considered essential employees and were expected to come to work each day to package meals and deliver them to those in need.

Now, organizations that were able to transition to virtual operations are returning to varied levels of in-person work and navigating a hybrid work balance. Employees are increasingly expecting more flexibility from their employers about where — and sometimes when — they work, and employers are eager to capitalize on any benefits from this shift. Both nonprofit and for-profit organizations with fewer employees in the office on any given day are asking whether there might be a way to reduce real estate expenses. Without the obligation of coming into the office, can staff be hired in locations where the cost of living is lower and, therefore, at lower salaries?  

At the same time, some organizations appear to be emerging from pandemic restrictions in better financial shape than before. Early on in the pandemic, it was predicted that many venue-dependent organizations like theaters and healthcare providers that require physical space to deliver on their missions would have to close their doors permanently. However, for many in the performing arts sector, this has not turned out to be the case. As a general rule, nonprofit performing arts groups require subsidies to support their programming in normal times; therefore, less programming requires fewer subsidies. If an organization could maintain its donor base (i.e., the source of the subsidies) while reducing expenses, there was the opportunity to build a one-time surplus. 

One nonprofit client of my company, Denham Wolf Real Estate Services, that has provided social services to the community for decades, saw its revenue increase more than 10 percent over the past year, thanks to donors recognizing the increased need for the organization's services during the pandemic. With the advent of work-from-home, this nonprofit was able to convert unused office space to program space, thereby improving efficiency and saving on expenses. Other nonprofits, however, were not so fortunate.

The pandemic compelled organizations across the sector to reevaluate their real estate and, in many cases, adapt to new modes of service delivery. Healthcare facilities, for example, have had tremendous success transitioning to using telehealth to provide necessary services to individuals and communities. To accommodate populations that lack access to technology and Internet services, some nonprofits have redesigned their sites or, in some cases, taken on additional space to provide computers and make telehealth services readily available to all.

In commercial buildings, landlords have been struggling to retain existing tenants and write leases for new ones, which has resulted in more robust incentive packages. In addition to lowering rents, landlords are offering longer free-rent periods and increasing tenant improvement allowances. Tenants looking to sublet space may also add incentives, including access to shared conference rooms, phone systems, and receptionists. For tenants looking to sign new leases, particularly for office space, there are very good opportunities in the marketplace.

Each nonprofit faces a unique situation that requires careful planning to ensure good decision making. As nonprofits reevaluate the role of real estate in support of their missions, there is also an opportunity to re-engage with the community to help determine the optimal way to connect in this altered landscape. Service organizations are using this opportunity to communicate with their clients and better understand how they can best serve them, whether that means keeping the same services or offering new ones. Needless to say, the goal is always to do what is right for the people they serve, and if budgets are constrained, taking into account community input and evaluating programs is critical. Many organizations are receiving positive feedback from those exchanges and even increased community support through fundraisers or volunteers, which fosters a deeper connection with the community. While this process can be both exciting and daunting, aligning operations and budgets with the current needs and desires of those being served can inform a more sustainable future.

Looking to recovery, nonprofits are presented with a real estate landscape that is gradually stabilizing. Indoor spaces for work and events are cautiously reopening, and some remote work adjustments remain permanent. Organizational attitudes are shifting from preemptive planning to actual decision making — a shift reflected most clearly in the rising rates of lease signings and extended lease terms, which are once again reaching five to ten years. However, as organizations plan their return to the office, they're taking the time to fundamentally reevaluate space requirements, usage, and purpose of having a physical location. Across the board, nonprofits are reconsidering how square footage requirements and location, among other factors, will be most efficient for serving their communities. 

Throughout the pandemic, it has been encouraging to see the tenacity and creativity of the nonprofit sector's efforts to adapt and persist. The continued dedication to a mission-first approach in the sector through these incredibly challenging times reaffirms our confidence in the nonprofit community. The commitment and ingenuity of the staff and volunteers providing services to their communities, whether in a physical space or through a screen, are both inspiring and impressive.

(Photo credit: Katie Haugland Bowen)

Headshot_Paul_Wolf_DenhamWolfRealEstate_PhilanTopicPaul Wolf is co-founder and president of Denham Wolf Real Estate Services and has more than thirty years of development, brokerage, and nonprofit consulting experience.

5 Questions For…Linda Goler Blount, President and CEO, Black Women's Health Imperative

July 08, 2021

Linda Goler Blount joined the Black Women's Health Imperative, the first nonprofit organization created by Black women to help protect and advance the health and wellness of Black women and girls, as president and CEO in February 2014.

Since then, Goler Blount has overseen investments totaling more than $20 million in Black women's health and research. She is responsible for moving the organization forward in its mission to achieve health equity and reproductive justice for Black women. BWHI recently announced that it received a $400,000 grant from the Rockefeller Foundation to improve vaccination rates among Black women and communities of color. The grant, part of the foundation's $20 million Equity-First Vaccination Initiative, supports hyper-local, community-led programs working to improve vaccine access and support educational outreach in five cities. BWHI will convene a Covid-19 Vaccine Awareness & Equity Task Force to provide high-impact advocacy recommendations to boost COVID-19 vaccine uptake. The task force will include the leaders of National Caucus & Center on Black Aging and National Coalition of 100 Black Women, policymakers, disparities experts, and community organizations.

Before joining the Black Women's Health Imperative, Goler Blount served as the vice president of programmatic impact for the United Way of Greater Atlanta, where she led the effort to eliminate inequalities in health, income, education, and housing through place- and population-based work. She was also the first national vice president of health disparities at the American Cancer Society, in which role she provided strategic vision and leadership for reducing cancer incidence and mortality among underserved populations and developed a nationwide health equity policy.

PND asked Goler Blount about the ways in which Black women have been disproportionately impacted by COVID-19, the Covid-19 Vaccine Awareness & Equity Task Force, and how to address the racial disparity in maternal mortality rates.

Headshot_Linda Goler Blount_Black Womens Health ImperativePhilanthropy News Digest: The Centers for Disease Control and Prevention reports that Black Americans are 2.9 times as likely as white Americans to be hospitalized with COVID-19 and 1.9 times as likely to die. In what ways have Black women in particular been disproportionately impacted since the pandemic began and what needs to be done to address this disparity?

Linda Goler Blount: The heavy toll of COVID-19 on Black America is sharpened for Black women, who live at the intersection of gendered and racialized oppression and are experiencing disastrous impacts on their health, economic stability, and social well-being. Black women are impacted disproportionately by underlying health conditions linked to severe COVID-19 cases, including obesity, cardiovascular disease, and diabetes, the high incidence of which serves as a consequence of America's long history of structural racism and gender oppression. The confluence of the gender pay gap and the racial wealth gap have made economic instability a harsh reality for Black women.

In addition, the physical health impacts of COVID-19 are clear, and the psychological stress of the pandemic is certain to have long-term effects on Black women's mental health as well. Perhaps most frustrating, though, is that the same structural racism that produces disease in Black communities is also creating barriers to treatment, care, and comfort — and worsening existing health crises. To address the physical health impacts on Black women, we need policy makers to ensure access to adequate and affordable health insurance, invest in initiatives that address systemic racism within health care; and expand Medicaid coverage in all states.

The economic fallout of COVID-19 extends beyond what many of us could have ever imagined, with 60 percent of Black households reporting severe financial problems and Black women maintaining the second-highest rate of unemployment during the pandemic. Policy makers should implement universal paid sick leave and expand eligibility for family and medical leave, raise the federal minimum wage, establish an independent equity committee to review and revise the eligibility criteria for economic relief programs, and develop a long-term funding strategy to support and increase businesses owned and operated by Black women. It is apparent that the social impacts of COVID-19 and racial injustice are wide-reaching and closely intertwined with the health and economic impacts of the pandemic and racial crisis — all of which affect Black women's quality of life. We believe lawmakers should address those impacts by extending the federal eviction moratorium and canceling debts, increasing the availability of affordable housing, and expanding quality broadband access across the country, with investments in low-income and rural communities to provide resources for quality distance learning and training.

PND: Black Americans report lower levels of trust in the healthcare system as a result of outright abuses like the Tuskegee study and day-to-day discrimination experienced when visiting healthcare facilities. What are some approaches you believe can work to restore trust in the healthcare system?

LGB: Vaccines save lives, but too many Black Americans have vaccine hesitancy. Vaccine hesitancy is well placed and often rooted in mistrust of the medical establishment and doubts about the safety and effectiveness of the vaccine. But I would tell those reluctant to be vaccinated that millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in history. COVID-19 vaccines have been proven safe and effective. If too many Black Americans put off vaccinations, achieving widespread immunity in this country will be increasingly challenging.

A reassuring aspect the public should be educated about is the vaccine was developed by a Black doctor, vetted by Black physicians, and clinically tested on Black trial participants during the research and development phase. Dr. Kizzmekia Corbett stands at the heart of Moderna's vaccine development, and her research was applied to the development of a coronavirus vaccine now distributed around the world.

One thing needed to make this happen is trust — for predominantly white institutions to trust Black physicians and Black researchers to implement the cultural approaches they know will work with Black communities. That is going to mean giving time and resources to those Black institutions and doctors and healthcare providers, so they can go into Black communities and engage in strategies that are going to be really effective. There is also a need for strategic messaging tailored to Black Americans. Because Black communities must seek COVID-19 vaccinations, there is a need to double down on healthcare providers' critical role as trusted messengers in overcoming vaccine hesitancy.

PND: The goal of the Rockefeller Foundation's $20 million Equity-First Vaccination Initiative is to ensure that at least seventy million people of color are vaccinated by July. How will BWHI's Covid-19 Vaccine Awareness & Equity Task Force's work assist in reaching that goal?

LGB: Raising awareness about the COVID-19 vaccine in communities of color and advocating for its equitable distribution is a key 2021 priority for BWHI. Accurate, culturally sensitive information provides Black women with the background and knowledge to advocate for equitable and affordable access to this critical lifesaving vaccine during these uniquely challenging times. To that end, the BWHI Covid-19 Vaccine Awareness & Equity Task Force will provide high-impact advocacy recommendations for community-based tools, resources, and grassroots implementation activities for COVID-19 vaccine education and uptake. This will include CEO leadership of its strategic project partners, as well as a diverse group of leaders, policy makers, disparities experts, and community advocates who will coordinate and consult on COVID-19 community engagements, strategic initiatives, and resources. To close gaps, BWHI will form strategic partnerships with National Caucus & Center on Black Aging, Inc. (NCBA) and National Coalition of 100 Black Women (NCBW) to deploy COVID-19 vaccine and equity initiatives among Black women in five U.S. cities: Baltimore, MD; Chicago, IL; Houston, TX; Oakland, CA; and Newark, NJ.  BWHI will also collaborate with several community organizations to encourage vaccinations, including the Southern Christian Leadership Global Policy Initiative (SCL GPI), R.E.A.C.H. Beyond Solutions, New Jersey Department of Health, and the Women's National Basketball Players Association (WNBPA). Now more than ever, it is critical to arm Black women, who are the vital arbiters of healthcare decisions for their families and communities, with culturally relevant and accurate information that they can act upon to reduce the threat of the COVID-19 pandemic on communities of color.

PND: BWHI is the first nonprofit organization created by Black women to help protect and advance the health and wellness of Black women and girls. After thirty-eight years, are the challenges today the same as when the organization began? What's changed?

LGB: Ironically, the biggest challenge today is the same as when the organization began thirty-eight years ago. Black women's most significant health issue is the system, as it was four decades ago. Deep-seated structural and systematic racism are not just obstacles to addressing Black women's health issues — they are the health issue. What underlies Black women's disproportionate myriad health issues and disparities is the country's long history of structural and systemic racism within social, commercial, and government systems that disadvantage Black Americans. They can be seen through inequities in socioeconomic status, segregated communities, and even how Black women's pain and conditions are disbelieved and dismissed by the medical community. Standard medical practice continues to fail to consider the unique challenges Black women face.

Today, however, there is greater recognition. The CDC declared racism a public health emergency by observing structural inequities that have resulted in stark racial and ethnic health disparities that are severe, far-reaching, and unacceptable. More than twenty cities and counties and at least three states — Michigan, Ohio, and Wisconsin — have also declared racism a public health crisis. There is a greater understanding among the medical establishment that Black women are made less healthy by medical racism and biases held by healthcare workers against people of color in their care. Even though the principal challenge remains the same, with the right tools, resilience is possible. BWHI will continue to advocate for advances in health equity and social justice for Black women, across their lifespan, through policy, advocacy, education, research, and leadership development. Since our founding, we have strived to identify the most pressing health issues that affect the nation's twenty-two million Black women and girls and invested in the best strategies and organizations that accomplish these goals and will continue to do so in the future.

PND: Since a maternal mortality checkbox was added to death certificates in all fifty states, the U.S. has better maternal mortality data and we now know that Black women are three to four times more likely to die from pregnancy-related complications and to suffer from severe disability resulting from childbirth than white women. What are some of the policies lawmakers should enact that would improve maternal health outcomes for Black women?

LGB: To address maternal health outcomes in Black women, BWHI calls for policy solutions to help us understand why this occurs, through the data and further conversation with Black women, and then fight for change. Our goal is to understand more clearly how racism, bias, and disrespectful care contribute to this tragedy and create a call to action to transform clinical practice and improve healthcare outcomes.

The Black Maternal Health Momnibus Act of 2021 is legislation pending in Congress designed to improve maternal health, especially for Black women most impacted by pregnancy complications. It comprises twelve individual bills that will address issues such as maternal mental health, social determinants of health, and COVID-19 risks for pregnant and postpartum women. It is an important first step toward addressing disparities in maternal mental health care and ensuring that all pregnant, birthing, and postpartum Black women have access to the health care they need. BWHI is also calling for policies that emphasize data collection, including a deeper analysis of data on the lived experiences of pregnant Black women. That data would inform a strategy to examine the underlying causes of poor maternal outcomes among Black women and to develop and implement strategies for policy, practice, and delivery systems to move the needle.

— Lauren Brathwaite

It's time to build a better behavioral health system

June 10, 2021

Mental_healthOur nation's collective mental health has been severely challenged since the start of the COVID-19 pandemic.

Now, as we begin to envision our post-pandemic future, it's important to take a step back and recognize that our behavioral health system needed improvements even before COVID-19, and that it's time for philanthropy to consider taking new approaches to funding and advocating in this area.

For more than a year, the isolation caused by the social and physical distancing necessitated by the pandemic and the ongoing stress created by the disruptions to our daily routines have impacted all of us — and those conditions have led to a massive spike in mental health issues. According to the Kaiser Family Foundation, an astonishing 41.1 percent of adults reported symptoms of anxiety disorder and/or depressive disorder in a January 2021 survey, nearly four times the average seen between January and June of 2019.

The toll has been especially heavy for our most vulnerable neighbors. Isolation has had a tremendous negative impact on the elderly and the young, while the daily stress of living through the pandemic has been especially intense for people of color, families living below the poverty line, the precariously housed, individuals with pre-existing physical or behavioral health problems, and single parents.

Foundations nationwide have recognized these risks and rallied to provide emergency funding to help support many of the urgent mental health needs created by COVID-19. The New York Community Trust (NYCT) — the community foundation where I oversee grantmaking in the areas of health, behavioral health, and biomedical research — has funded efforts to provide mental health counseling to frontline workers and technology to enable mental healthcare providers to connect with patients virtually and ensure that hard-to-reach populations receive the services they need.

These rapid-response efforts were, and remain, critical as we attempt to address the mental health crisis created by COVID-19. But we must now recognize that our system, as currently designed, is not built to accommodate the great need that already existed before the pandemic.

Prior to COVID-19, our systems for delivering mental health care were failing to help the majority of those in need of such support. In 2019, an estimated 51.5 million U.S. adults experienced a mental illness — roughly one in five people over the age of 18 — yet only 44.8 percent received mental health services.

This massive gap is largely the result of our healthcare system's lack of capacity to serve those who need help. Compounding the problem is the fact that even if there were enough trained providers to meet the need, many Americans do not have the means to afford it.

The human and economic cost of this failure is substantial. Each person with an untreated mental illness is a person who struggles to maintain steady employment and help support their family. Our criminal justice system is stretched beyond its limits, in large part because of the extraordinary number of incidents involving individuals who are experiencing behavioral health crises — the very challenges that also prevent millions of Americans from taking care of their physical health.

Imagine if we could rebuild our behavioral health system so it provided the ongoing care that's so clearly needed. Not only would we help those 51.5 million Americans with their mental health, we would create a better workforce, strengthen families, lessen the strain on our police departments and courts, incarcerate fewer people, reduce the number of people experiencing chronic physical health conditions, and increase lifespans. In other words, by putting a focus on mental health, we would be taking a critical step in addressing myriad social issues — and equipping our nation for a healthier and more prosperous future.

Yet for decades, despite our support for well-meaning interventions, both philanthropy and government have fallen short in addressing America's mental health crisis. Instead of improving mental healthcare systems, we've mostly invested in programs that address urgent needs and those in crisis — certainly an important aspect of care, but not the only one.

It's time to take a new approach. Philanthropy and government have an opportunity to join forces to make meaningful structural changes that will help millions of Americans who are not receiving the treatment they need to lead healthy, productive lives. And these changes are not as difficult, or as costly, as you might think.

For example, NYCT, along with Well Being Trust and the Sunflower Foundation, commissioned the Bipartisan Policy Center to study how to better integrate primary health care and behavioral health care. By taking steps to diagnose and treat behavioral and physical health in tandem, rather than separately, the center estimates that we can help improve outcomes for as many as a million Americans over the next ten years.

When I joined NYCT more than two decades ago, a mentor shared the adage “form follows finance.” A twist on the early twentieth-century architecture and industrial design principle of “form follows function,” it is perhaps more relevant than ever to the provision of behavioral health services.

The center's take on better coordination of care between behavioral and physical health is a clarion call for philanthropy to push for better coordination of delivery and financing systems. The federal government and several states have begun to advance models of care that prioritize outcomes over volume and pay for care that is delivered with this in mind.

This is a good start. But philanthropy must do more to ensure that its resources — modest as they are, compared with the country's healthcare spending, which by some estimates is almost 20 percent of our pre-pandemic GDP — ensure that financing aligns with a priority focus on coordinated care across all delivery systems, whether they be hospital- or clinic-based, or in community settings.

It behooves philanthropy to continue to pay attention to many of the root causes of mental and emotional distress that is so prevalent in communities across our country, often referred to as the social determinants of health — the conditions under which people live, work, and learn. Because historical inequities across the board — but especially within the context of race — have hampered such an approach, it is important that our funding address the complex challenges of inadequate insurance coverage, a stressed workforce, and the critical role of non-clinical providers in the delivery of services.

Finally, if America is to achieve a behavioral healthcare system that cares for those in crisis and enables them to manage chronic conditions, philanthropy has a critical role to play in advocating to ensure that financing actually supports such a system.

And for those of my colleagues who work at a community foundation or a grantmaking public charity that can legally engage in lobbying efforts, I entreat you to use that option. Let us imagine and work toward a healthcare system that covers the entire person — mind and body — and makes a healthier, more prosperous, and more equitable America possible.

Irfan_Hasan_NY_community_trust_PhilanTopicIrfan Hasan is deputy vice president for grants at the New York Community Trust, where he oversees health, behavioral health, and biomedical research grants.

Venture philanthropy: The secret weapon for unlocking biomedical research's full life-changing potential

June 04, 2021

Eye_retina_gettyimages_batkeMore than a year into the COVID-19 pandemic, there has been much reflection around "lessons learned" across all sectors. In the biomedical research space, we've seen science meet the urgent need for safe and effective vaccines at miraculous speed to contain the spread of the virus. The mRNA technology used in some of those vaccines has broad implications for future treatments for a variety of other viruses, cancers, and diseases and is a clear indication of how far science has evolved in a short period of time. Imagine what treatments and cures could be unlocked — with the necessary funding.

In the United States, public funding for basic research has long come from the National Institutes of Health, but the U.S. government lags other advanced economies in the amount of funding it provides for the translational research required to convert basic science into tangible patient treatments. And while more public funding for biomedical research at the critical clinical trial stage is essential, it is going to take public, private, and philanthropic dollars to ensure that biomedical research into promising treatments and cures doesn't wither on the vine. Federal programs such as the Cancer Moonshot, state-level initiatives like the California Institute for Regenerative Medicine, and promising legislation aimed at providing private-sector loans to companies developing novel treatments for disease and disability are all helpful — but still leave a funding gap. There needs to be a third leg to stabilize those public- and private-sector efforts, and we believe that third leg is philanthropy.

As successful entrepreneurs and venture investors, we see our donations as investments in the mission of the nonprofit organizations we support. We each have a personal connection to the mission of the Foundation Fighting Blindness: one of us has experienced loss of sight from retinitis pigmentosa as a young adult, and the other has raised two sons with vision impairment caused by Stargardt disease. Based on our personal experiences, we have a keen understanding of what it is like to be a patient or have a loved one waiting for life-changing treatments to become available.

For fifty years, thanks to the generosity of donors, the Foundation Fighting Blindness has successfully funded research in pursuit of treatments and cures for the entire spectrum of inherited retinal diseases (IRDs) and dry age-related macular degeneration (AMD), which together affect more than two hundred million people globally. Yet, more needs to be done. The key discoveries made in labs need to make it into the hands of industry-led therapy developers to conduct clinical testing and win FDA approval. But a gap in funding often prevents this progress, and in this case, the science is now outpacing the funding.

To bridge this funding gap, the Foundation Fighting Blindness created the Retinal Degeneration Fund (RD Fund), a nonprofit, pure-play venture philanthropy investment vehicle designed to help accelerate the technical aspects of the organization's mission and advance its financial goals. Our respective family foundations contributed significant capital to launch the fund, which allowed us to be more involved in the organization's work by funding highly visible activities in biotech startups and spinouts. We've taken concepts and techniques from our venture capital finance and business management experience and applied them to our philanthropic goals of accelerating the progress on treatments and cures, while positioning the organization for long-term sustainability.

Launched in late 2018 with $72 million under management, the first fund is now 90 percent committed, with nine investments plus reserves. This invested capital has attracted an additional $400 million in capital to date from institutional co-investors and has produced its first exit with the sale of Vedere Bio to Novartis for $280 million, enabling the organization to plug a financial gap in its long-range science spending plan and roll over significant funds to seed Fund 2. 

We take comfort in knowing that the venture philanthropy model already has been successfully scaled by the Bill & Melinda Gates Foundation, the Cystic Fibrosis Foundation, and the Juvenile Diabetes Research Foundation, just to name a few. One key element is to manage it professionally and deliberately; one cannot just wander into biotech equity investing without experience, deep scientific know-how, and world-class advice and oversight. The RD Fund has an independent board of directors with expertise spanning retinal biology, clinical ophthalmology, finance, and entrepreneurship, and the board works closely with an executive management team with significant operational, strategic, and leadership experience. Importantly, the fund is able to rely on an international scientific advisory board and leverage the organization's patient registry and clinical consortium. In other words, the brain trust of the Foundation Fighting Blindness and its venture arm have the collective scientific and business acumen to best determine what is or is not an investible mission-related opportunity.

We are encouraged by venture philanthropy's ability to reap a return to be re-invested in furthering an organization's mission, especially in times of economic uncertainty. Most important, our experience has demonstrated that jump-starting the pipeline for treatments and cures through venture philanthropy holds real promise as a viable, scalable approach for addressing other underserved diseases impacting so many.

(Photo credit: GettyImages/Batke)

Gordon Gund_Paul_Manning_PhilanTopicGordon Gund is chair and CEO of Gund Investment Corporation; after losing his sight from retinitis pigmentosa in 1970, he co-founded the Foundation Fighting Blindness with his wife, Lulie, and others. Paul Manning is founder, chair, and CEO of PBM Capital; both of his sons were diagnosed with Stargardt disease.

What COVID-19 has taught us about the humanitarian system and women's rights organizations

June 02, 2021

CFTA_feminist_humanitarian_networkWhen the COVID-19 pandemic struck — and with it came public health measures including stay-at-home orders — women's rights organizations (WROs) the world over were quick to sound the alarm: Gender-based violence (GBV) would increase. Women and "marginalized" groups would be disproportionately impacted by the pandemic, and the inequality they already face would deepen. The gendered impacts of crises are well documented, and COVID-19 would be no different.

WROs acted swiftly to address those issues, working to strengthen community-based mechanisms to ensure that women could report GBV and expect a response. Organizations adapted their systems and approaches to ensure that women could continue to access critical services during lockdowns, including psycho-social support, maternal and newborn child health care, and sexual and reproductive health services. WROs also advocated for recognition of the impacts of the crisis on women's rights and called for funding to be targeted to mitigating those impacts.

While responding to the pandemic and its fallout, WRO members of the Feminist Humanitarian Network (FHN), a collective of women leaders working together to transform the humanitarian system into one that is guided by feminist principles, saw an opportunity: Here was a moment to document the essential role WROs play in humanitarian action, to capture the work that they do, any time an emergency occurs, to ensure that women and "marginalized" groups aren't left out of relief efforts.

FHN member organizations — of which 70 percent are WROs working in the Global South and 30 percent are international non-government organizations (INGOs) and organizations based in the Global North — are working to achieve a global humanitarian system that is responsive, accountable, and accessible to women and the diverse organizations that serve them, and that challenges rather than perpetuates structural inequalities. A pervasive lack of recognition of WROs as humanitarian actors and leaders is just one of a number of critical issues that FHN is working to change.

The current humanitarian system and the actors it is comprised of (governments, United Nations agencies, INGOs, and national actors) systematically exclude women and their organizations from all phases of humanitarian action, from funding to decision making. WROs are rarely invited to contribute to national planning processes for humanitarian response or to sit on emergency committees. When a funding call is made, WROs rarely receive the information, and when they do, rarely succeed in their grant applications.

Needless to say, the impacts of this exclusion are enormous. Women's needs — and indeed, the needs of "marginalized" groups, such as people with disabilities, refugees, and the LGBTIQA community — go unaddressed as a result. WROs and women-led organizations, which often represent diverse groups of women and their communities, are uniquely positioned to highlight the needs of those they work with and ensure that they are addressed. When the leadership role of those organizations is undermined, basic requirements like including sanitary supplies in relief distributions and ensuring that distribution sites are accessible to people with disabilities are overlooked.

In addition to presenting an opportunity to showcase the role that WROs working at grassroots, local, and national levels play on the frontlines of humanitarian action, COVID-19 offered a snapshot of the global humanitarian system — how the current system works and the challenges it presents for WROs in the Global South — the patriarchal and colonial practices embedded in the system that are at the root of the lack of recognition, lack of access to resources, and exclusion that WROs experience.

And so FHN members in Bangladesh, Kenya, Lebanon, Liberia, Nepal, Nigeria, Palestine, and South Africa – conducted research to document their own humanitarian leadership, and that of their peers in the response to the pandemic. Their findings have been published in a series of national reports and a global report entitled Women's Humanitarian Voices: Covid-19 through a feminist lens. The reports highlight multiple critical barriers presented by the humanitarian system that undermine the leadership of WROs, and describe not only their ability to respond to crises but their long-term sustainability as essential women's rights actors working to protect and advance women's rights.

In six of the eight studies, WROs were unable to access donor funding, in large part as a result of excessive due diligence requirements that these organizations, working around the clock to respond to the emergency with limited resources, were (particularly in times of crisis) unable to fill. Instead, WROs undertaking critical work — ensuring that women with disabilities were able to meet basic needs throughout the crisis, for example — funded their efforts with their leaders' personal resources or funds contributed by the community. At the same time, women and their organizations were excluded from decision-making processes — left out of planning undertaken by international and national actors and from emergency response committees at all levels.

And yet those organizations persevered, working collectively in the "spirit of sisterhood" to challenge injustice, demand that their voices be heard, and work to influence the response efforts — and ensure that women's needs were addressed in each context. WROs continue to take action so that women are not left behind in the COVID-19 response and women's rights are advanced through humanitarian action.

For many of us working in the humanitarian sector, the pandemic has re-emphasized much of what we already knew: Emergencies exacerbate gender injustice, in part because the humanitarian system reinforces existing patriarchal social structures by excluding women from funding and decision making. Women's Humanitarian Voices: Covid-19 through a feminist lens has captured the creativity, resourcefulness, and deep feminist approaches of WROs in the Global South and has presented a powerful argument for why that system must change.

To be part of that change and to create a system that is inclusive of all and creates sustainable, transformative change, humanitarian actors across the system must immediately increase support for organizations advancing women's rights, in the form of direct, long-term, flexible funding. They must recognize their expertise and follow their leadership. A feminist humanitarian system is not only possible; it is critically needed and requires every humanitarian actor — including, importantly, donors — to take action.

Holly_Miller_Naomi_Tulay_Solanke_PhilanTopicHolly Miller is lead at the Feminist Humanitarian Network, a global collective of women leaders working together to achieve a humanitarian system that is guided by feminist principles. Naomi Tulay-Solanke is executive director of Community Healthcare Initiative and a member of the Feminist Humanitarian Network Steering Committee.

More Americans may be going back to work, but their jobs are getting worse

April 16, 2021

Essential_worker_Christine_McCann_sffLast April, the coronavirus pandemic brought the longest economic expansion in American history to an abrupt and shocking halt. In just a few short months, the unemployment rate shot up from a fifty-year low of 3.5 percent to nearly 14.7 percent. A year later, many people are breathing a sigh of relief as the rate has ticked back down to 6 percent, with some taking it as a sign that America is on track to full economic recovery.

But while recent headlines may be cause for optimism, they don't tell the whole story. Using the unemployment rate to gauge the health of an economy is like putting your hand on someone's forehead to check whether they have COVID-19. It can tell you whether they're running a fever,  but it doesn't provide enough data to make an accurate diagnosis.

The truth is, the unemployment rate tells us nothing about the quality of jobs, making it an inadequate metric to understand the true health of the labor market. Gallup's 2020 Great Jobs Report, which Omidyar Network supported in partnership with the Bill & Melinda Gates Foundation and  Lumina Foundation, found that more than half (52 percent) of those who were laid off during the pandemic — even if they were subsequently re-hired — reported a decline in their overall job quality as measured across eleven dimensions, including pay, benefits, stability, and safety.

First commissioned in 2019, the Great Jobs survey was groundbreaking: unlike simple "job satisfaction" metrics aimed at providing an overall sense of job satisfaction, the intent of the survey was to look under the hood of the labor market and identify trouble spots. A diverse group of more than sixty-six hundred working people were asked to define what a "good" job looks like and then assess how their own jobs stacked up against that standard. The original survey showed that less than half (40 percent) of working people in the United States believed they were employed in a good job, while one in six (16 percent) believed they were stuck in a bad job, with significant disparities by race.

The latest survey gives us a window into how the pandemic has impacted job quality. Those who started 2020 in a low-quality or "bad" job — based on their own assessment — were far more likely to have been laid off (36 percent) than those working a high-quality or "good" job pre-pandemic (23 percent). And low-wage workers with high-quality jobs in 2019 reported experiencing much lower COVID-19  risk and better employer-provided protective measures during the pandemic. The fact is, job quality matters, especially when a crisis hits.

Even before COVID struck, the topline numbers masked how unhealthy the U.S. economy really is. The richest 10 percent of Americans control 77 percent of the country's wealth, while for millions of Americans the rising cost of living has skyrocketed, wages have stagnated, and the wealth inequality gap continues to widen. These are not the hallmarks of a healthy economy.

The findings from The Great Jobs Report underscore the mounting evidence that the pandemic exacerbated structural inequities within the U.S. economy. Indeed, job quality in 2020 actually improved for people who avoided being laid off, with many reporting improvements in their compensation, flexibility with respect to where and when they worked, workplace safety, and  a sense of purpose in their work. By contrast, those who experienced being laid off reported lower scores on every dimension of job quality except safety.

But COVID-19 is just the latest driver of worsening job quality in the U.S., with technological disruption leading the list of other threats. While automation may not lead to the mass destruction of jobs — as feared by some — it could lead to deterioration in job quality in many industries and sectors. Meanwhile, the gig economy has made underemployment an acceptable alternative to unemployment. If someone who is laid off starts driving for Uber, they count as employed  — even though it is a more precarious, unstable, and lower-paid kind of work. This also has the effect of skewing the monthly unemployment numbers lower than they otherwise would be. An upskilling and job-matching program won't address these trends; the problem is with the jobs themselves, not the skills of the people in these jobs.

The alarming state of job quality in America reinforces how critical it is to empower working men and women to bargain for a fairer deal and better quality jobs across the dimensions that matter most.

We can create an economy where everyone has a good job. But if we don't start to pay attention to the quality, and not just the quantity, of jobs, we risk creating an economy where major disruptions driven by pandemics or natural disasters, automation, and climate change could lead to continued deterioration in quality of jobs for those who already find themselves in a precarious position. And if we continue to rely on the unemployment rate to tell us what's going on, we risk becoming dangerously out of touch with what's really happening.

We are heartened by the Biden administration's American Jobs Plan and the emphasis it puts on high-quality jobs. But it's going to take a concerted effort across society to detangle the perception that the unemployment rate is the final word on the health of our economy and working Americans. We urge other philanthropists and foundations, experts and economists, advocates, and activists to join the movement to put quality at the center of how we think about jobs and help us find better ways to measure, understand, and fight for quality jobs.

(Photo credit: Christine McCann, San Francisco Foundation)

Tracy_Williams_Omidyar_philantopicTracy Williams is a director at Omidyar Network, where she leads the social change venture's work to reimagine capitalism, build the power of working people, and shape a new economic paradigm.

To save lives, fund syringes

March 15, 2021

SyringesWhen COVID-19 struck, the United States was already facing a number of public health crises, with national rates of overdose, HIV, and viral hepatitis rising due to increases in substance use linked with a surge in prescription opioids.

The pandemic has converged with these crises, worsening health outcomes for people who use drugs — a crisis that is likely to persist unless we change our approach to drug use.

Take overdose deaths, which increased some 20 percent in the United States between June 2019 and June 2020, to more than 81,000, according to the Centers for Disease Control and Prevention. That's the most fatal overdoses ever recorded in a single year.

And while national figures for new HIV and viral hepatitis cases are not yet available, it's likely they are growing, too, given reported spikes in injection-drug use. (Both diseases can be transmitted via the sharing of injection supplies.) From 2014 to 2018, HIV diagnoses increased 9 percent among Americans who use drugs overall, while some 2.4 million Americans had been diagnosed with hepatitis C as of 2016.

Such grim statistics underscore the need for the U.S. to adopt evidence-based drug policies that can save lives and improve outcomes for people who use drugs. The willingness of the Biden administration to think differently about national drug policy and the changing views of Americans present a critical opportunity to do that.

For decades, policy makers and medical professionals have addressed substance use in two main ways: demand reduction and supply reduction. Both approaches treat substance use as an immoral behavior to be eschewed, instead of as a personal response to social factors or difficult life circumstances.

Neither strategy has significantly reduced substance use or its associated harms. Even though drug arrests jumped 171 percent between 1980 and 2016, the price of most illicit drugs fell, while attempts to dismantle the international drug trade have resulted in extreme violence.

Indeed, America's War on Drugs has tyrannized countless numbers of Black and brown families with racialized policies like mandatory minimum sentencing guidelines. Such policies have resulted in the overcriminalization of minor drug offenses, the mass incarceration of Black and brown people, and fractured communities across the nation.

Meanwhile, Americans are still using drugs.

It is long past time for the U.S. to embrace the principle of harm reduction, which has proven to lower rates of substance use around the world. Harm reduction recognizes the humanity of people who use drugs, acknowledging that people's relationships with substances usually change over time, and aims to minimize the negative consequences of substance use by fostering the inclusion of those who use drugs in an ecosystem of interventions and services.

The most effective harm-reduction interventions are syringe-services programs (SSPs), which were introduced in the 1980s and '90s as a community-based response to injection-drug use amid the HIV/AIDS epidemic.

Today, they provide syringes, overdose-prevention education, syringe-litter cleanup, infectious-disease testing, and — crucially — naloxone, the lifesaving overdose antidote. SSPs also connect their clients to treatment for substance-use disorder, as well as primary care and social services.

Despite this vital work, U.S. laws have long constrained service providers. In 1988, bipartisan opponents of syringe services prohibited providers from receiving federal funds until the government determined they were safe and effective. The ban remains partially in effect, even as reams of research have shown the benefits of syringe services, from reducing emergency medical costs to lowering rates of HIV and hepatitis C. SSPs still cannot use federal funds to purchase syringes, which help prevent infectious disease among people who inject drugs.

Since the COVID-19 pandemic began, I've seen a dramatic spike in people receiving syringe services through my work managing AIDS United's Syringe Access Fund, which disburses about $1 million in philanthropic funds to SSPs annually. And it is happening at a time when public and private funding for harm-reduction services was already inadequate.

Although Congress has allocated billions of dollars to combat the opioid crisis, many of those programs stop short of addressing the complex health, psychosocial, and socioeconomic factors underlying chronic substance use. For instance, half of all State Opioid Response (SOR) grants — a major federal initiative designed to help states expand their opioid addiction treatment services over the course of two years — went unspent, a federal watchdog has found, by the time the program was wound down. At the same time, our Syringe Access Fund grantees are struggling to meet their clients' needs and pay their bills. This not only imperils lives and public health but strains local resources.

It is time Americans recognize that the best way to reduce the staggering number of lives lost to overdose each year is to invest in services that support people while they are using drugs. To do that, we need to reach people who use drugs where they are. Syringe services programs are a cost-effective way to serve communities that many see as hard to reach, but which actually are hardly reached, as well as an opportunity to invest in a more holistic and inclusive public health infrastructure.

Without greater investment in that infrastructure, hundreds of thousands of Americans are likely to slip through the cracks and die from overdose in the years to come. We have the tools to prevent these deaths, so long as we invest in the lives of people who use drugs.

Zachary_Ford_AIDS_United_philantopicZachary Ford is a senior program manager at AIDS United, where he oversees the Syringe Access Fund, a grantmaking initiative focused on improving health outcomes for people who use drugs.

What COVID-19 has taught us about investing in public health

March 12, 2021

2020_May_Ho Chi Minh City_screening_Operation_SmileCOVID-19 continues to pose novel challenges to health systems around the world. With the rapid depletion of stockpiles of personal protective equipment (PPE) and severe shortages of physical space in which to care for those affected by this perplexing and terrible disease, even well-resourced surgical health systems have been pushed to the brink of their capacity.

But in many low- and middle-income countries, the virus that emerged in late 2019 has exacerbated a problem that remains anything but novel in 2021. In places that lack the infrastructure, funding, and healthcare workforce able to cope with the pre-pandemic needs of its citizens, COVID-19 has further limited the ability of public health systems to provide essential surgical care to people who need it.

A study published in the British Journal of Surgery estimates that over a twelve-week period during the initial surge of COVID cases last spring, hospitals in low- and middle-income countries were forced to cancel more than 15.5 million surgical procedures as they prioritized patients infected with the virus. The ripple effect caused by these cancellations has had costly consequences in terms of avoidable human suffering. People who need surgery for trauma, cancer, burns, or congenital conditions such as cleft lip and cleft palate have been forced to wait and grapple with the debilitating effects of their conditions. Lives have been lost.

On a personal level, the coronavirus pandemic has brought back memories of my experience in Liberia leading Africare's response to the 2014-15 Ebola epidemic. During that emergency, all essential and emergency public health services were suspended as the healthcare system struggled to respond to the surge in Ebola cases. As a result of insufficient investment over many years, the country was ill prepared to address the highly infectious nature of the disease, and its response was further weakened by the dearth of critical medical equipment, testing and diagnostic capabilities, healthcare workers with the training needed to respond to the disease, and adequate PPE.

We see many of the same factors at work today, with predictable results, including an erosion of trust and confidence in health workers' capacity to provide adequate care and in patients' ability to receive care without risking their lives. As reported in a Journal of Public Health paper, patients in need of surgery are not seeking care for fear of contracting COVID while in hospital or a clinic. And this is in addition to preexisting structural, financial, and socioeconomic barriers that prevent tens of millions of people from accessing safe surgery.

We must and can do better.

If we are to care for the countless number of people in need of surgery while remaining responsive and resilient when faced with outbreaks of diseases such as COVID-19, the global health and international development communities must step up their capacity-building investments in both surgical ecosystems and public health systems.

Early on in the pandemic, Operation Smile made the difficult decision to put all its medical programs on pause. We knew hospitals and frontline health workers would soon be overwhelmed by an influx of desperately sick patients and that we needed to protect the people who turn to us for help, their families, and our staff and volunteers by suspending international travel indefinitely.

These measures resulted in surgery and dental care being delayed for thousands of Operation Smile patients. At the same time, we decided to increase our investment in public health systems in the countries where we work, both in response to the virus and to improve the quality of locally available care after the pandemic was over. To that end, we leveraged our longstanding relationships with various ministries of health and NGO partners to procure and donate PPE, respiratory equipment, COVID-19 test kits, and food and hygiene supplies to hospitals and communities hard hit by the virus.

What has been especially impressive about the global surgery community's response to COVID-19, however, has been its unity. Despite all the challenges posed by international travel restrictions, NGOs have turned to one another for help in overcoming their logistics and implementation hurdles. We experienced this firsthand in our work with organizations like the World Children Initiative, African Medical and Research Foundation, Kids Operating Room, Lifebox, and Medical Aid International, all of which have been instrumental in helping us procure and distribute PPE and medical supplies and equipment across Africa.

And the response extends beyond physical donations. Academic institutions, surgical societies, NGOs, and corporations have also come together to provide virtual training and education opportunities to frontline healthcare providers in resource-constrained settings. Operation Smile today partners with the United Nations Institute for Training and Research, the College of Surgeons of East Central and Southern Africa, and ministries of health in a number of countries to help thousands of health workers upgrade their skills and address the unique challenges they face.

At the end of the day, investments in public health systems help build confidence among patients, who can see that they will receive care that is safe and effective, as well as health workers, who are empowered with the knowledge, supplies, and skills they need to deliver relevant care safely and in a timely fashion. Indeed, World Health Organization chief Tedros Adhanom Ghebreyesus recently affirmed that the time for such investments is now: "Public health is more than medicine and science and it is bigger than any individual and there is hope that if we invest in health systems…we can bring this virus under control and go forward together to tackle other challenges of our times."

In the same essay, however, Tedros warned that the response to COVID-19 is not enough to "address the global under-investment in essential public health functions and resilient health systems, nor the urgent need for a 'One Health' approach that encompasses the health of humans, animals, and the planet we share. There is no vaccine for poverty, hunger, climate change or inequality."

At Operation Smile, we've learned that the time is always right to invest in systems with the aim of making them more resilient and responsive to the needs of the people they are intended to serve. But only a global response will yield the kind of impact we desperately need to stop COVID in its tracks and end the pandemic.

As the old saying goes, "to whom much is given much is required." Today, more than ever, global health stakeholders and international development actors must step up and provide the financial and human capital needed to build public health systems that can respond to emerging health needs efficiently and effectively. There's a not a moment to waste.

(Photo credit: Operation Smile)

Ernest Gaie_operation_smile_philantopicErnest Gaie serves as senior advisor for global business operations at Operation Smile.

How human services charities stepped up and filled the gap in 2020

January 18, 2021

Sharp_chula_vista_medical_centerHuman services charities provided an essential lifeline in 2020 to millions of Americans grappling with the economic and health impacts of COVID-19. Indeed, the unprecedented events of the year reinforced the deep-seated value and tangible impact of organizations that support populations in need, from nonprofits operating homeless shelters and food banks to those providing services to the disabled and elderly.

This was especially true of populations supported by the Gary Sinise Foundation, a 501(c)(3) serving veterans, first responders, service members, and their families.

When the economy cratered and the unemployment rate soared in the spring, the foundation quickly saw an uptick in requests for financial assistance — an uptick that became a tsunami by the fall. Their stories were heartbreaking: many had fallen behind on their rent, mortgage, or car payments and were facing eviction or repossession. For others, purchasing groceries for their families came at the expense of making payments on already-overdue bills.

The employment picture for many was similarly bleak. Some of the people we heard from had been furloughed indefinitely or let go from their job, while others were unable to enter the job market because of family obligations at home.

At the Gary Sinise Foundation, we responded to the growing number of requests for help by launching a campaign focused on our constituents.

During a four-month span beginning in April, the Emergency COVID-19 Combat Service campaign delivered 60,795 free meals to hospitals, Veterans Affairs medical centers, and military bases in the U.S. and overseas. At 313 locations across the country, including 273 hospitals and 145 Veterans Affairs sites, pre-packaged meals nourished overworked doctors, nurses, and other medical professionals on the front lines of the pandemic. American troops and their families stationed in Germany and Korea were among those who received meals.

Grant funding distributed through the campaign also provided a lifeline for first-responder departments — particularly those in rural America and volunteer departments supported by a small tax base — enabling them to purchase protective equipment, including N95 face masks, face shields, and gloves. All told, more than $480,000 in grant funding was distributed to fire and police departments in twenty-seven states.

In a relatively short period of time, more than $1.4 million was raised by the campaign despite a raging pandemic and a battered U.S. economy. And those weren't the only challenges. A polarizing U.S. presidential race and bitterly contested election saw donations to the campaign ebb and flow, much as they had in the summer in the wake of racial justice protests sparked by the killings of Ahmaud Arbery, Breonna Taylor, and George Floyd. Still, the campaign went on, enabling the foundation to consistently deliver financial aid and other forms of support to veterans, Gold Star families, first responders, and others impacted in one way or another by COVID-19.

No year in recent memory has presented as many challenges as 2020 to the institutions and core identity of the United States. And yet no year has been as rife with opportunity for human services charities to step up in new and creative ways to help millions of Americans who are struggling.

Given the critical role these organizations play in their communities and the void they fill when resources and funding at the local, state, and federal level are stretched, it's clear they must continue to adapt their services in 2021 to the economic and political realities stemming from the ongoing public health crisis. They will need our support to do so.

There really is no choice. Too many people are counting on us.

(Photo credit: Sharp Chula Vista Medical Center)

Brandon_black_gary_sinise_foundation_PhilanTopicBrandon Black is senior communications writer at the Gary Sinise Foundation.

5 Questions for...Amoretta Morris, Director, National Community Strategies, The Annie E. Casey Foundation

December 10, 2020

Amoretta Morris joined The Annie E. Casey Foundation in 2013 as a senior associate responsible for overseeing the Family-Centered Community Change initiative. In 2016, she was named director of the foundation's national community strategies, in which role she leads its efforts to help local partners and community stakeholders strengthen their neighborhoods.

Morris's portfolio includes Evidence2Success, which supports partnerships aimed at engaging elected officials, public agencies, and community members in efforts to improve child well-being; community safety and trauma-response initiatives in several cities, including Atlanta; and nationwide efforts to create and preserve affordable housing.

Before joining the foundation, she served as director of student attendance for the District of Columbia Public Schools, where she oversaw activities ranging from chronic absence interventions and dropout prevention initiatives to services for homeless students. Before that, she was a youth and education policy advisor in the Executive Office of the Mayor and the founding director and lead organizer for the Justice 4 DC Youth! Coalition, an advocacy group that works to mobilize youth and adults in support of juvenile justice reform.

PND spoke with Morris about how philanthropy can help advance community health and safety during a pandemic.

Headshot_amoretta_morris_aecfPhilanthropy News Digest: How does family-centered community change differ from other types of change strategies, especially with respect to community health and safety?

Amoretta Morris: Unlike other efforts that focus on one specific element, such as education or health, the Family-Centered Community Change initiative took a multipronged approach to improving family well-being in three key areas: family economic stability; parent engagement and leadership; and early child care and education. The initiative was built around the belief that both parents and children will have significantly better outcomes if communities are able to strengthen and combine these services instead of relying on a single intervention.

PND: How has the COVID-19 pandemic affected the foundation's efforts to promote access to education, affordable housing, and employment opportunities? What have you and your colleagues done to adapt existing projects and/or strategies to address the immediate and/or longer-term impacts of the pandemic?

AM: The pandemic has created — and in many cases, exacerbated — educational, employment, and social pressures for young people and families. Knowing this, the foundation reallocated some of our funding, repurposed existing resources, amended grant agreements, and increased general operating support to our grantees so that they had flexibility to address the challenges their communities are facing.

In response, our partners adapted their strategies in creative ways to support kids and families. These efforts have included things like connecting people to health care; helping families access food and other critical resources; providing financial assistance to help keep families in their homes, as well as housing individuals experiencing homelessness and advocating to halt evictions and protect renters; working to prevent violence and support those affected by it; supporting immigrant families, including those who do not qualify for state or federal benefits; and helping students secure computers and the reliable Internet access they need for distance learning.

We know that communities are battling multiple pandemics simultaneously — COVID-19, economic distress, racial injustice, and gun violence — and that most of them, including COVID-19, will not immediately disappear, even with a vaccine. So, we remain focused on our commitment to young people and their families and the structural change needed to help all kids thrive.

PND: In 2012, the Family-Centered Community Change initiative implemented a new approach to community partnerships called strategic co-investing. The approach calls for the awarding of flexible grant funding, "nesting" an issue within an existing community change effort, and a rethinking of the funder-grantee relationship in which the funder serves as more of a strategic thought partner to its grantees rather than as the "buyer" of certain outcomes and deliverables. What are some of the lessons you've learned from the initiative — both for funders and for community partners?

AM: The strategic co-investor role with Family-Centered Community Change was a new way of working for the foundation — one that enabled us to examine the ways we engage with grantees, residents, and other local funders. Among many lessons, FCCC emphasized the importance of both systemic solutions that address structural barriers and targeted interventions with families and their children. Local leaders cannot "service" their way out of poverty — we need comprehensive policy solutions that create more equitable pathways to opportunity, coupled with services and resources that help children and their families achieve stability and thrive.

The strategic co-investor role also confirmed for us the catalytic effect national funding can have. Investment from a national foundation is often seen as a vote of confidence and can help partners secure additional funding from federal and state government, local funders, or other national philanthropies. And I believe that for our community partners, the work highlighted the critical importance of listening to the families they serve, respecting their knowledge and expertise, and leveraging them as partners.

PND: Your program at the foundation is focused on driving community change by providing a holistic suite of services to families. What are some of the things philanthropy can do to better support community members in designing and implementing their own strategies for improving community health and safety? What about gun violence, which is the leading cause of death for young Black males between the ages of 15 and 24 and has been on the rise since the early days of the pandemic in many parts of the country?

AM: At the Casey Foundation, we want all young people to have the power and resources needed to thrive in communities that are strong and safe. The foundation advances strategies to ensure that youth and families of color have what they need to flourish — safe neighborhoods, affordable housing, and access to resources that promote children's well-being and positive development. To realize that vision, we, as funders, must be willing to build and share power with communities. Providing tools, resources, and trainings is part of the solution. We must also commit to more authentically engaging with and building the capacity of youth and their families to meaningfully contribute their experience and knowledge in the problem-solving process.

With regard to gun violence, we focus on community safety and violence prevention as part of our national community strategies. That work is rooted in the understanding that violence is a health crisis that must be solved through comprehensive, community-led interventions. For example, in Atlanta, one of our "hometowns," we're partnering with grassroots organizations to equip city residents with the tools and skills they need to be peacemakers and provide pathways out of violence. Our nonprofit partner CHRIS 180 is leading the charge by implementing Cure Violence, a public-health approach to address shootings; it treats shootings like an epidemic that must be stopped before spreading. Under that model, credible messengers — people with strong community ties — act to intervene when violence or retaliation is likely to occur, while community-based organizations that run the programs partner with various local actors like hospital staff, nonprofits, and other organizations to prevent additional violence.

We also invest in national networks focused on promoting solutions in which violence is treated as an urgent public health matter. The Health Alliance for Violence Intervention, for example, supports hospital-based intervention programs where healthcare staff and community organizations provide bedside counseling to patients who have experienced violent injuries with the aim of steering them away from retaliation. And national advocacy partners like the Community Justice Reform Coalition and the Marsha P. Johnson Institute have launched campaigns that promote community intervention strategies and demand accountability from elected officials for ending gun violence in their communities.

But we're not alone in this work. We also invest in these efforts alongside our peers as members of the Fund for a Safer Future, a funder collaborative that supports policy, research, and community-based interventions aimed at preventing gun violence.

PND: You've led a nonprofit coalition that advocates for juvenile justice reform, a municipal government's efforts to support underserved and homeless students, and now a national foundation's strategy to center community change in families. Based on your experience in different sectors, what is the one thing we can do to improve child well-being and flourishing, for all children?

AM: The throughline is equity. No matter where the starting place is, your approach should center the voices and experience of those most directly affected by the issue you are trying to solve. In juvenile justice reform, it was organizing alongside formerly incarcerated youth and their families. In DC Public Schools, it meant listening to homeless students, parents, and the school counselors who were making herculean efforts to support those students and parents. And in philanthropy, it is all about deeply listening to grantees, walking neighborhoods, and having community residents take the lead. When you start with the people closest to the pain of the problem, they will lead you to the solution.

Kyoko Uchida

Quote of the Week

  • "[L]et me assert my firm belief that the only thing we have to fear is...fear itself — nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance...."


    — Franklin D. Roosevelt, 32nd president of the United States

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