Encouraging Leadership That Actually Leads Us

March 2, 2008
Kristine M. Gebbie, DrPH, RN
Kristine M. Gebbie, DrPH, RN

Volume 18, Issue 3

Leadership: the ability to move others in a desired direction. Perhaps that is not the definition you will find in Merriam-Webster’s Collegiate Dictionary, but it will do for this discussion.

Leadership: the ability to move others in a desired direction. Perhaps that is not the definition you will find in Merriam-Webster’s Collegiate Dictionary, but it will do for this discussion. Beyond just “moving others,” good leadership is understood to be the capacity to move others without the use of force, either emotional or physical. Certainly, we know that despots and dictators move others, but in the world of health care, with our general intention of doing good to others, we seldom use dictators as models. There are exceptions to this choice of models, such as the popular book, Leadership Secrets of Attila the Hun.1 Some consider leadership to be an innate trait; on the other hand, leadership can often be associated with good looks or height. Modern workforce development has made leadership a teachable/learnable function, with leadership institutes and courses available in many fields of endeavor.

The global effort to bring a halt to the pandemic of HIV requires leadership at international, national, and local levels. Looking at it from another perspective, this effort requires leadership at the family and neighborhood levels as much as within organizations and government. If 1 or more persons in every family do not lead in the effort to educate our next generation about self-worth and risk-taking behavior; include all family members regardless of gender or sexual orientation; and ensure that every child moves into adulthood ready to assume responsible, adult roles, then any organizational or governmental leadership is in vain. Alternatively, if the social structures supported by governments, including education, health services, public health, transportation, recreation, and economic development, are not led by people with knowledge, vision, and compassion, then individuals and families face an almost insurmountable burden in achieving their leadership goals.

A current noteworthy effort being undertaken by UNAIDS and the World Health Organization AIDS program is the Leadership Initiative on AIDS, which was born out of a meeting held in St George’s House, Windsor Castle, England. This initiative’s goal is to create a “network of global influencers to support a comprehensive response to HIV and AIDS by developing and implementing a leadership framework that ensures and fosters active and sustainable engagement.” While this may be bureaucratic speak, behind it is a vision of leadership to halt the HIV pandemic by creating catalysts for change at all levels of society, with much of the leadership coming from persons living with HIV/AIDS as well as persons from all sectors of a community. Further, the initiative’s core intention is to break the hold that shame, stigma, and discrimination have held on our thinking and policy making about HIV and AIDS.

This effort is in its infancy, and it may only be one more praiseworthy effort that while making a few people feel empowered to move others, will not yield measurable change in social inclusivity, access to services, effective prevention, or increased funding. What might help this new leadership initiative achieve the returns in leadership and the change promised in the initial discussions at St George’s is the supportive attention of the rest of the HIV-interested world. This means nominating participants as the dialogue expands; providing support and platforms for participants as they return to their daily routines; and more important, promoting parallel dialogue and investing in change in each community. HIV programs have had some success in pushing out medication for those infected, at least as long as international donors are in place. There have been waves of successful prevention programs, which are difficult to sustain when there is a change in government and political will; some previously ignored groups are getting particular attention in certain communities.

What will make this effort different? Maybe just that it is a new attempt to achieve what we have all hoped for in sustainable leadership. But there is also a clear and specific focus on the alleviation of shame, stigma, and discrimination as the critical issues that have consistently impeded our efforts to control the epidemic. The additional strength of this initiative comes from the decision not to segregate by social sector as have some of the previous efforts: youth leadership convocations, business leaders fighting AIDS, and the like. The participants in each wave of this new push are planned to be one third youth leaders; one third people living with the virus; and 8 to 10 from other sectors, including labor, faith, policy; donor organizations; business; and so on. Working across some of these traditional lines to build the skills associated with leadership should help these emerging leaders learn the language, world view, and culture of the other social sectors that must be engaged if we are to sustain real change. Keep an eye on the St George’s House Leadership Initiative: maybe it will break through the above-mentioned persistent barriers to sustain the global efforts to stop HIV.

An example of a leadership initiative on a more local level is the Trucker Health Project of the Spokane Regional Health District.2 The inland empire area of eastern Washington, eastern Oregon, and Idaho is not known as a hotbed of social activism, yet this project comes from a strong partnership of local businesses, churches, universities, and public health organizations. Support has come from the CDC and Emory University in Atlanta, as well as from a county office of emergency management, a local shopping center, and the Gay Trucker’s Association. The Project has not only distributed information on a wide range of health issues to a mobile and hard-to-reach population but also created and distributed “trucker condoms” packaged with a trucker logo. The history of the HIV epidemic includes multiple accounts about the role truck drivers have played in the spread of infection across Africa and Asia, and the United States is not immune. Abraham Vergese3 documented his experience with the highway-related arrival of HIV in eastern Tennessee. This new, culturally relevant health outreach program in the northwestern United States, a part of the country dependent on long-haul truckers for the necessities of everyday life, is an outstanding leadership initiative worth honoring and imitating.

References:

References1. Roberts W. Leadership Secrets of Attila the Hun. New York: Warner Books; 1985.
2. Spokane Regional Health District. Health To Go. Trucker Health Project. May 2007. Available at: http://www.srhd.org/downloads/info_pubs/reports/TruckerHealthReport.pdf. Accessed January 23, 2008.
3. Vergese A. My Own Country. New York: Simon and Schuster; 1994.