Slide 1

Report
Preparing for the Future: Public Health
Leadership & Management Preparedness Series
21st Century Global Health: A New
Leadership Paradigm
Stephanie Bailey, MD, MSHSA
Chief, Public Health Practice Office
Centers for Disease Control and Prevention
US Department of Health and Human Services
Northwest Center for Public Health Practice
Objectives
By the end of this module you will be able to:
• Describe the evolution of public health and public
health leadership.
• Describe the opportunities and challenges for
leaders of 21st century Global Health.
• Discuss the ramifications and implications of small
world networks for public health leaders.
• Define the concept of Meta-Leadership.
• Discuss the necessity and opportunities for crosssector collaborations.
"We need to learn how to build a connectivity that
includes people who are not like us—people in
business, people in the faith-based sector, people
in the health care delivery system, people in the
nonprofit community—and there is one absolutely
essential requirement to our capacity to do this
kind of collaboration. It is the concept of metaleadership."
—Julie Louise Gerberding, MD, MPH
Director, Centers for Disease Control and Prevention
Unique Features of the Public Health
System
• Social justice
• Inherently political nature
• Expanding agenda
• Link with government
• Grounded in science
• Focus on prevention (prime strategy)
• Uncommon culture and bond
A New Brand of Public Health
•
Living by design
 Making choices
 Vision
 New science
 Broadening the landscape
 Transformation
 Application
Building Connectivity:
WHO Collaborating Centers for Influenza
WHO Collaborating Centers
Countries with at least 1 WHO influenza laboratory
Building Connectivity and Expanding Scale:
CDC/WHO Global Disease Detection Response
Center Collaboration
3
ERO
region
3
EMRO
region
3
PAHO
region
3 AFRO
region
3
SEARO
region
3
WPRO
region
GDD Response Centers
Health Protection in a Small World
Requires:
• Fast detection
• Fast science
• Fast and effective communication
• Fast and effective integration
• Fast and effective action
Globalization, connectivity, and speed!
We know what the future promises:
Surprise. A speeded up existence. And a fair amount of
chaos.
The future also promises us new possibilities. Astounding
opportunities. A higher standard of living, more job freedom,
plus the chance to achieve more potential.
And the future will keep its word.
—Price Pritchett
(1995) (New Work Habits)
April 30, 2002
Nothing's Easy for New Orleans Flood Control
By JON NORDHEIMER
“There's no way to minimize the amount of devastation that
could take place under such circumstances," warned Walter S.
Maestri, director of emergency management of Jefferson
Parish, a suburban region with 455,000 residents on the city's
western and southern sides…
Many residents give little thought to such matters, counting on the
knowledge that New Orleans has escaped hurricane disaster in the
past.
The New Normal
• Protection of health from predictable threats
 Chronic diseases
 Environmental threats
 Injury
• Preparedness and response to emergencies





Pandemic
Food-borne illness
Natural disasters
Terrorism
Emerging infectious diseases
Question
How closely does this definition of “the new normal”
match what you are seeing in your agency?
A.
Exactly
B.
Pretty close
C.
Not very much
D.
Not at all
CDC’s Mission
To promote health and quality of life by preventing and
controlling disease, injury, and disability
Health Protection Goals for the
21st Century
Healthy People in
Every Stage of Life
Healthy People in
Healthy Places
People Prepared for
Emerging Health Threats
Healthy People in a
Healthy World
Centers for Disease Control and
Prevention—21st Century
Office of the Chief
Science Officer
Office of the Chief
Operating Officer
Office of Strategy
and Innovation
Office of the Director
Office of Enterprise
Communication
Office of Workforce
and
Career Development
Office of the Chief
of Staff
Coordinating
Office for
GLOBAL
HEALTH
Coordinating
Office for
TERRORISM
PREPAREDNESS
& EMERGENCY
RESPONSE
CDC Washington
Coordinating Center
for
ENVIRONMENTAL
HEALTH &
INJURY
PREVENTION
NCEH
NC
= National Center
Office of Public
Health Practice
NCIPC
Coordinating
Center for
HEALTH
INFORMATION
& SERVICES
Coordinating
Center for
HEALTH
PROMOTION
Coordinating
Center for
INFECTIOUS
DISEASES
NCHS
NCHPDP
NCPDCID
NCHM
NCBDDD
NCIRD
NCPHI
OPHG
NCHHSTP
NIOSH
Urgent Threats
Extremism
Extreme Poverty
Extreme Climate
Urgent Realities
Extreme
Aging
Extreme
Environment
Extreme Size
Extremism
Extreme Poverty: Numbers of Extreme Poor
Millions
(estimated 1.1 billion people in 2001)
450
400
350
300
250
200
150
100
50
0
2001
East Asia South Asia East Europe Mid East South Asia Sub-Saharan
Africa
Central Asia North Africa
Adapted from Sachs, J: The End of Poverty
Extreme Climate
Storms, Tornadoes, Hurricanes, Floods, Drought
Extreme Aging
Percentage of U.S. Population over Age 65
Percentage of Population
25
20
15
10
5
0
1930
1950
1970
1990
2010
2030
2050
Year
Source: From Baby Boom to Elder Boom: Providing Health Care for an Aging
Population Copyright 1996, Watson Wyatt Worldwide.
Obesity Trends* Among U.S. Adults
BRFSS, 1990, 1995, 2005
(*BMI 30, or about 30 lbs overweight for 5’4” person)
1995
1990
2005
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
Pandemics Do Happen!
H9*
1998 1999
H5*
1997 2003-2006
H7*
1980
H2
H1
1915
1918
Spanish
Influenza
H1N1
H3
2003
1996 2002
2003 2004
H1
1977
1925
1935
1945
1955
1957
Asian
Influenza
H2N2
1965
1968
Hong Kong
Influenza
H3N2
1975
1985
1995
2005
*Avian
Flu
Meta-Leadership
An overarching leadership that intentionally
connects the purposes and work of different
organizations or organizational units
Source: “Meta-Leadership and National Emergency Preparedness: A Model
to Build Government Connectivity”; Leonard J. Marcus, Harvard
University, Barry C. Dorn, Harvard University, Joseph Henderson,
CDC
Question
Are you currently involved with “metaleadership” within your community?
A.
Yes
B.
In some areas
C.
Not very much
D.
Not at all
Leading in the Silo
Vertical Connectivity
Horizontal Connectivity
Complex Adaptive Systems
More than the sum of the individual parts.
The whole is greater than the sum of its parts.
Meta-Leadership
Big picture:
Multi-dimensional perspective
Comfortable with the unfamiliar
Recognize cultural value
Can integrate diverse goals
The event
The person Connectivity
as leader
=
Optimal
results
Lead the
silo
Lead
Lead up
Five Dimensions of Meta-Leadership
Source: “Meta-Leadership and National Emergency Preparedness: A
Model to Build Government Connectivity”; Leonard J. Marcus,
Harvard University, Barry C. Dorn, Harvard University,
Joseph Henderson, CDC
The Five Dimensions of Meta-Leadership
• Know how to get out of the basement.
• Manage your behavior and emotions and be aware of
those around you.
• Know how and when to be a good passive/active leader.
• Acknowledge and manage chaos.
• Use your imagination to see where the event may take
you.
• Create and maintain an operational picture of the event.
Source: “Meta-Leadership and National Emergency Preparedness: A
Model to Build Government Connectivity”; Leonard J. Marcus,
Harvard University, Barry C. Dorn, Harvard University,
Joseph Henderson, CDC
Meta-Leadership: Hierarchy and Heterarchy
in a Small World Network
•
•
•
•
•
Leadership out and across organizational networks
 Collaborative
 Participatory
 Negotiated
Centralize strategy; delegate operations and tactics to
frontline experts
 Minimize central “authority”
 Distribute responsibility—network-centric
Coordinate via communication networks and
performance measurement
Let people lead!
Learn as you go!
Adapted from Denning: Network Laws. Communications of the ACM 47:15-20, 2004
A Spectrum of Partner and Public Engagement
1
2
Inform
Consult
3
Involve
4
Collaborate Empower
Increasing level of participation in decision-making
CDC: Roger Bernier, PhD, MPH
5
Remember:
Many hands make light work
and can solve complex
problems in the process.
Question
Can you think of ways in which you can contribute to
the building of organizational networks within your
community to facilitate meta-leadership activities?
A.
Yes
B.
In some areas
C.
Maybe
D.
I don’t know how to implement this
“The significance of the problems we
face cannot be solved at the same level
of thinking we had when we created
them.”
—Albert Einstein
Preparing for the Future: Public Health
Leadership & Management Preparedness Series
21st Century Global Health: A New
Leadership Paradigm
Stephanie Bailey, MD, MSHSA
Chief, Public Health Practice Office
Centers for Disease Control and Prevention
US Department of Health and Human Services
Northwest Center for Public Health Practice

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