José Luis Castro of Vital Strategies: “Be curious”

Be curious: Never accept what you see. Ask questions. I was always taught to learn more and to take initiative to learn about things I didn’t know. Even with a busy schedule, I have a habit of reading one or two books every week on diverse subjects. You must be hungry to learn. As part of […]

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Be curious: Never accept what you see. Ask questions. I was always taught to learn more and to take initiative to learn about things I didn’t know. Even with a busy schedule, I have a habit of reading one or two books every week on diverse subjects. You must be hungry to learn.

As part of my series about “individuals and organizations making an important social impact”, I had the pleasure of interviewing José Luis Castro.

José Luis Castro is the President & CEO of the global health organization Vital Strategies, where he has led a rapid expansion of Vital Strategies’ portfolio, working with governments to tackle the world’s leading killers, primarily in low- and middle- income countries. The organization now reaches into 73 countries and has touched the lives of more than 2 billion people.

Thank you so much for doing this with us. Before we begin our readers would like to get to know you a bit more. Can you tell us a bit about your “backstory”?

We’re often taught that skills bring success in life, but as a Cuban political refugee growing up in America, my perspective is that it’s the values that emerge from our personal experiences that guide our lives.

My childhood emphasized learning and education. Growing up in Cuba under Fidel Castro, we were subject to frequent searches of our home to eliminate books. My parents kept a well-stocked library despite the risks. I grew up memorizing plays and poems in case the books were taken. And even as a young child I saw the danger of propaganda and control of information.

My family was forced to leave Cuba when I was 13 years old and we were able to go to the United States. While we were lucky to have this opportunity, it was a difficult time for an adolescent. I was an outsider, with poor English and no knowledge of American culture, attending a school in New Jersey that had limited resources. When I later went on to Pace University in New York City, I finally found a place where I felt more at home. Among the many subjects I was able to explore at Pace, I ultimately chose to focus on political science and international relations, which helped me understand global issues and how governments worked, especially the UN systems.

I went on to graduate school at the University of Pennsylvania, then got a job in Philadelphia’s health department during the height of the AIDS epidemic. There was no treatment available at that time. I saw firsthand how people with AIDS — especially gay men and drug users — were marginalized and stigmatized. The AIDS epidemic was a pivotal moment in public health, not least because of the extraordinary activism required to push the government to do more. We need this kind of determination to address, and demand, commitment for health at the population level.

My subsequent jobs in New York City government and later in India brought me to work on tuberculosis. In the 1980’s in NYC, TB was resurging in tandem with the AIDS epidemic, and more and more cases were drug-resistant. Careful surveillance and treatment helped turn the tide by the mid-1990s, but today TB still sickens 10 million people around the world each year and kills 1.5 million. This led me on a path to becoming Executive Director at The International Union Against Tuberculosis and Lung Disease, where I worked for 19 years.

In 2004, while on a mission for The Union, I was frustrated by the effort required to get TB drugs out of customs. Lifesaving medications were literally sitting on the docks as people who needed them died. This is just one example of the huge gap between the health solutions “global experts” have endorsed, and what needs to be done at the country level to put those strategies into place in a way that will work in their systems and culture.

That was just one of many experiences throughout my career of interventions that failed to achieve their full potential because no one was looking at the big picture. I wanted to start an organization that would look at health systems broadly, informed by the latest technical expertise of what to do, but also deeply committed to supporting countries to find context-specific ways of how to do it. Three friends came together to found the organization we now know as Vital Strategies. Our mission is to work toward a world where everyone, everywhere is protected by a strong public health system.

Can you tell me about the most interesting projects you are working on now?

We’ve all seen how the COVID-19 pandemic has upended our world. In February and March of 2020, Vital Strategies rapidly pivoted to support governments in addressing COVID-19, while also addressing how COVID is changing health issues across our portfolio.

For example, Vital Strategies and our colleagues at Resolve to Save Lives helped more than 50 countries make policy decisions on COVID-19, such as whether to close schools and how to run testing and contact tracing programs. We trained more than 36,000 health care workers at 7,200 health centers across Africa. We published hundreds of COVID-19 communication materials in multiple languages.

At the same time, we had to closely monitor how the pandemic was affecting the other health issues we work on. For example, tobacco use claims 7 million lives every year, and COVID-19 initially drew time and attention away from progress we were making on this critical health issue. Despite the challenges, we helped achieve 17 tobacco control policy wins across several of the world’s most populous countries, including new tobacco taxes, and we have exposed the tobacco industry’s efforts to use the pandemic as an opportunity to burnish its image.

So how exactly does your organization help people?

People are getting sick, injured and dying in the tens of millions each year from diseases and injuries that are avoidable. Their environment can either enable health or drive people towards illness or injury. Of course, this includes clean air and healthy food and access to health care, but it also includes so much more: protection from predatory marketing of harmful products, smart cities that prioritize public transport, and a government that can spot and be prepared to address an infectious outbreak before it becomes an epidemic.

We support governments to identify and implement policies that promote health for as many people as possible, ideally millions of people at a time. And we work with governments to build the know-how and capabilities they need to maintain these strategies, such as strong health data systems and a well-trained work force. Simple, proven measures can save millions of lives every year, from regulations that keep toxins out of our food and pollutants out of the air we breathe, to programs that bolster countries’ capabilities to prevent and treat hypertension. We provide technical assistance to governments and organizations at the city, national and global level to help put these measures in place.

We envision a world where people are surrounded by opportunities for good health and protected from the leading drivers of disease. Our goal is to provide support that enables governments to build systems, and to train and fill gaps, so that leaders can then take it forward.

Can you tell me a story about a person that you helped?

One of the things I am most proud of is that I recently established two scholarship funds at Pace University in the name of each of my parents. They are the people who inspired me and taught me the value of education. The scholarships are for people who have experienced adversity and have overcome it, and as a result, have used their voice to help their community. This year, it will provide tuition assistance for several students.

This obviously is not easy work. What drives you?

I still think about the horrors I saw in Philadelphia during the height of the AIDS epidemic. I remember seeing a dentist friend of mine whose health deteriorated over just six months — he looked like a ghost, emaciated, with facial lesions. I have not been able to forget what a disease can do to a human being, how it dehumanizes.

I knew I could not do my work effectively if I didn’t see firsthand what people were facing. I started volunteering at a church and a community-based organization that served food to black men with AIDS. I talked to them, and I listened. They carried bags of medicines, which would maybe extend their lives by a few weeks. I worked in a call center counseling people, and our phones never stopped ringing.

HIV/AIDS was finally prioritized after a tremendous amount of activism and advocacy. I remember seeing the activists chain themselves to the railroad tracks in Philadelphia. In New York City, activists showed up at every meeting that the health commissioner went to. This level of activism, fight by fight, led to a national strategy.

I have committed my career to figuring out how to build that same political will even — or especially — when there isn’t that level of activism. How, for example, can we make that happen for cancer? When there are interventions that work, they need to be expanded so they help as many people as possible.

COVID-19 is a story in contrasts. For the first time in history, we have developed a vaccine in under a year. Why couldn’t that happen with AIDS? So, what drives me is helping build political will for better health.

Are there three things the community/society/politicians can do help you address the root of the problem you are trying to solve?

We need to keep commercial interests out of health policymaking. What we call “commercial determinants of health” can have an enormous impact on people’s lives. For example, the food and beverage industry should not dictate what nutritional labeling looks like, because their goal is to sell products, not to protect health. In the same way, we can’t trust the fossil fuels industry to determine emissions standards for the quality of the air you breathe. More often than not when it comes to our health, industry’s gain is our loss.

Especially in the COVID era, we should prioritize now those policies that both benefit health and grow economies. These range from banning trans fats in foods, to avoiding incentives to the alcohol industry, to implementing smoke-free environments and tobacco taxes.

Public health and health providers must look beyond technical solutions and push for social change. Many of the root causes of poor health lie in negative social determinants: poverty, racism, and limited access to education and health care. Achieving health equity and minimizing disparities is something that all societies must take urgent action on.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are?

I always start with my parents. Everything starts at home; my parents valued learning and curiosity, and they allowed me to be who I was. Because I had that support, I could confidently develop into a leader and take risks. This was not a given, as we had lived through such a tumultuous time and were exiled from our own country.

What are your “5 things I wish someone told me when I first started” and why. (Please share a story or example for each.)

Be curious: Never accept what you see. Ask questions. I was always taught to learn more and to take initiative to learn about things I didn’t know. Even with a busy schedule, I have a habit of reading one or two books every week on diverse subjects. You must be hungry to learn.

Take risks: To reap big rewards or make a big impact, you must take risks. At Vital Strategies we have rapidly expanded our work and launched new programs nearly every year. I have found that when you push yourself to do work that is new to you, maybe even out of your comfort zone, creativity flourishes.

Find your mentor: Everyone can benefit from a mentor. I am grateful that one of my mentors was Linda Quest, a professor at Pace University and one of the brightest people I have ever met. I studied international politics with her, and she really helped me see the world more clearly, and to analyze situations to understand what is really happening and not take it at face value.

Learn to communicate: The ability to communicate clearly and effectively is crucial to any position of leadership.It’s important to have well-rounded experiences and education because you can use them in any profession that you pursue. And these days there are lots of ways of speaking out: in person, of course, but also on social media, through video and more. Find what works for you and use it.

Listen more: My grandfather once told me “Listen a lot, speak little, and work very hard.” To be a good leader you have to be a good listener. Listen to those whose lives you are seeking to improve and listen more than you speak. Great ideas exist everywhere but we have to take the time to listen and collaborate with others for them to come to fruition.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

Diabetes, heart disease and cancer, what we call noncommunicable diseases (NCDs), account for 1% of global health funding in low- and middle-income countries, despite accounting for nearly 67% of deaths. That’s an outrageous discrepancy.

COVID-19 has made it even more difficult. The attention of governments is on COVID and boosting economies and recovering from this pandemic. In the meantime, the NCD disaster is ravaging lives. More than 41 million people are dying every year. We can do the most amount of good and save thousands of lives if we invest in prevention and care for these diseases. They are largely preventable, and we know what policies must be enacted to make the biggest difference.

We can’t see these as separate challenges. We hope to create a movement at the local and national level that addresses NCDs and pushes for solutions that increase investment and attention, at the same time strengthening health systems to respond to COVID and the next pandemic.

Some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might see just see this. 🙂

A leader I have met, but who I would like to spend more time with, is Mirai Chatterjee, one of the leaders of the Self-Employed Women’s Association in India. She helped create a national movement to bring together women who work in the informal economy, and found ways for them to collectively promote their businesses and develop worker protections, including an insurance cooperative, health care, childcare and housing. They now have more than 1.5 million members.

What is the best way our readers can follow you on social media?

I can be found on Twitter @JLCastroGarcia, Instagram, joseluiscastro.official and LinkedIn José Luis Castro.

This was very inspiring. Thank you so much for joining us!

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