Taking CARE

Ending global poverty will take no small effort. In fact, it will take millions of small efforts, says Helene Gayle, CEO of CARE USA—efforts that are carefully coordinated and compounded to produce significant and lasting change.
Taking CARE

For Helene Gayle, ending poverty is really all in the numbers. Women, she says, do two-thirds of the world’s work and produce nearly 60 percent of its food; however, they own less than one percent of the world’s farmlands and earn only 10 percent of the world’s income. They make up 70 percent of the world’s poor and three quarters of those without access to education. Due to the lack of proper maternity care, many women in developing regions die in childbirth, leaving their children behind to continue the cycle of poverty.

 “Statistics show that women and girls are most affected by poverty, but they also show that by investing in girls, you start a virtuous cycle, creating the greatest and most long-lasting change,” Gayle says. “Educated girls are more likely to marry later, have fewer children, earn an income, and make sure their own children go to school. That’s why we emphasize empowering girls and women in all of the work that we do.”

As president and CEO of CARE USA, a humanitarian relief organization based in Atlanta, Georgia, Gayle is determined to realize that vision. Under Gayle’s leadership, CARE directs much of its $700 million annual budget toward programs that educate and empower women in the world’s poorest regions. “Our work focuses on living, learning, and earning,” she says. CARE builds selfsustaining programs that promote girls’ education and leadership, encourage financial empowerment through savings programs, provide access to healthcare, and reduce maternal mortality.

Gayle started her career intending to save patients, not the world. She earned her medical degree from the University of Pennsylvania School of Medicine and planned to specialize in pediatrics. But during her residency at an inner-city hospital in Washington, D.C., she saw how disease is often a symptom of larger social problems. Interested in tackling those social ills, she earned her master’s degree in public health at Johns Hopkins University.

She went on to work for the Centers for Disease Control and Prevention for 20 years, eventually becoming the director of its National Center for HIV, STD, and TB Prevention. In 2001, she moved to the Bill & Melinda Gates Foundation to direct its HIV, tuberculosis, and reproductive health programs.

Gayle’s rich perspective on the links between health, wealth, and society has earned her a number of recognitions. In 2006, she was one of the Wall Street Journal’s “50 Women to Watch,” and in 2009, she ranked among Foreign Policy magazine’s “Top 100 Global Thinkers.” She serves on several boards, including the Rockefeller Foundation and the Center for Strategic and International Studies in Washington, D.C. Last year, she was tapped to chair the Obama Administration’s Presidential Advisory Council on HIV/AIDS.

Active and ongoing partnerships with the private sector are key to CARE’s success, Gayle says. In an interconnected global economy, more companies are coming to the developing world for products and raw materials, as well as new workers and markets. Some partner with CARE because they realize their future success is directly tied to the fortunes of emerging economies, Gayle says. She believes that business schools, too, should explore the link between nonprofit and private sectors in their curricula, to prepare students to bridge both worlds after they graduate.

CARE partners with many for-profit companies—such a Coca-Cola and UPS—to achieve its goals. Why do you think these partnerships are successful?
More companies—particularly multinational companies—are viewing “corporate social responsibility” differently than they used to. They no longer think of it as simply giving a charitable organization a few dollars and claiming credit for being good corporate citizens. Instead, they’re asking, “Which organization has strategic goals that also advance what we’re doing? Which one has a vision that’s aligned with our business in key ways?”

We all know that capital is the engine that runs the world—businesses create wealth. But we can recognize that wealth creation, done right, can be linked with social good. CARE works with companies whose businesses align with what we do, which helps them become good corporate citizens and helps their bottom lines. In turn, they help us do our work much better than we could ever do by ourselves.

Could you give some examples?
Environmental degradation and a lack of access to clean water are becoming growing problems in areas where we work. These issues aren’t just important to these populations—they’re key to Coca-Cola’s business. So Coca-Cola works with us to help solve the problem of access to clean water.

A company like UPS has a huge capacity in the area of logistics, so its help is crucial when we’re working in areas where there are considerable logistical constraints and where it’s important to have a good supply chain and be able to forecast different needs in different geographic areas. But this work also helps UPS improve its own systems.

We also work closely with WalMart, which sources from women in many of the emerging markets where we operate—women who own small farms or who are in the garment industry. The company is very invested in what we do. It’s in WalMart’s business interests to help develop the skills of women in those communities so that it can get a better product to market. For example, we are currently working on a project with Wal-Mart that involves women in India who grow cashews. If we can help them produce a better crop, they’ll have a better product to bring to market.

You’re a member of the Global Leadership Forum at Georgia State University, which promotes this idea of organizations working together—of “connected capitalism.” How important is such a forum in helping you develop these partnerships?
I think forums like this are great, because the not-for-profit and the for-profit worlds speak different languages. We come from different worlds, and we view our bottom lines differently—ours is a social investment and theirs is a capital investment. This forum helps us talk more about these issues, about how we can blend and bring our different assets to the table in ways that can enhance the work we all do. We can all drive a movement around this notion of connected capitalism in a way that is incredibly powerful.

What do you see from business schools that you find encouraging? And where do you think business schools could do more, to support the needs of organizations like yours?
Business schools are recognizing that the distinction between for-profit and non-porfit is becoming increasingly blurred. More schools are setting up nonprofit centers, because more and more young people are interested in this area. Young people are increasingly idealistic and want to make a difference in the world, but they also want the practical skills to be able to do that. 

But more can be done. I think business schools can view organizations like CARE as learning laboratories, where students can experiment with this notion of connected capitalism. My message to business schools is that we need to find new approaches to create wealth equitably and improve people’s lives in a sustainable way. 

What skills would students develop in the “learning lab” that CARE has to offer?
They’d learn a great deal about how communities are organized, how to recruit personnel, how to train workers in ways that are relevant in different societies. They’d learn how to consider cultural contexts as they help people build businesses. They’d learn about the impediments that still exist for women entering the workforce. They’d learn about the barriers, obstacles, and assets that different communities have.

For example, many people don’t understand that some societies don’t yet have rules of law firmly in place. They don’t have vehicles that we take for granted in Western countries, like banking infrastructures. There are places where the ability to take out a mortgage doesn’t exist; people can buy homes only if they can afford to pay cash. Students need to understand what to do when these structures are missing and learn what it takes to put them in place. Those are the kinds of practical things that often sabotage business efforts.

What kinds of skills do you look for in the people you hire?
Of course we need people with strong managerial and strategic skills, who know how to analyze complex problems and find solutions. We need people who know finance, budgeting, and administration. Those skills are pretty general and universal.

My message to business schools is that we need to find new approaches to create wealth equitably and improve people’s lives in a sustainable way.

But for us, what sets people apart is their desire to apply those skills to a set of problems that is very different from what we see in the for-profit sector. The traditional person coming out of business school expects to work for a revenue-generating enterprise. That’s not our enterprise. Our business is generating social change. We look for people with business skills who have passion, as well as a willingness to be flexible and see the world a little differently.

What have you learned in your career that you think has most helped you develop your skills as a leader?
When you run an organization, it’s easy to want to do a bit of everything. But if you do that, you’ll get nothing done. So, I’ve learned that it’s important to keep a sense of humor, create a vision, and stay focused on the things I most want to get accomplished. Then, I must make sure that I have a team in place to support that vision, because there are some things that need to get done that might not suit my particular skill set. I need to use my time in the best ways, so I can drive change and move the organization forward.

As you look to the future of your organization, what concerns you most?
Close to 3 billion people in the world live in extreme poverty, and we want to eradicate poverty. That’s a bold ambition. If we’re going to accomplish it, I know we need to work smarter. Obviously CARE cannot complete this work alone. We need to stay focused on the things that we do well, and then find partners to supplement our work in ways that utilize their strengths. If we do that, we can build momentum toward big changes.

What gives you the most encouragement that CARE can bring its ambitions to fruition?
I draw the most inspiration from going into the field and seeing how the lives of people we work with are changing in tangible ways. I was recently at a summit for microfinance in Kenya, where I talked to a woman who was about 50 years old. Five years ago, her husband died. Women in Kenya have so few property rights that she and her children were left homeless. However, she was able to join a group savings and loan that we had created, where women in a community can pool their resources and then provide small loans to each other to start small businesses. 

In five years, this woman went from being homeless and unable to feed her children to owning a small vegetable business, which she has been able to expand with larger and larger loans. Today, she’s renting decent housing, and her children are in school. Her life has turned around.

Stories like hers give me hope—and I know that this woman’s story is being multiplied many times over. When I see just how small an effort and how few resources it takes to give people the capacity to change their own lives, I know we’re making a difference.

I imagine your position today is much different from what you thought it would be when you first entered medical school. What can business students most learn from your career and life trajectory?
To follow their passion, be willing to take risks, and not necessarily stay on any prescribed path. I went into medicine because I wanted to make a social contribution, but I was drawn to public health because it combines medicine with social issues. When you’re a clinical doctor, your patient is an individual. You treat the symptoms of disease, but not the underlying broader issues that put some people more at risk for disease than others. Often it’s because they’re poor, or they’re from marginalized communities, or they have less access to healthcare.

When you’re in public health, your patient is a community, a nation, or even multiple nations. At CARE, I can attack the root causes of problems, not just the symptoms. I can address the drivers behind why some people are healthy and why some people are sick. That’s why I went into medicine to begin with—to change people’s lives.