Talks and Lectures

World Patient Safety Day: Health Worker Safety in a Time of Pandemics

September 17, 2020

I had the privilege to host a UGHE webinar to mark the occasion of WHO’s World Patient Safety Day. Joined by a great panel of experts, we discussed how healthcare worker safety is integral to patient safety, and identified and assessed both the challenges in protecting the physical safety and mental health of health care workers in the current pandemic, as well as their access to needed resources (including PPE and psychological counselling). Panelists included Dr. Edward Talbott Kelley, PhD, Director, Department of Integrated Health Services, World Health Organization; Dr. Raji Tajudeen MD, MPH, FWACP, Head of Public Health Institutes & Research, Africa CDC; Dr. Fauzia Akhter Huda, Project Coordinator, icddr,b; and Dr. Giuseppe Raviola, MD, MPH, Director, Program in Global Mental Health & Social Medicine, Harvard Medical School.

Watch full video here:

COVID-19: The Impact in Africa

September 16, 2020

I was honored to join Belinda Archibong, assistant professor of economics at Barnard College, Columbia University and Albert G. Zeufack, the World Bank’s chief economist for Africa for a discussion on the impact of COVID-19 in Africa hosted by Stanford’s King Center for Development.

Watch full video here:

NCDI Poverty launch

September 15, 2020

As part of the global NCDI Poverty launch, I moderated a penal discussion on NCDIs and Poverty: How Do We Change Business as Usual? The speakers inlcuded Sania Nishtar, Special Assistant on Poverty Alleviation and Social Safety, Pakistan;Matshidiso Moeti, Regional Director, WHO AFRO; andLea Kilenga, Executive Director of the Africa Sickle Cell Organization. This was a very interesting, conversation through which we deeply explored solutions to finance, advocacy, and the strengthening of the capacity of health systems.

Watch full video here:

RIGHT TO HEALTH ACTION: “Country- & Community-Led Responses: Creating Sustainable Solutions to a Global Pandemic”

August 29, 2020

The current COVID-19 pandemic has disrupted families, communities, and countries around the world. Joined by great leaders, I had the privilege of participating in RIGHT TO HEALTH ACTION’s panel discussion on creating sustainable solutions to a global pandemic like COVID-19. I was joined by Chris Collins, President and CEO at Friends of the Global Fight Against AIDS, Tuberculosis and Malaria; Kumba Tekuyama, Community-based Program Manager, Partners In Health Sierra Leone; and Dr. Bailor Barrie, Strategic Advisor to the Executive Director, Partners In Health Sierra Leone. We know that we will face more pandemics in the future, and it is our duty to prepare for it. 

Watch the full video here:

Rush University: Presidential Lecture Series

August 3, 2020

I had the opportunity to virtually speak at Rush University’s Presidential Lectures Series to discuss the “Moral Imperative to Build an Equity-based Health Sector Prepared to Respond to Health Threats.” I spoke about Rwanda’s response to COVID-19 and the importance of evidence-based decisions to keep the country’s COVID-19 spread under control. In the fight against COVID-19, accountability is key. This helps fight corruption and improves human development, with a focus on the most vulnerable. I also reminded the audience that Trust is a social determinant of health. In order to protect communities against COVID-19, people must understand that you are trying to protect them.

Watch the full video here:

Implementation Science-Why It’s Needed Now, More than Ever

July 21, 2020

I had the opportunity to join the University of Global Health Equity’s panel to discuss the significant role of implementation science during COVID-19 and future outbreaks. On the panel, I was joined by Dr. Lisa Hirschhorn, Professor of Medical Social Sciences & Psychiatry and Behavioral Sciences, Northwestern University; Dr. Quinhas Fernandes, Ministry of Health, Mozambique (Senior Public health staff), Implementation sciences program (Dep. Global Health), University of Washington; and Prof. Kenneth Sherr, Professor, Global Health, Adjunct Professor, Epidemiology, Adjunct Professor, Industrial and Systems Engineering. I shared about the need to increase the capacity to do research using implementation science. We always do not need to invest in new tools, we just need to use and maximize what we have and we will save millions of lives.

Watch the full video here:

Devex: On the Frontlines: A Conversation With Global Health Leaders

July 21, 2020

In the era of COVID-19, health workers are experiencing different challenges while on the front line of the fight against the pandemic. I was invited to join Devex in a timely panel discussion focused on amplifying calls for increased investment in capacity building for the healthcare workforce. On the panel, I was joined by Dr. Emanuele Capobianco, Director of Health and Care, IFRC; and Dr. Mickey Chopra, Lead Health Specialist, World Bank Group.

Watch full video here:

Evidence and Policy: What does follow the science really mean?

July 6, 2020

I had the honor to participate in a panel discussion hosted by the University of Aberdeen. The event was a discussion that explored the meaning of the mantra ‘follow the science’ in public policy responding to Covid-19, and looked at evidence-based policy making from the global south and north, as well as the role Universities have to support new ways to be inclusive, values-based evidence and accountability in public policy. The discussion was moderated by Professor George Boyne, Principal and Vice-Chancellor of the University of Aberdeen and panelists as a discussion between myself, Dr Lucia D’Ambruosom, Professor Paul Cairney an internationally renowned political scientist at Stirling University.

Watch full video here:

WOW Global 24: Snapshots of Health and Hope

June 27, 2020

I had the honor to take part in the WOW: Women of the World Festival. The WOW Foundation is a charity that believes a gender equal world is desirable, possible and urgently required. The discussion focused on understanding what women’s sexual, physical, and mental health looks like right now. On the panel, I was joined by the chair,  Jude Kelly, Founder and Director of The WOW Foundation (UK); Collie Mashaba, District Coordinator, (Mpumalanga, South Africa); Dr. Yasmeen Qazi, Family Planning & Reproductive Health Expert (Pakistan); Sonia Adesara, Medical Doctor (London, UK); and Madara Hettiarachchi, Director of Programmes and Accountability Disasters Emergency Committee (UK). As women at the forefront of global health responses, we looked at how the pandemic is affecting women, how we can protect women and girls, and what models can be used to get it right.

Watch full video here:

Leadership Lessons From Ebola to Fight COVID-19

June 3, 2020

On June 3rd, 2020, I had the opportunity to join Dr. Raj Panjabi, Co-Founder and CEO of Last Mile Health for a conversation hosted by the Aspen Global Innovators Group in which we shared our expertise on how African leaders can use lessons from Ebola to combat COVID-19. COVID-19 is a global crisis that needs everyone’s support, action, and intervention.

Watch the full conversation here:

CWL/CARE Virtual Health Forum

May 15, 2020

I was honored to take part in the CWL/CARE Virtual Health Forum, Connected Women Leaders, an initiative of the Rockefeller Foundation, which aims to connect women leaders across all sectors of life and work to activate networks in communities, and offer up ideas and solutions to address the world’s most urgent challenges. The lively discussion focused on COVID health care systems, and I offered my thoughts on Rwanda’s early preparation and capacity for emergency response, through national participation, information sharing, and a multisectoral approach. This important debate was moderated by Pat Mitchell, Co-Founder of Connected Women Leaders and Michelle Nunn, President & CEO of Care, and on the panel I was joined by Dr. Nana Twum Danso, Managing Director of Programs for Health at the Rockefeller Foundation, Prof Heidi J. Larson, Director of the Vaccine Confidence Project at London School of Hygiene and Tropical Medicine, and Ilhas Altinci, Sexual and Reproductive Health Advisor at Care, Turkey, Beth Cameron, Vice President, Global Biological Policy & Programs of the Nuclear Threat Initiative, and to close the session, Gayle E. Smith, resident & CEO of The One Campaign.

Read the transcript of my comments here:

Watch the full video here:

COVID-19 and the world’s vulnerable communities

April 30, 2020

I had the privilege to be invited to join McGill’s School of Population and Global Health in a timely panel discussion focused on how the most vulnerable in our global community have been and continue to be disproportionately affected by the COVID 19 pandemic. On the panel, I was joined by Dr. Ariel Pablos-Méndez, Professor of Medicine at Columbia University Medical Center; Patricio V. Marquez, former Lead Public Health Specialist, World Bank Group; Dr. Raj Panjabi, CEO of Last Mile Health; Dr. Joanne Liu, Associate Professor of Medicine at the University of Montreal and hosted by Dr. Timothy Evans, Inaugural Director and Associate Dean of the School of Population and Global Health, Faculty of Medicine, McGill, and Derek Cassoff, Managing Director, Communications, McGill Advancement. I spoke about the myth of “COVID 19 being a great equalizer” and about how the world needs to come together to support those among us who are most vulnerable.

Watch the full video here:

Per Fugelli Annual Lecture

December 12, 2019

Image credit: Unni Gopinathan

I was honored to be the speaker at the 2019 Per Fugelli memorial lecture where I spoke about the journey of rebuilding the Rwandan health system in the wake of the 1994 genocide against the Tutsi. The principle of equity in health and dignity of the vulnerable is what lies at the center of Rwanda’s recovery based on solidarity and something that Dr. Fugelli spent his life fighting for. It was great to share Rwanda’s progress so far and reflect on how far we still have to go. The lecture was attended by members of the Rwandan diaspora in Norway, The Vice Dean and the student of Oslo University, and the family of the late Dr Fugelli.

Read more about the Per Fugelli lecture series here:

Commonwealth Road Safety Initiative

December 9-10, 2019

Image credit: David Ward

It was my pleasure to speak at the reconvening of the Commonwealth Road Safety Initiative hosted by the UK Department of Transport.  As Co-Chair of the initiative, I gave a presentation titled “Putting Road Safety on the Commonwealth Agenda: A perspective from Africa”. I spoke about the emerging burden of road safety related deaths, especially in Africa, the example of some Rwandan campaigns to address these problems, and the way forward globally, with strong leadership, policies, a multisectoral approach to improve road safety. I look forward to continuing this conversation in future Commonwealth meetings, including CHOGM in June 2020 because road accidents remain the first killer of healthy young people under 30 around the world.

Read more about the Commonwealth Road Safety Initiative here:

TEDWomen 2019

December 4, 2019

Image credit: The Female Quotient

I had a lot of fun to being at the most recent TED Women event in Palm Springs, California where I joined impressive women leaders from around the world. My talk was about the strength I saw in Rwandan women prioritizing Rwanda’s recovery, development and forgiveness, and the significant impacts that occur worldwide when women are in leadership positions. I explained why we need more women in leadership roles, and that we need strong, educated African women to come back to Africa with their unique strength and contribute Africa’s development. 

Read more about TED Women 2019 here:

Watch the full TED talk here:

Tore Godal Honorary Lecture

November 23, 2019

Image credit: Seth Berkley

I was honored to join my dear friend, Tore Godal, as he received the prestigious King’s Medal of Merit for his many decades of work in global health. The agenda of the ceremony consisted of lectures and panel discussions from global health actors on how far we have come and what the future of global health needs to look like. I had the privilege of presenting the keynote speech discussing what we should prioritize as we work towards achieving the SDGs emphasizing the need for smarter investment in building resilient health systems that can withstand future health threats.

Read more about Tore Godal’s career here:

Hamwe Festival

November 8-13, 2019

Hamwe Festival Opening Night

From November 8th to November 13th, Artists, Creators and Global Health Leaders from across the world participated in the first edition of the annual Hamwe Festival, created by UGHE to celebrate the collaboration between the health sector and the creative industries. These two fields can and have historically worked together to bolster the global health agenda.

She Matters Concert

The festival’s flagship artistic event was the She Matters Concert. “First conceptualized by Globe-athon, a movement dedicated to building connections with leaders on every continent to help women talk about below the belt cancers, the ‘She matters’ concert was held at Camp Kigali and hosted by the University of Global Health Equity (UGHE). The Rwandan singer, actress, and supporter of domestic violence victims, Nirere Shanel, performed ahead of the evening’s headliner; Grammy award-winning Malian singer, Oumou Sangare, a legendary artist using her platform to advocate for women’s rights. The first edition of Hamwe Festival was attended by the Minister of Health, Dr. Diane Gashumba, Peter H. Vrooman, US envoy to Rwanda, Princess Dina Mired of Jordan, and the Vice Chancellor of UGHE, Agnes Binagwaho.”

Hamwe Masterclass

In addition to celebrating the role that arts have historically played in the health of people, the Hamwe Festival hosted a Masterclass on Arts and Global Health. The objective was to give participants an opportunity to learn from people working within this nexus about how they use their preferred medium of artistic expression to improve the health of people all over the world whether it be film for advocacy or theater for healing trauma. I opened the masterclass with an introductory lecture on the principles of global health equity. Some topics that were covered during the two-day master class included what it takes to design and evaluate arts in health programs, fund mobilization, and what it means to use arts as therapeutic tools. We hope that this cohort and the future cohorts will keep growing the network of artists and health workers committed to working together to improve health and access to health care for all across the world.

Read more about the Hamwe Festival here:

Women Leaders in Global Health Conference 2019

November 9-10, 2019

It was an honor for UGHE to host the Women Leaders In Global Health conference for 2019 in Kigali. WLGH 2019 brought together more than 1000 participants from the global health community, with the majority coming from the developing world. All continents were represented and contributed to conversations about changing the face of global health leadership and creating enabling environments for women to thrive in health work. Some themes that were brought up included leveraging innovation to accelerate gender equity in health, the role of men in the fight for gender equity, and the need for continued meaningful collaboration and disruption of the status quo. I was honored to deliver a message of a bright future as I introduced the brand-new Center for Gender Equity at UGHE. The goal of this new center will be to identify and address gender-based barriers to reaching the health goals through community centered research and engagement. We have high hopes that this center will contribute to achieving and advocating for the objectives of the conference and help all of us to keep the momentum.

Watch the highlights video here:

Read the conference report here:

During the conference, the participants came together to provide insights on how to improve the position of women in global health and conceived a call to action that is inclusive, and concerns all the sectors of global health.

Read the full WLGH 2019 Call To Action here:

UGHE Emerging Leaders Academy

November 8, 2019

Along the sidelines of WLGH 2019, in collaboration with Dr. Modupe Akinola, Associate Professor of Management, Columbia Business School; Dr. Katherine Klein, Edward H. Bowman Professor of Management and Vice-Dean, Wharton Social Impact Initiative; Peter Drobac, Director of the Skoll Centre for Social Entrepreneurship; UGHE brought together an impressive group of 92 young leaders of the health sector, aged less than 35 years old, for a day of initiation to leadership and learning from leaders in global health and entrepreneurship. The goal of this gathering was to facilitate discussions around how to learn to be an effective leader, and equally important, how to be an effective team member. The participants committed to undertake a full online leadership course and upon completion will benefit from a two year mentorship, where they will be paired up with a strong mentor. We hope that gatherings like these will pave the way for more young women and men from the global south to take up space on the leadership tables. The future of global health leadership is truly promising.

Grand Challenges Annual Meeting

October 28-30, 2019

The Grand Challenges Annual Meeting is a convening of over 1000 key leaders from across the global community to share best practices, encourage collaboration, and seek solutions for common challenges. The annual meeting aims to build momentum for global health and development innovation and foster scientific collaboration among international groups and researchers. At this year’s conference in Addis Ababa, along with my Research Associate Mimi Frisch, we presented a poster entitled: UGHE: innovation in medical education. It was a pleasure to share the dream we have for UGHE with others in the field of global health and medical education. During the meeting, the African Academy of Science and the WHO signed a memorandum of understanding to seal a partnership whose goal is leverage innovations and sustainably scale them up to guarantee a healthier and more productive future for Africa. It was a very moving moment that promises to further develop research in Africa.

More about the AAS and WHO partnership here:

MANOVA Summit on the Future of Global Health

October 16, 2019

The Manova Summit is an annual conference that brings together global health stakeholders from the private, public, academic, and policy sectors to learn from each other how to create the health systems that the future needs. I spoke to them about the importance of looking at innovations as more than just new and shiny technology and products. Innovation is a mindset and can be created through good governance, collaboration, and having a shared common vision. Using examples from the Rwandan health system such as the Zipline drone program, the HPV Vaccine rollout, and the University of Global Health Equity, I emphasized the need to create health systems that foster innovation especially for countries with few resources. Innovations allow us to fly but we also need innovative advocacy in order to be able to bring others on board whether it be our leaders when mobilizing resources, peers when we need partners in implementation, or the communities that we serve because if the community is not convinced of the usefulness of a program or innovation, it is as good as having created nothing.

Read more about the Manova Summit on the Future of Global Health here:

Vermont Oxford Network Annual Quality Congress

October 5-6, 2019

The Vermont Oxford Network is a network with the mission to improve the quality, safety, and value of care for newborn infants and their families through a coordinated program of data-driven quality improvement, education, and research. At the annual VON conference of 2019, I was invited to give a plenary presentation entitled: The Future of Global Health: Equity, Collaboration and Education, as well as a keynote presentation entitled Reducing neonatal mortality: an equity agenda. As part of the keynote presentation, I also participated on a panel with neonatologists from Zimbabwe, Norway, and Puerto Rico to discuss and compare the challenges and successes of neonatal care in our countries. We learned a lot from each other.

Read more about the Vermont Oxford Network Annual Quality Congress here:

Chicago Council on Global Affairs

October 3, 2019

I was honored to be invited by the Chicago Council on Global Affairs to participate in a public dialogue with Brian Hanson about the lessons learned from the rebuilding of Rwanda’s health system following the 1994 genocide against the Tutsi. We spoke about the thousands of health workers and civil servants who came together to build a health system out of nothing and who created a system based on equity and service to the most vulnerable. There is still much work to be done but we are proud of how far we have come together. I am always honored share and learn with the world that it is always possible to build health systems that serve all even starting from scratch.

Read more about the Chicago Council on Global Affairs here:

University of Chicago

October 3, 2019

At the University of Chicago , I was invited by the Center for Global Health to give a presentation on the HPV vaccination launch and rollout in Rwanda, describing the key factors that led to the success of the program. I spoke about the need for innovative advocacy to ensure that the needs of the most vulnerable are met and the importance of community engagement during every step of the development and implementation of public programs. Partnerships between good leadership, scientific advocates, community, and religious leaders were what made this program a success and they are the key to the success of any health program. This talk catalyzed the partnership between UGHE and the University of Chicago and I look forward to what we can accomplish together.

Read more about the University of Chicago Center for Global Health here:

Access Challenges Panel on Responsive & Resilient Communities & Health Systems

September 23, 2019

While in New York for the UNGA, I was invited by the Access Challenges (explain) serving as a panelist on the Responsive & Resilient Communities & Health Systems panel. This was an interesting conversation discussing the diverse ways that communities and health systems can be strengthened. I spoke about the importance of global health systems and workforce training through equitable education. Others spoke about health data access, community and reproductive health, health systems level responses to disease, and empowering communities by improving infrastructure. This was a timely conversation to happen while the UN community was committing to working towards Universal Health Coverage. The conference was also attended by WHO leadership and H.E. Amira El Fadil the Commissioner for social affairs for the African Union.

Read more about the Access Challenges conference here:

Commonwealth Road Safety Conference

September 3, 2019

I was honored to be invited to speak at the International Road Safety Conference organized by the Towards Zero Foundation and the UK Department of Transportation to make formal commitments towards halving road deaths and serious injuries by 2030. Road related incidents are currently the leading cause of deaths of young people between the ages of 5-29 years. I spoke about why this is a pertinent issue for countries like Rwanda where the majority of the population falls in this age range. This conference brought together some of the leading minds in road safety from all over the world to share best practices and ideas on how to make sure road safety is treated as a priority on a global scale and created a call to action for the global community.

Read more about the International Road Safety Conference here:

Masters of Science in Global Health Delivery Graduation – Class of 2019

August 11, 2019

It was truly an honor to give the welcoming address at the 2019 MGHD commencement ceremony. The graduating class of 2019, cohorts 3 and 4, is made up of 46 students from 11 countries – a global class in every sense of the word. Joined by Her Excellency the First Lady of the Republic of Rwanda, Mrs Jeanette Kagame; the Minister of Health, Hon. Diane Gashumba, who was representing His Excellency the President of the Republic, Chancellor of UGHE, Paul Farmer, and Jim Yong Kim, our key note speaker for the day; we congratulated the students for their great achievements and implored them to keep building strong partnerships of good will to make the world better.

The class pledged to lead with intentionality, integrity, and dignity and to maintain the utmost respect for human life and rights as they go out into the world. We are very proud of our newly graduated lions and look forward to all the great things they will accomplish wherever they go.

View more images from the 2019 MGHD graduation here:

MGHD Masterclass 2019

August 10, 2019

It was one of my proudest moments to moderate a discussion between the students from our two graduating cohorts and my dear friend and brother Paul Farmer. During this two hour conversation, the MGHD students engaged in discussions on philosophical ideas such as neocolonialism and restorative justice as well as more practical issues like resource mobilisation for better health systems. We also spoke extensively about the role of anger in mobilising the work needed to change the world for the better. The graduating class of 2019 includes doctors, nurses, civil servants, mental health professionals, to name a few, and it gives me great hope to know that they will be leading the charge for better health for all especially the vulnerable. 

Read more about the MGHD program here:

ALforHealth Conference

July 19, 2019

I was pleased to be a part of African Leadership Academy’s inaugural healthcare conference, ALforHealth, which was held in Kigali, Rwanda with the aim to build and sustain a network of changemakers who will work hard to change the world with big ideas. I spoke to small groups of young, ambitious African women and men about the work we all for the recovering of the Rwandan health system from the complete destruction of the Genocide against the Tutsi of 1994. Central to this conversation was the role that innovation and research have played in both my own career and the development of my country’s health system.

This conference was in partnership with our university. Later that afternoon, we had the pleasure of hosting a breakout session at the UGHE Kigali Campus to introduce the group to the vision and mission of our organization and discuss what universal health coverage means and how we will achieve it.

Read more about ALforHealth here:

Global Health Corps Training Institute

July 12, 2019

I was thrilled to speak to the new class of Global Health Corps fellows before they went out to start their year of intensive immersion into global health work. I spoke to them about the importance of optimism in the work that we do in global health. Without optimism, we would not have gotten Rwanda from where we were 25 years ago and we will need to stay optimistic for the journey ahead. I was proud to spend the day with the future of global health leadership who set out into the world to do everything with equity in mind. The future is bright!

Read more about Global Health Corps’ work here:

Health and Humanitarian Logistics Conference

July 10, 2019

The 19th Conference on Health and Humanitarian Logistics, brought together people from various sectors, private and public, to tackle the issue of logistics for health. I joined Dr. Lloyd Matowe, Program Director, Pharmaceutical Systems Africa and Dean of the Faculty of Pharmacy at Lusaka Apex Medical University, Zambia; Ugochi Daniels, United Nations Resident Coordinator- I.R. of Iran, United Nations.Former Head of the Humanitarian Branch, UNFPA HQ; Dr. Henry Kyobe Bosa, Outbreak & Epidemic Senior Public Health Officer, Outbreaks and Epidemics, African Risk Capacity; and Dr. Julie Swann, Department Head & Professor, Department of Industrial and Systems Engineering, NC State University; Co-founder, Center for Health & Humanitarian Systems (CHHS) to discuss different ways to build resilience into our systems through education, early warning systems, and not leaving anyone behind. Applying the principles of implementation sciences with honesty and transparency will support all journeys to success.

Read more about the Health and Humanitarian Logistics conference here:

The Inauguration of UGHE’s MBBS Program

July 9, 2019

Image credit: Phaedra Henley

On July 9, 2019, we officially welcomed the inaugural class of medical students to our beautiful UGHE Butaro Campus in Burera, Northern Province, Rwanda. The class is comprised of 30 young and eager minds, of whom 70% are women. All students have made the commitment to work for vulnerable people in need, for at least six years after they finish their training. The education is free. They can work for public sectors, governments, UN, NGOs, etc…and keep all their salary without reimbursing anything as long as their work is in service of the vulnerable in need. The six and a half year bachelor level medical degree, coupled with a masters degree in global health delivery, is heavily grounded. We are very excited to be educating the minds and hearts that will change the way health sciences are taught and health care is delivered around the world, for the better. I gave a lecture introducing them to the history, the mission and vision of UGHE, that they are now a part of and the responsibility they have to upholding the values of equity and community.

Read more about UGHE’s MBBS program here:

Kigali Global Dialogue

July 3, 2019

At the inaugural Kigali Global Dialogue, I was pleased to be on a planel of exceptional African health leaders to discuss the intricacies of building strong health systems especially during and post crisis. I was joined by Hon. Dr. Patrick Ndimubanzi, Minister of State, Ministry of Health, Rwanda; Hon. Issa Mardo Djabir, parliamentarian from the Republic of Chad; Rachel Toku-Appiah, Programme Manager, Graça Machel Trust; Freddy Nkosi, Senior Manager, Advocacy & Communications, VillageReach; and Virginia Comolli, Senior Fellow for Conflict, Security and Development, International Institute for Strategic Studies. This Dialogue was a start to what will become an annual convening of minds to tackle contemporary issues surrounding development and growth. We discussed the mutual accountability that concerns government but also NGOs that receive money to care for the vulnerable. They need work with the same efficiency and efficacy during peace and development or during war and unrest. How to do this successfully is part of what we teach at UGHE.

Read more about the Kigali Global Dialogue here:

Taking the Lead on Global Health panel during the Aspen Ideas Health

June 22, 2019

Image credit: Katie Drasser

On this panel during Aspen Ideas: Health, I joined Victor Dzau, President of the United States National Academy of Medicine; Robert Newman, Director of Aspen Global Innovators Group; and moderator, Peggy Clark, Executive Director of Aspen Global Innovators Group, to discuss the role of good, effective leadership in the delivery of global health. I spoke about the need for humility, trust, and listening to the people when it comes to delivering health services and leading in general.

Watch the full session here:

Reproductive Rights Still a Battleground Panel during the Aspen Ideas Health

June 21, 2019

Image credit: Leana Wen M.D.

On this panel during Aspen Ideas: Health, we discussed the way forward for reproductive rights globally. I had the pleasure of joining a remarkable group of women: Leana Wen, MD, President of Planned Parenthood Federation of America, Shadia Elshiwy, MD, Assistant Regional Director for International Planned Parenthood Federation in the Arab World, Aspen Institute Fellow, and moderator, Pat Mitchell – TEDWomen. I spoke about the global nature of the fight for reproductive rights and the power that comes with women being able to have full control over their own healthcare.

Watch the full session here:

Wellcome Global Monitor Launch

June 19, 2019

Image credit: Rob O’Malley

At the launch of the world’s largest survey on global attitudes towards science, I had the honor of sitting on a panel with Julie Gerberding, Executive Vice President & Chief Patient Officer, Strategic Communications, Global Public Policy and Population Health, Merck, Mae Jemison, First woman of colour in space and Principal of the 100 Year Starship Initiative, and Imran Khan, Head of Public Engagement, Wellcome. With Jon Clifton, Global Managing Partner, Gallup, moderating we discussed the findings of the survey and their implications on the global community going forward. I spoke about Rwanda’s high levels of trust in vaccines and how we achieved this using a participatory process that involved all stakeholders.

Read more about the Global Monitor Report here:

T20 Summit

May 27, 2019

At the annual Think 20 Summit of 2019, I participated in a panel discussion along Masahiko Kiya (Deputy Assistant Minister, International Cooperation Bureau, Ambassador for TICAD, Ministry of Foreign Affairs of Japan), Sachin Chaturvedi (Director-General, Research and Information System for Developing Countries (RIS)), and moderated by, Gabriel Leung (Dean of Medicine and Helen and Francis Zimmern Professor in Population Health, the University of Hong Kong) discussing recommendations to be made at the G20 Summit regarding achieving Universal Health Coverage globally. The recommendations will be presented at the G20 Summit in Osaka in June. I insisted on the need to create global regulations that protect the developing world against brain drain. The loss of qualified medical professionals to the developed world is a significant obstacle to achieving universal health coverage.

Read more about the T20 Summit here:

Exemplars in Under 5 Mortality: Bangladesh workshop

May 2019

In this dissemination meeting, I and my Co-PI Lisa Hirschhorn, along with my team, presented the findings from the Bangladesh Exemplars in Under 5 Mortality case study to the various stakeholders. Together we discussed the validity of the findings and answered questions from the stakeholders who were present at the meeting. We were positively impressed by the responsiveness and the quality of research skills from the ICDDR,B.

SDG3 Workshop: Elevating national research for health priorities to achieve effective scale-up

May 5 – 7, 2019

Image credit: UGHE

Co-hosted by UGHE and Wellcome Trust, I was honored to be a part of the team leading this workshop that brought together health research professionals from all over the world to come up with ways we can improve how research is carried out on a global scale. Some of the topics that were covered were: who sets and owns national health sector research agendas, how can we coordinate global health research in a more efficient way, how do we increase the numbers and variety of the people producing quality health research? We agreed that we need to create skills in countries to set their own national health research agendas that respond to their specific needs. Wellcome Trust and WHO will present the report to major global players.

Read more about the Global Action Plan here:

Women’s Leadership Summit

April 23, 2019

I was honored to join an incredible group of women at The Rockefeller Foundation Bellagio Center for a few days of reflection, learning from one another, and committing to engaging in regular connected and facilitative leadership as we work towards various global goals. I spoke about the importance of improving access to reproductive health and rights if we are to build a more gender equitable world, not only for women but for everyone.

Read more about the Women’s Leadership Summit here:

Exemplars in Under 5 Mortality – Senegal workshop

April 14 – 19, 2019

In this dissemination meeting, I and my Co-PI Lisa Hirschhorn, along with my team, presented the findings from the Bangladesh Exemplars in Under 5 Mortality case study to the various stakeholders. Together we discussed the validity of the findings and answered questions from the stakeholders who were present at the meeting. We congratulate the team in Senegal, who stayed until 7pm to finish, for their show of commitment.

Unite for Sight Global Health & Innovation Conference

April 13, 2019

Image credit: Marie Martin

At the Unite for Sight GHIC on April 13th 2019, I gave a keynote address emphasizing the moral imperative for us all to be optimistic on this road to achieve the SDGs. I elaborated on the ways in which optimism has been a large driving force behind the development of my country’s health sector and Rwanda’s progress as a whole. I was also a part of a panel seeking to highlight the importance of responsible engagement and integrity in global health along Jordan Levy, Chief External Relations Officer of Ubuntu Pathways, and Joia Mukherjee, Chief Medical Officer of Partners In Health and Associate Professor in the Department of Global Health and Social Medicine at Harvard Medical School.

Read more about the Unite for Sight Global Health and Innovation conference here:

Vassar College Visit

April 12, 2019

On April 14th, 2019, I visited the Vassar College campus in Poughkeepsie, New York to meet with President Elizabeth Bradley and some of the diverse student body. It was a pleasure to exchange with the Vassar community on the need for  the equity agenda in the development of a health system. The mission of the trip was to cement the partnership between UGHE and Vassar College in educating the future of global health in Rwanda. Vassar will be contributing to the liberal arts part of our curriculum and in turn assuring our students graduate with a better understanding of the world and the societies in which they will work. I also attended a great lecture by Jamaica Kinkaid… I felt the solidarity from the Vassar community when they assisted remotely with me to the commemoration of the genocide against the Tutsi event at UGHE.

Watch the video on the Vassar – UGHE partnership here:

SGO 50th Annual Meeting on Women’s Cancer

March 16, 2019

Image credit: Paula Anastasia

I was invited to be the presidential speaker at the At the 50th Annual Meeting for the Society of Gynecologic Oncology on Women’s Cancers (March 16-19) in Honolulu, HI. In attendance were many professionals from every stage of the gynecologic cancer care spectrum. I spoke about Rwanda’s success with rolling out the HPV vaccine, as well as the need for data driven social and political activism for change. We discussed how lack of trust can lead to missed opportunities such as the underutilization of the minority cancer program in the United States.

Read more about the Society of Gynecologic Oncology here:

SDG3 Global Action Plan research accelerator workshop – optimising the global research system

February 22, 2019

Image credit: Rachael Crockett

At this workshop hosted by the Wellcome Trust in London, we discussed strategies that can be employed to produce and use research more efficiently on the road to achieving SDG3. In line with the Global Action Plan: Accelerator 5, ways to increase international collaboration, research agenda streamlining, and recommendations for the future of health research and development were some of the topics of discussion. During this meeting, we made the decision that the next one would take place in Kigali.

Read more about the Global Action Plan here:

Fixing the Fundamentals: Lessons from Rwanda’s Healthcare Sector

Published by the Africa Business Conference at Harvard Business School

March 10, 2019

Image credit: Claire Wagner

“A good entrepreneur is a good advocate”

In this keynote address to the Africa Business Conference at Harvard Business School on February 16, 2019, I described the successful strategies taken in the Rwandan health sector to rebuild and work for equity in the time since the genocide in 1994. I elaborate on ways in which a government can make great progress by planning and acting as a business, and I describe how the private sector has an essential role to play in human development and health for all.

Watch the full keynote address

Leadership and Management: Critical Barriers to Improving Health Outcomes

Panel during the Consortium of Universities for Global Health Annual Conference on March 8, 2019

“Former CDC Director William Foege stated, ‘the lack of management skills appears to be the single most important barrier to improving health throughout the world.’ Strong leadership and management capacity are essential ‘force multipliers’ within health systems that increase the prospect of better health outcomes. However, without consensus on definitions and investment in robust evaluations to measure impact, evidence isn’t available to inform decisions regarding prioritization, adaptation, or scale-up. Panelists will describe efforts to build leadership and management and discuss the pressing need to create a shared agenda for professionalization of leadership and management education in the global health context.”

It was a privilege to start International Women’s Day with a panel composed of such knowledgeable women, Amy Lockwood, Strategic Advisor to AIDS Research Institute & Center for Global Health Delivery and Diplomacy at UCSF’s Institute for Global Health, Heather Anderson, Senior Vice President of Programs at Global Health Corps, Erika Linnander, Lecturer in Public Health (Health Policy) and Director of the Global Health Leadership Initiative at Yale University, and Erika Willacy, Program Lead for the Improving Public Management for Action (IMPACT) Training Program at CDC.

Read more about CUGH 2019 here:

Planning and Action for Cervical Cancer Elimination in Rwanda: Lessons Learned from Sustaining Success and the Way Forward

Panelist on “Eradicating Deaths from Cervical Cancer” at the 7th Annual Symposium on Global Cancer Research

March 7, 2019

Image credit: CUGH News

In this panel presentation, I delivered a keynote address describing the planning and implementation of HPV vaccine in Rwanda and efforts for cervical cancer elimination. I shared lessons learned and next steps for other countries and for international actors regarding cervical cancer elimination and delivering quality cancer care in developing countries and around the world.

Read more about this symposium here:

Global Public Health Today and Tomorrow Panelist at Festival of the Arts Boca

March 4, 2019

Image credit: Festival of the Arts Boca

“Two esteemed experts on global health issues – one American, one Rwandan – offer a panel discussion on the state of world health.

Dr. Agnes Binagwaho, Vice Chancellor of the University of Global Health Equity, an initiative of Partners in Health, brings her perspective as a practicing physician, scholar, and government health official, including having served as Rwandan Minister of Health. She is active in advocacy and political mobilization on behalf of women and children, in Rwanda and worldwide. Partners In Health is focused on changing the way health care is delivered around the world.

Thomas Bollyky offers the insights of a scholar and author, having directed the first Council on Foreign Relations-sponsored Independent Task Force devoted to global health, and he also is the author of Plagues and the Paradox of Progress: Why the World is Getting Healthier in Worrisome Ways.

The panel will be moderated by Dr. Felicia Knaul, Director, Institute for Advanced Study of the Americas and Professor, Miller School of Medicine, and it will be introduced by Boca Raton Regional Hospital President and CEO Jerry Fedele.

Read more about the Festival of the Arts Boca here:

Global Health Equity and the Research University: An Update from Rwanda Panel discussion with Dr. Paul Farmer and moderated by Dr. Salmaan Keshavjee

February 14, 2019 at Harvard Medical School

Image credit John Meara

In this panel discussion, Paul Farmer and I share our experiences and secrets for success in global health delivery. The central motivation is focusing on those who have been excluded, and, in doing so, you will reach every person. Dr. Farmer and I also discussed how the University of Global Health Equity will solve a leadership, research, and implementation science gap in global health delivery by educating our students in the principles of equity, One Health, and evidence-based decision making.

Interview and Discussion at Harvard School of Public Health

February 14, 2019

Image credit: Kateri Donahoe

On February 14th, 2019, I was interviewed by Dr. Joseph Rhatigan, Associate Professor in the Department of Global Health and Population, at the Harvard School of Public Health regarding my experience working for health and development with an equity agenda. I engaged with Dr. Rhatigan and his students in a discussion of the nuances of implementing this equity agenda and shared my experiences as a global health fighter, public servant, and now Vice Chancellor.

Read more about the Harvard School of Public Health’s academic offerings

Screening of Bending the Arc and Moderated Discussion at The Conduit in London

Screening and discussion on February 11, 2019

On February 11, 2019, I participated in a screening of Bending the Arc and a post-screening panel discussion with Dr. Peter Drobac, Director of the Skoll Centre for Social Entrepreneurship at the Said Business School. Our discussion centered around the lessons from the film and the lessons we can draw from the activism and advocacy of Partners In Health that resulted in systemic change in many countries.

Read more about the film

Optimizing leadership and organization in healthcare: Restructuring health systems to ensure universal coverage

Speaker at the Rhodes Healthcare Forum at Oxford on February 9, 2019

Image credit: Wilder Wohns

“In 2019, our theme is ‘From Surviving to Thriving’. We rightly celebrate our remarkable progress to reduce death and disease worldwide. Our focus must now shift to goals beyond just reducing mortality, to create a future where everyone can enjoy thriving health. We must pursue wellbeing, prevent disease, reduce inequality and seek justice for all. We will discuss opportunities and approaches in technology, epidemiology, public health, drug discovery, biomedicine and policy to promote global thriving

We have invited experts and innovators in to bring depth to these discussions. Scholars will be encouraged to apply the ideas generated over the weekend in initiatives spanning their time at Oxford and beyond.”

In this talk I outlined successful strategies for optimizing health systems for the benefit of all citizens, with the goal of universal health coverage, using Rwanda as an example.

Read more about this event

Opening Address at AMP Health’s Leadership Lab Welcome Reception

January 27, 2019

Image credit: Aspen Innovators

I spoke to the participants in the Aspen Management Partners for Health Leadership Lab at the kickoff of their intensive training in Rwanda about the importance of leadership and management in Rwanda’s journey to health excellence and in achieving the goals for Primary Health Care across Africa. UGHE and AMP Health are seeking to build strong health systems of the future and are forging the potential for even stronger collaboration. AMP Health works in partnership with Ministries of Health across Africa by strengthening leadership and management capabilities to accelerate achievement of the shared goals of the Primary Health Care (including Community Health), Universal Health Coverage, and the health-related Sustainable Development Goals.

Read more about AMP Health

Welcome Address at UGHE’s Butaro Campus Ribbon Cutting Ceremony Address

January 25, 2019

“Dr. Agnes Binagwaho speaks at the campus inauguration ceremonies for the University of Global Health Equity in Butaro, northern Rwanda, on Jan. 25, 2019. Photo by Illume Creative Studio for UGHE” from

On the event of UGHE’s official Butaro campus launch on January 25th, 2019, I spoke to our esteemed guests and colleagues to share our collective story of Rwanda and PIH’s journey in health equity, our thanks to the community and local and national government for their support, and our vision for this university and the field of global health delivery.

Read more about this event

Promoting research and Education towards Hepatitis Elimination in Sub Saharan AfricaCo-moderator of session with Professor Phil Cotton

December 12, 2018

Image credit: PIH Rwanda

Professor Phil Cotton, Vice Chancellor of the University of Rwanda, and I led a lively discussion about the promotion of research and education for Hepatitis C virus elimination in Rwanda and the world. This event was convened to mark the launch of Rwanda’s Hepatitis C virus elimination plan.

Read more about this event

Leadership Master Class at the Gavi EPI LAMP Closing

Interviewed by Erika Linnander of Yale University’s Global Health Leadership Initiative

Image credit: Yale Global Health Leadership Initiative

I spoke with the participants in the Gavi EPI Leadership and Management Program on the occasion of their graduation from the program to deliver a call to action for the health sector leaders to continue to develop their leadership and management skills and implement innovative projects in immunization.

Read more about this program

Observations and Expectations for G20 Universal Health Coverage: An African Perspective Presented at T20 Inception Conference

December 5, 2018 in Tokyo, Japan

Image credit: Think20 Japan Inception Conference

I was invited by the T20 Japan Secretariat, in preparation for the G20 meetings in Japan in 2019, to discuss global cross-cutting issues and advise on roadmaps for policy recommendations to the G20. At this conference, I shared my views on universal access to care for the developing world and emphasized the importance of not doing “one package” for the world but instead to move forward based on capacity of countries, keeping with high expectations for global progress.

Read more about this event

Safe surgery: collaborating to increase access and improve outcomes

Panelist at UBS Global Philanthropy Forum

November 30, 2018 in St. Moritz, Switzerland

Image credit: UBS Global Philanthropy Forum

On this panel I encouraged all actors to align with the Lancet Commission on Global Surgery recommendations and met with philanthropists who are eager to help countries around the world to help in this effort. I offered advice on how to do this in an integrated systemic manner. I also spoke about my experiences in building a health sector and working within a leadership culture that has an equity mindset.

Read more about this event

Speaker/panelist at World Innovation Summit for Health

November 13, 2018 in Doha, Qatar

Image credit: Kateri Donahoe

On this panel, we engaged in a lively discussion about the need for distinctions and cooperation between measures of social capital and human capital. I argued that social cohesion is a more important factor for mental health than economic potential and that this is key to understanding and addressing mental health challenges for children and adolescents.

Read more about this summit

Equity in Academic Global Health Partnerships Panelist at Women Leaders in Global Health Conference

At the London School of Hygiene and Tropical Medicine

November 9, 2018

Image credit: Kateri Donahoe

On this panel, we discussed inequity in academic partnerships as a serious problem that needs to be addressed. We came together to talk about the barriers and opportunities for more equitable partnerships in the interest of advancing science and health for all. I spoke about the need to raise awareness and build partnerships and relationships with other institutions in the developed and developing world in order to combat structural violence and “-isms” that prevent true gender equity and fair partnerships in academia around the world.

Read more about this conference

Taking global health work from silos to systems: How might we align incentives across sectors?

Panelist at Prescription for Progress: The essential role of partnerships in strengthening health systems

October 30, 2018 at Devex in San Francisco, California

Image credit: Devex

In this panel, I argue for stronger partnerships between the public and private sectors and communities and push all stakeholders to take risks on innovation. To move forward for equitable healthcare access for all and effective health systems, we need to gather everyone involved around one table and one vision for health and development, and stop treating governments like children who are out of touch with the needs of their people. This requires greater accountability from all parties.

Watch the full panel (43:37 – 1:16:48)

Reimagining health education for quality service for all is a good business

Presenter in Med 285 course at Stanford University

October 24, 2018

Image credit: Fauzia Dawood

I gave a lecture to the Stanford Distinguished Careers Institute Fellows about why quality health education is a smart business strategy – because less money is spent on economic development when funds are spent disproportionately on disease. When populations are healthier, more economically productive people are able to work and build their local economies, leading to overall economic development. This was a vibrant, multigenerational group with a wide range of expertise from around the world.

Read more about this institute and fellowship

Quest for an effective health system: 20 years of Rwandan experience Grand rounds presentation at El Camino Hospital

October 23, 2018 in San Francisco, California

This presentation focused on accelerating access to health by embedding trust between clients and service providers, and the need to cultivate that trust among community members. I described the experience of Rwanda in rebuilding our health sector through individual and community trust in the leadership as a key tool for implementing needed health reforms.

Address to Students of the Castilleja School

October 22, 2018 in Palo Alto, California

Image credit: Fauzia Dawood

I was delighted to speak with this young group of women about my career in global health. These children were truly thinking strategically about how to find solutions for being productive in the communities in wish they will work in the future when they are young professionals. It showed me again how important it is to receive quality education that encourages this type of strategic thinking and a sense of social justice in students.

Read more about the Castilleja School

Rwanda’s Health Care Transformation: A Model for Success

Featured speaker

October 18, 2018 at the World Affairs Council of San Francisco

Image credit: World Affairs

In this “salon talk-style” conversation with Krista Donaldson, CEO of D-Rev, I discussed what it takes to build an equitable health system and how human development is needed to sustain economic development. I shared stories of using technology (like Twitter) to communicate with beneficiaries and call out big health multilateral organizations to reconsider their inaccurate Rwanda data and how to use “reverse innovations” and innovative partnerships for better health outcomes for all.

Watch the full event

The Role of Educational Institutions in Creating Social Change

Fireside chat

October 16, 2018 at the Harvard Club of San Francisco

In this presentation, I described why we need to revisit educational systems in order to create social change for better service delivery. I examined if the training provided today appropriate to reach the SDGs, why we need to take a global health approach, how Rwanda’s brought about progress using knowledge-based development strategies (and the consequences of not doing so), and how we can change access to education to foster positive social change.

Read more about the event

Rwanda’s Journey to Reducing Under-5 Mortality: Embedding equity in child health

Keynote address at the 2018 Summit for Pediatric Global Health, Mass General Hospital for Children

October 15, 2018 in Boston, Massachusetts

Image credit: Global Health @ MGH

In this address, I shared Rwanda’s journey for under-5 mortality reduction – a journey of collaboration and visionary leadership to ensure healthy lives for kids and for all. We did this through an equity agenda and evidence-based decision making – as we did with everything in the health sector – as a key strategy for saving lives and reducing morbidity.

Read more about this summit

Screening of Bending the Arc and Post-screening Discussion

October 12, 2018 at the Dickey Center at Dartmouth College

Image credit: Kateri Donahoe

After the screening of Bending the Arc, students, faculty, and staff engaged with me in a discussion about bringing stakeholders around a singular vision for better health outcomes for all.

Read more about the film

Meeting of the Friends of Vision group at the United Nations

Speaker on October 11, 2018 at the United Nations Headquarters in New York

Image credit: Kateri Donahoe

At this meeting, to mark World Sight Day, I spoke at the founding meeting of the Friends of Vision group at the United Nations, which includes Clearly, Ambassador Webson, UN Permanent Representative of Antigua & Barbuda, and the International Agency for the Prevention of Blindness. I shared lessons learned in Rwanda from working with Vision for a Nation to fight for universal access to eye care.

Read more about this event

Invest, Innovate, Empower: Marshalling Collective Action to Drive the Women’s Health Research Agenda Forward

Panelist at the Magee-Womens Research Summit

October 9 2018 in Pittsburgh, Pennsylvania

Image credit: Kateri Donahoe

On this panel, we discussed the persistent gender inequity that leads to both a lack of women in research and a lack of research about women’s specific health needs. We need to increase women in STEM fields – in representation as researchers, which will hopefully also increase representation in research. Building a sustainable health system requires the competency to design and implement policies and legal frameworks that are evidenced-based and utilize available data but if your data misses half of your population’s needs, then your decisions will not be truly evidence-based. I argued for shifting the health research agenda towards gender equity, elaborating on lessons learned from HIV/AIDS research advocacy and proposed the way forward to increase resources for women’s representation in health research.

Read more about this summit

Reducing the Rate of Maternal and Infant Mortality: Trends, Challenges and Opportunities Panelist at the Magee-Womens Research Summit

October 9 2018 in Pittsburgh, Pennsylvania

Image credit: Kateri Donahoe

Each country faces different social determinants of health that must be addressed to solve clinical issues. Not doing that will make you fail to create the health system based on inclusion, equity, and quality for all, responding to the needs of the people in their community. In this panel, I discussed how to realistically address maternal and infant mortality – which in US means you must have honest discussions about institutional racism, and in other contexts means facing your unique challenges and threats to women’s health head-on.

Read more about this summit

Forum on Neglected Tropical Diseases Panelist at the Access Challenge’s Universal Health Coverage Conference 2018

September 24, 2018 in New York

Image credit: Kelly Healy

I joined other global health leaders on this panel to discuss NTDs, which affect 1.5 billion people globally, and why we need to sustain ambition toward Universal Health Coverage to beat these diseases. I spoke the importance of integrating NTD care more strongly into primary health care structures, building country capacity, encouraging leadership to tackle these illnesses, and using data to measure successes to incentivize action towards eliminating NTDs.

Read more about the Access Challenge

The Humanitarian Use of Drone Technology: Innovations for Health in Rwanda

Presenter at Hong Kong University of Science and Technology

September 20, 2018

Image credit: Umulinga Karangwa

In this presentation, I described Rwanda’s successful implementation of drone technology for delivery of needed health supplies to remote locations, greatly reducing delivery delays and, ultimately, saving lives in difficult-to-reach areas. I illustrated how the use of drones can be a great innovation for health service delivery. It is a lesson about how Africa can leap into the future and solve problems using science the most advanced technology to solve persistent health issues.

Read more about Rwanda’s drone delivery program

Nationwide Rollout of the HPV Vaccine in Rwanda: Embedding equity in cancer control planning Presidential plenary speaker at the International Gynecological Cancer Society Meeting

September 15, 2018 in Kyoto, Japan

Image credit: BJ Rimel

I was invited to deliver the Presidential plenary address at the IGCS 2018 meeting about Rwanda’s national HPV vaccination program: the need, advocacy efforts, rollout, controversies, and the larger context of cancer treatment in our setting. I also shared lessons learned and next steps. This example is a perfect case study of Rwanda’s practice of early adoption, of innovating for health, and of putting the most vulnerable citizens at the forefront of our minds when implementing health interventions.

Read more about this event

Exemplars in under-five mortality reduction: A case study of implementations strategies and contextual factors in Rwanda

Research presentation at Rwanda Ministry of Health 2018 Health Research and Policy Day

August 24, 2018 in Kigali, Rwanda

Image credit: UGHE

At this Health Research and Policy Day, I presented the preliminary results of a novel research project that involves using implementation science methods to seek out transferrable knowledge for reducing under-5 mortality from countries that have exceeded expectations in this key health indicator. Rwanda was the first of many countries where this research was conducted, and we plan to use this methodology to develop a toolkit for countries who wish to successfully reduce child mortality.

Promotion of multisectoral partnerships for the prevention and control of non-communicable diseases

Presenter/panelist at the Interactive Hearing as part of the preparatory process toward the Third High-Level Meeting of the General Assembly on NCDs

July 5, 2018 at the United Nations Headquarters, New York.

Image credit: United Nations Web TV

In this interactive discussion, we discussed the opportunities and challenges of engagement with the private sector, academia, civil society, and communities for the prevention and control of non-communicable diseases. I argued that private, public and community partnerships are key to reducing the burden of NCDs and efforts to do so in Rwanda have been possible for us because of the government’s support of community health centers, new health interventions, and other private and public health organizations within the country. We know that civil society has an essential role to play, alongside government and business, in tackling NCDs in Rwanda, and around the world. I also argued that the private sector has shirked their responsibility for the current state of NCDs and their role in creating obesity- and smoking-related illnesses. To move into an era of real partnerships, the private sector must employ real accountability, transparency, and truth-telling.

Watch this event

Read the event concept note

Health Systems Strengthening: The Experience of Rwanda

Presenter/panelist at Global Health Corps Training Institute

Yale University on July 2, 2018

Image credit: Mia Lei

At this GHC Training Institute, I spoke to the new GHC Fellows about health systems strengthening and the building blocks of health systems needed to foster human development and break the cycle of poverty and disease. I shared my experience in the Rwandan health sector and the revolutionary solutions we employed in leadership, data collection and use, community engagement, and equitable health delivery in order to achieve more for the health of our people. After my presentation, I engaged in a panel discussion with Dr. Prabhjot Singh about how these young professionals could work in their fellowships to reduce health inequities.

Read more about the GHC Training Institute

The U.S Vs The World: Who Has The Best Healthcare System?

Published by Aspen Ideas on June 22, 2018


“You’ll go nowhere if you don’t create the system to provide good services.”
According to the commonwealth fund in a recent report, the united states health care system does not perform at the level that should be expected based on how much is spent, particularly when it comes to outcomes, access, and equity. In this panel, I describe the approaches we took in the Rwandan health sector to reduce inequity and increase access to health for all, resting on principles of inclusiveness (“whatever program you do, make sure you leave no one out”), addressing the social determinants of health, and a governance structure that puts human development first. These practices have allowed us to make great strides with little money, which is a stark contrast to the united states health system. I share these lessons learned from Rwanda, and around the world, about equitable health delivery and how we are educating future global health professionals in these lessons at the university of global health equity.


Fighting Cancer in Africa

Published by Aspen Ideas on June 22, 2018

In this panel, I discuss the misconceptions surrounding cancer care in Africa and the barriers to effective treatment that still exist for African cancer patients. I tie these barriers to lack of political action on the part of local and national governments on the continent; pervasive stereotypes about why Africans do not or cannot seek treatment in time; lack of effective advocacy for non-communicable diseases; and biases among international policymakers, advocates, and researchers regarding what is “appropriate” or possible in cancer research and treatment in Africa. These barriers align with our understanding of the social determinants of health and the continuing structural violence that African cancer patients face when seeking diagnosis or treatment for cancer. To adequately address the rise in cancer incidence in Africa, we will need to embrace task-shifting for cancer care because, as i say during this panel, “cancer is too serious to leave in the hands of doctors only.” This is the lesson we teach at UGHE, that there is a need to be disruptive and to do business as “unusual”, which means being radical in the way we educate health professionals about cancer and not accepting of the status quo. 



ENOUGH: Making 2018 The Year For Action and Impact on NCDs

Published by the NCD Alliance on May 21, 2018

In this panel, I shared my perspective on how to make the un NCDs high level meeting count, stressing the importance of integrating services into existing systems, utilizing lessons learned from previous large-scale disease responses (HIV/AIDS, for example), and leaving no one out of benefit. Addressing NCDs will require a collaborative, multisectorial response that attacks NCDs from every side – health, education, governance, society, and more.


The Lazarus Effect, 15 Years Later

Published by The George W. Bush Presidential Center on May 9, 2018

In this panel, (06:00 – 51:45) on the 15 year anniversary of PEPFAR, I discussed the impact of the program in Africa and the role PEPFAR played in turning the tide against HIV/AIDS in Rwanda.
Panelists: former Rwandan minister of health prof. Agnes Binagwaho,  key architect of PEPFAR Ambassador Mark Dybul, m.d.

Washington post columnist Michael Gerson watch the entire panel presentation here:

African Women’s Leadership Conference at Wellesley College

Published by Wellesley College on April 13, 2018

On march 8th, 2018, I spoke about the challenges faced by African women in the health sector at the African women’s leadership conference organized by Wellesley college. I began my talk by reminding the audience that Africa as a continent has been misrepresented on the map for so many years, where it is made to appear smaller than it is. I went on to talk about how difficult it is for African women to move up the ladder as leaders in healthcare and other sectors such as politics. I mention the false perspective society has of women’s ability to perform due to their biology. My talk ended by highlighting the great achievements that have been accomplished because of women’s leadership and by encouraging African women and women in general to take a stand and show the world that we, women, can be both mothers and leaders in this world.

Oxford Union Debate: The Role of Universities in Creating Social Impact

Published by Skoll Centre for Social Entrepreneurship on April 12, 2018

In this debate at the historic oxford union, i argue against the proposition that “universities lack the necessary ‘proximity’ to be effective agents of social innovation in the 21st century.” I make the case that universities are increasingly using pedagogy that encourages students to engage with communities and seek innovative solutions that can be sustainably implemented in poor, rural areas. I also note that universities are and will continue to be convening spaces for the exchange of ideas, which is only made ever easier by technological advancements and communications connectivity. These are the tools and values of the university of global health equity, where I serve as vice chancellor, which is truly “walking the walk” when it comes to proximity to those we have committed to serve.


TEDMED Talk: DR. Agnes Binagwaho

Published on the TedMed Youtube Channel on April 5, 2018

In this TEDMED talk, I shared my personal journey as a passionate healthcare provider. I shared about my love of medicine, my family’s move from Rwanda to Belgium in the years before the genocide and my later return to my homeland after the devastating 1994 genocide against the Tutsi. I shared about the hardships I faced after making such decision and the rewarding fruits of my hard labor. I went from being a regular clinician in Rwanda, to running the national aids control commission, to being appointed as permanent secretary to the minister of health and to later becoming the minister of health. Through my journey, I played a major role in the transformation of Rwanda’s healthcare sector, a work that now serves as a model to both developed and developing nations. My journey has led me to my current position as the vice chancellor of the university of global health equity (UGHE).

CIFAR Women in Leadership Workshop 2018

On March 22, 2018 at Hotel de Mille Collines in Kigali, Rwanda

On march 22, 2018, during the CIFAR’s women in leadership workshop that took place at hotel de Mille Collines, I presented as a keynote speaker about “women’s leadership in science: global challenges and the way forward.” In this presentation, I touched on the importance of fighting against brain drain, to prevent current and future African scientist from leaving the continent in search of better paying jobs from the western world or elsewhere. I also explained how gender inequity is a global issue and how there is so much that can be done to prevent it such as investing in girls education or establishing institutions like the university of global health equity (UGHE) in places where education is most needed. I ended my talk by highlighting UGHE and its mission to create the next generation of global health professionals who are being instilled with a passion to serve and advocate for the most vulnerable. Following my talk, I joined a panel of five other women to discuss more deeply about the challenges that are inhibiting women leaders in science from making progress and how those challenges can be prevented.


Advancing Global Health With Tech

Published by Techonomy on November 14, 2017

In this panel we discuss the development of technology as an absolute and urgent priority to advance global health if we want to reach the sustainable development goals by 2030. I argue that this is true, but we need to accompany technological advancement with the development of social capital and we need to purposely bring technology to the most vulnerable members of the communities in which we work.


Message Foe Members Of The Task Force On Global Advantage

Published by Mount Sinai Health System on September 12, 2017

In this video, I speak about the progress Rwanda has made by highlighting different programs that have contributed greatly to the development of the healthcare within the country in order to support the health of the people. Such programs include community health workers (CHWs) and other policies that were implemented under my leadership.


Healthcare Quality

Published by Harvard X on June 28, 2017

Quality needs to be at all stages of the chain of health service delivery, from patient participation, to infrastructure, to proper use any of the tools necessary for clinical services, to name a few …



What’s Next in Global Health

Published by the Aspen Institute on June 24, 2020

This year marks the 100th anniversary of the 1918 Spanish influenza pandemic, which killed more people than world war I. In this panel, we discuss how to better use the lessons learned from the past to face “global health threats of today”: the next global pandemic, non-communicable diseases, climate change, the refugee crisis, and many other emerging killers.

TEDxSkoll: Healthcare For All Is The Duty For All

Published by TEDxSkoll on April 19, 2017

In this talk, I explain the importance and power of speaking the truth even when there are numerous forces working against you. I detail the history of my country, Rwanda, as I struggled to make sure that the rest of the world was aware of the true nature of the devastating situation there. Through my experience as a Rwandan who came back to help rebuild her country, I describe why every life is worth fighting for because “being healthy is an economic asset for families, communities and countries.” This is why an institution like the university of global health equity (UGHE) is so vital as it sets out to educate all, starting with those in the most impoverished areas. I explain my belief that by standing in solidarity with the most vulnerable, we will always be able to promote truth. 


Blessed Unrest: A Theory Of Change

Published by on April 8, 2017

No global health fighter should be satisfied. Dissatisfaction and unrest will animate them and give them the energy needed in their quest for social justice and better access to quality health services for all. 
As the Skoll world forum looks to create common ground, in this panel, I explore with independent storytellers and social entrepreneurs how dissatisfaction can fuel positive changes. We discuss the truly global nature of our work and the work that is described in the film bending the arc. I also discuss my experiences of returning to Rwanda after the genocide against the Tutsi and averting the potential spread of Ebola to Rwanda, and the role of anger in being a global health fighter.

(MY PARTICIPATION FROM ~35:00 – 1:15:00): 

Universal Health Coverage in Low and Middle Income Countries

In this video, I share my thoughts on the importance of the underlying principles that are key in building and implementing Universal Health Coverage (UHC). UHC is a crucial aim of social justice and the basis for each person to access equitable, quality, sustainable care.

Here is the link to watch the lecture:

The Quest for Universal Health Coverage in Low and Middle Income Countries

Published by Johns Hopkins University, Maryland, USA (Filmed in Kigali, Rwanda) on April 4, 2016

I gave a guest lecture titled “The Quest for Universal Health Coverage in Low and Middle Income Countries” for Professor Afsan Bhadelia’s Johns Hopkins University undergraduate public health course.  This video displays a part of the rich discussion the students and I had during the Q&A following the lecture.

Here is the link to watch the lecture Q&A:

Building Resilience for NCDs: Integration in Basic Care

Published by Yale University, School of Public Health, Connecticut, USA (Filmed in Kigali, Rwanda) on March 28, 2016

On March 28, 2016, I gave a guest lecture titled “Building Resilience for NCDs: Integration in basic care” followed by a Q&A in Dr. Nicola Hawley’s Yale University School of Public Health course, “Global Non-Communicable Disease.”  The Masters-level students were from various departments across Yale University- including public health, epidemiology, infectious diseases, anthropology, and management. 

Here is the link to watch the lecture:

Accepting the 2015 Roux Prize from the Institute of Health Metrics and Evaluation (IHME)

Washington DC, USA on October 21, 2015

On October 21, 2015, I was deeply grateful to represent Rwanda in receiving the Roux Prize from the Institute of Health Metrics and Evaluation (IMHE). We received this esteemed award for our health sector’s use of Global Burden of Disease (GBD) data to make evidence-based decisions around improving neonatal health in Rwanda and, though this, decrease neonatal mortality and reduce suffering among the youngest in our population.  Read more about the Roux Prize and theInstitute of Health Metrics and Evaluation (IMHE) here:

Watch full video here:

Guest on the Big Q (TV Station)

Published in Kigali, Rwanda on October 1, 2015

On October 1, 2015, I was invited to be interviewed on the Big Q, a television show, to discuss health.  Watch the recorded videos above. 

Speaking About Health and Safety on Work Day in Bralirwa Gisenyi

Gisenyi, Rwanda on May 1, 2015

On May 1, 2015, I spoke to the community of Bralirwa in Gisenyi, Rwanda about health and safety on the annual holiday Umunsi w’umurimo, or “Work Day” in our national language of Kinyarwanda. On this day, we take time as a community to discuss employment, workplace safety, and new innovative ideas.

Inauguration of Children’s Week

Stockholm, Sweden on April 19, 2015

On April 19, 2015, I was honored to speak about the principals of building a system to promote child health in Rwanda, discussing how the future is in our hands. 

Featured on #1o1RW with Eugene Anangwe

Kigali, Rwanda on August 25, 2014

On August 25, 2014, I was invited to be a guest on “One on One” with Eugene Anangwe on 89.7 Contact FM here in Kigali to discuss Rwanda’s position on Ebola related issues and other issues in the health sector. It was a fun experience and I hope many were able to listen in for the great conversation!

Dartmouth Lecture: “Building a Health Sector Alongside a Nation”

Dartmouth College, New Hampshire, USA, on July 23,  2014

On July 23, 2014, I was invited to speak at Dartmouth College to give a presentation on how my Rwandan colleagues and I have built the health sector alongside the development of our nation, led by His Excellency President Paul Kagame of the Republic of Rwanda.  As I share in my lecture, a health sector must be integrated into the broader development of a country.  Here in Rwanda, we are guided by our national development plan, Vision 2020, and our Economic Development and Poverty Reduction Strategy.  Each of the strategic plans of the sectors within the government, including the health sector, are aligned with these overall, comprehensive national plans in order to ensure that we are all moving forward together in harmonized, complimentary efforts.

Giving the Inaugural Address at the 3rd National Food and Nutritional Summit

Kigali, Rwanda on February, 2014

On February 18, 2014, I was honored to give the inaugural address at the 3rd National Food and Nutritional Summit here in Kigali. Learn more about the Summit and the conversations we had here:

Voice of Africa Interview: Perspective On U.S. AIDS New Initiative To Increase Research For a Cure For HIV

Published by Voice of Africa on December 3, 2013

Here, on December 3, 2013, I was invited to be a guest on radio station Voice of Africa (VOA).  VOA’s Vincent Makori interviewed me and asked for my thoughts on U.S. President Barak Obama’s new initiative to increase research to find a cure for HIV.  Visit VOA here:

UCL-Lancet Lecture 2013: “Charity Does No Rhythm With Development”

Published by UCL Lancet on November 13, 2013

On November 13, 2013, I was invited to give a UCL-Lancet 2013 lecture.  In this presentation, I shared my perspective of Rwanda’s experience in mobilizing partnerships to help us achieve universal health coverage, with a social-entrepreneurship-business mindset.  We discussed how open access research, “reverse innovation,” and equitable global partnerships rooted in solidarity can reinvigorate the pursuit of health for all. 

Read more about the UCL-Lancet lecture and other presentations here:

2013 Skoll World Forum: “Can It Be Replicated? A Look at Rwanda’s Development Gains in Context”

Published by Skoll on August 2, 2013

On August 2, 2013, I was invited to speak at the Skoll World Forum and present a discussion, “Can It Be Replicated? A Look at Rwanda’s Development Gains in Context.”  I was joined by the following social entrepreneurs:  

MARY ROBINSON, Former President of Ireland, President of Mary Robinson FoundationMary Robinson is President of the Mary Robinson Foundation — Climate Justice. She served as President of Ireland from 1990-1997 and UN High Commissioner for Human Rights from 1997-2002. She is a member of The Elders and the Club of Madrid, and is the recipient of numerous honours and awards, including the Presidential Medal of Freedom from the President of the United States, Barack Obama. Mary served as Founder and President of Realizing Rights from 2002-2010.

Dale Dawson is Founder and CEO of Bridge2Rwanda, a social enterprise that facilitates business development in Rwanda and creates opportunity for Rwandan students to study abroad. He serves on President Paul Kagame’s Presidential Advisory Council and the Urwego Opportunity Bank, Rwanda’s largest micro-finance bank. In the first half of his career, Dale was an investment banker, entrepreneur and KPMG partner.

PAUL FARMER Co-Founder, Partners in Health
Paul Farmer, MD, PhD, is Kolokotrones University Professor and Chair of the Department of Global Health and Social Medicine at Harvard Medical School, Chief of the Division of Global Health Equity at Brigham and Women’s Hospital in Boston, and Co-Founder of Partners In Health. He also serves as UN Special Adviser to the Secretary-General on Community Based Medicine and Lessons from Haiti.

MATTHEW BISHOP, US Business Editor, The Economist
Matthew Bishop is the US Business Editor of The Economist.

He is the author of several books with Michael Green, including ‘Philanthrocapitalism: How Giving Can Save the World’, ‘The Road From Ruin’ and ‘In Gold We Trust? The Future of Money in an Age of Uncertainty’. Mr Bishop is also the author of ‘Essential Economics’. Mr. Bishop chaired the World Economic Forum’s Global Agenda Council on Philanthropy and Social Innovation, and was a member of the Advisors Group to the United Nations International Year of Microcredit in 2005

The Skoll World Forum on Social Entrepreneurship aims to “accelerate the impact of the world’s leading social entrepreneurs by uniting them with essential partners in a collaborative pursuit of learning, leverage and large scale social change.” 

Learn more about the forum here:
The Skoll Foundation brings together social entrepreneurs and other innovators to solve pressing problems across the world.  Learn more about the Skoll Foundation here:

International Society for Neglected Tropical Diseases Meeting

London, UK on July 15, 2013

On February 12, 2013 I spoke at the International Society for Neglected Tropical Diseases Meeting in London about the global healthcare implications of co-infections with NTDs and with other diseases. Watch videos of additional presentations here:

Commenting on Lancet Publication “Redefining Global Health-Care Delivery:” Reflections On Global Health Delivery

Kigali, Rwanda on May 23, 2013

World Bank President Jim Yong Kim, Dr. Paul Farmer, and Professor Michael Porter recently published a paper in the Lancet, titled “Redefining global health-care delivery.”  The publication, which analyzes health care delivery in the heart of the intersection of poverty and serious illness, can be found here: In this video, I offer my comments on my colleagues’ paper.  This video was recorded by Daniel Murenzi. 

Discussing the Importance of Priority Setting in Health

Kigali, Rwanda on May 1, 2013

In this video, filmed on May 1, 2013, I share my perspective on the importance of priority setting in health.  Planning is an integral tool in any sector, and priorities and timelines must always be set in order to move forward effectively and efficiently.

2010 Global Burden of Disease Study: Country-Level Data Launch

Kigali, Rwanda on March 5, 2013

On March 5, 2013, the Institute of Health Metrics and Evaluation (IHME) in Seattle, Washington launched their data findings from the Global Burden of Disease (GBD) 2010 Study.  The GBD Study is the largest and most comprehensive effort to date to measure epidemiological levels and trends worldwide. More than 1,000 GBD collaborators from 108 countries participated in the study.  I strongly believe that health decisions must be evidence-based and driven by sound, culturally sensitive data.  My Rwandan colleagues and I use the IHME’s GBD data often as we make our evidence-based data-driven decisions for the Health Sector.  Learn more about the IHME, the GBD Study and to access data here:

Delivering Open Remarks at the Susan G. Komen International 2013 Global Women’s Cancer Summit

Washington, DC on February 19, 2013

On February 19, 2013, I was very honored to deliver the opening remarks at the  Susan G. Komen International 2013 Global Women’s Cancer Summit in Washington, DC. This Summit brought together leaders from across the world to discuss the growing burden of women’s cancers, an important issue as we each face the growing burden of non-communicable disease on national levels.  Learn more about the Susan G. Komen International Global Women’s Cancer Summit here:–Komen-for-the-Cure-Convenes-Global-Women-s-Cancer-Summit;-Worldwide-Collaboration-Aims-to-Tackle-Breast,-Cervical-Cancer.html

Presentation for the the International Society for Neglected Tropical Diseases Co-infections 2013 Meeting

London, UK, February 11, 2013 (Filmed in Kigali, Rwanda)

On February 12, 2013, I spoke at the International Society for Neglected Tropical Diseases (ISNTD) Coinfections Meeting, which took place at the Wellcome Trust in London, UK.  This society aims to create multidisciplinary partnerships with NTD specialists, development professionals, research scientists, governments, donor & philanthropic organization and the private sector in order to improve healthcare outcomes globally.  
Watch videos of additional presentations here:
ISNTD Coinfections brings together experts in NTDs, other diseases and associated conditions of poverty – including HIV/AIDS, TB and malaria – who will be addressing the latest developments in these fields and their impact on NTD control with a view to effectively impacting poverty and development in the long-run. The Aim of this Coinfections group is to improve the delivery of healthcare and poverty alleviation among the most vulnerable by integrating resources across research, funding and advocacy with a focus on disease prevention and cure programmes.
Learn more about the International Society for Neglected Tropical Diseases here:
Learn more about the International Society for Neglected Tropical Diseases Coinfections group here:

Presentation for 2013 GET-Health Summit

New York, NY, USA, February 7, 2013 (Filmed in Kigali, Rwanda)

On February 2013, I shared this video message at the Global Education and Technology (GET) Health Summit in New York City, hosted at the United Nations. My remarks were part of the Ministerial Forum and were shared on February 7th. The summit was convened by the Johns Hopkins Center for Clinical Global Health Education and by the Global Partnership Forum.
Learn more about the Global Education and Technology Health Summit here:

Presentation for 6th World Congress on Pediatric Cardiology and Cardiac Surgery

Cape Town, South Africa  Published: February 5, 2013 (Filmed in Kigali, Rwanda)

For the 6th World Congress on Pediatric Cardiology and Cardiac Surgery, that took place 17-22 February, I offered a video remarks. My presentation titled “Uniting to address pediatric cardiac disease in Africa: A message from Rwanda” provided insights into the principles leading health care delivery in Rwanda.

Presentation to US National FACE AIDS Leadership Summit

Boston, MA, September 30, 2012 (Filmed in Kigali, Rwanda)

On 30 September, I spoke to leaders of FACE AIDS student groups at universities across the US about the continued global activist movement to fight HIV/AIDS. FACE AIDS currently works in Rwanda (among many other countries) to build awareness among youth around prevention, care, and social support for HIV/AIDS.

Interview with Dr. Agnes Binagwaho

New York, NY, September 26, 2012 (Filmed in Kigali, Rwanda)

On 26 September, I spoke about the importance of participation, consensus, evidence-based health science, accountability, decentralisation and governance, and the role these factors have played in moving Rwanda forward. 

A Talk for Harvard University’s Conference, “Universal Health Care: Challenges, Measurements, and Evaluation Strategies”

Boston, MA, September 13, 2012 (Filmed in Kigali, Rwanda)

On 13 September 2012, Harvard University hosted a conference on Universal Health Care. I participated via video-lecture and a video-Skype discussion with economists and public health professionals from around the world.

“The World is a Little Village”

Published by Dartmouth College, Hanover, NH on August 1, 2012

On 1 August 2012, I gave a brief interview on Rwanda’s new Human Resources for Health Program in collaboration with the consortium of universities in the United States.

“Time for a Paradigm Shift in Global Health: Equity, Science, Participation, Sustainability”

A talk with Dartmouth College, published on July 30, 2012

On 30 July 2012, I gave a public lecture in partnership with The Center for Health Care Delivery Science at Dartmouth College on how Rwanda’s experience can inform a paradigm shift in global health and why there is an urgent need for global solidarity.

Global Health Corps Fellows Orientation 2012

New Haven, CT, July 10, 2012

On Tuesday, 10 July 2012 I spoke via YouTube at the Orientation for the 2012-2013 Global Health Corps Fellows. This message can also can be applicable to students and young people interested in global health issues.

Wilton Park Conference: “The New Era in HIV/AIDS Treatment and Prevention: Science, Implementation and Finance”

Geneva, 27-28 June 2012

During the 2012 Wilton Park Conference titled “The new era in HIV/AIDS treatment and prevention: science, implementation and finance,” I spoke via YouTube with Dr. Sabin Nsanzimana, Head of the HIV/AIDS, STIs and Other Blood Borne Infections Division in the Rwanda Biomedical Center, on Rwanda’s country perspective on treatment as prevention for HIV. 

Salzburg Global Seminar – Strengthening Leadership and Policy for Improving Care in Low and Middle Income Economies

Salzburg, Austria, 24 April 2012

This week, I spoke at the Salzburg Global Seminar on “Strengthening Leadership and Policy for Improving Care in Low and Middle Income Economies.” I was invited to speak on a panel during the seminar’s fourth day, and discussed improvements in system-wide procurement and infrastructure development as an example of Rwanda’s approach to quality improvement. You can view the video of my speech above, and a program description at the Salzburg Global Seminar website.

Harvard College Course Video Presentation: Health Systems Strengthening and Social Justice

Cambridge, Massachusetts, 22 November 2011

I delivered these remarks via Youtube for a course taught at Harvard College called “Case Studies in Global Health: Biosocial Perspectives.” This video presentation on Tuesday, 22 November 2011 was aired in conjunction with a lecture by Partners In Health – Rwanda Country Director, and Chair of the Rwanda Biomedical Center, Dr. Peter Drobac. My video presentation and Dr. Drobac’s lecture were accompanied by a discussion with Professors Paul Farmer and Arthur Kleinman.

Salzburg Global Seminar – Concluding Remarks

Salzburg, Austria, 30 September 2011

On the concluding day of the Salzburg Global Seminar: “Innovating for Value in Health Care: Better Cross-Border Learning, Adaptation, and Adoption,” I delivered remarks via teleconferencing technology.
Seeing and hearing the presentation and ideas on innovation delivered by the Salzburg participants on both individual and group levels throughout the week, I found the type of community created in such a short time to be one that has great potential to continue in several important ways.
In my remarks, I shared four key ideas on my perspective on the importance and concept of having a vision: (1) the creation of a vision, (2) the measurement of the progress to reach this vision, (3) the strategy in order to attain targets, and (4) the ability and prioritization of documenting the vision and the process taken to achieve. Every person and Health System must have a vision; we must know where we want to go. We need to know where we are now and how to get where we want to go in order to achieve our mission. We need to document how we did each step so that we can learn from our efforts.
The first part is the vision is identifying where we want to go, no matter whether other people find it too ambitious. It is our vision, and we need to stick to it. In doing so, we assure that all of our actions will be according to our own priorities. I believe that this vision must be shared because alone we cannot accomplish much. But when everyone is together, we can design together a national strategy and plan that is country-owned and community driven, because communities should be a part of the design from the beginning.
This participatory process brings together communities with the public and private sectors. It is then easy to be morally sound because, from the start, no one is left out and the vulnerable people are taken care of. This is the essential human rights concept behind access to care.
The second part of the vision is measurement – we need to effectively measure the health of our population, the quality of our health care system, our people’s to access to care and treatment, and the utilization of health services across our country. This is useful, on one hand to provide a baseline for evidence-based planning but also, on the other hand, to set targets according to the financial, human, and infrastructural resources that we have. This means that we can design results-oriented strategies and plans. If we do such assessment periodically, they will show us over time where we stand compared to our vision and our plan.
In my presentation, this brought me to the third category: how to reach our targets. We do this by designing good strategy, good action plans, and by creating good tools. We reach our targets by thinking outside of the box – with creativity, with flexibility, by learning as we are doing, and by being always being ready to question how we can do better. Innovation, of course, includes the pursuit of new partnerships, such as North-South partnerships like that between Dartmouth and Rwanda as well as South-South partnerships like that between Haiti and Rwanda.
The final fourth part of the vision is documentation of how we build our health sector. We need to learn from our progress and, more importantly, from our mistakes. To facilitate this learning, we need to conduct research for better policies, better strategies, and better ways to implement. This is implementation science, which teaches us to reduce to gap between what we know from clinical research and what we actually deliver to our population. Today, implementation science requires as much research as clinical science because improving policies, strategies, and delivery allows us to produce better health with the same resources. Sometimes, improvement of our strategies and implementation produces even greater results when it is about public health by teaching us how to bring things to scale using opportunities in a synergistic way that makes the money go farther. We need to see health care delivery as a social business where the units to produce are health, enjoying life, and wealth.
Friends, good intentions, innovations, creativity, flexibility, and clinical science are not enough because poor planning and bad procurement can undermine health just as much as bad will, business as usual, bad clinical services, and laziness. For example, in 2008 in Rwanda, we had an argument with the Global Fund on mosquito net procurement that delayed distribution for twelve months. Because we were not allowed to use the Global Fund money before an agreement was reached, we were obliged to redo the entire process. In the end, the money we received was the same, because we had been genuine and had indeed done the procurement honestly; yet as a result of this delay, Rwandans died of malaria. This can be understood by health care delivery science: the Global Fund should be held responsible for system outcomes in the same way that the health professional is held responsible for the death of patients because of his or her bad practice.
Another example is the bad decision not to vaccinate Haitians against cholera during the country’s cholera outbreak because the vaccine was said to be too expensive. This decision has cost thousands of Haitian lives. The development partners who made that decision should be held responsible for this, as it has cost the lives of innocent, vulnerable Haitian people. Health care delivery science teaches us how to attain the best outcomes with the resources we have while making us totally responsible for the principles upon which we  implement and for the results that come from our actions.

Salzburg Global Seminar – From HIV to HPV

Salzburg, Austria, 27 September 2011

This week, I spoke at the Salzburg Global Seminar on “Innovating for Value in Health Care Delivery: Better Cross-Border Learning, Smarter Adaptation, and Adoption.” You can view the full program description here.
I was asked to present on Rwanda’s experience of integrating funding and programming for HIV into a comprehensive national strategic plan for quality basic health care. The talk was entitled: “From HIV to HPV: Same Principles in Building an Accessible, Affordable, and Equitable Health Care System in Rwanda.”
I started by discussing how, the week prior, I was in New York City for the United Nations High Level Meeting on Non-communicable diseases. It was intended to be a turning point in the global approach to tackling NCDs.
In that same UN hall, 10 years ago, we met to discuss how to make access to HIV prevention, care and treatment services a global priority. The 2001 UN summit on HIV/AIDS changed the conversation about HIV around the world.
At that time, we were told that we did not have the roads, the infrastructure, the cold chain, and the procurement capacity for drugs, consumable and reagents. We were told that we did not have the specialists, or even enough general practitioners and nurses, as many were killed during the 1994 Genocide Against the Tutsi. On top of all that, the so-called “experts” of health implementation said that our population was illiterate.  They said that our people did not wear watches, so they could not read and know the time when they would have to take ARVs and could thus not adhere to therapy. They claimed that we should concentrate on prevention and not try to introduce ARVs to save the lives of those already infected, as it was too costly and dangerous for the health of the rest of the world –they expected our people would be non-adherent and said that this would create deadly resistance. But what they did not into account for was the cost of inaction, a cost that Rwanda would not tolerate.
Today, despite all of the barriers, we are proud to say we now have universal coverage for antiretroviral therapy and one of the lowest prevalence rates in Africa at 2.8%.
We are also proud to say that we just completed our second dose of the HPV vaccine for girls aged 11 in Rwanda through our national comprehensive cervical cancer prevention and screening program. The coverage rate was 95% for the first dose and 97.4% for the second.
These two achievements, scaling up access to HIV care and launching the developing world’s first national HPV vaccination program, are not unrelated. Rwanda was able to vaccinate all of its girls aged 11 against HPV because we have strategically built upon the foundation of advances made in HIV care and treatment, among other communicable diseases.
We moved from a destroyed health sector after the war and the genocide to tackling and managing HIV and other infectious diseases.  We moved to tackle and manage non-communicable and chronic diseases while not dropping our advances in infectious disease control.
Health in Rwanda in general is understood as an important element of development. The HIV program needed to be coherent with the overall development vision of the country. And, just as our HIV plan, our overall health plan is evidence-based and results-oriented. The strategy of the health sector must follow national priorities and be linked to the national development vision (in Rwanda this is our Vision 2020 as well as our plan for the MDGs). The results must be monitored and used for planning and programming. Implementation and adaptation must be results-oriented.
When a massive influx of new HIV treatment resources was made available after years of effort by activists and people living with HIV around the world, we immediately made the choice to apply to access these funds. We used them to save the maximum number of lives in the most sustainable manner. This meant building a system that provided the best possible care for all Rwandans.
This was also a political choice, as it was rooted in the principle of assuring that the plan left no one out of the benefits. During our needs assessment in 2001, we realized that women use less health services than men. We acknowledged this disparity and the Government issued a Ministerial instruction to assure that if one member of a family is on ART there would be no additional cost for all additional members of the family to be put on treatment. A unit cost for the family with the objective to assure women and children access to prevention, care, and treatment was the first step in implementing an equitable health program based on gender, age and geographic equity. This is also why we made PMTCT the key family entry point to treatment.
Furthermore, we needed to assure in the beginning that people from higher socioeconomic levels would not be served more than poor, vulnerable patients, as we only had medicine for 3,500 people compared to the high volume of people in need of ARVs in order to survive. We assured this by putting civil society at the heart of the fight to regulate the selection of beneficiaries in health facilities.  We also put civil society on the board of coordinating bodies for the fight against HIV. While we no longer face these problems today, as we currently have enough treatment for all, this principle still guides us to fight discrimination and segregation.
Our strategy is based on national ownership and responsibility. We have strong national leadership. In order for the government to be in the driver’s seat from A to Z, we coordinate our development partners in committees chaired by a Rwandan civil servant. We developed national tools, which meant developing a policy, a strategy, and a plan.
Our institutions are responsible for normative functions (e.g. clinical standards, site accreditation) on performance. These are results-based contracts that do not allow delay. Once this national framework was in place – development partners were, and are still today, given a framework to which they can integrate.  Partners align their programs to the national plan. If they don’t want to align with our plan, they can go to another country. Parents are also asked to align with us and follow our lead around the location of their work. Many development partners come and want to be in the city, or they go to a country and want to be by the beach to do their work.  We realized quickly that we needed to be careful about this type of coordination with partners as well.
To assure the alignment of partners, we needed a participatory process. Partners need to participate in the design of the policies, strategies, and plans. They also need to sign their commitment of clear actions to be taken to support the process and clear indicators to be rigorously evaluated over time. This has allowed us to succeed with innovative approaches, including our common basket of procurement for ARV and consumable procurement and activities.
We assure also an equitable geographic coverage through strong coordination of our partners and with the political will to move resources out from the capital city. Another strategy we promote to assist with equitable distribution of human resources is performance-based financing, which helps incentivize nurses and doctors to continue working in remote areas as well as to increase and maintain the quality of the care they provide.
The other tool developed was the community-based health insurance (called Mutuelles de Sante), which aids in eliminating financial barriers to basic health care.  One pillar of our strategy is to provide systematic health insurance for civil servants through a program called RAMA. For the rest of the population, we began Mutuelles. This health insurance scheme aims to protect every Rwandan citizen from all common diseases. Since some very poor people cannot afford the 2 USD co-pay per year, there is also a free health insurance paid by the government for the poorest percentage of the population.
All this is done to protect people living with HIV, as well as those who are HIV free, against the most common diseases. It is not effective to save a child through antiretroviral therapy, costing more than one hundred dollars a year, and then to lose that same child to treat diarrhea or malaria, for lack of five dollars.  It is also not right to improve only the life of a small portion of our people.
The government’s financial support for Mutuelles for the poorest people in the population provided the opportunity to show to those who have to pay for themselves, that the poorest people with Mutuelles have better access to care than them. The result is that, last year, 98% of Rwandans had health insurance. We created both the demand and a new mentality among the rural population, who saw people poorer than themselves having access to health care. It created a revolutionary demand for pre-payment in a country where paying prior to needing care no longer existed.
In the area of capacity building we accomplished many goals that improve the health of all Rwandans, including the training of health staff at different levels and the provision of solar panels, computers, ambulances to the health centres. “AIDS money” has allowed the country to train health workers and to improve overall care. We have used it to provide incentives to improve human resources, allowing health workers to serve the poor.  When you train a lab technician for HIV testing, you also train him/her to test for syphilis, other diseases and even pregnancies. The lab infrastructure and microscope he uses serves all diseases. Almost half of HIV/AIDS funds in Rwanda were directed to strengthen the general health system and to support non-health, multi-sector development. 
Plans need to be community-driven if we want to solve the real problems at the community level. Because HIV is a disease linked with poverty, integration of HIV and AIDS programs needs to be part of a larger strategy for economic development and poverty reduction for the achievement of MDGs. I believe that this notion of health as a basic right is critical, and that this right must be protected and promoted by everyone.
We must have zero tolerance for vertical programs. This means we must consider an individual as a whole, not tackling one disease but instead tackling all public health issues by using the same service structures for the same communities with the same health workers.
Here is a concrete example of how, with “AIDS exceptionalism,” we strengthened the entire health system: to provide ARV services, we need to be able to first test for VCT and PMTCT to know if a person or pregnant women is HIV-positive. That means we need a laboratory for the testing. Before building or improving an existing laboratory, we need to provide common basic care to the clients of the sites where HIV treatment will be given. That means basic care for all, not only for PLWHA, and there is no site aimed only at HIV but, rather, aimed at comprehensive health facilities that treat the entire population for all diseases. Integration of HIV services in the health system is a prerequisite to provide ARVs in a safe manner while taking into consideration the needs of the entire population.
In Rwanda, we managed to use the influx of AIDS money to strengthen all sectors of the health system. We know that HIV is a cross-cutting issue. Within the health sector, AIDS money was used to rehabilitate or build infrastructures from scratch, such as health centers, delivery wards, laboratories, and consultation facilities. We have bought materials for communications, including telephones, computers, and ambulances.
Another key requirement for building a system is ensuring accountability from both sides, including countries and donors, through enforcement of transparency and anti-corruption measures. The greatest challenge that Rwanda and many other African countries face is that the health sector is largely externally financed. We have solved that partially by making the funds country-driven and directed them to meet community-defined needs.
However, many interventions remain under-funded, such as programs to address the link between food insecurity and health. Sustainability issues for interventions like ARV therapy remain beyond the financial means of most developing countries. We face the challenge of maintaining balance between our investments, by addressing the human resources deficit, while providing necessary services today. Development requires long-term support, and we face difficulties in firming up long-term donor commitments to projects focused on health systems strengthening. Partners must bring a spirit to plan for achievement and results, not simply a limited and arbitrary timeframe – what is not achieved in a sustainable way it will be lost one day.
While we face significant challenges, we also have a lot of opportunities. These include clear political and technical vision, strong government leadership, broad community and civil society participation, goodwill from all partners that results in global solidarity put into action, strong foundational programs on which to build, and motivated teams of health workers with the right skills.
By dedicating ourselves to making the new resources for HIV work to meet our vision, we have seen remarkable progress in the health of our population. Over the last five years, malaria morbidity has been reduced by 60% and under-five mortality has dropped by 50%. We have increased the proportion of infants receiving all basic WHO recommended immunizations from 75% to over 90%. Maternal mortality has dropped by nearly two-thirds. 98% of Rwanda’s 11 million people have health insurance. We have 45,000 community health workers and have successfully implemented our performance-based approach in the health sector.
So, on the shoulders of these advancements, we decided to tackle non-communicable diseases, which we saw as an important investment. The fight needed to start somewhere, and it is clear that for women we can mitigate cervical cancer with a vaccine, and breast cancer with self-detection or clinical detection. This is the place our government wanted to start. So on April 26th and 27th of 2011, 128,000 young Rwandan girls received their first shot of Gardasil – with no out-of-pocket payment – and Rwanda became the world’s first low-income country with a national HPV vaccine program.
Several early decisions were crucial to the success of our HPV vaccine initiative. First, we decided to vaccinate the girls at age 11, because at this age they are ready to receive and understand messages on reproductive health. We decided to vaccinate them in schools because 96% of girls in Rwanda go to school. Accordingly, we decided to widen our technical working group on vaccinations to include the Ministries of Education and Gender and Family Promotion, the Center for Treatment and Research on AIDS, Tuberculosis, Malaria, and Other Epidemics (TRAC Plus), and health workers engaged in the provision of cancer care. At the same time, throughout Rwanda, a sensitization campaign was done months in advance of the HPV vaccination. Many were involved in this, including health care professionals, local government officials, clergy, and the First Lady.
Second, the committee decided on a multi-phased vaccination strategy spanning three years. It started for girls in primary 6. After this first year, we planned to have two years of vaccinating girls in the second year of secondary school to assure that all girls aged 14 are vaccinated. After the third year, we planned to continue to vaccinate only in primary 6.
Looking at the central considerations of our decision to roll out the HPV vaccine, it is clear that an effective HPV vaccine program has to build on a national vaccination program. The HPV vaccine in Rwanda is also based on public-private partnership with Merck, which we see in reality as a public-private-community partnership, since our community health workers have helped us to identify the children that were not at school on the day of the vaccine. When you vaccinate at school, universal access to education is key to health equity.
I should note that the same accusations made against antiretroviral therapy and MDR-TB, as Jim Kim and Jaime Bayona have publicly spoken about, were raised against our HPV vaccine program. Researchers said that it was too expensive for Africa and that the HPV vaccine would take away from other vaccination programs (which already have nearly universal coverage in Rwanda). Also, they alleged that Africa’s high HIV prevalence would make the vaccine dangerous. But what they did not consider again was the cost of inaction and the danger to women, who would die of cervical cancer without the vaccine. Rwanda and its health sector leaders would not tolerate this cost. 
The HPV vaccine in Rwanda relied heavily on government leadership and support, as well as a community health system that reaches all rural and urban persons. To provide timely, quality services without stock-out, the supply chain, distribution systems and cold chain have to be in place and monitored extremely carefully.
Integration was, and is, key to our approach to non-communicable diseases. Detection should be integrated with family planning, with life skills, and with economic development. The point is to be cost-effective while providing health care in an equitable manner that ensures accessibility and affordability to all individuals.
Historically, there has always been a 15-20 year lag between the introduction of a vaccine in rich and poor countries. But in Rwanda, thanks to the good partnerships we have and our human rights-based approach to development, we shortened that lag time in delivering the HPV vaccine to less than 2 years. This is something that can and should be done in many other poor countries – those who bear the brunt of the burden of disease are generally the last beneficiaries of advances in science and medicine.
Rwanda’s richest resource is its population. For this reason, all of the policies and strategies in our health sector are rooted in the pursuit of health equity and social justice. These advances in combatting communicable diseases and strengthening the health system have led to increased life expectancy, which now exceeds 50 years, leading to our people living longer and now showing an increased prevalence of NCDs later in life.  This is an opportunity and a challenge, reflecting both our progress and the immense mountains we still have to climb to provide the necessary new services to our population.
Fighting diseases needs to start by good policies, strategies, and plans and needs to be integrated across sectors with the goal of strengthening the entire health system.

Global Health Principles: A focus on Health System Strengthening

Cambridge, April 7, 2011

This talk was given to undergraduates and graduate students at Harvard University, and hosted by the Harvard Institute for Global Health in Cambridge, MA. Prior to a Question and Answer session, I spoke to the students about how it is important to develop a health care system based around national programs and ownership. I discussed the example of HIV programs, the fight against cancer, care of people living with handicaps, and issues of human resources for health including professionals and community health workers. Students posed terrific questions about accountability, national ownership and challenges to scale-up.

Global Health Financing, Panel at Harvard Kennedy School

Cambridge, April, 7, 2011

A panel hosted by the Harvard Kennedy School; the Program in Global Public Policy and Social Change, in the Department of Global Health and Social Medicine of Harvard Medical School; the François-Xavier Bagnoud Center for Health and Human Rights, of Harvard University; and Partners In Health.  Several panelists participated in a discussion concerning the payment for health services and access to essential services in resource-limited settings. Dr. Binagwaho spoke on the panel with other scholars including Paul Farmer, Kolokotrones University Professor, Harvard University; Cristian Baeza, Director for Health, Nutrition and Population, Human Development Network, World Bank; Robert Yates, Senior Health Advisor, DFID; and S.A.S. Kargbo, the Director of Reproductive and Child Health in the Ministry of Health in Sierra Leone.  Each explained different models of health care financing and payment for services in various countries in Africa and other parts of the world. Dr. Binagwaho insisted on home grown solutions to payment schemes and on the sustainability of financing. After the panelists shared their views on payment for health care (e.g. individual payer, insurance provider, government as the payer), there was a designated period of Question and Answer with the audience. To conclude the event, the panelists agreed on the need for universal access to basic care with a shared understanding of health care as a human right.

Innovations to Improve the Quality of Health Care in Resource-Limited Settings

Lecture given in Boston, MA on 31 March 2011 on Innovations to Improve the Quality of Health Care

This lecture concerned innovations to advance the quality of health care in resource-limited settings with a focus on current programs and projected opportunities for improvement. In order to reach the Millennium Development Goals, especially those for health, countries must invest in innovations – both technological and political. We must agree that the responsibility to provide health care belongs to all people including the Government, the private sector and the general population. Improving access to prevention, care and treatment especially for those who are most vulnerable such as women and children, we need to have targeted innovative actions. Generally speaking, the world has come far since the MDGs were set in 2000. And yet we have a big push ahead of us. In order to advance as quickly as we need to – a big shift toward technology and communication must be made. 

If health care is taken as a basic human right – something I believe strongly – these innovations must reach all persons within a country, with a focus on those who are most vulnerable. In Rwanda, there are four examples of such innovation: (1) the new non-surgical male circumcision device that does not require a sterile environment, PrePex; (2) the alert system called Rapid SMS whereby community health workers can alert the district and central levels of, for example, a woman who needs an ambulance to take her to the hospital to give birth simply by sending an SMS; (3) mUbuzima, another cell phone technology that allows the community to send a set series of indicators on the MDGs within their communities; (4) and the system of governance in Rwanda wherein the population is given a strong voice in policy, action and major decisions.

With innovative tools and new ways of managing them with enhanced ownership and accountability, countries will be able to accelerate providing access to health services for all.

The Cycle of Poverty and HIV Infection

Boston, July 8, 2011

With Dr. Paul Farmer giving a lecture in the Harvard Medical School Course: Introduction to Social Medicine

This lecture explores the role poverty plays in preventing access to health care and discusses the vicious cycle of poverty and HIV infection. This is well illustrated by maps by of HIV distribution and poverty distribution worldwide.

Countries have to break the cycle of disease and poverty in order to achieve good health. The fight against HIV is one of the clearest examples of how the lack of access to care and treatment is a death sentence for the poor. And, beyond the affects of HIV/AIDS, a poor country in sub-Saharan Africa will not be able to reach development goals efficaciously without addressing the burden of other infectious diseases like malaria. Malaria claims millions of deaths in addition to debilitating tens of millions through chronic anemia. There is a need to promote prevention and, at the same time, improve case finding and treatment at the community level. This will lower the number of patients hospitalized for malaria and thus lower absenteeism among workers and students.

To fight HIV infection and malaria we need to link improvement in both prevention and care. We have to avoid choosing between one approach or the other given that both prevention and care are vital.Why does Africa face the vicious cycle of disease? By losing skilled people due to diseases, including doctors and nurses, rates of death among the population from other common diseases will rise since fewer professionals would be there to treat them.

In hospitals, beds occupied by those suffering from HIV-related diseases are limiting the space for patients sick with other treatable diseases. Thus, we see that AIDS kills even non-HIV infected patients because of lack of heath practitioners and lack of hospital spaces. In the education sector, the lack of teachers decreases the quality of education for the next generation (and a loss of investment for governments that have disbursed funds to trained teachers).

Most importantly, parents are dying in their productive and reproductive years and leaving orphans behind. As it is in the tradition, extended families and communities struggle to absorb these orphans.  The times there have been no parents left and children without adults alive at home struggled to organize themselves into new families. But extended families, and even moreso child-headed households, cannot afford school and health care for their children, brothers, and sisters without solidarity—locally and nationally and internationally. The orphaning of all of these children makes people even poorer and more vulnerable. Without appropriate action we have feared that Africa would become more and more poor, with diminished capacity to defeat poverty.

So, thinking beyond the examples of AIDS and malaria, what is needed to break the cycle of disease and poverty? Good health increases production capacity, which in turn leads to economic growth and poverty reduction. This leads to better health for the overall population as they have more money to pay for health services.

Taking examples of Rwanda, this lecture indicated the importance of developing a national policy framework, coordinating partners, proactively promoting gender-equity, mobilizing funds, integrating vertical programs in public health facilities, assuring sustainability and breaking down geographic and financial barriers.

We cannot ensure the basic human right of access to care for all without this battle. In breaking the vicious cycle of poverty, no one is exempt: no government, no sector, no agency, no NGO, no part of civil society, no multilateral organization, no individual – no expert, no scientist, no public health professional. All must join the fight.

Health and Human Rights: Creating an Open Forum to advance Global Health and Social Justice

September 17, 2008

HumanRights Journal Launch, Here the link:  – Part 1

HumanRights Journal Launch, Here the link:  Part 2
The Right to Health and the Right to Information are linked. Open Access Journals are good entry point to access to information and improve access to health care.

Rwanda’s history, and particularly, before 1994, the role of state-controlled radio stations in the genocide, had demonstrated that the right to information was critical to protecting individuals. The Rwandan government sees Information and Communication Technology as a top priority, and is working tirelessly to increase Internet access nationally.

This lecture reflected also on the irony of research done in developing countries that can’t never been available to the study subjects, without them paying for it. This is why the efforts of open access Journal in promoting access to a wider audience should be applauded as it increases access to education, information, and health all necessary for fighting against the cycle of poverty.