What's working

A report from New York. Plus, a miracle in the Middle East, electrifying Africa, global progress against domestic violence, and a cancer moonshot.

What's working
José Andrés and Jane Goodall onstage during Day 2 of the Clinton Global Initiative 2024 Annual Meeting at New York Hilton Midtown on September 24, 2024 in New York City

Hi everyone, it’s Amy here. I’ve been in New York all week, alongside global leaders and activists from every corner of the globe. I watched them criss-cross the city, racing between sessions at the UN General Assembly, Climate Week and the Clinton Global Initiative (CGI) where I spent Monday and Tuesday. Forget about rush hour in Times Square, this week New York felt like the drop-pin at the centre of the world.

It’s easy to be cynical about these big, global events – yet another round of high level talks and diplomatic back-patting as the Middle East burns and the sea levels rise. But from where I stood, there was also plenty of evidence for a different story unfolding in corners of the planet near and far, a story of persistence, partnership and the grit of people driving change at the ground level.

The theme of this year's CGI meeting was 'What’s Working.' Against a backdrop of global conflict and escalating climate emergencies, the meeting gathered its ‘community of doers' from over 80 countries to share stories about what kind of progress has already happened, and the necessary steps to keep it moving forward.

We wanted to have a meeting where people didn’t just talk about big problems, but where we could roll up our sleeves and get something done.
Bill Clinton 

By the end of the two days, 175 Commitments to Action were made, addressing a range of issues from the crisis in Sudan to climate resilience, global mental health and the rights of women and girls. They reminded me that even in the most tumultuous times, there are people looking for solutions.

I’ll give you the low-down, including what I learned from two of the world's most prominent individuals making a difference for people and the planet right now.

But first, some good news.


World leaders at the UN adopt the Pact for the Future by consensus
We believe that there is a path to a brighter future for all of humanity, including those living in poverty and vulnerable situations. Through the actions we take today, we resolve to set ourselves on that path, striving for a world that is safe, peaceful, just, equal, inclusive, sustainable and prosperous, a world in which well-being, security and dignity and a healthy planet are assured for all humanity. UN

Jordan becomes the first country to eliminate leprosy
A real-life miracle in a country where Abraham, Jesus and Muhammad once walked, a region that half of humanity views as the geographic and spiritual heartland of their faith. 'As the first country to achieve this target globally, Jordan stands as an inspiration to other countries, encouraging them to enhance their efforts and overcome barriers to achieve this remarkable feat.' WHO

In a world first, a woman’s diabetes is reversed by her own stem cells
A 25-year-old woman with type 1 diabetes has become the first person with the disease to be treated using cells extracted from her own body. It's a 'stunning result' a complete reversal of the disease in a patient that previously required substantial amounts of insulin. A reminder: diabetes affects close to half a billion people worldwide. Nature

World Bank says global poverty has returned to pre-pandemic levels
Their Poverty and Inequality Platform just released new estimates through August 2024 showing that the pandemic caused global extreme poverty to rise from 8.8% in 2019 to 9.7% in 2020, but that it fell to 9% in 2022 and is expected to drop to 8.5% this year. World Bank

Also—Max Roser says it's time to lift the global poverty line to $30 per day. 🎁

UNICEF to add nutrients to polio vaccinations for kids in Gaza
The second round of a vaccination campaign to protect 640,000 children in Gaza will also deliver micronutrients—essential vitamins and minerals—and conduct nutritional screening. Discussions are also happening about the feasibility of adding further vaccinations, including a measles immunisation. Reuters

A massive effort to electrify Africa gets underway
A plan to bring electricity to 300 million Africans by 2030, backed by an initial pledge of $30 billion from the World Bank and the African Development Bank, has kicked off with an assessment of the first potential beneficiaries. It's a really good idea (🎁). 'Electrifying the world could produce the largest development gains since the 1990s.' Bloomberg

India reduces childhood stunting
In 2018, the country launched the Poshan Abhiyaan, a programme to reach kids in the first 1,000 days of their life, led by an army of 860,000 frontline workers. In the 11 states with the highest burden, stunting decreased from 41% to 37%, the proportion of undernourished women fell from 24.5% to 20.3%, and exclusive breastfeeding increased from 54.1% to 64.6%.

Sierra Leone almost halves maternal mortality in five years
The number of women dying from pregnancy, childbirth, and postpartum complications has decreased from 717 per 100,000 births in 2019 to to 443 per 100,000 births in 2023. UNICEF

Everything in America is awful
Aside from the fact that overdose deaths are down by 10%, the FBI says last year saw the largest one-year decline in murder ever recorded and that reported violent crime has fallen to levels last seen in the early 1970s, wages have been ahead of inflation since May 2023, and a record 92% of the country is now covered by some kind of health insurance.

Oh, and over 100,000 Americans have joined a programme to welcome refugees in their first three months, helping them find homes, enrol in schools, and pursue their dreams. No cats, dogs, or geese were harmed.

North Dakota court restores reproductive rights
Abortion will again be legal in North Dakota after a state court ruled that its near-total abortion ban is unconstitutional. Abortion has been illegal in North Dakota since April 2023. Center for Reproductive Rights

Kentucky's governor bans use of conversion therapy
'My faith teaches me that all children are children of God. And where practices are endangering and even harming those children, we must act.' AP

Most of the world now has legal protection against domestic violence
Twenty years ago, 8 in 10 people lived in countries without legal penalties for domestic violence. By 2023, this had more than reversed, with 9 in 10 people living in countries with legal measures against domestic violence. There are still huge gaps in implementation and enforcement—but this is progress. OWD

Quad countries launch cancer moonshot
The United States, Australia, India, and Japan are launching a groundbreaking effort to help end cancer in the Indo-Pacific, starting with cervical cancer. It's backed by a ton of money: billions of dollars from governments, philanthropic partners, and multilateral organisations, and a commitment from India for something like 40 million doses of the HPV vaccine.

How the lessons of COVID-19 ensured a rapid response to the mpox outbreak.

A major advance in the fight against drug-resistant tuberculosis
Last month the WHO recommended three new regimens for multidrug-resistant tuberculosis. It's a big breakthrough—the new regimens allow patients to be cured in nine months with all-oral treatments, compared to the current, conventional 18-month regimen, which includes daily painful injections. PIH

First patients start receiving treatment for sickle cell disease
His life with the disease has been punctuated by episodes of excruciating pain, requiring days in the hospital as doctors tried to control it. Sickle cell eroded his hip bones. It prevented him from riding a bike or playing soccer or even going outside when the temperature was below 55 degrees Fahrenheit because cold often brought on intense pain.
Now he could see a future — in a month or so — without pain from sickle cell.
'I can’t wait to start my new life.'

New York Times 🎁

Kendric Cromer undergoes infusion gene therapy for his sickle cell disease at Children’s National Hospital in Washington earlier this month. His parents, Deborah and Keith, stay in his room every time he is hospitalized. Credit: Kenny Holston/The New York Times

The watering hole of progress

The Clinton Global Initiative was founded on the idea that action drives change. Its Commitments to Action are specific, measurable projects and programs that have impacted the lives of more than 500 million people in 180 countries.

This year's meeting was a blur of big conversations and spotlight sessions where a who’s who of business and philanthropy discussed everything from access to healthcare to freedom of the press and water conservation.

In between sessions, everyone mingled in lounges; a cross-section of people from the public, private and philanthropic sectors along with commitment-makers from small charities and niche organisations. Many who would never cross paths in everyday life found themselves standing next to each other.

Changing the world is tireless, invisible work. And watching these change-makers connect in real-time across sectors and national borders, I realised that these kinds of global conferences can be more than just an annual benchmark, they're crucial watering holes that bring people together, to stock up on reserves for the work ahead.

Chatting with Zach Wyatt, CEO of the Carolina Farm Trust, a network of regional farm with a big vision to support local food production, CGI was his chance to step out of the grind and look around at the other work that was happening.

All the doing is heavy, the work takes so much out of you. But when you come here and see people from all around the world doing important work and under circumstances that are ten times harder than your own, it's hard not to feel gratitude.

For some it’s an opportunity to share resources, for others it’s about finding the necessary partners to take their mission to the next stage. Over the two days, I lost count of how many times someone told me that the commitment they were making at this year’s event was the result of a conversation that happened at a previous meeting.

While progress is always intentional, when you bring all these people to the same table, you drastically increase the probability that it will actually happen. Global change, by definition, thrives on cross-sector pollination. The more diverse it is, the more resilient and sustainable it is.

This idea was highlighted in a conversation between Jane Goodall and José Andrés. Reflecting on how their individual passions have inspired people around the world to join their movements, Jose shared how learning about Jane’s work helped his own mission evolve.

What her love for protecting animals and chimpanzees tells me as a cook, is that I need to make sure that in the process of feeding humanity, we are not taking away the forests.

In the early stages of World Central Kitchen’s work in Gaza last year, José realised that the organisation needed to make their kitchens sustainable. By using solar and briquettes to cook the hundreds of thousands of meals, they could ensure that whatever trees were left in the area were not cut down for fire.

It was a reminder from one of the world’s most powerful fixers that solutions never happen in isolation. "All these things are highly interconnected, and this is why it’s important that we keep relying on each other. When we share what we know, we all become better."


'Hope is partnership'


These were the words of Dr Yael Admi, co-founder of Women Wage Peace, the Israeli, women-led peace movement who shared the stage with Reem Al-Hajajreh, co-founder of the Palestinian women-led group, Women of the Sun. Across enemy lines, these two groups are working together to create a shared vision of a peaceful future.

No one makes progress alone. This was a common theme throughout the meeting; from local initiatives to global alliances, partnership remains constant across the scale.

One of the first announcements was the Coalition for Mental Health Investment, a global alliance committed to bridging the $200 billion annual financing gap for mental health, to make mental health services more effective, affordable and accessible.

We often report on these kind of announcements in this newsletter, but this was the first time I had the opportunity to meet some of the people behind the headlines. Huddled around a small bar table after the announcement, Erica Coe, co-lead of McKinsey Health Institute, Jules Chappell, CEO of Kokoro, and Bec Smith, a director of policy at Wellcome, shared how they teamed up with the African Venture Philanthropy Alliance.

Although all these organisations had been chipping away separately at mental health solutions for years, the idea for an alliance was sparked at a CGI event last year when funding partners and experts in global mental health together asked the question – why is our ambition not bigger?

“It's about timing and all the bits of the puzzle being ready to come together,” Jules explained. “We have a shared vision and together we can do this.”

Mental disorders represent about 15% of the total global disease burden but until now have only received 1-2% of global financing. According to Erica, this alliance will help create sustainable, long-term financing to scale existing solutions so that they reach those most in need.

When it comes to mental health, every country is a developing country.

This is big work that has the potential to change the game for people suffering from mental health around the world. “The stakes are high but there is joy in this work. If we can get this right, we're going to be part of something that makes so many people's lives better,” Bec Smith added, “It's a real privilege to have a job where you feel like you're contributing to something like this.”

I know it sounds obvious, but this conversation really brought home that it's not organisations or corporations that drive progress, it's people. Behind all the acronyms are groups of committed individuals who aren't getting enough sleep, and have to drop their kids at school and do the laundry, while chipping away at these problems one conversation at a time. Progress is global, but it is also deeply personal.

One of the best examples of this was the story of Adebayo Alonge, the founder of RxAll, a data platform that enables hospitals and pharmacies across Africa to authenticate pharmaceutical medication.

Every year 100,000 Africans die from counterfeit drugs, which is estimated to account for 30% of all medication across the continent. At 15 years old, Adebayo almost lost his life to one of these drugs and made the decision to become a pharmacist, to solve that problem.

20 years on, he’s created an AI spectrometer, a device that works with mobile apps to test the quality of medication in 20 seconds. Adebayo’s personal mission has now reached 5000 pharmacies across Africa, impacting the lives of three million patients.

And he hasn’t stopped there. He’s also creating a micro-finance profile for all the pharmacies that use the technology to help to unlock financing for 3,000 women-owned pharmacies who couldn't access capital from traditional banks.

It's very important that when we are rolling out our technologies, we're not coming as a paternalistic provider of technology, but as someone who listens to the main issue that they're facing.

The lottery of progress

The future of funding was a big topic this year. As the world’s problems become more urgent and complex, traditional models of charity are not going to cut it. One of the big shifts is something called trust-based philanthropy, which allows recipients to choose how they distribute the funds and to pivot when they need.

It’s an approach that’s rapidly gaining momentum, but for the Postcode Lottery Group, the world's third largest private donor after the Gates Foundation and the Wellcome Trust, it’s just the way they’ve done things for more than 35 years.

On this week’s podcast we chatted with their CEO, Sigrid van Aken, about their innovative approach to fundraising and how they help charities drive significant social and environmental change. With over 14 million subscriptions and record turnover of €2.5 billion in 2023, this is one of the world's greatest philanthropy initiatives you probably haven’t heard about.


Some other highlights...

A lead-free future
Lead poisoning kills more people than HIV and malaria combined. Now the first-ever global public-private partnership has committed $150 million to end lead poisoning in children in developing countries once and for all. Over the past few years Bangladesh, Malawi and Madagascar have all achieved outsized impact in fighting lead expose with low-cost and effective approaches. 

$500 million annual investment into women’s health
First lady Jill Biden unveiled a new set of actions to address health inequities faced by women in the United States. The research will focus on why women experience endocrine, haematological and other immunity-related disorders twice as often as men.

Big boost for global food security and school meals
The U.S. Department of Agriculture pledged more than $466 million to bolster food security in 16 other countries by providing school meals or implementing climate-conscious farming technology.

Trauma programs in Gaza
The Centre for Mind Body Medicine committed to significantly scale programs in Gaza to provide more than 500,000 children and adults with trauma healing services over the next three years.


This is obviously a fraction of what happened at the meeting this year, but hopefully it gives you a sense of why these events are such an important part of the story of global progress.

Next week we'll be back all of the climate and conservation stories I heard about, as well as a special edition of the podcast, featuring all the people I interviewed while I was roaming the corridors.

With love,

Amy


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