Dr. Michael J. Free is becoming PATH’s senior advisor emeritus after more than 30 years as leader of our work in health technologies. Last week, Dr. Free discussed his career at PATH and what makes a global health success. This week, he looks ahead to the future of the field.
Q. What should PATH be working on right now? What will be the big challenges in the future?
A. It’s going to be so hard to predict some meta-events that are likely to be hugely disruptive. I think a lot of what we learn might be applicable to displaced populations and disaster scenarios.
Q. Do you mean natural disasters?
A. We can’t call them natural anymore, can we? They’re not natural. They’re man-made disasters, the result of the bad practices of many generations. So I think we should stand prepared to move into those sorts of areas.
Apart from that, we’re clearly now up against the inescapable notion that we have to deal with whole systems rather than single-shot interventions. I think there’s an opportunity to achieve ever expanding increments of integration as we influence funders and other stakeholders. We need to expand the scope of interventions to deliver whole solution sets.
Q. Does an example come to mind?
A. If a mother is coming in for treatment, it doesn’t do much good to treat just one of her problems without treating the others. Service providers have to be equipped and optimized to make and keep her well in all respects.
Also, as developing countries are maturing, they’re beginning to demand solutions that can scale. They don’t want any more pilots without passengers, I suppose you could say. They’re beginning to have a much better idea of what their problems are and how they can go about finding solutions. And one of the options is the potential for local innovation—harnessing local innovation and providing the know-how and the competencies to allow those local innovations to become solutions. And we know how to do that. We’ve got to expand on that, I think.
Undoubtedly there are a lot of other trends underway, which if they played out, really are going to lead to some whole new ways of doing development.
Q. Can you give an example?
A. Well, the question of integration goes beyond health. It goes to agriculture and education and energy. And also another big example where we’ve developed great competence in the last decade is household health products.
Q. Such as water filters?
A. Yes, or sanitation, hygiene, clean cooking stoves, or mosquito-prevention curtains, or bednets—any health-promoting products where the user is the buyer. Families become the ultimate procurer of those products. It requires a very different approach—a standard, but very tough, consumer market approach. It needs a lot of innovation both in adapting appropriate products and also in the sales and distribution systems and the financing systems. They all need to be brought together.
Q. What have you learned since you started working in this field?
A. Everything I know, I suppose. It’s been an extraordinary journey and an enviable one due to its fulfilling nature, the variety, the opportunity to do something useful that could impact the world in some way. To work with fantastic people. To work in a wonderful culture. It’s been remarkable.
Q. Any words of advice for people who want to get into a career like this?
A. Certainly, I think you do need to find an opportunity to play a role in a situation that tests your mettle and gives you credibility.
Q. What tests your mettle?
A. I mean you really need to discover yourself. You really need to find out if you like uncertainty and deprivation. You need to know if you like being hurtled into a situation that you could never have imagined you’d face. And it needs to be bliss. It’s got to be your passion. You’ve got to have incredible patience and dogged persistence because you don’t get results in Internet time. You don’t even get it in agricultural time. It takes decades. It will speed up in the future, but it’ll still require a great deal of patience.
Q. Speaking of agricultural time, I understand you have a tractor.
A. I do, yes, and a backhoe, too.
Q. Do you expect to be driving it a lot more now?
A. No, probably not, because I drive every weekend now.
Q. What do you like about it?
A. Well, I’m an old farm boy, you know—Devonshire. It’s a fabulous combination of outdoors, exercise, productivity, and short-term results. You can see what you’ve done. And that’s very useful to compensate for these long, long runs we have in this field.