Jono Quick, President & CEO, Management Sciences for Health

By Evelyn Garland, Project Manager, Christian Connections for International Health (CCIH)

Dr. Jonathan Quick leads Management Sciences for Health, a 1800-people organization that aims to improve health care around the world through better public policy and management. Previously, he was Director of Essential Drugs and Medicines Policy for the World Health Organization (WHO) in Geneva. Quick graduated with an A.B. degree magna cum laude from Harvard University, and an M.D. with distinction in research and a Masters in Public Health from the University of Rochester; USA. Quick is a family physician and public health management specialist. He spent nearly 20 years of work in international health. He served as a long-term advisor for health systems development in Pakistan and Kenya and carried out assignments in over 20 countries in Africa, Asia, and Latin America. He practiced family medicine in the U.S. Indian Health Service, Oklahoma and Boston Quick has written or edited 11 books and more than 40 articles and chapters on essential medicines, public health, stress management, and executive health. He is Adjunct Associate Professor of Public Health, Boston University School of Public Health; a Diplomat of the American Board of Family Practice; a Fellow of the Royal Society of Medicine (UK); and a fellow of the American College of Preventive Medicine.

Getting into Global Health

Evelyn: You started as a physician, then got into global health. How did you make that switch from practicing medicine in the United States to working in global health?

Jono: It actually was not a switch in the sense that I got involved in global health before I finished my residency. I was a third year medical student in 1978, and decided to get an MPH. I wanted to work overseas. I wrote a lot of letters and found Management Sciences for Health. For 8 months, my job was to travel around the world to look at essential medicines programs, and that eventually became a book. So I actually started international health even before I finished medical school. I completed medical school, did my residency and chief residency in family medicine, spent 2 years in the public health service, and then decided that what had been a hobby [i.e. international health], I would make into my career.

No Game Plan?

Evelyn: Did you always know what you would be doing in the future?

Jono: I never had a game plan. I always, at any step, when I had a decision, I said “What would be the most interesting and the most fun?” I never could finish anything straight away. In college, I took a year out and worked as a mental health counselor; in medical school, I took a year out and did this [essential medicines] travel; and during residency, I took time out to finish the book on essential medicines. I never went looking for my next job –the opportunities came up. So, to me, it is kind of the blessings of an unplanned life.

Hard Times and Tough Situations

Evelyn: Was there any period of time when you really questioned yourself, for example, on what you wanted to achieve in life? Or, whether you had made the right decisions in the past?

Jono: Hum… yeah… One of the things that I have concluded is that any job you can do well on Day One is not worth having. When I was at the World Health Organization – I spent ten years at the World Health Organization –about two years into that, we started to hit some really challenging times. I was running the essential drugs program. We were regularly knocking heads with the U.S. industry and other folks who had a different idea about what we ought to be doing and expressed it really strongly. It took political skills, not just technical skills. I was a family doctor, running this global medicine program. I spent a lot of time saying to myself: I either need to get another job, or I need to change, because I did not have the political skills to do it. I ended up learning those skills.

Now I am running Management Sciences for Health, which is a non-profit organization with 1800 people in 30 different countries. We are driven and fueled by a passion for having an impact on health. But we have to run like a business in order to achieve that health impact. When I started the job five years ago, I did not have some of those business skills and reflexes. I said: You know, we’re doing great things for public health, but I can’t do part of the job that I have. And again, it was either getting another job or learning those skills.

I have never, never had second thoughts about being involved in international health, but I have definitely had second thoughts about whether I have landed at the right place. To be honest, particularly in the last five, ten years, it was my wife… I was making these important decisions… my wife and I made them together with discussion and prayer. Whenever things got really tough (laugh), my wife would say: “Ah, God must have something really good ahead there, otherwise, He wouldn’t be trying you this hard.” It has actually been faith that has gotten me through the tough times, challenging times, and growth times.

Evelyn: Having worked in the WHO for ten years and dealt with people with conflict interest as well as bureaucracy, what advice do you have for young professionals in dealing with conflict of interest and bureaucracy?

Jono: One word about bureaucracy. Bureaucracy is neither good nor bad; it is a set of rules to get something done. You must choose how you are going to deal with that. You either say: “I don’t like these rules, and I don’t agree with them” You fight them Or say: “These are the rules, if there are some we can change, fine. But we figure out how to use these rules to get good things done – we put our energies into getting things done.” Certainly it was the case at WHO that if you did that, you could achieve a lot.

There are a couple of things about how you really do that. One is to be very clear in your mind what it is you are trying to achieve. It can be really simple. With the WHO medicines program, our compass was quite simple: access to medicines, quality and safety of medicines, and rational use. It did not matter whether you were in the public sector or private sector; it was focused on ultimately the care in the household. With that as our compass, you could say what was important and what was not important. Did it contribute to my purpose?

In terms of all the different conflicts and stakeholders, I found one of the most inspiring and helpful books out there was Nelson Mandela’s autobiography. He treated everyone with respect, even people who he completely disagreed with, even people who were pouring out hatred in the street. Martin Luther King said that, ”Love is the only force powerful enough to turn an enemy into a friend.” I have seen all sorts of negotiations and everything else, and I’ve been amazed at unexpectedly positive outcomes. I think it is important to be respectful of other people, keep focus on your goal, and be not afraid to dig in.

Another thing is -- particularly when you are working for an organization -- if some of the directions are pushing you toward things that you really just are not personally comfortable with, just decide not to compromise. It is tempting to compromise basic values to keep the job, but at the end of the day you have to look at yourself in the mirror. Being willing to stay on track and take some risk, I think that’s important.

So keep on target, respect everybody, but do not compromise your fundamentals.

Evelyn: As the President of Management Sciences for Health and Director for Drug Policies at WHO, did you get a lot of criticism in certain periods of time?

Jono: Yep.

Evelyn: How did you cope with that?

Jono: (Laugh) One of the things I started doing when we were having some of the toughest challenges and really vigorous attacks on work we were doing on patents and access to medicines at WHO: I started praying for the people who were the most vociferous against the work we were doing. It really changed our relationship with those people. Of course, they did not know we were praying for them. But I genuinely thought that they were misled. I do think in this sense praying for your “enemy” is really valuable.

It helps to have a team to work with and to be able to share the burden with others, realizing that ultimately that you are not in control, and there are forces above us that control things. Whether you succeed or fail on a particular issue, you did the best you can, and you just accept the results and move forward.

I also learned an important lesson by watching the diplomats in Geneva. They would fight, argue and wrestle about terms, about whether to say that health should take precedence over commercial interests, and so on. But at the end of the day, when the issue was resolved, they would go off and have a glass of wine together. So take the words and purpose seriously, but do not take yourself overly seriously.

Finding One’s Niche

Evelyn: A lot of students find themselves knowing that they want to do something good in the future, preferably as their career, but they haven’t found God’s calling or their own niche. What advice would you give to such students?

Jono: First, have in mind what we mean by calling. Some people think that you need to hear a voice, like “Joseph, I want you to do this.” It was very interesting reading Mother Theresa’s biography. She never felt a specific voice that said: do this. So in a sense, at least what I took away from the reading was that, she knew she when got there, but she never quite felt that clear call.

I think we should not have a lot of angst about whether we’ve been called or not; there is always going to be some doubt and uncertainty. I really think that people do best in the sweet spot of their talents and passions. So figure out what you are good at and what you enjoy. Then keep your eyes open for the opportunities. When you do have an opportunity, do all things for the glory of God, really put your heart into doing it well. Even the simple things, do them well.

Job, Job, Job! & Networking

Evelyn: In this economy, a lot of international health organizations are cutting their budget and laying off people. Is there any advice for students who just graduated looking for a job in international health?

Jono: I guess a few things. One is realizing that life is long. I always think it is good to have a plan B. Whenever I have really felt like what I was doing was under threat one way or another, whenever I was feeling insecurity about where I was, I always thought about plan B. Having a plan B always actually makes me more confident in pursuing plan A. Figure out some alternative. For example, thinking, “I want to do international health, but I realize that this may not be the right time.”

The other thing is that you need to make it a job out of looking for a job. Some people when they decide that want to, for example, be a writer, they write when they want to. You have to make it a job, and really block the time to write. Similarly, when you are looking for a job, you have to take that as a full time occupation. Part of the time is devoted to systematically looking for job opportunities and being persistent. The other part of the time is saying: What can I do with the time I have? The most precious resource you have is time. You can read, you can write, and you can develop other skills. When I am looking for people, I look at what they have written – writing is an important skill. Very few people are really good writers. You can do some self-help things. I would get people to really hone writing skills and reading skills.

I would suggest that anybody job hunting get the book Learned Optimism, by Martin Seligman. You can learn the skill of having a more optimistic outlook. People who are more optimistic do better at getting jobs and do better at keeping jobs. And again, it is part of using you time. It is part of the job of getting a job: to build those skills.

Evelyn: What is your advice to students on networking?

Jono: First of all, one of the questions is: Who do you network with? In an organization of our size, divided up in all sorts of programs, I hardly make any hiring decisions. There are scores of people at MSH who are making decisions and actually hiring people. So, you need to identify who in an organization you are going to network with. I think that’s one part of it.

Evelyn: Well, a lot of times, a student may find it challenging to network with professionals, because he has not run many programs or has much experience. What is your advice to such a student on networking?

Jono: Initiative. I think that is an important thing. Really having an initiative – that shows how people use their time. If between jobs they use their time just to hang out and shoot darts, that is not very impressive; if they use it to get involved in a project to do volunteer research project. I was coming back on a plane a couple of week ago. I met a young woman who was working for a research company. It was a company that was developing diagnostics that they wanted to do in Southern Africa. She just really wanted to do something in the field. So she finally bought a plane ticket, went to South Africa, and networked around – first volunteered, then got paid to do capacity building with some small local NGOs. She started as a volunteer and then she got paid. That was tremendous initiative.

Faith

Evelyn: In your professional life, outside of CCIH, are you often quite open about your faith?

Jono: It depends on the setting. I have occasionally found myself in a position where it just seemed the right thing to do was to pray. For example, in medical school, there was an honor society AOA, Alpha Omega Alpha. I was not smart enough in medical school to get into it, but as an alumnus somehow I had gotten smarter. So they had me come back for an induction dinner at which I was supposed to share a few things about my professional life with students. Dinner was arriving while I was talking, so I decided to say grace. It just felt like the right thing to do. So it depends. I do not hide my faith, but I do not flaunt it.

One thing that I am a little sensitive about is ‘religious harassment’. People should come to faith because they are convinced. Whenever you can have the conversation and really lead people on the way, the evidence for faith and for Christ is overwhelming. So when you have the conversation people can come there. But they should not become – or appear to become Christian because their boss is a. I am a little bit wary about doing things that could be seen as ‘religious harassment’ -- you know, repeated unwanted efforts. My view is that I keep trying to do the best I can, living life in a way that I am really happy with. I slip a lot in that effort, being short with people and not always as respectful as I ought to be. But if you live life in a good way and people associate that with being a Christian, that sends a message. And that is what I try to do.

More about Jono – A Realistic Idealist

Holding on to his dream and lofty ideals in global health, Jono is absolutely an idealist. However, this same idealist has a very good grasp of the reality, so good that he has turned his hobby into a successful career. Yet, he never had a game plan, never heard a divine voice calling, often questioned himself in hard times, and struggled in school and at work. I believe that many of us can easily identify with Jono in one way or another. And, I hope that you could also find insights, encouragement, and support from Jono’s experience.

Jono lives in the Boston area. He enjoys jogging, writing, drumming, jazz and rock’n’roll.