Loyalty, honesty, and integrity. What to prioritize when there’s a disconnect.

For most of my career, I’ve been in the business of “saving lives”. I’ve worked for humanitarian non-governmental organizations (NGOs), where children had to try to survive or flee wars, famines, or natural catastrophes. I’ve worked for international financial institutions (IFIs), which tried to raise funding to end preventable deaths of children and their mothers. I’ve worked for the government, trying to end a global pandemic that has to date led to 26 million excess deaths. I consider this “mission” I am part of purposeful, needed, and worthwhile of all the hours and effort I put in each day.

Loyalty

Starting each new job, I have signed confidentiality and non-disclosure contracts and conducted training to ensure I was aware that leaking any information could risk the lives of my colleagues, some working in the middle conflict areas. I was also trained and reminded to be mindful of what I posted on social media, as this could pose a reputational risk to the entire organization.

Having worked in organizations engaged in conflict zones, I have lost colleagues to kidnapping and attacks. I know these risks are very real.

Believe it or not, reading my blogs, I consider myself extremely loyal. I have never violated my contracts, leaked any confidential materials or information, or shared information between workplaces. (In other words, I’d still have lots and lots of beans to spill, if I’d chose to do so.)

Honesty

Strangely, when signing all these non-disclosure and confidentiality agreements, I was never asked to sign or train for “honesty”. If the President or CEO asked me if we were doing the best we could, my training and work culture implied I should nod and praise, and be thankful that I was allowed to work in these hallowed halls.

If I saw dishonest behavior, I should contact my manager, and in severe cases the ombudsperson or ethics commissioner (who as I quickly learned from other cases, made sure leadership was warned, and reputational damage control immediately kicked in: return back to loyalty, please.) More often, I was by managers explicitly ordered to stretch the truth to fundraise that bit more, or to ensure we looked successful to leadership and in the race for more funds (or manager promotions).

Integrity

As regular readers of this blog will know, I started struggling with this disconnect. Loyalty that was expected of me – not towards a mission or results – but rather to an organizational brand, reputation and current leadership. As I held higher roles and got a better overview of what we were actually doing, I began struggling with the (very strong, clear) pushback I received when I suggested we should be more honest and transparent.

I began having ethical concerns.

Money fundraised from individuals and pledged by governments on behalf of taxpayers was being sold in annual reports (accountability, with a small ‘a’) that were more like fictional novels than independent monitoring of reality.

Leadership and managers who were known to be toxic towards staff were kept on, promoted, and time and time again cleared in (confidential, silenced) ethics cases.

Utopia? Loyalty, honesty, AND integrity

Many organizations I have worked for have great people. Some have become lifelong friends of mine, and I would trust my own children in their care. Some of the organizations I have worked for really do great things. Often at a high price, but I’ll leave the question of overheads and process costs to others. Some managers and leaders I have worked for are the best of the best, and I have learned how to lead, manage, and try to stay human from them, and am forever grateful of how they treated me and other staff.

Yet, sadly, most workplaces with life-saving missions, big brands, and great recruitment carrots that I have seen are simply lost. They prize loyalty over everything, and have created structures and processes that protect leaders from hearing a single honest piece of information. They have established tokenistic ombuds’ offices and ethics committees that protect one place: the top of the organization and its existing leadership.

I’ll continue signing my confidentiality and non-disclosure contracts. I’ll continue being loyal, and to protect colleagues from any risk.

But I’ve also chosen to take a path of honesty. If you want me to write and sell blatant lies, please ask elsewhere. If you want me to at all times yay-say and praise all management and leadership, I’m not your candidate. Because I’m loyal to the mission I believe in, not to a PR branding exercise or someone’s leadership and legacy ambitions.

This stance may cost me many jobs, and definitely doesn’t make my career a bee-line to the top. But it’s a stance I’ve chosen until I find a place where loyalty, honesty, and integrity intersect, and we focus on the mission we claim we are in the business of.

Honesty and humility in global health

In this last article in a series unpacking my personal 2023 global health manifesto, I explore my fifth and final value: honesty and humility.

Cartoon: (c) Mark Anderson

Imagine…

“Many thanks for inviting me to take stock of the past two years of the pandemic response. Has our response been a success? I’d like to be honest: we have failed to equitably distribute vaccines, diagnostics, and medicines globally.”

“What went wrong in your opinion?”

“We designed a distribution model that assumed pharmaceutical companies would ramp up production massively and keep prices low, to cater for global demand. Our model also assumed that richer countries would pace their response, and prioritise health workers and vulnerable populations globally first.”

“So are you saying the model was based on incorrect assumptions?”

“Yes, that’s exactly what I’m saying. We should have adopted lessons from the AIDS-response, but we assumed Covid would be different. We were wrong. We have also learned that pharmaceutical companies in exceptional circumstances need to waive IP rights. We could have saved millions of lives, and shortened the peak period of the pandemic by months, if not a year.”

“Who is responsible for these failures?”

“We all are, and I in my leadership role also take full responsbility for my own decisions. Our board does too.”

“What has to change for us to prevent this from happening again, in your opinion?”

“Everything has to change. We have learned that our current model is not delivering in the face of global catastrophic crises, which we know will become more frequent, with climate change, increased conflict, and a more polarised world. We need to take a hard look at incentive structures, business models, and the role of government regulation and responsibility.”

“Are you personally willing to admit that you have made mistakes, in your leadership function?”

“We have all made mistakes, and yes, I too was blinded by a belief that my organisation, based on previous operations, could be able to deliver even when all facts were pointing in a different direction already early on in the pandemic. We should have changed course, but instead tried to sell a model and product that was clearly broken, with ever more buzzwords that seemed to make our donors and funding partners satisfied. I take full responsibility for our mistakes, and lives lost as a result.”

Who cares if we stretch the truth a little, and just a bit more?

In my personal global health manifesto, I wrote: “If we fail, we must admit failure, trigger a sunset clause, and learn our lessons to be better next time. Let‘s be honest enough not to continue to sell what we know doesn‘t deliver.” We’re clearly not yet anywhere close to this point. The scenario I imagined above could not be further from what we are seeing happen right now at this moment.

The consequence of stretching truths, or sometimes selling blatant lies is that “global health is not only failing, it is doing harm.” Real people suffer – real people die – just because some people have prioritized shiny egos over honest stocktaking and accountability.

What has to change?

To achieve real impact in global health, we need to:

1, 2, 3 and always) Be honest and speak truth to power. Ask uncomfortable questions, dig deeper when something feels wrong, speak out, and ensure wrongs are not repeated. Every single time. Silent bystanders are complicit to wrong-doing, perpetuating injustices, and maintaining a global health sector that is broken and does not deliver what it needs to – and could.

***

Many thanks to everyone who has followed this series of blogs, and for providing insights, feedback, and ideas! Are we ready for transformational change, and are we ourselves willing to change? I am not sure. Will I stay in this sector? I am not sure.

Leadership Communication – when rhetoric does not match reality

Leaders often say things in public that do not reflect reality. This is a real problem when they stop caring and do this knowingly.

I Photo: ITV

I once had a boss who pulled me aside during one of our work trips. “We have a problem,” she said to me, “our programs are not working. They are not doing what we are saying.”

Most of the briefings and talking points we had received to do our public communication were wishful thinking for the future. They had in a complex editing process (with very many cooks in the kitchen/organisation) been stretched in many directions.

A simple fix would have been to change our talking points and communication. I (very naively) suggested this. I was immediately vetoed, as this wouldn’t work for fundraising. And this was not the image and legacy my boss wanted to have and leave: heading programs working on the margins, not the silver bullet transformation that changes the world.

Another more complex solution would have been to reform our programs. But our claims were so extraordinarily ambitious.

So we all lived with this knowledge (some of us for a shorter time, some longer): we were not doing what we were saying.

What leaders communicate, and why

The above anecdote will resonate with many people, working in government, private sector, multilateral organisations, and NGOs.

In government and politics, it’s common to criticise “lying politicians” who stretch truths (especially before elections) to gain or stay in power.

In the private sector, it’s known that there is always some fine print (often in hidden annexes and contracts) that fully contradicts grand promises.

In many multilaterals and NGOs, fundraising often drives public communication, not the reality of programs.

There are of course leaders who are simply ignorant of the fact that what has been drafted for them isn’t true. Middle managers and staff who are fearful to speak out keep toeing the line. Some who try may be reprimanded that they do not see “the full picture”, and it may indeed be the case that their specific part needs some edits, but that’s because of their own poor performance.

Other leaders knowingly stretch the truth (or leave out critically important information), because their boards expect them to do this. Leaders’ KPIs (and triggers whether they get to keep their leadership positions) are often based on growth, profits, and visibility – not on creating change. The latter is a problem left to programming and implementation.

Some leaders may grapple with this tension personally, but put up a stoic face to justify their claims in public. A grave problem arises when leaders stop caring. As long as the limelight is there, their legacy is a step to another leadership position, or keeps them in power, all means are justified for these ends.

Reality – whose reality?

Some leaders suffer from a reality disconnect. They work in large organisations and hierarchies, and reality is buffered through so many middle managers. They may be receiving fully contradictory or incomplete information. And you just need one weak link, just as in the game “telephone”, where one wrong or knowingly distorted whisper results in wrong messaging.

Some leaders also prefer spending their time and energy engaging with other leaders. They spend so much time planning what they would like to say compared to others that they don’t have time or capacity to listen or digest what their organisations are actually doing or can do.

Other leaders believe that what they say will become reality. It’s just the reality in the future, which others much figure out how to implement.

And finally, information on “reality” may simply not be available to leaders or entire organisations. Data may not be available, or may only become evident later, or may not be accessible or of sufficiently reliable quality. Without data (quantitative or qualitative), leaders and entire organisations may be (for some conveniently) flying blind.

Values and integrity

Ultimately, leadership communication comes down to values and integrity.

Does a leader know what they are trying to change, and are they honest about where things stand in reality right now?

When something does not work, is a leader willing to take the ultimate responsibility (and be willing to step down)?

Are leaders willing to be transparent about all information? Or do they cut and try to hide what is less shiny in the fine print. Do they correct media which distorts or gets information wrong?

And are leaders and organisations open to honest communication from staff and middle managers, including whistleblowing where needed?

The case of G7 and Covid19 vaccines

Right now, G7 leaders are meeting in the UK. We’re seeing a live example of rhetoric not matching reality.

UK’s Prime Minister Boris Johnson is issuing statement after statement about “landmark global leadership” of the UK, while simultaneously pushing the largest ODA cuts in recent UK history.

And nearly all G7 members are making grand pledges to donate funds (and some, vaccine doses) to the global multilateral vaccine mechanism for Covid19, Covax. Most adding qualifier clauses (“when domestic situations permit”), or dropping timelines (perhaps one day, in 2040?). Even when timelines are mentioned, the “domestic situation” qualifier clause is included (such as the recent US pledge of 500 million doses to Covax).

In these cases, G7 leaders are very knowingly trying to mislead citizens, media, and also multilateral and civil society organisations.

Sometimes, neither side cares. Applause for donors, success stories for multilateral fundraising? Tick.

This is a prime example of a moral failure. It will cost lives. Is that really the price of limelight, some initial media and civil society applause, and power?

If the answer is yes, is this the leadership you want?