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Breaking Barriers: Chris Alando’s Trailblazing Journey in African Health Financing
GFO issue 449

Breaking Barriers: Chris Alando’s Trailblazing Journey in African Health Financing

Author:

Samuel Muniu and George Njenga Kiai

Article Type:
Interview

Article Number: 3

This article explores Chris Alando's 28-year career from volunteer and banker in 1996 to a global health opinion leader currently, highlighting his dedication to equitable access to health, quality and a passion for sustainable macroeconomic development. With experience in macroeconomics and having workers across 76 countries, Alando promotes evidence-based approaches and teamwork. He supports projects like gender-sensitive budgeting, and mobilization of more money for equitable health through Universal Health Coverage.

In the field of global health and community development, Chris Alando’s voice carries significant weight as a passionate advocate for more money for health, equitable access to healthcare and social impact. His journey reflects a steadfast commitment to empowering communities and ensuring their involvement in shaping policies and programs. Alando is well-known in macroeconomics and global development. From the age of 12 he struggled amidst political, social and economic difficulties to remain among the top 1% of Kenyan students who would earn a place at the then few available ‘National’ high schools and public universities. He eventually obtained his degree in Economics/Applied Statistics, and French from Moi and Kenyatta Universities in 1999. Later, he earned a professional certification in Macroeconomic Management and Policy from the World Bank Institute in Washington DC. The World Bank also awarded him a special recognition for his contributions to macroeconomic policy and management, following several analyses that revealed how long-held macroeconomic theories and formulae affect developing countries differently compared to developed economies; implying the need to differentiate development financing and programming across countries, sectors and communities.

 

Alando also holds a Master of Business Administration from United States International University-Africa and SolBridge International School of Business in South Korea, and business certifications from Harvard Business School in the United States. During the past 28 years, Alando has consulted with governments, development partners, private corporations and civil society groups across 76 countries.

 

Apart from economics, he has been fortunate to contribute to the review of health sector and HIV, TB and malaria strategic plans in 47 countries and two regional economic communities. He has also advised the East African Community and Southern African Development Community in health financing and development issues. As the CEO of Globesolute Corporation, Alando is in charge of the consulting and business development departments, and places special emphasis on quality assuring the technical and advisory services.

 

A 28-year journey of dedication, resilience, and leadership

 

Chris Alando’s 28-year journey highlights the incredible impact of dedication, resilience, and a passion for learning. Starting as a volunteer, he has emerged as a leader in global health and financing systems, overcoming challenges along the way to make a positive difference. A son of one of Africa’s first, and Cambridge University-trained computer scientists, his family’s fortunes crashed at the dawn of opposition politics in the late 1970s and an ‘Attempted Coup’ in Kenya in 1982 that assigned his extended family to marginalization, prison, and exile. Looking back on his path, Alando reflects, “For much of the past 28 years, I’ve been focused on improving global health and financing systems. It all began when I volunteered to assist in rehabilitating drug and alcohol addicts and orphans around Nairobi’s Eastleigh and Ngara estates in 1995, right after finishing school.”

 

His early volunteer work with a Swedish NGO in Nairobi set the stage for his lifelong commitment to serving others and empowering communities. It was during the following year that he was interviewed and provisionally hired as a MasterCard salesman at a local bank. Moving into the corporate world brought both highs and lows for Alando. Despite early struggles, he saw failure as a lesson, saying, “As a salesman, I failed miserably at first – I sold only 2 credit cards and missed my monthly target of 11, not once but twice … but a few days into my third and last provisional month before I was due for sacking, I came across an old book on sales that my late grandfather had probably left on the shelf. Ironically the lesson on its first page was, “You really can’t sell anything to anyone who doesn’t first want it.” This realization drove him to change his sales strategy from talking about the bank’s products to listening to clients and recognizing their needs first, prior to aligning available products to their needs. This change in mindset proved valuable in that he was able to sell 12 cards and avoid retrenchment in the nick of time. In the ensuing months he sold and networked so well that by October 1996 he was promoted to head the bank’s main credit sales unit, recruit, train and supervise over 120 and contribute to the bank’s great success in Eastern and Central Africa.

 

Alando values education deeply. He explains, “Africa and education have always been priorities… I chose to attend school even while working partly at the bank.” He obtained a diploma in French from Alliance Française, studied ICT, Accounts, Financing, Sales, Marketing, Total Quality Management as he awaited admission to public university.  Despite admission to one of France’s leading economics universities, University of Paris – at Pantheon Assas, and a later recommendation to Ivy League universities by his mentors at the United Nations and Bureau of Statistics (Dr. Don Okpala, formerly at Harvard and MIT; and Prof. John Blacker, former dean at the London School of Hygiene and Tropical Medicine who was then consulting at Kenya’s Central Bureau of Statistics) Alando originally chose to study and continue working in Africa where he learned from hands-on experience in urban, health, and financial economics at UN Habitat, UNICEF, PricewaterhouseCoopers (PwC)  and Futures Group which gave him a broad understanding of economic development and governance from grassroots to international policy level.

 

Alando sees the connection between education, entrepreneurship, and societal advancement. He stresses, “If we don’t invest in the human capital of our people, our economies may keep growing on paper, but we are not going to attain sustainable development. We have just conducted a study of economic and population growth trends in Europe versus Africa, using Germany and Nigeria as case studies. While Nigeria has grown by 100 million people since 2000s, and added 400 billion dollars to her GDP, Germany’s population has barely grown by 1 million during this time, but added 2 trillion dollars to her GDP. The difference is due to Germany’s intensified investment in human capital, in the health and education of its population by government and private sector, and on innovation, digitalization and entrepreneurship.”

 

Journey in global health financing

 

Reflecting on his early foray into global health, Alando recalls, “When I left the banking sector in 1998, I joined the development world by undertaking cost-effectiveness analysis for PMTCT [Prevention of Mother to Child Transmission] in sub–Saharan Africa. There were no ARVs as we know them today. We wanted to find out what drugs people took, their continuum from sickness to treatment and care, and how to strengthen PMTCT programs across 23 countries. I followed a cohort of patients at the Kenyatta National Hospital. One patient, ‘Caroline’ particularly caught my attention.

 

 

The pivotal shift towards advocating for free medicines underscored Alando’s understanding of the economic burden facing patients. “TB drugs and palliative care costs were accounting for much of the cost,” he observes. Leveraging his expertise, Alando contributed to the development of financing models and was one of the many advocates who joined the call for the establishment of critical organizations like the Global Fund, and special funds for women, catalyzing investments in health systems across the developing world.

 

Alando’s journey didn’t stop there. Embracing roles in academia and consulting, he continued to contribute to shaping health financing, health sector, community, and disease strategies across more than 50 countries. This included a review of several HIV strategies in Africa, Asia, and Latin America on behalf of UNAIDS. His impact reverberates through initiatives like the East African Community’s (EAC) Universal Health Coverage Financing Strategy 2018-2023, where he assisted in efforts to commit EAC Partner States to progressively increase health budget allocations by 10% annually, driving tangible progress in resource allocation and healthcare outcomes.

 

Advancing gender equity in budgeting

 

Reflecting on his experience, Alando recalls pivotal moments where the need for gender disaggregated indicators became apparent: “Prior to the formation of the monitoring and evaluation reference group in Geneva around 2003, programs were collecting biomedical indicators, but community level and gender disaggregated indicators were for the most part missing.” Recognizing the importance of gender-responsive data, Alando and his colleagues advocated for the inclusion of such indicators to address the disproportionate impact of HIV/AIDS on women and girls.

 

 

“In the last 20 years, there has been an improvement, with many gender-focused interventions and funds.” However, he acknowledges that the world is still far from fully addressing gender inequities, particularly in sectors like agriculture where the needs of women and girls must be prioritized. “We need to continue advocating for gender-sensitive budgeting across all sectors, ensuring that resources are allocated in a way that addresses the unique needs and challenges faced by women and girls.”

 

Advocating for change

 

Alando’s perspective is deeply rooted in his experiences on the ground, where he has witnessed firsthand the challenges faced by vulnerable populations. His words carry the weight of years spent advocating for change and pushing for greater accountability in resource allocation. For Alando, evidence is paramount in driving effective advocacy efforts. “Evidence is critical,” he emphasizes. “Rely on credible evidence for everything you do and say.”

 

But advocacy isn’t just about presenting data—it’s about mobilizing communities and fostering collaboration. Alando stresses the importance of unity and alignment in advocacy work, noting, “Let’s respect different organizations’ mandates, while realizing we all need to demonstrate a higher impact on the lives of individuals, at SDG level… we need to support coalitions and networks so that advocacy is impactful at national and international level.”

 

Alando’s vision extends beyond traditional boundaries, “innovative financing mechanisms can address fiscal constraints,’’ he emphasizes while recognizing the pivotal role of the private sector in driving meaningful change. “The private sector has serious money,” he acknowledges. “We need to harness it towards all areas of the health system value chain.” He cited examples such as leveraging private sector resources through bonds and UHC service delivery partnerships for capital projects, enrollment into pooled social protection mechanisms, insurance claims verification and other non-traditional areas.

 

Yet, amidst his calls for progress, Alando remains acutely aware of the persistent inequities that plague marginalized communities. “Economic growth hides a lot of injustices amongst marginalized communities,” he observes. “The suffering is real, and if left unaddressed, it continues to have devastating consequences.”

 

Alando shared insights into two groundbreaking projects reshaping healthcare funding landscapes. “There are many health financing projects I have been involved in, but I’ll mention two stars.”

 

 

Insights into the intricate dynamics of trust and its profound implications for effective governance and advocacy

 

Alando, with his extensive experience shed light on a key challenge he has encountered throughout his career: trust. “Trust is a challenge,” he acknowledges, pinpointing a fundamental issue that permeates various spheres of operation. He explains the nuanced nature of trust in different settings. “When you’ve worked for government or the private sector for instance, being fully trusted by either to be independent can be elusive,” he notes, highlighting the complexities involved in navigating internal workings and dynamics. “Once you obtain that trust through results and remain technical rather than political, it helps you to be more credible and accepted across sectors,” he observes, underscoring its role in facilitating effective engagement and understanding stakeholders’ priorities. He emphasizes the importance of trust in policy formulation and implementation. “Understanding government perspectives, processes and its struggles between accountability and rapid implementation, enables one to better advise civil society, partners and the private sector,” he explains, stressing the significance of aligning advocacy efforts with fiscal realities. “Earning trust especially amidst cronyism, is a slow process,” he remarks, emphasizing the need for authenticity, consistent quality, and perseverance in building credibility.

 

Alando recognizes the paradoxical nature of competition and collaboration in fostering trust. “Sometimes our competitors are our best marketers,” he reflects, acknowledging the role of constructive competition in driving excellence and accountability.

 

Looking into the future

 

As Alando looks to the future, he remains committed to the principles of integrity, collaboration, and equity. His involvement in the newly launched International Coalition for Health Financing and Advocacy (ICHFA), a groundbreaking initiative aimed at enjoining health financing advocates worldwide, reflects his unwavering dedication to advancing global health agendas. “We envision a robust and adequately financed health system,” Alando asserts, urging stakeholders to unite in pursuit of Sustainable Development Goal 3. “We have a collective vision for a world where quality healthcare is truly accessible to every individual,” In his closing remarks, Alando extends a heartfelt invitation to all stakeholders to embark on this transformative journey together. “Let us work hand in hand to create a future where healthcare knows no barriers,” he affirms, encouraging enhanced collaboration and innovation in global health financing and governance.

 

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