- Well, welcome everybody, nevertheless,
this is our first session,
we have a terrific
speaker tonight, that, I.
(gentle speaking)
Oh, yes, exactly, you know, yes.
We start at the top and
work our way from there.
So, I'm gonna introduce, I'm gonna
turn this over to professor McKean,
but just wanna be sure everybody had,
I just wanna say thanks to everybody,
to the emails, just a reminder
about how this program works.
You know, we'll have a
structured conversation with our
speaker for about, you
know, half hour, 45 minutes
that will then turn to the three students
who did the briefing to
lead the conversation.
We'll turn it then to the
remainder of the class,
and then anybody who's not enrolled here,
and I'm not sure of who that is,
but if you're not, then
you can, there'll be plenty
of time for questions from
the rest of the class.
So, with that, Maeve, do you
wanna do the introductions?
So, thank you for coming.
- So, thank you so much,
really excited for our
spring 2020 Conversations
in Global Health class,
and to have my friend Kiefer Buckingham
come and talk to us about her current work
and her career leading up to here.
So she is at, as everyone knows,
at the Open Society Foundations,
and I realize, I'm guessing your title,
because I always say that you're
the senior advisor of global health.
- Sure, yeah.
- But I actually realized I should
actually ask you, what
is your title, Kiefer?
- Oh, I guess I can, senior policy
advisor for international public health.
- So the senior policy advisor
for international public
health, and we've known
each other, probably, for over 10 years
back when we were both advocates
at different nonprofits, and so I'm really
excited because I think a lot of,
I think, Kiefer, your
career trajectory is very
similar to what a lot of
our students will have.
Working in non profits and advocacy.
Working on Capital Hill and then going
into the foundation world
from an advocacy work.
So, I just, what we would love to do
is just talk about, you know, a little bit
in chronological order of
where you were at college,
what you were thinking about,
what you were studying,
and how, you know, sort of that first
job out and what you learned there, so.
- Totally, great, well, thanks so
much for having me, I love Maeve.
So, of course, and I love you too.
So, I was more than happy to come chat.
There were many people
in my academic career
and then early in my
career who I depended on
to learn things about, you know,
where should I go interview
and is this the right job,
and is this the right
title, and how do I get in?
And do I have to go the policy route,
or kind of the implementer route?
And is that a decision I have to make?
Maeve was one of those people who I had
many coffees with, and
like, "What do I do?"
You know, so, yeah, and
I tried to give back
and do those informational
coffees frequently.
This is better 'cause I don't have
to have coffee with 20
people individually.
I get all of you here, so that's nice.
But I will give you my card,
also, after and you're more
than welcome to e-mail me
or hound me, or, you know.
So, I went to undergrad
at a really tiny, private
liberal arts school in Arkansas,
called Hendrix College.
So, I don't know, most people east
of the Mississippi haven't heard of it.
I'm from Tennessee originally,
so it was a little bit more my speed.
(gentle speaking)
Right, there you go, okay,
so it is a great school,
and if, people East of
the Mississippi may have
heard of like Centre or Sewanee or Rhodes.
It's kind of like that,
it's like very small.
And there I, it's very
crunchy, it's very, you know,
(laughs) I don't know, I don't know
what words people use these days.
Back then, we said hippie,
now, we say hipster.
Apparently, it's different,
I don't know, no, anyway.
But I created my own
major, 'cause why not,
in international development,
because there wasn't
really a lot there, I knew
I wanted to something.
At the time, I was
excited about agriculture
and the impact that, we didn't
call it climate change then,
but we called it global warming,
had on people's ability to.
- [Maeve] You're dating yourself.
- I am, I know, and I keep looking at you,
I'm sorry, I shouldn't do that (laughs).
(laughing)
But I (laughs), no, it's okay, it's okay.
But yeah, I didn't, we
had the whole Al Gore
and global warming and
that was it at the time.
So anyway, the impact
that that had on people's
communities and livelihoods,
and so that's what
got me into quote, unquote development.
So I said to my professors,
all right, I've got some econ,
I'm doing some African
history stuff that's exciting.
Can I just kinda do my own thing,
and they were like, "Sure,"
so I focused (laughs).
(gentle speaking)
I know, yeah, yeah, but it's really cool,
because now, because of the the work
that I'd did and the
curriculum I came up with,
it's now a official minor at Hendrix.
So there were a lot of
people who kinda came up
after me and were like,
"I wanna do that, too."
And there were more, and more things.
Hendrix is a great pre-med school,
so that's kinda where the
public health started to come
in where more and more folks
who I was talking with were
excited about the combination
of the health curriculum
that we had at Hendrix, but
then taking it globally.
And now, there are tons
of students at Hendrix
that are going into global health,
and I'm glad that I was kind
of a small part of that.
And so when I was in
undergrad, I was not really
into public health, I was
more into like development.
I don't know what that means,
you know, I thought it was cool,
I didn't really know what it meant
at the time, but I went on a trip.
I was fortunate enough my
freshman year to go to Rwanda.
Hendrix started a like exchange program
where we brought four,
like the best of the
brightest of STEM
students from Rwanda to go
to full four-year scholarships at Hendrix.
And we made a commitment
to President Kagame
to do that for eight
years, so eight times four,
you know, whatever that math is.
That's how many students we
had, which was really cool.
But it was there that I
started to, I actually visited
a PEPFAR funded clinic, did you know this?
(gentle speaking)
Yeah, in like rural
Rwanda, and I was like,
"Oh, I wanna do that," you know?
There was just sorta this moment
where I was there for like, again,
these students were STEM,
and it was about education,
and I was kinda like, "Well, whatever,
"I get a free trip to Rwanda."
But being there and just
sort of seeing the impact
of U.S. investment very
early in my academic career,
I was like, okay, this is
what I'm gonna focus on.
And then, if you had asked me
my sophomore year of college
if I was gonna go to grad
school, I probably would have
said, "No, Peace Corps," or
other things, yeah, I know.
(laughing)
Or other things.
But I ended up actually going straight
to grad school, because I got
into a great program at GW.
Their masters--
- [Maeve] Why MPH,
Master of Public Health?
- Yeah, and that was, I mean, I was like
I probably should go
to grad school, right?
Like maybe I'll make more
money, I mean, I wasn't sure,
but I was looking around at
programs and I found one,
and this was this GW
masters in public health.
'Cause I was like, do I
do an MS, do I do an M,
like there were so many
different options to do.
But this program, specifically,
was the thing that drew me to the MPH.
And it was a program where
it was two year masters
with six months, like,
grown-up study abroad.
We did six months intensive in
Kenya where we went to school
at a local university in
Kisumu and did, you know,
real projects that were
effecting the community which is
around Lake Victoria, which
has the highest malaria rates
in that part of Sub-Saharan
Africa, but definitely in Kenya,
because of the lake, right,
water, mosquitoes, right?
So and various other compounding,
very interesting factors.
And I was like, "Well,
I'll do that," (laughs).
So I mean, it really wasn't like I decided
that I was gonna go get my MPH.
It was like this program sort
of showed up and as I was kind
of researching one day,
and I was like I'll apply,
and if I get, great, if not,
maybe I'll go work somewhere.
And yeah, it just kind
of happened and I knew
I wanted to be a little bit
more on the policy side,
which was why the debate
MPH versus public policy
or some other graduate program
was a little bit difficult.
- And what about going there made you,
when you were doing that
debate between being a policy
versus an implementer,
do you have any memories?
Because I think going and
seeing a PEPFAR program
in the field makes you
want to be an implementer,
because you want to be the
one who makes that happen.
So I think it's interesting
that when you went overseas,
you had like the opposite
reaction of what others had.
- So when I came back from that
trip in Rwanda in undergrad,
I sort of was like, okay,
this is what I wanna do.
But when I eventually
started, I took a really
amazing HIV policy class,
also, my freshman year,
and all of these things
started to come together
about the establishment
of the global fund,
the establishment of PEPFAR,
what the politics were
at the time, the Bush administration,
the politics of HIV in the
United States and what that meant
to a debate about making this
giant investment globally.
And then, the paper that I ended up doing
for undergrad was about the impact of U.S.
laws on contraceptive access globally.
So I sort of was like, I'm
not really good at science,
I'm not really good at math,
so implement, you know,
being like in the field would be nice,
but not something I felt
like I had the skills to do.
I was like I'm a public
policy person and I like,
you know, I'm wonky like
that, and it just sort
of made more sense, like this
is how I can get into it.
- I feel you, like many
people in global health,
somehow started in the HIV world.
And you'll see this if you
look at anyone's resume,
at some point in time,
they have PEPFAR on it.
More or less.
- Usually, yeah.
In the policy space, yeah, yeah.
- But then, you transitioned from that
into a reproductive health advocacy,
and so can you talk about,
I actually don't know what
you did at Ipas, because that
was before my time with you.
- Right, that's true.
- So can you explain what Ipas
is to everyone and what you did there
and how that transitioned to advocacy?
- Yeah, so that transition started
when I was in grad school,
because when we started
doing this program, you know, I didn't,
I did my MPH in global
health policy, right?
I didn't get more specific than that.
It's not like I was like HIV policy
or reproductive health policy or whatever.
I was interested in reproductive
rights domestically,
and there were more and more
questions that I had about,
well, what are the impacts
and how are we, you know,
how is the U.S. policy
on reproductive health
as a implementer or as a
provider of key services,
how does that impact
people's lives on the ground?
It started out like women
and girls, like, you know,
gender-based violence and, you know,
that has to do with HIV for sure, right?
And then, it just sort of, and
then I learned more about the
global gag rule (chuckles),
or the Mexico City policy,
or the Protecting Life in
Global Health Assistance policy,
depending on who you are
and what decade it is and,
you know, what your
political affiliation is
and various other things,
that was the thing.
It was like, okay, how are
we really going to accomplish
these goals that are laid out politically?
You know, a piece of legislation
that says that we wanna do X, Y, Z on HIV.
How do we from a public
health perpsective,
social and economic
determinants of health, right?
Y'all learned that day one, right?
It didn't really line
up for me that we have
all these goals on HIV,
but at the same time,
these same women who are at
risk, also have trouble planning
their pregnancies, 'cause they
don't have access to care.
You know, people's lives
don't happen in a silo, right?
Women don't necessarily want
to go to like one clinic
for HIV and one to go get
their bed net and one to,
and so that was the thing
that started to bring me in.
I was like how do we really
think that we can accomplish all
these goals with this policy,
which, now, is even more
impactful on HIV programs, but
that, you know, that really
kind of brought me into the
reproductive health space.
And to your point,
everybody's working on HIV.
Now, there's more and more people
working on reproductive policy, but yeah.
- So what do you think those
skills, what did you learn
those skills working at
an advocacy organization?
- Yeah, so I think one of
the first things I did.
Before I was at Ipas, I was at
the Public Health Institute,
and my boss started sending
me to coalition meetings.
You'll find, mm-hmm, yeah.
(gentle speaking)
The Public Health Institute is based
in the Bay Area of California,
so it does a lot of great
domestic health work.
Good, basic, awesome public health stuff
like working to eliminate food
deserts and provide access
to healthy fruits and
vegetables in communities
that are more at risk
for diabetes and obesity.
They also do great work
on smoking cessation
and stuff like that, but they
had a great, pretty large,
portfolio on women and girls...
on...
providing...
They also had a really huge contract
from USAID at the time
that was providing...
critical staffing for country teams,
program teams, so anyway,
all that's to say.
Yeah, all that's to say
Public Health Institute
is one of those advocacy
organizations in D.C.
that was sort of fighting for funding
on the Hill for global
health programs like maternal
and child health programs,
things like that.
And they would send me to
these coalition meetings,
and you'll find in D.C. on
policy stuff especially,
it's not like one group or one person.
Everything has to be done in coalitions.
So we'd sit around rooms
like this and have very
long meetings, which
Maeve is familiar with,
where we discuss strategy
and then we move forward.
And of course, I'm like, at
the time, I was an intern,
and I was just excited,
'cause I got to see
all these people, people like Maeve,
who have been doing this
work and who are advocates,
and I was taking notes furiously.
And so that was an interesting
shift, because I had gone
from policy analysis to
policy in practice, right?
Like I'd written my paper,
you know, for grad school.
I had written my paper for undergrad,
I thought I knew all
the stuff about policy,
but when I got to an
advocacy organization,
you learn a little bit
more about politics, right?
And for global health advocacy
it's both, it has to be both.
It's little P politics and big P politics,
and that was super exciting to me.
- I think that's actually,
I was just having
a conversation with
someone yesterday who said,
he was talking about how
there are people who say,
"I'm really interested in policy work,
"but I don't want to do politics.
"I'm not political, that's
not what I'm interested in."
And it was such a funny thing to me,
because you can't do policy if you're not
interested in politics, because
policy without the ability
to actually implement
it, which means working
with people and working with coalitions
and building those,
nothing's gonna get done.
But you clearly appreciated
that from, you know--
- Mm-hmm, I love both.
- Yeah, you love both,
and then you ended up
going to where, one of the most political
places you can go, which is a
job on Capitol Hill (laughs).
But that really, and not
everybody, again, not everyone
likes that world where you
are, I mean, I think it'd be
really fun to work for Barbara
Lee, I never have (laughs).
But can you talk about sort
of the, what you saw as
the skills that you need to
be successful in that highly
political realm, because for
me, you were sort of advocating
from a place of higher
power than when you were--
- For sure, we're just different, right?
I mean, a different
place, because you know,
I think, especially working on the Hill,
the biggest need, and it's similar
to the one outside, is
relationship-building.
I mean, really, y'all, you
can teach anyone the ins
and outs of a certain policy or whatever,
but D.C. especially, if
you plan to work here,
whether in advocacy or in
grantmaking or whatever that is,
so much of what we do is
about relationships and trust
and that's how PEPFAR
got done, frankly, right?
In a tumultuous political
time, think about it,
right after 9/11, the
country was at war, I mean,
think about the context at
which PEPFAR was passed.
There was a lot going on, and
people were kinda desperate
for something that they
could work together on.
And we talk about that now as like this
watershed moment, but
it was hard at the time.
I mean, there were nasty
political fights that happened.
We've kind of forgotten all those now,
but that's the reality,
and so thinking about,
and that happened because
people built those
relationships with one another, and to me,
that was the most exciting
part about being on the Hill.
I mean, when I worked
for the congresswoman,
I was thrown into a portfolio, of course,
I got to work on global
health, which was great,
but I also had 20 other
things that I had to work on.
Like I was the immigration staffer,
I had no, it was during the Muslim ban
and like various other things, I was like,
"I can't be the immigration, like,
"you're deporting people, what?"
You know, I couldn't be
the immigration staffer,
but I figured it out, because you know,
those basic skills I
thought that I brought
and that I felt like you
needed was honesty, trust,
you know, being able to be
very flexible in the moment.
Those are not things
that you learn in school.
I really think those are
things that you learn working
together on group projects
and things like that, frankly.
Those are the huge, the skills that I
think work here in
D.C., and you know that.
- What about just, you
know, sort of working
together and PEPFAR came together
because of coalitions of
nonlike-minded people.
So how, you were clearly
a very fierce advocate
on the things that you believe
in, but how do you work
with people that you, you
know, I'm thinking the
Muslim ban or other issues
that you just disagree with?
- Yeah, I mean, it's really
hard, especially on the Hill
when we had things like
that that would happen.
And I had an interesting
time, because I was there
during the last year of
the previous administration
and then the beginning
of this administration
and not when democrats,
and I worked for democrat,
but not when democrats
were in the majority.
And so we were on the, so we're
offense, offense, defense.
And that was really interesting,
because what that changes
is sort of, okay, the people who you
were just talking crap about, you now have
to figure out how to work together with.
And so the importance of
maintaining those relationships
despite whatever is happening
out here was really important.
And so a good example of what
we did is a couple years ago,
there was really bad
famines that were happening
across various parts of the
world, so Yemen, there was
sort of issues at port of
Hodeidah, which was bringing
in a lot of food, we had
issues in South Sudan.
And so a bunch of, you
know, I sort of went
to a couple of my republican
colleagues and said,
"Look, y'all, I know that
your bosses care about this."
Some of them have big like
agriculture states and things
like that, so you're like,
"I know you care about this.
"Let's ask the speaker, you
know, let's ask the majority
"for additional money to
fight these four famines."
Me and a couple of republican staffers,
and a couple outside activists,
and a couple democratic
staffers came together
and wrote this, you know,
this like, essentially,
a memo to our bosses
that said I think we
can ask for this money.
And it happened like
overnight, they were like,
"Yeah, you're right, this is horrible."
But those people that I built
those relationships with,
I ended up going to frequently for things.
And sometimes, it would be
like, "Hey, I hear you guys
"are planning an amendment
in committee tomorrow,
"can you give me a heads up on that,
"'cause I do not want to write
that speech for my boss."
You know, or something
like that where I needed
those relationships with, in my case,
it was republicans or,
you know, a democratic
staffer who I didn't agree with on things.
Being able to still disagree
with each other on 95%,
but then finding that
5%, and unfortunately,
I think that that is
hard to find sometimes.
And that's why, again,
the relationship-building,
the honesty, the trust
stuff is so important,
because they also knew
they could come to me.
And I worked for Barbara
Lee; she's not exactly like,
she's a little bit of a democrat,
a liberal sort of outspoken,
you know, really powerful
democratic member who's been
there for a really long time.
Lot of republicans don't like her,
but I knew a staffer could
come to me and be like,
"Hey, can we work together on this,
"even though it's Barbara Lee."
So yeah, I mean, we found ways to do it.
- I was gonna ask you for, I
always tell students, you know,
you're in Washington D.C.,
if you have the opportunity
interning on the Hill even
for a semester, the skills you
learn are extremely
important, like we've talked
about relationship-building
and how things get done.
And also, I think for
those who haven't worked
on the Hill before, it's
this black box where no one
actually understands
what people do all day.
So I think you've, sort
of, described very well
what some of the things
you do, which is talking
to people about what you want to get done.
But if someone said, what
exactly did your job entail,
other than having 20 different
topics you had to work on.
- It was a lot of meetings.
(Maeve laughs)
I would say, during recess, I
mainly met with constituents.
So I usually scheduled all
my constituent meetings,
you know, groups that were coming in.
So I was the health
staffer, the LGBT staffer,
the abortion staffer,
the immigration staffer,
the global health staffer,
the foreign policy staffer,
and the appropriation
staffer, so if anyone wanted
to talk to the congresswoman
and bring their concerns
about those issues, I
was their go-to person.
And of course, constituent,
that's our job,
that's our number one
job, right, is to serve
the people of the Bay Area, the East Bay,
so that's Oakland, Berkeley, okay.
So that's UC Berkeley, that's Clif Bars,
that's, you know, Ghirardelli Chocolate,
that's the Public Health Institute
is a constituent of Congresswoman Lee's.
So yeah, I mean, that was my job,
but I usually try to
schedule those during recess,
so that's when the
members are out of town,
so I can spend a little bit
more time with those people,
making sure that their
concerns were heard.
When we were in session, it was meetings
with other staffers,
calls with other staffers,
staffing the congresswoman,
so I wrote, you know, 20...
to 30 speeches a month.
A lot of them didn't get read.
Let me tell you, that is
hard when you spend a lot
of time on a speech, and
she gets up and she's like,
"I wanna talk to you about
something," and she just puts,
(laughing)
you know, and she just
doesn't use that.
I really ant someone to do a
great memoir where they pull
together like a collection of
speeches that never got given.
(laughing)
You know?
The speeches that never got delivered.
Or the speeches that like you really wish
your boss had delivered, 'cause (laughs).
(gentle speaking and laughing)
Yeah (laughs), yeah.
- [Maeve] So one of the practice
we have for the students
is to write a two-page memo to their boss.
- Oh, nice.
- [Maeve] How many two-page
memos do you think you've--
- Oh, never, two pages,
always like a page.
The clear and concise thing
was also really difficult,
because these members, as much as I had
20 issues, she had a hundred, right?
I mean, she had various
different committee assignments,
and for someone who was so senior,
everybody wants her for everything.
So being able to put a memo
that was clear and said,
"Okay, here's your top-line, you know.
"If you want more, I'll give you more."
But I knew that there was
like something bolded,
and then like two bullets,
and especially if I was asking
her to do something, that had
to be like the first line,
'cause otherwise, it's just, you know.
We sent her home with homework everyday.
So bless her heart, she
had this big folder,
and she would get it, and
she'd have to take it home,
you know, and she had homework.
I mean, because she's worked all day.
Her day started at seven,
her day maybe ended
at eight or nine when votes are over,
and then she has memos to read,
and she has speeches to edit.
And so her, you know, our
job, was really to also
make her life a little bit easier,
because she is also such
an activist herself,
and so she wanted to be
everything for everyone.
And every once in a
while, our job was to say,
"Sorry, you can't, you need
to eat food, please, you know.
"Please drink some water, take a break.
"You know, you can let this one go."
But she was like, "No, we have to do this.
"We have to fight and scrape."
It's a great problem
to have, but sometimes,
that was the job, too, was
to be able to, a tough job,
was to be able to say, "You
know what, this, maybe,
"let's give this to someone
else, or maybe we gotta."
And so the staffing up,
you know, the managing up,
which people talk about sometimes
is, you know, as a manager
you think about how you manage
all the people below you.
But as staffers, a lot of what we were
doing was just looking out for her, too.
And "Congresswoman, have
you eaten since breakfast?
"You haven't, okay, let me
go get you a sandwich, sure.
"Yep, No mustard, great, yep."
So there are less
glamorous parts about it,
but it's all about, you know,
taking care of this person
who you want to be all the
things for all the people.
But yeah, tons of memos, tons of speeches,
late night text messages,
phone calls, you know.
Then, when she was in
California, that was three
hours behind, right, so
I would usually work till
much later, 'cause she
was awake and ready to go.
You know, and I was trying to go to bed.
And she's like, "All
right, what are we doing?"
"Okay, sure," so yeah, I mean.
Every member has their
quirk just like any,
even if you're not working on the Hill,
every boss has their quirk, as you know.
I think that, it all
goes back, again, to that
kind of trust thing,
and being able to prove,
especially with memos,
the one thing that Barbara
always wanted know was,
do you know the answer?
And if you don't know the
answer, you better say so.
'Cause that was the other thing, it's like
if you write a memo and
it's kinda wishy-washy,
like if you're not being like,
"Here's your number one point.
"You're gonna sign onto
this bill because of this.
"If you don't sign on, here's
the possible ramification.
"Here's the pro and con for sure,
"but you need to sign onto this bill."
If she asked me a question in committee,
and she'd lean over and she'd go,
"Kiefer, how much money is
this thing and what do we do?"
If I wasn't immediately
like, "It's this, blah,
"blah, blah, here's your
answer, you vote yes."
If I sort of said,
"Well," she'd go, "Nope,"
and like ask someone else,
and just be like, you know.
So the confidence also
of being able to say,
back up your points, and say
why you're pushing for A or B,
but also to be like, "You
know what, Congresswoman,
"I don't know, but I'm gonna
get you an answer right now."
That was the appropriate
answer, not like, "Well."
So that's another thing, too,
like especially if you're
gonna be all on the policy
side, you know this.
- That is really great
advice, and so true.
And that moment of (gasps),
know what, I'm done.
- Which is terrifying.
- I do wanna make sure students
have time to talk to you,
as well, but I just want,
this transition you then
went sort of, again, from
the advocacy to Capitol Hill
to a very senior member to
the Open Society Foundations,
which is, it's the Open
Society Foundations
in a job that didn't exist
before in the, you know,
so you're the first person
to have this position.
And you have it during an administration,
which as you talked about is very
different from the last administration.
So can you talk about sort
of what in your life made you
make that transition, and
then how different the job is,
this is a big, huge three-part question,
but I'm gonna throw it all at
you, which is how different is
this job given the current
dynamics of the U.S. government?
And then, just talk
about sort of what you're
working on and what you're hopeful for.
- Okay, (blows air).
- I know, yeah, four more questions.
- Just explain what the
open society foundation is.
- Oh, excuse me.
- Yeah, that's a great question.
I will try to, he asked explain
what the Open Society Foundations are.
I will try, we are giant, we are called
the Open Society Foundations
because we have various
entities all around the world, in Ukraine,
we're called the International
Renaissance Foundation,
and in East Africa we're called OSIEA,
and in South Africa, we're called OSIWA,
and you know, so we have
all these different names.
But I work for Open Society-U.S.,
which is also a new
entity, which is exactly
what it sounds, we work on U.S. stuff.
Open Society is a big
philanthropy which our founder,
George Soros, calls a
political philanthropy.
So we do not do political
work, but our work is,
in a way, political,
because to Maeve's point,
policy is political, whether
you like it or not, it is.
And a lot of what we do
are things that people,
especially governments that
like to suppress free speech,
like to prevent civil
society from organizing
and showing themselves up,
it's real political, right,
the things that we do,
the things that we fund.
But to go back to your original question,
there are two answers to the first one,
which is like how did I transition
or maybe why did I leave.
So one was I wanted to start a family,
and so I want to be very
clear that, that's important,
being able to balance both
your career and being very true
to yourself and being okay to
say I need to make more money,
and that being an okay answer, right?
I deserve more, I deserve more time off,
I deserve more money in my pocket,
I deserve a good family leave policy.
And as you all know on the Hill,
and just until recently,
federal employees had
no paid family leave,
now, we have 12 weeks.
But that was the reality that I was in.
And I said, I can't do this
in this current environment.
I love the congresswoman,
but I need to find
something different, so
that was like one very
important part of it, and I'm
not shy to talk about that.
But the other part of
it was I was burnt out.
I was so tired, and I
actually left the August
before the election where
democrats would have been in,
you know, are now in the majority.
And a lot of people were like,
"You're leaving in August, what if we win?
"And then we'll be legislating."
And I'm like, "And then,
it's even more work."
(laughs) You know, I mean, I happened
to work for someone who liked to describe
herself as the resistance,
so we did more work than
anyone anyway at the time,
you know, in the minority.
But you know, then you're in the majority,
and then you have to really do stuff,
right, then you need to legislate.
And it wasn't that I was scared of that.
I was just like, "Well, what
if we don't win?" you know,
and so, for me, it wasn't
an important calculation.
A calculation for me was find
a job where I can continue
to love what I do and also
get paid what I'm due.
And I found that at Open
Society that has a lot of,
you know, their values both externally
and what we fund are reflected internally.
So I'm really lucky to
work for a place that cares
for me and my family, and
so that was important.
From a sort of values and a content space,
it's my dream job, you know?
It was one of those
situations where (laughs),
Maeve and I talked about
this, one of those situations
where the job description
came out and people are like,
"Kiefer, it's your resume,
this is your job, right?
"Did someone write this for you?"
So when that happens,
the universe is like,
"Hello, warning, take
this, apply for this job."
You know like, "Spend more time on this
"resume than you have on any others."
(both drowning each other out)
(laughs)
- [Maeve] The job description
was need somebody who--
- Yeah, I think it was like, you know,
to do like international,
like global health policy,
including reproductive
health, like global gag rule,
PEPFAR, it was like all these keywords,
and I was like yes, yes,
yes, yes, yes, so yeah, so--
(gentle speaking)
(laughs) Well, I feel so lucky,
I mean, that's the thing.
It was like we're meant to be together.
So that transition was hard, though,
because it's a philanthropy.
I was like I've never done,
I've never given out money.
You know, I don't know how to do this.
Luckily, I don't have a
lot of money to give out,
because I mainly do policy advocacy stuff.
Although, I have been able to do
some grantmaking, which
is really exciting.
And it is, it's a political philanthropy.
So we sort of say, what
are the things that would
be most impactful in
terms of an investment.
So those relate to things
like global health policy.
Like one that I funded this
year, and this is all public,
it's okay, that I'm really
excited about that is completely
nonpartisan slash bipartisan
is this effort to get
the presidential candidates
to all talking about ending
the global pandemics of AIDS,
TB, and malaria by 2030.
So we sort of said,
"Here's some principles
"and here's a platform, we would like each
"of the presidential candidates
"to take these things and make it
"their own and maybe if you mention it
"in a debate, that'd be awesome."
So that's been really cool,
and so there's people in Iowa
bird-dogging Buttigieg, and
there's people, you know,
tweeting during a debate,
and we helped fund that.
And that is important
because we do think that
the next president or
the next administration,
whether it's the current one or a new one,
should make those
commitments, because that's an
important historical U.S.
moral leadership thing,
right, so that's really cool.
- [Maeve] Because there's
so many negative things,
I was gonna, I asked you
something you're hopeful about.
That actually was a very
positive thing that you did
talk about something that
you are hopeful about,
the increasing the advocacy
and the engagement.
- Yeah, I mean, under this administration,
it's been difficult, because I do work
on reproductive health and rights,
which has been something
that this administration...
has in my opinion undermined dramatically.
And so for us, it is about making sure
that civil society folks that want to, A,
hold an administration accountable or, B,
maybe provide another
administration with a blueprint
for what they could do that's
better, or whatever that is,
making sure that civil
society, and this is what OSF
does around the world, is
well-equipped to do that.
That folks have the resources
to lobby their members
of congress or have the
resources to meet with PEPFAR
and USAID about how
they're distributing money.
I mean, whatever it is,
and so that is the kind
of exciting part about
what I do, I get to both go
on the Hill, do my own
advocacy, and then, also,
make sure that my colleagues
and friends that I work
with are well-equipped
to to the same thing.
'Cause many voices is
better than a couple, right?
- I'm gonna, John, do you
have any last questions
before I turn it over to our class?
It's so exciting, so
I'm gonna turn it over.
We have three students
who are gonna start off
asking some questions,
and then we're gonna open
it up to the rest of the
room, so if you can--
- Should we pass the mics or do you--
- We're gonna pass the mics,
and if you could please.
(gentle speaking)
Okay.
(gentle speaking)
I was gonna, yeah, so we can
just, just for the video.
So if you could please
remind of us of your name
and what program you're in
that would be wonderful.
Thank you so much.
- Mm-hmm.
- [Shui] Hi, I'm Shui, I'm a sophomore
in the STIA program in
the SFS, and STIA is just
Science, Technology, and
International Affairs.
- Oh, cool.
- SFS is the School of Foreign Service.
- [Shui] Yeah, sorry, a lot of acronyms.
- I knew that one, at least.
- So something I was
kind of interested in was
this kind of, the idea of
reproductive health rights.
Over the summer, I did a little bit
of research on refugee
camps, and there was a lot
of talk about reproductive
health and rights there,
but that idea was kind of
different from the reproductive
health rights which I
kind of got from what you
were saying about domestic
policies in the U.S.
Over there it was about
making sure that women
had access to prenatal and postnatal care.
Whereas, it seems like the conversation
here is more on allowing
women to have access
to have abortions and things like that.
I mean, I think in the first place,
it's really good that we have a discussion
of reproductive health
rights here in the U.S.,
'cause I think, at least
my impression was like,
oh, we're fine here in the U.S.,
let's look internationally,
but it's like, it's kind
of awakening to see like,
oh, we still have problems
here that need to be addressed.
I guess my question is is there,
do you have like, is there
a global definition of what
reproductive health rights is?
- Okay, I got you, are we doing all
of them or just one at a time?
- We can do one at a time.
- Okay, cool, so first of all,
there is an official definition.
A couple years ago, the
Lancet Commission had a really
great paper that our friends
at the Guttmacher Institute,
which is a research
organization, and they actually
came up with what is considered
the globally recognized
definition of sexual and
reproductive health and rights.
So that's kind of, we say
them all together, so SRHR,
sexual and reproductive health and rights.
And what's interesting is
you can really break each
of those things down, sexual
health, sexual rights,
reproductive health, reproductive
rights, so reproductive
health, you know, everything
from access to me.
Now, I think if you ask
different people beyond that
technical definition,
you ask different people
about what services are included in that.
To me, reproductive health
is everything from access
to menstrual pads for girls
in schools to, you know,
access to condoms and
information for young people to,
and then, you know, and then
you can just keep going, right?
And same with like sexual
health and sexual rights.
That's everything from sexual orientation
and gender identity all the
way to being able to have
a child if you want and the
right to that, which we don't
talk about enough, like
access to fertility treatment.
And then, the ability to not have
a child if you don't want to, right?
So all of these things, and
then there's a whole nother,
you know, conversation
about the right to pleasure.
And so there's a lot packed in there.
I think when we talk about
reproductive rights in the U.S.,
you're right, it often
goes to abortion rights,
A, because there's an
assumption that like we've done
everything else, so this
is the last frontier,
but that's also a false assumption.
Reproductive rights in the U.S. is also
about racial and economic equity.
It's about the fact that women of color
have a maternal mortality rate beyond,
like times and times and
times that of white women.
That trans people have lack
of access to reproductive
health care, and so, you
know, again, there's like
assumptions, right, about like
what's there, what's there.
In refugee camps, and
if we talk about a good
example of sort of the
impact of U.S. policy, we,
under this administration, defunded UNFPA,
which is the United
Nations Population Fund.
But in this, this is a great example,
refugee camp in Jordan
that the U.S. government
has funded for many years,
and there's actually
like little bassinets at this
camp that have like U.S. flag
on them that say from the
American people that had to be
like scratched off after
we stopped funding them.
They, with the help of U.S.
money and other multilateral
donors, had not one child
death in an entire year,
because of the access to
services in the most dire
of circumstances, right,
so then that's reproductive
health and the right to
not die in childbirth.
So anyway, there's a lot to unpack there,
but I think it's a
discussion that hopefully
we're having, that we're
expanding here in the U.S.,
that it's not just about abortion rights,
it definitely is about abortion rights.
And then about all the other things.
It's a great question and
one that I'm super passionate
about and that a lot of other
people are passionate about.
But from the global health perspective,
check out that Guttmacher definition,
because I think it's the one that
most people like really attached to.
- I think it also, that's
such a great understanding
of how sexual reproductive
health touches all of us,
even if it's not the thing that drives
us in our passion in global health.
It is so much a part of
the global health world.
So turning to our next student.
- [Maya] Hi, I'm Maya, I'm a junior in the
Nursing and Health Studies
schools, studying global health.
I'm very interested in
policy, so it was really
awesome to hear you talk about that.
Over the summer, I worked a little bit
on bringing, again, the global gag rule
to some congress people
and also some senators.
I met with the office of
Senator Kamala Harris.
And I was wondering if you've
seen any progress on that.
So I know that, like I
went, I talked to them,
it happened, but what is going on now?
What is the, What does it look like now?
- I'm happy to also have a
separate conversation about this.
The global gag rule, AKA
the Mexico City policy,
AKA the Protecting Life in
Global Health Assistance policy
is dramatically expanded
under this administration.
And that was something that I think a lot
of activists actually weren't expecting.
So that has been really
interesting, as well, right,
because the traditional, I'm
sure you'll learn about this.
(gentle speaking)
Mm-hmm.
- Might wanna do a--
- I'll do a quick primer.
- The 90 second--
- Yeah, the 90 second.
- I'm sorry to always interrupt.
- No, please.
- It's good, no, it's great, it's just
if you could the 90
second (gentle speaking).
Got it, yeah, got it.
Yeah, very quickly.
- We have lived this, and then--
- Eat, sleep, and breathe it.
(Maeve laughs)
Yeah, no, very quickly,
so the Mexico City policy
was established under the
Reagan administration.
The goal is to prevent, or
it prevents U.S. funding,
people who receive U.S.
funding from using their
own funds to do any
abortion services or to even
talk about this, so it's
gag, right, gag rule, okay?
So that's like kinda
the way to remember it.
And it is not statute, it
is what, something that
gets established by
presidential memorandum
or executive order,
right, so what happens is,
you know, Reagan put it in place,
and then Clinton rescinded
it, and then Bush put it
in place, and then Obama rescinded it.
And then, we just thought the same
old thing would happen, right, Trump.
And it literally happens on day one.
I mean, that's how big
P political this is.
Like you could do so
many things on day one,
on your first day of
office, and this is the
one that you choose to
sign the piece of paper.
You know, Obama with his left hand, right,
on day one, you know,
of his administration
undoing the Mexico City
policy, it was great.
And then, Trump, you know, day one, right,
with his, you know, so
his giant, marker, giant,
like this thing, right,
that's his signature.
But this administration
dramatically expanded it.
So traditionally, this
funding has only applied
to family planning and
reproductive health funding.
And to be clear, we say
only, but the U.S. has
historically been, and
actually still remains,
the leading bilateral donor in that space.
So like if you're going to a clinic like
in many of the countries
where the U.S. works,
it's very likely that U.S.
money helped fund that.
- [Maeve] It's family planning
and reproductive health
money out of our USAID,
so development agency.
- Exactly.
- [Maeve] Last 20 years of this.
- So bilateral meaning
just the U.S., right?
Whereas, multilateral meaning
putting a lot of countries'
money into a pot of a agency
like UNAIDS, right, or UNFPA.
And so, but this administration
decided to expand that
to all of global health
assistance, which includes PEPFAR.
So that is a huge,
multibillion dollar program.
And so that's the global gag
rule, AKA all the other things.
Right now, so we had some great early wins
when the democrats took
back over the house,
we, there was like a, it was in the middle
of a budget thing, and
Speaker Palosi put in repeal
of the global gag rule
in that budget document.
And I am, personally, of the mind that
budgets are moral documents,
and so even when a budget
doesn't get passed, it's
important from a policy
perspective to say what we care
about in those budgets and principled way,
which is just like the president's budget,
which will come out in two weeks.
It means nothing, president's
budget means nothing,
except that it's a moral
document, except that it's a,
you know, you put your money
where your mouth is, right?
And so therefore, if
you're putting out a budget
that says I want to remove
all funding for X, Y, Z,
morally, you are telling
us your principles,
you know, you're putting it all out there.
And so democrats have included repeal
of the global gag rule in all
of their budgets, which has been great.
We have a bill, there's a standalone bill
called the Global HER
Act, which you probably
talked about when you were on the Hill.
And I am not lobbying, I'm just saying
that this a thing that
exists, and it has like
90% of the democratic caucus on it.
Unfortunately, it's not bipartisan.
This used to be super
bipartisan, actually.
There were several republicans who,
even when the expansion first came out,
they were like, "Wait,
what, we thought you guys
"were just doing the family
planning and reproductive
"health money, really,
all of PEPFAR, too."
And there were several
republicans who quietly were like,
"Oh, oh, no, we're not okay with that."
Because global health
funding is very bipartisan.
We have had, or at least,
it used to be, tremendous
amount of, and not even
bipartisan but nonpartisan.
Like this is not something
that we talk about,
republicans and democrats,
this is just like what we do.
So right now, that bill
has not moved in that
it has not been marked up in committee,
which is the House
Foreign Affairs Committee,
but there's a lot of
pressure to make that happen
right now before the end of this congress.
Because what happens, you know,
congress has two sessions.
We're in the second
session, so next January,
when we start back, it
will be a new congress,
the hundred and 19th congress.
And then, you have to
reintroduce the bill,
and you have to get
more people to sign on,
and the process starts all over.
So there was some movement
in the senate side,
Senator Shaheen is a big fan of repealing
the global gag rule, but
it lost, despite having
bipartisan support from
Senators Collins and Murkowski.
So the answer is not so
much, but what's happening,
also, is behind the scenes
and it's why important,
you know, why folks like
advocates, researchers,
what they're doing is trying
to understand the impact.
And we had known for many years the impact
when it had to do with
just family planning
and reproductive health,
but we've had to, obviously,
dramatically expand
our scope of knowledge.
And for those of you who are
interested in kind of the
monitoring and evaluation
research side of global health,
that is, a lot of that
is happening right now.
Folks at amfAR, Foundation
for AIDS Research, Guttmacher,
various other research-oriented
folks are working hard
to understand and to
bring that information
to legislators and say, "Look,
you really are impacting,
"for example, PEPFAR that
enjoys broad bipartisan support,
"and maybe, you're not gonna reach your
"targets for HIV testing or treatment
"because the people who could be providing
"those services or may be most trusted
"in the community or best
positioned to provide
"those services can't get
the money or won't sign."
You know, so anyway, that's
another way to think about it.
The research is happening,
and so politically,
unfortunately, there's
not a lot of movement,
but more and more people are trying
to at least communicate what we're losing.
- Could you say just a
word about how funders
support organizations
that analyze the data
like you just described
to show the impact.
Because it's, the current administration,
for example, because they supported this,
this isn't a primary focus
of their own oversight.
So maybe you could,
'cause that's a critical
way in which funders and advocates work
together to bring
information to the policy.
- Yeah, that's a great
point, I'll be real brief,
'cause I know there's
someone else, no, no.
But we have, for example,
funded a lot of organizations
to do this research, to literally go
in country and do both quantitative
and qualitative research,
focus groups, you know, talk.
And people are fearful to talk,
by the way, that's the other thing.
People are scared that they'll, you know,
if they do receive U.S.
money, they're scared
that they'll lose it if
they talk to someone.
So it's also about, you know,
good research practices and,
you know, inform consent
and all this stuff,
and security of people's
information and things like that.
But the administration was,
technically, supposed to be
providing reviews of the
policy every six months.
They did that once, after
a year, and it was woefully
inadequate, partly because
it had only been six months.
I mean, they did it for six months,
but it wasn't released for
a year, so like we also
couldn't prove impact after
six months, it was so,
you know what I mean, it
hadn't been enough time.
And so they put out this
paper that was like,
"See, nothing's happening,"
and we were like,
"No, no, that's not," you know?
We were also as advocates,
and at the time,
I was on the Hill, so from
an oversight perspective
and from a member of congress
who was an appropriator,
which means that like she
writes the checks, right,
for PEPFAR, she was able to be like, "No."
In theory, members of congress,
from an oversight perspective,
should be able to be
like, "We're not gonna
"give you your money, unless
you clean up your act,"
or you know, in theory, that's what
should happen, doesn't usually happen.
Members of congress can now depend
on organizations that OSF
and others fund to say,
"Okay, well, if the government isn't gonna
"do the right research and monitoring
"and evaluation of how
this policy is impacting,
"then we will do it for
you, and then we will
"show you, we will hold the
government accountable."
You know, that is a core
valuable of OSF principles
and how we do our funding,
so it's a great point,
and it's been really
critical, like I said,
amFar has put out some really amazing data
on the impact of global
gag rule on PEPFAR funding.
And that has, I mean, including my boss,
she was like real mad,
you know, 'cause that's,
PEPFAR is her baby, so she was
like, "Oh, no," so (laughs).
- Incredible role of data for advocacy.
So if you're interested in
data, get more interested in it
to segregate it, put into
incredible data visualization
so that those of us who are
not data geeks can understand
what you're talking about.
- Like me.
- And then, use that in order
to achieve whatever the goal is.
- Pretty graphs, very important, yeah.
- But it's an extremely important,
especially as big, there is
more data and there's more--
- Mmh-hmm, yeah, for sure.
- [Rachel] Hi, I'm Rachel,
I'm a senior in the NHS,
also a global health
major, I was wondering
with the global push
towards UHC for everyone,
what are some of the
ways that aid-dependent
nations can provide adequate reproductive
health in the current Trump era?
- Oh, my God, that's such a
loaded question, it's great.
No, it's a great question,
so universal health
coverage is like a big deal right now.
I mean, there's been all of
these, you know, UN meetings.
And I think a lot folks,
bilateral donors aside
from the U.S., are grappling
with this right now.
For example, the global fund is a really
great place to think about this.
So the global fund for
AIDS, TB, and malaria,
multilateral, huge program,
everybody puts their
money in the pot, and the
great thing about it is
you don't get to earmark
where your money goes.
It just, you know, and then
the global fund board decides
where the money goes: AIDS,
TB, malaria, blah, blah, blah.
But increasingly, the discussions at a lot
of those board meetings have been,
this isn't specifically on
repro, but just generally
about how do we set countries
up to meet the need of UHC.
And that's where a lot
of people are going.
So you hear a lot of nations who say,
"Yes, we, of course, need
to continue to fund AIDS,
"TB, and malaria, because
these three programs are,
"or these three diseases are still
"highly burdensome in a lot of countries."
But how do we make the health systems fit
for a purpose where, to my
earlier point about siloing,
you know, you can't, it
doesn't, it's not sufficient
to sort of just give someone a bed net,
and then also not talk
to them about nutrition,
and you know, access to family planning,
and all of these other things,
because that's what people want,
that's what we're hearing,
right, is that people want
it efficiently, they want
it close to their community.
And that's what UHC is
about, too, about everyone
getting access to the care that they need,
including reproductive health care.
And also in a people-centered way.
Or at least, I think
that's what UHC is about.
I think UHC is also one of those things
where you could ask like
10 different people,
and they would give you
10 different answers.
But like the Germans, for
example, the Japanese,
a lot of those countries are starting
to think about their aid differently.
Do we do more health system strengthening?
At the global fund, they call it
Strengthening Systems
for Health, but whatever,
I don't know why that
needs to be so different.
But in the U.S., that
often is a dirty word.
You know, if you talk to
republicans, they're like,
"Yeah, we're gonna do health
system strengthening,"
and they're like, "(hums) That sounds
"(exhales heavily) hard, that sounds like
"we can't count all the
shots that you're giving.
"That sounds like we can't measure
"all the babies that have," you know.
And so from a U.S. political perspective,
our system, in turns of
how we write the checks,
the appropriations process, is not set up
to think about breaking down silos.
It's not, because for us, if
we think about accountability
for taxpayer money, we're like,
"The taxpayers want results.
"They wanna know how
many babies we've saved,
"and how many mommas we've saved,
"and how many pills, how many bed nets."
and so the hard part is shifting
the way that people think about health.
For me, as a human rights person, as well,
it's about the right to health,
and it's about the right,
which is a fundamental human right.
Some people don't think it
is, but how do you provide
services in a way that
that is the framing,
not like the lack of
disease, but the actual,
and we can get all theoretical about that.
But in terms of reproductive health care,
it's even more difficult, because
a lot of people would like
to say universal health care is all the
things except abortion, or all the things
except reproductive health care.
And it's like you don't
get to pick and choose.
It's not like a la carte
menu, the different
governments get to say,
"Well, we're providing UHC,
"except we don't provide
people with food aid,"
or, "We're doing UHC except we don't
have speed limits on our roads."
And so from a public health perspective,
it is hard and everyone
is grappling with it.
And advocates have a certain
sort of thing that they're
pushing on, and then
governments are struggling with,
"Well, do we turn the global fund
"into this UH mechanism for UHC?"
and then other people
say, "No, not necessarily,
"but if you continue to
only fund in silos, AIDS,
"TB and malaria, then we will
not accomplish our goals."
Because, for example, in
DRC, we now have women
who are getting HIV
tested, they test positive,
they're immediately on ARVs,
they are serosuppressed,
and they're dying of
cervical cancer, right,
because we don't have
cervical cancer treatment,
which can be actually very cheap.
But then, if you do screen positively
for cervical cancer, we don't
have access to services.
So that is the struggle
that people are bringing up,
and that's a perfect
example of kind of repro
where we need to strengthen systems.
I don't have an answer
for you, I'm just sort
of waxing poetic about why this is hard.
I don't know, maybe you
may have better insights.
- No, I think that, no,
the only insight is UHC is,
it's everything, and so it becomes unlike,
it becomes in some ways too aspirational.
That being said, when PEPFAR was created,
the president's emergency
plan for AIDS relief,
in many ways addressing
HIV, which was killing
10,000 people a day, was
aspirational and we did it.
And now, we're at a place
where it's a chronic disease.
And now, we have other challenges.
But currently now in 2020,
UHC is so aspirational
that it can mean whatever
it means to anyone.
And I do think that's a challenge,
because here in Washington D.C.,
we don't have universal health care.
We haven't achieved it
in our nation's capital.
How are we going to achieve it in--
- Yeah, yeah, I'm sorry, that just gives
you more questions probably,
but this is a great
question for you to have,
and I'm like really excited
that you're thinking
about it and tackling it,
because a lot of people are, so yeah.
- And we have time for a few more
questions from the rest, if anyone.
(gentle speaking)
- [Hannah] Hi, I'm
Hannah, I'm a neurobiology
major and SDM minor,
and I'm actually taking
a seminar through the Kennedy Institute
right now called current topics.
- Excuse me, at the
institute for bioethics?
- [Hannah] Yeah, I'm taking a seminar
on current topics in bioethics,
and something that we
were actually talking about
earlier today was the idea
of reproductive health and
reproductive rights and how,
in societies where there isn't
a history of having very open
reproductive rights in cases
where there is like moral
justified reason for switching
to a more open policy
on reproductive rights, they
may have a hard time doing so.
And sort of the idea that in those cases,
what obligation is there
to then sort of fill
that gap in providing support
for vulnerable mothers
who can't receive these
services through support
systems like post birth
and things like that.
So I was wondering what
experiences you have
or what roles you see, you
know, like international
governments or philanthropic
organizations playing
in the meantime while
we make this transition
towards more open
reproductive health rights.
What role you see them
playing and things like that.
- Yeah, I mean, and you're neurobiology?
That sounds terrifying
(gasps), oh, my God.
Okay, that's great, good for you.
I'm glad that other people do that
and not me, so thank you for doing that.
Yeah, that's really interesting,
I mean, especially that
you had that discussion like
the context of bioethics,
because for us as, you
know, if you think about it
from the human rights
perspective, we can sort of say,
you know, at the 30,000 foot
level, everyone has the right
to live life free of what
is it, blah, blah, blah,
and we include repro in that,
so right to health, right?
And so then, it's just there,
and then whether or not
governments as the arbiter or sort of like
the rights holders, how much
can they hold their government
accountable to achieve that
right and blah, blah, blah.
It's really interesting,
too, 'cause I come
from a very conservative
society that does not
believe in reproductive
rights as a concept or...
that people's bodily autonomy
is particularly important,
right, so either from an LGBT perspective
or from an abortion rights perspective.
And so that's happening
here in the U.S., right?
Let's be very clear, there
are tons of people who,
whether it's from a
philanthropic side or, you know,
like doctors who provide
services, you know,
across borders or things like that,
that's happening, and it
has always happened, right?
That people have always
sought clandestine services,
safe or not, and that could
be abortion, but it could also
be various other things, right,
contraceptives, you know.
And so the question is at what point,
I think for us as like especially as OSF,
our goal is to make
sure that civil society
is empowered to hold everyone accountable.
Like it's not up to
us, while we would like
governments to be more
liberalized on these issues,
it is not up to us to tell
governments what to do.
Although, we can, the point
is to have individual civil
society in that country to
sort of speak up and be like,
"No, but really, though, we
need access to these services."
But you're right, I think
the responsibility you can,
there's interesting debate to have there
about the responsibility of
folks to provide services
in the context at which
it is not available.
And I think a good example
of that is LGBT services for,
we call it, key populations
so LGBTI people, sex workers,
people who inject drugs
in the context of HIV.
So in many countries in
which even PEPFAR works,
but for example, the OSF works, as well,
governments are like, "We don't have a,
"we don't have an HIV
problem," or early in the
epidemic, "We don't have
an HIV problem," and now,
(gentle speaking)
"We don't have gays, they don't exist.
"I don't know what you're talking about.
"We didn't just arrest, don't look.
"We didn't just arrest 30 people
at a hotel room for having
"a birthday party and being
suspected of being gay."
You know, in Zambia, "We
didn't just sentence two men
"to 15 years in prison for
a consensual relationship.
"What are you talking about (chortles)."
It is the responsibility
of others to step in
and make sure that those
people have access to services,
and I don't think that reproductive
health is any different.
And then, at the same time,
making sure that those
populations that civil society
has the ability to organize,
to speak up, to hold their
governments accountable,
to ask for more, to ask their
governments to be better,
and to in many cases, too,
to sway their neighbors.
It's also not just about the governments,
but it's about changing
hearts and minds, too, right?
As we know here in the U.S.
that being so critical.
So it's a really interesting question.
I have no question about it in terms
of the responsibility
to provide the access
to those services, 'cause
I think it's a human right.
But many other people have
different views about what,
about the fact that it's not a right,
and therefore, you are not allowed to,
there's a sovereignty
question, for example,
that many folks would like to
argue, which I think is wrong.
It's a question of whether
what you value over
the sovereignty of a
government to make decisions
and then the point at
which the government is not
providing the services
that their people desire,
which is like a constant foreign
policy question, right, that people have.
To be clear, global health
funding has, you know,
in a bipartisan way,
members of congress have
pushed back on this administration's
desires to cut global health funding.
Like I told you when the president
puts out a budget, it
doesn't really matter.
And in this, the president over
the last couple of years has
put out a budget that really
guts global health funding.
I would say that in the past
no one would dare do that.
And so to be totally fair, we
have pushed back against that,
but there has not been additional funding,
like we're, we've been sort of stagnant.
I would also say that
I think that we've lost
bipartisan support for
global health funding,
because despite this policy being
extended to global health,
we didn't find people
stepping up and saying,
"No, you don't get to touch
"maternal child health
funding, you don't."
And I, personally, don't
think that one account is more
important than the other
or that we should trade,
but I kind of like would have
hoped that that would happen.
And I think that's reflective
of the time that there are
less and less moderates on
either side of, you know,
just moderate, like little M
moderate, in the political.
People have grown more
apart on the spectrum,
and nothing does that like abortion.
And so I think that is an
unfortunate consequence.
I'm hopeful that we can continue to sort
of support this funding
in a kind of broad way,
but it's just unfortunate because family
planning and reproductive health funding,
which, again, is just really critical.
This is kind of like basic
stuff we're talking about,
just like access to
contraceptives and access
to implants for women who are
in an abusive relationship
and can't have pills be found,
I mean, that kind of stuff.
That stuff has been,
continued to be under attack,
and that's the part that
used to be the most,
it used to be super duper
bipartisan, actually,
family planning and reproductive
health account from USAID.
And you know this, too,
and it has just become
so much more politicized
because of abortion.
And there's various other like policies
that I haven't even
mentioned that are under,
that are not just presidential
politics but are statute.
So things that are in both the PEPFAR law
and the Foreign Assistance
Act, and those create
additional problems and
restrictions for U.S. funding.
And by the way, I could talk
about this for like three
hours, because it's my like,
it was my academic studies
was on impact of U.S. policies
on reproductive health.
But I think that the
important thing here is that
the impact on the ground is
such that even if the policy
isn't in place, there's
this insane chilling effect.
I mean, there's so many
organizations that are scared,
and maybe like two things happen,
right, they'll either say,
"You know what, I'm just not gonna,"
like even if the policy
isn't in place, they'll say,
"You know what, I'm just not
gonna change my policies,
"'cause I don't know, I don't understand
"the U.S. political
system, I don't know what
"the next president is gonna do.
"So I'm just gonna err on the side of not
"saying things, or not referring people
"for services, or not
providing certain services."
So that's scary, and
then, or on the flip side,
we have people who are perfectly qualified
to provide services who
say, "You know what,
"we're not gonna, we're
not gonna deal with y'all.
"I'd rather work with
DFID, the UK aid program.
"Or I'd rather work with AusAID.
"I'd rather work with the Germans."
And the point is that they're all great,
but they just don't, they aren't playing
with the amount of money that we are.
And so I think the
international responsibility
to me, again, as stewards
of taxpayer money
should be that we use it in a way where it
gets to the most people in the most need.
But the flip side is
that this administration
and it's colleagues feel very sincerely
that what they are doing
is making sure that they
are being good stewards of
the U.S. taxpayer money.
And so that's the important
thing to understand, as well,
is that the goal for both
sides, really, is the same,
which is like, "We're
gonna make sure that U.S.
"taxpayer money is spended
in the best way possible."
Now, how you defend that,
how you describe that is what's different.
- I was thinking of one, this is one,
you know, historically, one of the most,
times we're most divided as a country.
So while we're talking
about global health,
there are also topics
outside of global health
that are traditionally
bipartisan that are not now.
- Exactly, Title X Family Planning.
- Even immigration.
- Yeah, immigration.
- And the other thing just
on being good stewards.
An investment in family
planning is one of the best ways
to use money, and so, which
is logical that those same
organizations that give
maybe access to reproductive
health services are also
giving the access to what the
comprehensive reproductive
health services for abortion.
So taking away those, and these are some,
these reports that I think will be really
interesting to review is
what is the financial,
not even the human impact of
it, but how are we, therefore,
investing in other less
cost-effective health
interventions in order
to achieve those goals.
And so that's really interesting.
- Yeah, if you're not sold
on the whole like health
and human rights thing,
like even just the money.
It's one dollar, every, for every one
dollar spent on family planning,
you get a seven dollar
return on investment.
So whether that's more,
you know, that could be
like increased productivity from mothers.
It could be increased
community investment.
I mean, there's all these other things
that are rolled into that seven dollars.
So from a money
standpoint, it makes sense.
So then, if that's, you
know, then what is it
that is preventing you from
seeing this as effective.
It's sorta a moral or an ideological one,
which makes it more
difficult for folks to have
a discussion, obviously,
because it's like a
closely held moral or ideological belief.
You can e-mail me, I need to go
home for bedtime with my baby,
(Maeve laughs)
but you can call me.
(gentle speaking)
- Asking if, you clearly love
advocacy both in government and outside.
I think one of the things
that, and you alluded to this
at the beginning is that
students look at do you focus,
partly it's what you
care about, it's like,
or what moves you, or the skills you have.
You're not a physician, I'm
not, none of us are, right?
But as you think about
your impact, your personal
impact through advocacy, what
are the things you focus on?
You know, the politics of
the U.S. can be complicated,
and victories can be
distant or hard to measure,
or victories can be the
bad thing you prevented,
as opposed to the good
thing that you advanced.
And I guess, maybe, before you leave us,
just a reflective for students who might
be thinking about that
as a, the advocacy space.
How do you get your energy to know
that those victories
are making a difference?
- Yeah, well, that can be hard,
especially in, to Maeve's point,
in these times when
there's just divisiveness,
and no matter what what you work on,
no matter what you're
interested in, or what family
you have around the
Thanksgiving table, right?
And so I think I get
energy from, I get energy
from the colleagues around me, frankly.
I mean, so much of what we
do is in coalition, it's not.
You know, I had seven Hill meetings today
that I did by myself, but
I'm expressing the message
of a coalition of civil
society organizations
that reflect and bring the
voices of people globally.
And I think that being
able to be also a part
of an organization that really centralizes
the voices of those who
don't generally have a voice
or can't just go walk into the
Rayburn House Office Building
and have a meeting, you know what I mean.
And so that is tremendously valuable.
I also just really enjoy
working with people,
and I'm a people person, as
you can tell I like to talk.
And so I enjoy human
interactions with people,
and to your point around
like those little things,
sometimes those little things are just
getting one person to sort of be like,
"You know what, yeah,
you're right," or, "Okay."
And even republican colleagues
who I was able to be like,
"You know what, how can we
get your boss to a place
"where he just doesn't
say something harmful.
"You know, maybe he's not
gonna vote with us, maybe,
"or he's not gonna sign on to our bill,
"or he's not gonna sign
that advocacy letter.
"But maybe we can get him
to not go down on the floor
"next time and talk, you
know, against something."
And it's little, it's
things like that where even
the do no harm is
important, and I get a lot
of satisfaction from using
those, and this goes back
to my original point,
those kind of interpersonal
relationships that you have with people.
And you know, this sounds really cheesy,
but at the end of the day, it is a lot
about hearts and minds, and right now,
being able to even just move
a couple people to a more like
empathetic, honest,
you know, compassionate
place is really satisfying where there's
a tremendous need for empathy,
for curiosity about other human beings,
rather than an assumption
of, you know, of something.
I know I'm getting a little
nebulous, but it's late.
That part is really exciting for me,
because I think that
we need more curiosity
and empathy in the world,
and so a lot of what I do is,
yeah, it's like super
political, it's big P political.
It's little P policy, but those
people who are doing those,
either on the Hill or
this administration, all,
everybody has things that they care about.
And it's like how do
you find those things,
and how do we meet each other.
I'm not saying I'm gonna
go sway a vehemently
like sort of anti-abortion person in this
administration to not
do what they're doing.
But it's like how can we at
least have a conversation.
And that's the part that I enjoy the most.
And it is not always
satisfying (laughs), you know,
but when it is, it's
like, feels really good.
- I love it, the how do we
have more empathy and be
more curious, I think that's
really (gentle speaking).
So everyone can thank
Kiefer Buckingham for coming
(applauding)
this evening.
