Earlier this month I was invited to speak on a panel about the rules and standards for happiness. The event was held at Vienna’s MuseumsQuartier, one of the largest art and cultural complexes in the world.
 
Happiness has become a popular topic for research and discussion. Given the fact that happiness has many dimensions – from neurological to political and economic – it was only fitting that panellists came from very different backgrounds. While I reflected on happiness from a research angle and focused on measuring happiness and societal progress, other discussants brought in a business philosophy perspective or represented the Archdiocese of Vienna and focused on history and theology.
 
What made the format particularly exciting was that it touched on all senses: at regular intervals during the discussion, a violin player brought music to the audience’s (and panellists’) ears; a chef was preparing gnocchi al funghi right next to the stage (using an electric water boiler rather than the a conventional hotplate or stove); and an artist (who had changed into a bathrobe just prior to the discussion) did the moderation. The format also included a gender component: It was emphasised that camera women rather than men were filming the event, thus literally bringing new perspectives to the way the various dimensions of happiness are perceived.
 
Unconventional, ey? What might have been a rather intellectual and to some people tedious discussion was actually a pretty sensual and very enjoyable event, allowing for deeper engagement than conventional formats. To me this is certainly a format which the organisers of those many meetings bringing together academic, corporate, UN, NGO and other actors can learn from.

Perhaps this is something to consider when you’re next involved in designing a conference, workshop or other type of event!

Improving access to medicines has long been recognised as a development issue. Both public and private actors, including pharmaceutical companies, are working to improve access for poor and middle-income populations in developing countries. Access to medical technology, however, is not yet talked about much. This is interesting given that some medical technologies – ranging from spectacles and syringes to ultrasound devices and total body scanners - have similar life-enhancing and life-saving features and yet access to medtech is severely constrained in low-resource settings. This is all the more curious given that many medtech companies are looking for opportunities to expand to emerging markets in the global South.
 
To date, most medtech multinationals appear to be focused on delivering their existing offerings to premium market segments in poorer countries. Or, they serve low- and middle-income markets with older generation or lower quality products. At the same time, well-meaning but misguided public and civil society players sometimes make expensive medtech available to under-resourced health facilities in low-income settings without considering contextual factors. Thereby, fancy devices end up not being used at all or according to their designation, and in the worst case they drain resources away from life-saving devices and procedures.
 
In low-resource settings health systems face numerous challenges. The medtech industry must take into account the shortage of health care professionals, their lack of training and knowledge, regulatory hurdles, potential political and financial risks, and other factors. At the same time, the market potential for medtech products is large: In India, for example, demand for medical devices is growing at double digit growth rates. To cater to this growing demand, medtech companies must reconsider their strategies. They need to develop innovative technologies that use alternative power supplies; resist heat, humidity, and dust; relieve the workload of overworked health personnel; require little maintenance; and can be operated - with no risk to patient safety - by personnel with little specialised training. Moreover, such technologies must be embedded in innovative business models that are tailored to low-and middle income market segments, making treatment with new devices accessible and affordable.
 
Together with Endeva UG, I am developing a study and guidelines for medtech players on business models in low-resource settings. We will investigate the potential of low- and middle-income markets, assess and analyse current practice of medtech companies, and document best practices and strategies. Please contact me if you are a medtech company interested in participating in this research project.

What is an innovation? A sophisticated new engine running on readily available biofuel? A novel drug that can cure cancer without negative side effects? Would these be social innovations? And how much research is needed to get there?
 
Last week I attended Austria’s annual CorporAID Conference on business and development, bringing together public and private stakeholders looking for solutions to maximise business contributions for development. Besides facilitating a panel on research & innovation I was asked to provide input on social innovation in the context of low- and middle-income countries. And what a learning experience this was!

Having recently worked with endeva on analysing a set of health business model innovations for the World Bank I thought I’d draw from this experience. Using the 4A model (acceptance, awareness, availability and affordability) as the analytic framework, I set out to explain key elements of social innovation we had identified when investigating business models focusing on female hygiene.

“Female hygiene?” you may ask. Yes exactly, sanitary pads to be precise. Female hygiene happens to be a hugely important yes under-researched development issue in which innovation can have an enormous impact. Until recently, sanitary pads received only little attention by businesses and development stakeholders.  My educated guess is that a key reason for this lack of attention is the simple fact that menstruation is a subject about which the majority of the population feels somewhat uncomfortable – it certainly isn’t what fairly conservative and predominantly male conference participants were expecting when attending my panel on research and innovation. In fact, you may be feeling a little awkward as you are reading this right now.
 
Why is female hygiene such an issue? In a nutshell, there is enormous unmet demand for female hygiene products (of which sanitary pads are the most common). This has a lot to do with the price of internationally-branded products, which simply are too high for households in low resource settings. Therefore, in India alone, more than 300 million women go without adequate products and resort to cloth, newspaper or other unhygienic alternatives, causing various health issues. Moreover, inadequate menstrual hygiene management products and facilities cause girls to stay away from school and women to be absent from jobs, with associated negative impacts on female education and productivity.
 
Now do we need sophisticated new sanitary pads? No, quite the opposite. Do we need innovation? Yes, absolutely! A number of South Asian and African social enterprises have begun addressing this important development issue in recent years. Quite some innovation has gone into ensuring sanitary pads can be produced cheaply, sustainably, and with locally available materials. Other social innovators have focused on developing machines which allow uneducated women in remote rural areas to produce pads themselves, thus covering local needs while creating income generation opportunities for poor women in rural areas. All these are prime examples of frugal innovation. Nevertheless, research and innovation are still needed to develop business models that actually work, i.e. that allow the social enterprise to make at least a modest profit.
 
Given that these clearly are important social innovations (providing new solutions to a societal problem) I found it all the more interesting that a member of the audience stood up after just a few minutes of my speech and asked when we’d finally get to the point of the panel, i.e. the ‘real’ research and innovation bit. It became clear that even within the sustainability and development communities there is still a lot of work to do in terms of bringing everybody on the same page.
 
When it comes to social innovation, a lot of that ‘real’ research and innovation is indeed about stuff which seems simple, but is actually quite complex: ensuring a product or service makes sense locally (acceptance), that people know about it (awareness), that the logistics work (availability) and that it is priced appropriately (affordability). In other words, rather than increasing technology-intensity and adding ever more features, social innovation is about maximising impact and sustainability by minimising complexity.

“What do you actually do at that refugee shelter?”, people ask. Who are these refugees passing through Austria on their way to Germany? How can we help them? From the tiny bit I’ve seen after spending a few days at a refugee shelter close to my home in Vienna – a place providing beds, food, washing facilities, basic medical care, clothes, and a safe place to play for children - I would sum this up as keeping an eye out for what needs to be done, getting it done as efficiently as possible, and not losing sight of the bigger picture.

On my first day, after checking out the building (a former hospital pavilion, hosting around 300 refugees at the time) my first task came along immediately: a (volunteer) doctor had identified a man from Syria who had suspicious insect bites and felt a specialist’s opinion was needed. I took the man and his friend to a dermatologist in the hospital located at the same premises, trying to ensure that they (for once we were there it became clear that the friend also needed help) get seen without bureaucratic hurdles or fees involved, and ideally without waiting time (to get us back to the shelter as soon as possible – so that I could use my volunteering time efficiently). The Syrian men spoke hardly any English but we did manage to patch up an anamnesis.

We were back at the shelter in less than an hour, and now part B of the task began: one of the two men had been diagnosed with scabies, a contagious disease that particularly spreads under crowded conditions where close body contact is frequent. In other words, not something you need at a refugee shelter. I therefore had to ensure that the man took a shower, discarded his clothes, and got new ones. Easier said than done when the patient doesn’t speak English or any other language I’m at least remotely familiar with; he had also just received his ‘new’ (donated) clothes a few hours before. After finding yet another set of clothes, soap, a towel and a plastic bag for the clothes to be discarded – all located in different parts of a building I was just learning to navigate - I finally managed to identify a young Afghan who was able to translate. I guided my Syrian friends to the shower and never saw them again thereafter.

My second task had become obvious: I needed to help find interpreters who,  unsurprisingly, are absolutely key in handling anything to do with refugees at the moment. While there had been calls for interpreters via social media and some (volunteer) interpreters I was told were on their way I felt there was a better and rather obvious solution: get refugees to help. While some were exhausted from endless days on the road (and most didn’t speak much English), many seemed restless and quite happy to be engaged, and thus empowered. The young Afghan who had helped me talk to the Syrian patient seemed very pleased and even proud when I asked him to be involved. Giving him a sticker that identified him as a volunteer, other staff and volunteers quickly started assuming he was ‘one of us’. His English was brilliant, and from one minute to the next he was in high demand, translating during doctor’s appointments, making group announcements and helping me answer the big question that most refugees had on their minds: how can we get to Germany?

Suddenly there was news of the ‘imminent’ arrival of several hundreds of refugees at an adjacent building, which urgently needed to be converted into an additional refugee shelter. Time was ticking, and I assembled a team of volunteers to help populate the building with dorms, a kitchen and dining room, clothes and hygiene product storages (doubling as dispensaries) and a child-friendly playing area. Again, I found it obvious to ask for help also among refugees, and quite a few seemed happy to follow me.

However, as we were about to enter the building six police officers showed up. They had been called to deal with ‘aggressive refugees’. However, there hadn’t been any incidents and nobody had witnessed any aggressive behaviour. Therefore we assumed that neighbours had felt threatened by the mere sight of refugees in an otherwise empty street… this was less obvious for the team of young men I had just assembled, they did not understand what was going on and, quite understandably, were reluctant to go anywhere near the police out of fear that this would be the end of their journey to Germany, or worse, the end of their goal of being granted asylum in Europe.

Once the police were gone we set out to set up the building as best we could, given available time (uncertain), staff (refugees and non-refugee volunteers) and items (provided by civilians and the military). It was great engaging refugees and feeling that they felt appreciated, and perhaps driven by a wish to ‘give back’. When we were almost finished, khaki-coloured buses started rolling in. However, they did not bring the hundreds of refugees we had been expecting. Instead they came to collect those that had spent the night at the other pavilion, dreaming of Germany. That night only about 50 refugees remained at the complex.

I recently volunteered in a shelter for refugees near my home in Vienna. For those who don’t now: Austria is a major hotspot in the current refugee crisis. At the moment, most refugees from Syria, Afghanistan and Iraq come through Austria, a small country wedged between a diverse bunch of nations, including Hungary and Germany. As a result, Austria is currently seeing over 10,000 new refugees crossing its border every day, most of them aiming to reach Germany, the new ‘land of promise’.

Managing such an influx of people is challenging at the best of times, and particularly given the refusal to prepare we have seen around Europe. Some countries, such as Austria and Germany, have made considerable progress nevertheless. Moreover, in Austria and beyond, the support provided by NGOs, civilians as well as some public and private institutions, including the armed forces, has been enormous (and, for some, surprising). Many would argue that volunteer support is what has kept the refugee crisis from turning into a disaster so far.

When arriving at the former hospital that had been converted into a refugee shelter I expected that someone would be in charge and assign me a role, perhaps even one that provided a reasonable fit with my skill set. Instead, I encountered mostly chaos. All I was told was that a large group of refugees had arrived a few hours before, just as another large group of refugees was picked up – with very little notice. There was no hard data on the current group’s nationalities, gender ratio, how they had got to Austria, or what their ordeal had been until then. While I would normally have frowned upon such an apparent lack of organisation and overview, it quickly became clear that given the degree of uncertainty about refugee movements in general, the unfolding crisis of Europe and the fact that most ‘helpers’ are volunteers  – there was no other way, and it was pretty effective (I'll write more about life at the shelter in another post).

After what many refugees would have experienced recently, I assumed that some of them might be tempted to stay a night or two, given the availability of beds, hot showers, clean clothes, food, medical treatment and a safe place for children to play. However, most of them seemed to have just one question on their minds: how can we get to Germany?

Having identified a young Afghan who spoke excellent English I quickly found myself encircled by a number of young Syrian and Afghan men (who had come either alone or with their families). They kept asking about getting to Germany and made it clear that they had no time to lose. In providing an answer I wanted to do justice to the complexity and uncertainty of the situation while being straightforward enough not to confuse them any further. Under normal circumstances, the answer would have been easy: take a tram or taxi to the station, hop on the next train, and you’re there in just a few hours, no document check involved. This may have been true even now, but we simply had no way of knowing under the current circumstances and given the constantly changing border scenarios and enormous information gap. At the same time, we were told there was a good chance the Austrian armed forces would send buses to the shelter to take people straight to the border. We just didn’t know when they would come, or whether they would come at all. In other words, we could not be sure of anything, and I certainly did not want to raise false hopes among refugees. No, we cannot promise you that police won’t be there when you get to the border. And no, we cannot promise you there will be room for everyone on the buses, should they come. But yes, you are free to leave the building if you want, we are not keeping you, we are not a prison. The latter statements came as a big surprise to many, as did the fact that Austria is a safe and wealthy country where they could register and may be granted asylum, just as in Germany. In fact, some were not even sure which country they were in, nor what to associate with Austr(al)ia.

The buses came, and most refugees got on. I have no idea where the Afghan and Syrian men, women and children I met are now. Hundreds of new refugees have arrived at ‘my’ shelter. I have been back and I hope I’ll find time to volunteer again. While I cannot know what to expect (this includes the possibility of turning up and finding the shelter almost empty – this has happened before), I’m certain that I’ll always learn something new. Not having hard data, or even reasonable anecdotal evidence about key parameters, is a reality of this crisis as it unfolds. What has become very clear is that the lack of information makes dealing with the crisis difficult on both ends – from the refugees’ perspective as much as for those who want to help.

I just hope that people’s dreams won’t be shattered if and when they arrive in Germany. Many refugees may be more optimistic about being granted a right to stay and work than is warranted. Perhaps the current lack of unbiased information is a good thing after all – it may have helped the luckier ones focus on their goal, and reach it; one step, one country at a time. Let’s just hope it will have been worth their ordeal.

McDonald’s has famously been using a franchise model to grow its global business, for the most part highly successfully. Similarly, Greenstar, an NGO-backed network of reproductive health clinics in Pakistan has successfully employed franchising to bring healthcare to the poor. Recently, when researching such social business models, I noticed both commonalities as well as differences.

Around the globe, and particularly in South Asia and Sub-Saharan Africa, there are number of 'social franchises' offering affordable quality services to low-income populations. Greenstar, with a network of 7,500 clinics and close to four million patient visits so far, is among the bigger ones.

While social franchise models have the potential to deliver a variety of services with a social value, many such models focus on health, particularly family planning and other reproductive health services. So what do they have in common with a fast food company? And what are the differences?

Social health franchises share the same goals of expansion and financial sustainability as McDonald’s. However, while conventional, commercial franchising is essentially about maximising both franchisors’ and franchisees’ profits, social franchising aims to maximise social impact.

Why do social franchises, including health providers in rural Pakistan, need to make a profit you may ask? Well, mostly to ensure financial sustainability, i.e. to make sure health services continue to be provided and made available to the poor at a reasonable quality. In other words, profits, even though they are often rather small, are an important incentive for health providers to offer their services. After all, not many McDonald’s outlets would exist if they weren’t making a profit!

Nevertheless, there are important differences. While aiming at profitability at the franchisee end of the spectrum, many health franchises, such as Greenstar in Pakistan, are not profitable at the franchisor end and may rely on (public or private) grants and donations to provide training, quality assurance, brand building and other services to their network of franchised providers.

Social franchising thus constitutes an excellent and efficient entry point for private and public donors and impact investors: They get to support an established network of franchised health service providers (e.g. clinics) that cater particularly to the poor in heard-to-reach areas. In other words, they get to make an impact in areas which purely commercial models are unable or unwilling to reach.

And I do wonder what a woman in rural Pakistan might buy for the price of a cheeseburger...

Language helps us communicate. Foreign languages help us communicate in different cultures and contexts. But do they? We all know that a lot gets lost in translation. We also know that even without the need for translation a great deal of what we aim to convey gets lost or distorted in the communication process. This results in misunderstandings the outcomes of which range from funny to potentially politically disastrous.

So is language a divisive factor or a unifying one? Last week I gave a guest lecture at Salzburg University in which I discussed examples of intercultural (mis)communication in Africa and Asia. In my experience the biggest misunderstandings happen when people are not aware that they operate in different cultures and contexts, i.e. that they need to look through a cultural lens. For example, while Europeans may be alert to cultural differences when doing business in Africa, they often underestimate the influence of culture when working together on common projects within Europe (or, by extension, with other Europeans elsewhere).

Secondly, I find that a common language, such as English – which can be considered the world’s lingua franca – can mislead people to believe they fully understand each other when really they are using the same words, but with very different meanings. When I first arrived in Zambia in Southern Africa (where English is the official national language) after a long flight from Europe I was dropped off at my hotel. When saying goodbye, the driver asked what time I wanted to be “carried” to the office the next day. Only after making it very clear that I did not expect to be ‘carried’ and was quite happy to walk if no car was available did it dawn on me that ‘carrying’ simply meant ‘driving’. While my post-plane fatigue may have extended the time it took me to realise the misunderstanding at play it was certainly my familiarity with the word ‘to carry’ that had fooled me and delayed my putting on those cultural glasses.

While some misunderstandings - like the one in Zambia - are a good laugh at the end, other misunderstandings have a bigger impact. For example, nowadays most people in the business world will claim to understand what ‘sustainability’ and ‘corporate social responsibility’ (CSR) mean. However, individual knowledge and definitions tend to differ widely, which does not stop people from frequently using those terms. Definitions for CSR, for example, range from investing in true corporate responsibility for what goes on in society, to one-off projects far off core business which may have a mild public relations effect but are seen by companies as a cost rather than an investment and barely scratch the surface of any societal issue.

As long as such implicit definitions are not made explicit, there is enormous room for misunderstanding and for miscommunication causing partnerships to fail. This is why when engaging in partnerships, such as public-private partnerships, significant time must be devoted to ensuring all parties are on the same page and that they literally understand each other, from the outset. In other words, partners need to talk about communication before touching the issues at stake.

Have you ever encountered a female pilot on a commercial flight? I haven’t yet, despite flying pretty regularly and having been a frequent flyer in the past. Knowing that airlines do not have specific body height and strength requirements for pilots anymore I have been curious about the enormous gender gap in cockpits for a while. Now that I am finalising a publication on gender equality in private sector development for UNIDO, the United Nations Industrial Development Organization, I’m even more curious.

According to the International Society of Women Airline Pilots, only 3 percent of commercial pilots are female (4,000 out of 130,000 worldwide), the majority of them in the United States. A few more hold licenses but don’t fly commercially. Aviation is not a sector covered by UNIDO, but I have been looking at parallels in other sectors, such as Information and Communication Technology (ICT), engineering, manufacturing, investment, etc.

While women account for about 20 percent of engineering graduates, they represent only about 11 percent of practicing engineers. In ICT, women account for about 20 percent of jobs, but only 11 percent among IT strategy and planning professionals (according to the International Telecommunication Union). The proportion of women in manufacturing differs widely globally, ranging from as low as 4 percent in Kuwait to around 10 percent in India and Iran, to 55 percent in Sri Lanka and 58 percent in Vietnam. Within countries there are stark differences between sectors. For example, in Ethiopia women account for 31 percent in total manufacturing; 50 percent in textile and chemical manufacturing; 16 percent in electrical machinery and apparatus manufacturing; and only 2 percent in machinery and equipment manufacturing (UNIDO statistics). You get the idea.

What explains those gender disparities? What do these sectors have in common? Is it because of sexist or discriminatory work environments? Is it the fact that in most societies women still bear the brunt of domestic work? In aviation, does it have to do with the military as an entry point into flying, helping future pilots get around otherwise prohibitive training costs? Or are gender stereotypes by clients and customers to blame (there have been cases of passengers stepping off a plane when realising that a woman was going to fly it)?

A mix of reasons probably is the answer. However, reasons commonly brought forward, such as time commitments and willingness to spend time away from home, do not explain why women are abundantly present in lower-level positions (think cabin crews which are predominantly female) while being absent in higher-level positions. Above all, women’s underrepresentation in specific sectors may have to do with a lack of role models getting young women interested in these sectors. As airlines, engineering schools and other institutions make efforts to attract women, gender equality is improving slowly but surely.

And this is absolutely crucial since companies cannot afford to miss out on half of the population when looking for the best candidates for a given job. The next time I step on a plane I certainly want the best pilots in the cockpit, regardless of their sex. In other words, I would like to know that they are the best available pilots, not just the best available men.

PS: While it is mostly women who are discriminated against, and this is what this blog focuses on, there are of course many cases of men being treated unfairly as well. For example, there is evidence that in textile manufacturing - an industry where cleanliness is highly important - men are discriminated against as they are perceived to be ‘dirtier’ than women.

“The welfare of a nation can scarcely be inferred from a measure of national income.” This is quite intuitive. Nevertheless, all over the world Gross Domestic Product (GDP) is used as the macroeconomic measure for progress. GDP growth is globally regarded as a central economic goal and last but not least as a precondition for facilitating social development.  This is all the more interesting given that it was Mr. Kuznets who made the above statement, the very man who in 1934 developed the GDP for the US Congress. Robert Kennedy, too, in 1968 publicly said about the GDP that “it measures everything, in short, except that which makes life worthwhile”.

So why are we so firmly holding on to the belief that 1, growth is great and 2, that it helps sort out societal problems? There are many possible answers to this, including the fact that the GDP as a national measure really is quite useful, not least because it facilitates comparison across countries. While not dwelling further on the GDP in this particular blog I would like to talk about what progress and happiness actually mean, and how this relates to politics.

When analysing the concept of happiness is important to distinguish between ‘luck’ as a fleeting emotional peak or coincidence on the one hand, and ‘happiness’ in the sense of contentedness and wellbeing on the other. Researchers also talk about “optimal challenge”, i.e. the best possible use of a person’s interests and skills. Happiness can have many faces: high quality of living, life satisfaction and wealth as well as democracy, freedom, safety, education, and health. And this distinction is key: happiness means different things to different people. 

A number of governments, international organisations and other institutions have developed indices to try and measure ‘happiness’ since they have generally subscribed to improving education, health, safety, etc. in their domains. Most of them were inspired by the tiny mountain kingdom of Bhutan which has famously been using its Gross National Happiness index for years. While happiness and social progress are quite complex and thus cannot be reduced to one universally-applicable measure, a number of useful indices exist. To mention only one: it is worth checking out the OECD’s Better Life Index.

The Better Life Index is a web-based interactive tool which allows people to engage in the debate on wellbeing and on what matters most to them. It compares and visualises wellbeing across countries according to individual wellbeing preferences. The Index offers 11 dimensions: community, education, environment, civic engagement, health, housing, income jobs, life satisfaction, safety and work-life balance.

And finally back to the GDP with a quick comment on the GDP vis-à-vis other indices: while a number of people seem to suggest that other happiness-oriented indices should replace it, my view is that, for the time being, we should definitely keep the GDP. Nevertheless, we must add a system for national and global monitoring of happiness and wellbeing which enjoys the same level of priority in financing, tracking and communicating results as the GDP. The latter point is of particular importance since what is not measured cannot be managed and will not be prioritised by politicians. In other words, we desperately need a governance system to consistently measure happiness and societal wellbeing, thus holding decision-makers to account and contributing to societal progress and development. Eureka!

2015 marks a turning point in sustainable development: For the first time in history, governments, businesses and civil society are coming together to agree on a set of global development goals which are binding for rich and poor countries alike. The Sustainable Development Goals (SDGs) are expected to be formally introduced in September 2015 at the the Global Summit in New York.

The SDGs build on the Millennium Development Goals (MDGs) defined in 2000 with a 2015 target date; they are often referred to as the post-2015 development agenda. In bringing a lot more stakeholders to the table and aiming to tackle a much larger number of development themes than the MDGs, the SDGs are also much more ambitious. One of the MDGs’ key strengths was that they focused on eight goals with a manageable number of sub-goals and targets. It currently looks like the SDGs will comprise 17 goals and 169 (!) targets.

In addition to the larger number of goals, the enhanced degree of participation and stakeholder consultation also adds complexity. Developing a system to measure progress on the SDGs will not be a mean feat. Financing too still has to be sorted out. A Financing for Development Conference in the summer will discuss the means of SDG implementation.

When considering the challenges ahead it is important not to lose sight of the fact that great and previously unthinkable progress has already been made through the MDG agenda. The latter got the world to focus on key development areas, communicating them widely and, most importantly, agreeing on common goals and transparent tracking of progress. Focusing on poverty, health, education, gender and other important aspects of human development, the MDG process was revolutionary at the time. While not all goals and targets have been achieved in all countries, solid progress has been made overall and the fact that most of the world’s governments came together and agreed to work towards the same set of goals, including through making their progress transparent, cannot be overstated enough.

Watch this space!