Dr. Rajiv Shah
speaker
124 appearances
1 recordings
1 series
first heard Mar 2025
last heard Mar 2025
Dr. Rajiv Shah’s voice in public audio — every appearance, attributed to the second.
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I want to solve a problem like vaccine preventable disease, do it at massive scale. And if it takes 25 years, and if there are going to be ups and downs, and we're experiencing a down point right now, I'm going to stay in the fight.
Well, I think that methodology, by the way, is textbook Silicon Valley, right? It's just starting with a clean sheet of paper and saying, I'm going to disconnect from the current way things are done to understand what could be and to identify a strategy for achieving a truly audacious goal.
In that case, vaccinating every child on the planet, which by the way, we estimated would cost many, many multiples on an annual basis of the entire endowment of the Gates Foundation at that time. So it wasn't even something we had anywhere near the resources ourselves to accomplish. It just helped the world see
if we came together and they did in this platform now called the Vaccine Alliance, that we could solve this problem together. And I'd say that the biggest part of that methodology is being clear about the goal. And that's where Bill was extraordinary. Whenever we all tried, and I tried, we all tried to say, can we kind of have a more incremental and more quote unquote achievable goal
And the answer was, well, you can do whatever you need to do initially, but you got to stay focused on the big picture goal. And we're going to use that to make criteria-based decisions. A second big thing is asking a lot of others.
And we would go around and people would say, well, you can't do this because the regulations at UNICEF don't allow you to procure vaccines in a multi-year contract over a long period of time. You'd say, okay, how do you get people to think differently, think outside of their own set of constraints? And we would say, if you have a magic wand, what would you do?
And then you'd get these folks who you could call them bureaucratic, But the minute you unlock their creativity, they have the expertise and the knowledge to actually generate solutions that are transformational.
And so the magic wand tool is just a way to break people out of the sort of, well, we're not allowed to do this, or we don't do this, or this isn't how things are, and let them get to how things could be. And then the final thing I'd just say is success begets success. So once we started to make some small progress, more people got on board.
When we got Wall Street to really help us shape, I think it was the world's first notable large-scale social impact bond that raised $5 billion, that sold without any unique backing, and that was outcomes driven by actually vaccinating kids and measuring the results along the way. That unlock the market and the supply base for a global initiative that went on for many decades.
So success begets success. And those are some of the themes I think that come together to make it possible.
Sure. Well, I'd left Gates to join the U.S. Department of Agriculture as their chief scientist and overseeing the research and economics enterprise. And we were working a lot on international food security issues in that role. And one morning I got to the office. I used to get there pretty early. Other people weren't there yet. Seven, seven thirty.
And one morning we had BlackBerrys back then, my BlackBerry rang. So I picked it up. And on the other line, it was like, hi, Raj, this is Hillary Clinton. And I said, oh, hi, how are you? Not a phone call I usually get. And she said, you know, I was talking to the president and he and I would like you to run USAID, which...
Obviously, he's been in the news now a lot, but a passionate collection of 10,000 amazing human beings and civil servants and foreign service workers with the sole mission of really making our country safer and stronger by projecting the best of our values, often into very difficult circumstances and communities and often at great personal risk.
And my first week on the job, I was very, very fresh. You mentioned I was 36. I was new to that agency. I had just finished touring our emergency operations center when I got a note from my front office that said, Raj, the president would like to speak to you, which also hadn't happened at that point.
And it was because there was a massive earthquake, 8.0, in Haiti that had led to 21 of 22 ministries collapsing. It had led to loss of communications and visuals on what was going on. Ultimately, 250,000 people would have perished in what was the largest humanitarian catastrophe we had ever experienced to that moment.
And the president asked me to lead a global and whole-of-government civilian military response. And that was my, I think, sixth day on the job. So it was pretty intense. But it was also a chance to see America's values in practice being applied at a moment of real need to a neighbor that's two hours from our shores.
I've listened to some of your other guess, also say something very similar, which is, look, a lot of this is luck. And in that moment, I consider myself just lucky. I think, practically speaking, there are lots of great candidates for a role like that. A lot of people wanted that role, and any of us could have been highly qualified to get it. So a lot of it in that setting was luck.
I think part of it was we knew, again, interesting given current events, but we knew that for America to have a strong development and humanitarian enterprise, we'd have to take a tough, hard look at reforming USAID and making the enterprise much more results oriented, much more accountable and much more efficient. And I think I had built a reputation for being
very quantitative, very results-oriented, and very businesslike practices I learned from Bill Gates and others in pursuit of this mission. This is not about just doing good. This is about the strategic application of American power in a hyper-efficient, results-oriented manner. And no one ever gets all the way there, but we made huge strides against that. And I think that reputation helped also.
The lesson I drew from that that I write about in the book is to just ask for help a lot. And I'll tell you, my instincts are always to be kind of quantitative and data-driven. And so we built a scorecard very quickly and we had a basic strategic construct for how one would have to step in and provide feedback
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