Accelerating progress – or decelerating regress? 2023 can not just be a year to call for doing “more, faster, better”

I’d love to be an impatient optimist who believes in linear progress. But I’m not. In 2023, it’s time to wake up and stop stating that “more, faster, better” will be the solution to the dire challenges our world faces.

The only way isn’t up

In the middle of the 20th century, the second World War had shown a barbaric side to humankind. In 1947, a seminal book, The Dialectic of Enlightenment, was published to explain how, after constant progress expected following enlightenment (the age of reason and science), a track of regress had occurred in parallel – and had made the holocaust possible.

I read this book in my early 20s, and was at the time also hugely influenced by the work of Nietzsche, who also explores the concept of dialectic (good and evil, progress and regress, etc., coexisting).

In the 21st century, my generation and that of my parents, who never experienced World War II, has been influenced by a narrative of linear progress, the same way as enlightenment influenced people centuries before. We experienced the fall of the iron curtain and Berlin wall, and Fukuyama’s book End of History gave us hope that everything would only get more peaceful and prosperous.

Then 9/11 happened. And wars in Syria, Yemen, Ukraine, and many more. Climate disasters began occurring more frequently. Famines. Refugee crises. Mass shootings. A rapid widening of inequality.

Yet especially in the sector I work in (global health), the impatient optimist narrative continued. We should focus on long-term progress, and take a look at the state of the world as if we’d be looking at long-term bonds, and not short-term share prices. Ignore the fluctuation. Ignore the crises. Focus on the silver-bullet products that will save the day. If we invest more, produce and create markets faster, if we innovate even better, the line of progress will continue to rise.

Yet that line of regress, running in parallel – with inequities, restrictions in civic space, abolishment of women’s rights and bodily autonomy, climate change, conflicts – has become increasingly evident to many people. They’re no longer buying the narrative of linear progress, because it never reaches them, or if it does, it is overshadowed by multiple crises. In global health, by the Covid-19 pandemic the latest, millions of people realised that the model we’ve set up has never been designed to serve all people. It has been designed to create markets for products. And products require profits.

Accelerate!

I’d love to accelerate progress, so that progress reaches every human being on the planet. I’d love to continue raising billions of dollars, and to continue advocating that products and services that I personally have access to – vaccines, doctors, midwives, any medicine or medical equipment I will ever need – would be accessible to every person on this planet. If I only look at the data and lines of progress that are being presented to me on many platforms and portals, I could still sing with the chorus of “more, better, faster”.

But I see the lines of regress, and I am unable to see them. I see the rising inequality, and I know for a fact that there is increased conflict around me. I see what is happening to women’s rights and LGBQTI+ and especially transgender rights. I have for three years during the pandemic, together with many others, looked at the inequality in access to vaccines, tests and medicines – and felt embarrassed, depressed, disgusted.

Yet every global health press release I read, every annual report I see, calls for acceleration. And I have to use this term too in my work, because this is what is expected, mid-point to the 2030 SDG goals.

Wake up! And don’t forget to decelerate regress!

As with the enlightenment, global health is a technocratic world that believes in medicalised science. The calls to consider and take into account a socio-political context in which science and medicine operate in – some would say are integrally intwined in – have been ignored for many decades.

“But science is always right.” “We can innovate and leap-frog to overcome challenges.” “Market-shape-market-create-product-innovate.” The rest is not our work. It’s not our problem? It doesn’t affect the impact we’re trying achieve?!? Wake up!

There are many people, and many great advocacy movements, who are focused on decelerating regress. It’s a tough battle, because it’s inherently political, it’s a battle against those who have power and money, and it’s a battle against the status quo (on climate and energy policy, on production and consumption, on patriarchy). Some of these people and movements are trying to shape what we do in global health, and how we do things, e.g. focusing on addressing inequality and its drivers, rather than just focusing on a single disease and innovating new vaccines. But they are the exception rather than the norm, and the funding is nearly all elsewhere (with the technocrats).

It’s time for global health to break out of its technocratic bubble, and stop believing the impatient optimist narrative.

Just speak to young people – as I do with my three teen kids – about the world they see around them. They are growing up in this world where regress is more than evident than ever. It directly affects their current lives, that of their friends and peers, and their future. If I tell them my solution and contribution is to do “more, better, faster”, they will ask me in frustration whether I’m kidding, whether I don’t see what’s happening around us, to them, to millions of people, and to the planet.

2023, at crossroads

For those of us who still believe in the value of achieving the SDG targets (things like having a healthy planet, and healthy people), 2023 is indeed literally a mid-point to 2030. The calls to accelerate action, and to do “more, faster, better” are growing louder with each day that we get closer to September’s UN General Assembly, and SDG Summit, where heads of state will take stock of (lack of) progress, and recommit to doing better and more (of the same).

I’m not saying that I don’t value science, evidence, or innovation. Scientific discoveries such as vaccines have saved millions of lives, and continue to do so. Evidence drives decisions I make for myself and for my children.

But there’s more out there, and there’s more affecting our lives and health. Women’s rights. Gender rights. Civic space. Inequality. A sick economic system that places profits above people. We can’t ignore these issues, if we seriously try to claim all lives matter. Because all lives should matter now too, not just in the long-term legacy run. And these issues require highly political approaches and solutions.

As after World War II, it’s time to wake up to the fact that we live in a world and time where progress is not just linear. Stop telling me to celebrate our model because maternal mortality has decreased globally since 1990, when it’s shockingly unequal and rising even in countries such as the US and UK due to racism and inequality as well as health systems that have been reformed to focus on profitability and private financing.

Let’s not simplify or blatantly oversell just one part of a model, when we know that reality is complex and not a pretty upward arrow. We may not be able to fundraise as easily, and we can’t constantly post on LinkedIn how proud we are to be part of this life-saving legacy model, but at least we are looking at facts, being honest, and can address the real drivers of life-and-death and health.

Career growth or stifling?

Many organisations fail to support personal growth when you progress in your career. Instead, the path gets narrower until it becomes stifling. Something has to change.

As you progress in your career, your teams, budgets and responsibilities grow. You can make more decisions, have more access to different leaders and networks, can decide how you get work done and when, and can shape an organisational culture, and reap all benefits of personal growth.

Except that in many organisations, you can’t.

The reality is often that you end up spending most of your time and energy stuck in between various leadership battles, dealing with bosses and staff who all want to claim they hold budget lines and manage all staff themselves. You’re slapped on the fingers for trying to make changes, and shown your place when you thought you were entitled to make decisions, no matter how small.

You’re sometimes stuck in the void of middle management meaninglessness, and left only with the hope that if you make it even higher, you’ll finally get to make those decisions, have more freedoms, be able to shape the culture….

The triangle narrows at the top

Everyone knows that competition at the top levels is fierce. The air gets thinner, and there are simply not that many leadership jobs out there, for a large pool of people who’d like to have them.

But there’s very little out there that prepares you for what these leadership steps mean in practice. The triangle gets thinner in other ways too. You don’t have time and are no longer allowed to “do work”, because you become responsible for managing people who do this work. You then become responsible for the managers.

And at all levels, everyone wants to do things, wants to gain more responsibility, and wants to shape things. What’s left for you to do?

Too many leaders slip into excessive micro-management at this point. They crave to do what they did when they produced concrete outputs. They want to be part of the team. They want to discuss and decide budget details, statements, and visuals. They de facto want to be part of the bottom of the pyramid again, with the exception that they get ten-fold the pay, and can use the “boss card” whenever it suits them.

Why leaders need to be supported in seeing their progress in an inverse triangle

The image below on the left exemplifies this pull to revert back to what other people in a team should be doing. In such a situation, it quickly becomes clear that no-one is leading, and everyone is battling to do the “doing”.

Leadership as a craving to do the things others in your team should be doing – or leadership as progress and growth?

The image on the right side is what should be happening. As your career progresses, your opportunities grow, and you progress, both in your responsibilities but also your personal growth. You allow those staff members who are expected to do things – well – to do those things, and don’t micro-manage. You lead and clear the way for people to get their jobs done well, and in a healthy working environment.

What needs to change

Careers that include not only more pay and fancier titles, but also growth, require a number of things.

Most importantly, the right people need to progress and take on leadership roles. If a manager or leader is only interested in nitty-gritty issues or doing all of the actual work, they shouldn’t be managing teams or leading organisations. Someone needs to manage and lead teams, and if a manager or leader is too busy in their comfort zone (left triangle), the result is usually competition and chaos.

Equally importantly, there needs to be clear division of responsibilities. Who prepares plans and decisions, who gives feedback on these, who makes a final decision? What issues get taken to the next hierarchy level, and what is only tackled at a higher hierarchy level? The larger the team and organisation, the less can keep going up and to the top, simply because that route will otherwise become a disastrous bottle neck.

Third, organisations need to allow space for their leaders to lead. Too many organisations keep rotating leadership levels as if managers and leaders were just cogs in a machine, all doing the same things, the same way. They stifle any freedom to suggest changes or improvements, or to do things in a different way. They are hugely risk averse, and treat managers and leaders as if they were work horses, not creative, intelligent, experienced people.

Final thoughts

Some leaders are not interested in growth, increasing their responsibility, or shaping organisational cultures. Some are there simply for higher pay, status, and ego.

But for everyone who is interested in a broader definition of career progress, give some thought to the above. Where have the above challenges been the norm, and felt disappointing and stifling as you have progressed in your career, or seen others progress? Where has a step upwards actually felt like progress, not like a disappointment?

There are, of course, also great organisations and leaders who know how to nurture careers and personal growth. They’ve understood that they need both the right people in management and at the top, and have understood that these people need more space. They work with an inverse triangle as their framework, and others should too.

Things to do, things to park

One of the things I do during my transition period is to keep “idea lists“. Now that I have a lot of mental space, I get lots of inputs and inspiration from books, articles, TED talks, podcasts, social media, friends and colleagues – and most importantly when my mind just wanders.

I guess there are many people who don’t deal well with periods when they don’t work regularly. We’re trained and socialised to attend classes or meetings, meet deadlines or targets, and just be present. A transition period suddenly opens up a million possibilities and options, and instead of going from one position to a promotion, or one job directly into the next, the number of paths that are out there can feel quite daunting.

What if I try to take the wrong path? What if I get rejected or fail? What if none of the paths work out? What if I just end up going in circles? What if I don’t have the courage or energy to try? What will other people say? What if I don’t have the skills or experience needed? I can imagine that these questions and all the insecurity can be paralysing. I experience this too on some days, but have learned to be more patient. Tomorrow is a new day, and I’ll just try again.

I definitely share the challenge of having many ideas. But as I’m no longer 25, I feel like certain options are not worth pursuing anymore. Or I have already tried and tested some of these, and know that although they feel intriguing, they are not exactly for me (e.g. starting a PhD, writing a novel, starting out in a completely different field). I keep telling friends and colleagues who worriedly ask whether I’ve already found my next job that I feel like I am in an absolutely luxurious position – and age – to be incredibly picky. This may change a few months down the road, but right now, I’m enjoying this freedom of choice and reflection.

What helps me organise some of the ideas and options is to keep “idea lists”. I just jot down in a journal, on a piece of paper, or in an email or file for myself whatever it is that comes to mind. And then I park it. It’s a bit like a very long period of brainstorming, where I keep track of all possibilities, but also write them down so that they don’t keep circulating in my head.

I have in parallel also been spending a lot of time thinking about values, priorities and impact. These lists can also become endless and overwhelming, so I’ve also spent a lot of time talking to people who know me well, to get their feedback on what they have seen really counts for me.

During these past months, I have also tested a few possible paths. I have sometimes been invited to discuss work opportunities, and have for some few positions that felt really suitable submitted an application. Some paths have not felt right for what I want to do right now, others haven’t worked out. And I’ve kept exploring other paths during the process.

One thing that I always try to take time for is to give feedback or support to people who ask for advice. This is the one thing I don’t park.

I may not be taking huge strides in doing things. Covid19 and the shutdown period with four children at home has definitely slowed down my process and timelines. But I still feel like I am getting important things done, and starting on a few initiatives that feel right.

For one, I’ve tried to support people who ask for advice, but also initiatives I care about deeply. One of these is Women in Global Health, a network and advocacy organisation that aims to further gender equality and ensure more women lead in global health.

Second, I’ve put an initiative I founded six years ago back online. KarriereFamilie is an initiative that aims to make having a career and children more compatible and easier in Germany. I’ve been engaging in this area for a long time, but the Covid19 crisis’ impacts on working mothers in particular triggered me to bring this initiative back into the public space.

Third, as anyone who has been following my blog knows, I’ve kept up regular blogging, hopping from reflections I have on global health to writing about my personal transition journey, and associated thoughts about our ways of working and managing, and work-life balance. Some of this discussion happens on Twitter or LinkedIn, but I’ve rediscovered my love for writing through this blog, and it helps me organise my thoughts, and also push me out of my (reactive, passive, private) comfort zone. I also hope that my journey and sharing this helps a few people along the way, or at least triggers food for thought.

Finally, I’ve over the past weeks been chewing on an idea I had that felt needed and right. We’ll see what comes out of it. It may end up on my to do list, it may get parked. Most importantly, I’m not stuck.