Dr. Rajiv J. Shah: Leading in Times of Crisis. Navigating Ebola, COVID, and the Haitian Earthquake Emergency | E271

Dr. Rajiv J. Shah: Leading in Times of Crisis. Navigating Ebola, COVID, and the Haitian Earthquake Emergency | E271

Dr. Rajiv J. Shah: Leading in Times of Crisis. Navigating Ebola, COVID, and the Haitian Earthquake Emergency | E271

Raised by Indian immigrants outside of Detroit, Michigan, Rajiv Shah had no idea that he would end up becoming a global impact leader. Shah’s desire for actionable change led him all the way to the White House to serve as the 16th Administrator of USAID. In this episode, he will share insights from his newest book Big Bets: How Large-Scale Change Really Occurs, and he will unpack how to instill the Big Bet mindset into our own businesses and organizations.

Dr. Rajiv J. Shah is an American physician, economist and executive. He is the president of the Rockefeller Foundation and a former government official and health economist. Shah served the Bill & Melinda Gates Foundation as Deputy Director of Policy and Finance and Chief Economist, and was responsible for raising more than $5 billion for the Global Alliance for Vaccines and Immunization (GAVI). He served as the 16th Administrator of the United States Agency for International Development (USAID) from 2010 to 2015. Shah is also the author of the book Big Bets: How Large-Scale Change Really Occurs, which was released by Simon Element on October 10, 2023.


In this episode, Hala and Dr. Shah will discuss:

– Unpacking the leadership playbook for success

– Navigating and avoiding the aspiration trap

– Harnessing the power of simple yet impactful questions

– Importance of having a strategic “scorecard” for tracking progress

– Building trust through effective delegation

– Leveraging entrepreneurial skills for charitable endeavors

– Creating a “big bet” mindset

– And other topics…


Dr. Rajiv J. Shah is an American physician, economist and executive. He is the president of the Rockefeller Foundation and a former government official and health economist. In 2009, he was appointed USAID Administrator by President Obama and unanimously confirmed by the U.S. Senate. He led the U.S. response to the Haiti earthquake and the West African Ebola outbreak, served on the National Security Council, and elevated the role of development as part of our nation’s foreign policy.


Prior to his appointment at USAID, Shah served as Chief Scientist and Undersecretary for Research, Education, and Economics at the United States Department of Agriculture where he created the National Institute for Food and Agriculture. Shah founded Latitude Capital, a private equity firm focused on power and infrastructure projects in Africa and Asia and served as a Distinguished Fellow in Residence at Georgetown University.


Resources Mentioned:

Dr. Shah’s Twitter: https://twitter.com/rajshah

Dr. Shah’s Book, Big Bets: How Large-Scale Change Really Occurs: https://www.amazon.com/Big-Bets-Large-Scale-Change-Happens/dp/1668004380


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[00:00:00] Hala Taha: Young and profiters, have you ever wondered what it takes to make that one big bet on yourself, the one that could transform your life, your business, or even change the world? Well, today's guest is all about pursuing moonshots and taking calculated risks to get there. Dr. Raj Shah is a physician, economist, and executive.

Shah has worked for Bill and Melinda Gates, helping their foundation raise billions to provide vaccines to the developing world. He served in government as the administrator of USAID under President Obama, helping to figure out large scale solutions to like the Haiti earthquake and the Ebola outbreak.

And he's currently the president of the Rockefeller Foundation, a global institution with a mission to promote the wellbeing of humanity around the world. Shah is the author of the book Big Bets, How Large Scale Change Really Occurs. And today with his help, we're going to try to take some of that big bet mindset into our own businesses and organizations.

Raj, welcome to Young and Profiting Podcast.

Thank you, Hala, for having me. 

So Raj, you've experienced what it's like to make big bets in so many different contexts of your career, from philanthropy to government, to the private sector. And I want to get to all of that in our conversation later on. But first, let's talk about your leadership playbook, your new book called Big Bets, because I think it's relevant no matter if you're in philanthropy or government or nonprofit, it is extremely relevant for my audience who are made up of entrepreneurs, freelancers, and corporate professionals.

So what can you hope we can take away from your career and your experiences, and how does that really transfer to the business world?

[00:03:02] Dr. Rajiv J. Shah: Well, you know, the book Big Bets is really about how large scale change really happens. And I tried to go through a number of different case studies and identify really specific leadership lessons that apply to entrepreneurs and builders.

across sectors. I personally think they certainly apply in the social sector. But if you're starting a small company, which I've done in the past and actually I'm doing now, if you're in the nonprofit space, if you're in government, you can use these tactics and these tools and these plays, so to speak, to really just help win friends, build partnerships, measure and document results, find innovative solutions and bring it all together for success.

And that's what I hope readers will take away. 

[00:03:43] Hala Taha: I love that. And something that you wrote in your book is that you don't have to be a saint, a billionaire, or even a president to make big changes in the world. So why do you feel so optimistic about the fact that we actually have agency to make a difference in the world, specifically now in 2024?

And how does that differ from the past? 

[00:04:02] Dr. Rajiv J. Shah: Well, never before in history have we had this much agency to make change happen in your communities, on this planet. In your sector of the economy in the corporate environment whatever sector you live in and the reason is we have more information than we've ever had we usually get it right in the palm of our hand through our phones but information moves fast and freely today and if you know how to find it you can make a huge difference you can get smart on issues we have the ability to connect with each other in a way that we've never had before and so before you might have had to you know have.

a unique set of upbringing or relationships in order to find partners and build alliances that can really do dramatic things. And I write in the book about how I grew up in a fairly normal community in suburban Detroit, didn't have a ton of relationships that were well known people or super powerful people.

But over time, you can connect with folks, make friends. In an authentic way and do some amazing things together. 

[00:05:02] Hala Taha: Yeah, it's so true with the internet, basically, it's like almost anything is possible to your point. Information is right at our fingertips, starting communities is right at our fingertips, even like fundraising is so much easier now because you can leverage social media and all these cool platforms to crowdsource and fundraise and do everything that you need to 

[00:05:20] Dr. Rajiv J. Shah: do.

Yeah, I go through examples as global as fighting hunger and food insecurity on a global basis. And examples in the book that are as local as helping to bring down a handful of statues in New Orleans, you know, the community movement did a few years ago. Whether your aim and your scope is deeply local in your community or totally global, you can get information about where those statues came from, why kids don't suffer from malnutrition and hunger.

Who the key partners are to make change happen. You can do all of that really at your fingertips today. And that wasn't true even 20 years ago. Totally. 

[00:06:00] Hala Taha: And so a lot of us, we technically could be world changers because to your point, we've got the internet and that makes things a lot easier, but sometimes we just never go for it.

And we talk about this a lot on the podcast of the hardest thing with a project is just starting, right? Getting the momentum and the motivation to just get started. You call this the aspiration trap. Can you talk to us about that and break that down for us? 

[00:06:24] Dr. Rajiv J. Shah: The aspiration trap to me is honestly, if you kind of fall prey to public messaging and normal media messages about things are bad out there, people don't get along, our politics don't work, we don't solve problems.

As a result, you see in all the data that people, especially younger generations, really no longer trust institutions, companies, universities, and leaders to tackle the challenges we face. And to me, that's the aspiration trap. It leaves us in a place where we say, you know what? I'm going to walk by that homeless person because there's nothing I can do, and I'm not going to tap into my humanity and learn about how to solve homelessness in my community because it's too complicated.

It's beyond us. There's nothing I can do. And what I tried to do in the book is offer a series of examples, some from my experiences, many from the experiences of other people, local heroes you maybe haven't heard of and super famous people you certainly have. Where they showed you can do things differently.

You can dream big about making bold change happen, but it starts with betting on yourself. And so that's why I like to say big bets start with betting on yourself. I love 

[00:07:34] Hala Taha: that. So I want to talk about your background and we have something in common. We both have immigrant parents that pressured us to be doctors.

All of my siblings are doctors. I have three siblings. They all ended up being doctors. I'm the baby. I didn't listen. You listened. So talk to us about embarking on a career path that is heavily influenced by your parents. And then also, how else did your parents influence you? 

[00:07:59] Dr. Rajiv J. Shah: My parents, maybe like yours, and I love that example from your own family.

 mine came from India. They came here with no real resources, but with educational scholarships. My dad became an engineer, my mom ran a Montessori school, my father worked at Ford Motor Company for 30 plus years, and we grew up around Detroit. And I was raised in a pretty tight knit Indian American immigrant community.

And the kids were basically taught, you know, if you were pretty good at school, you should either be a doctor or an engineer. So I spent much of my youth thinking about engineering. I thought I would be an auto designer and maybe start a car company. Then I switched to becoming a doctor. The truth is I didn't really explore things outside of that because that's what I understood I should do.

And at the same time, as I grew up, I was more and more interested in social justice and politics and understanding why there's inequity in the world. I remember as a kid going to India and visiting my relatives, but then my relatives said, let's get in the car and I want to show you how other people here live.

And driving into a slum at the age of 10 or 11, having never seen that kind of poverty and watching children playing in an open sewer and just thinking, why is it like this? Isn't there something we should do? Or is there something we can do? And that, and many other experiences got me really motivated to make a difference.

My issue is I just didn't know how. You know, I knew how to go to med school. You take tests, you go to med school. I didn't know how you work on quote unquote making a difference. 

[00:09:32] Hala Taha: It's so true because to your point, that's not a straight path, right? A doctor is just like, you just go to med school, you go to residency, you become a doctor.

So I feel like that's why immigrants really push their kids because they just feel whether it's the right thing or the wrong thing, they feel like that's the safe bet to make sure that you're like at a certain level of success.

[00:09:52] Dr. Rajiv J. Shah: Yeah, absolutely. So I, you know, one day I was in med school after years of dreaming about being in politics and public service. And my then girlfriend, now wife of 23 years said, Raj, you know, you really got to just give this a shot. And so I applied three times to be a volunteer on Al Gore's presidential campaign.

Twice got rejected. And the third time I was invited to show up in Nashville, Tennessee. So the day after my board exams, I sort of gave up my medical school scholarship, got in my car, and Shivam and I drove 14 hours to Al Gore's mom's best friend's pool house. where I lived for the next three months while trying out presidential politics.

[00:10:33] Hala Taha: That's so cool. And then how did you end up transitioning to work at the Gates Foundation? 

[00:10:38] Dr. Rajiv J. Shah: Well, it turns out we lost that campaign. So I was then unemployed, which is every Indian parent's nightmare is like a kid within med school left and finds himself unemployed because this shot at politics didn't work out.

But it turns out one of the people I met on the campaign became a friend and said, you know, Bill and Melinda were looking for someone with. My profile, I started there something like an intern, a glorified intern, I think they called me chief economist at the time, but there were no other economists and we work to start to tackle some of the biggest challenges and inequities in the world.

And more than anything, I just got to learn about this big bets methodology from Bill and Melinda and the team they had assembled. 

[00:11:21] Hala Taha: so you actually did some really cool stuff with the Bill and Melinda Gates Foundation. They had an extraordinary goal of vaccinating every single child in the planet.

Can you share with us the steps that you took to tackle such a big goal like that and what you were able to accomplish? 

[00:11:37] Dr. Rajiv J. Shah: Yeah, well, the lesson I learned was the power of asking simple questions, and I learned it from Bill because he would pull us all into a room and say, How much does it cost to vaccinate every child on the planet?

And believe it or not, the world's experts who would join us in these conversations struggled with answering that. They said, Look, it's really complex, and it's hard to be that reductive, and it's just a big, complex question. But Bill's simple questions really forced us to model out What it would cost to vaccinate all 104, 105 million kids who were born every year.

It forced us to study who was really getting vaccinated and who wasn't. It turns out probably half of that birth cohort was going without vaccinations. It forced us to learn the consequence of that, which was that 11 million children under the age of five every year were dying, many of whom from easily preventable diseases if they could get vaccines.

And it forced us to do some other analysis on the demand and supply side of the global vaccine industry to really understand what it would take to scale up vaccinations. The bottom line is, those simple questions led to some big breakthrough innovations and ideas. It led to Bill's and Melinda's big investment to create the Vaccine Alliance, and 20 years later, 980 million children have been vaccinated, and 16 million child lives have been saved, and to me, that's what a Big Bet is, and what a Big Bet looks like, delivering results at scale to make humanity much, much better.

[00:13:08] Hala Taha: That's incredible, and you should be so proud. And one thing that I really want to drill on is this concept of asking really simple questions. So can you talk to us about how that can actually help us solve bigger problems and get to the root cause of what's going 

[00:13:23] Dr. Rajiv J. Shah: on? Sure. Well, look, often, especially as you kind of, I think, get more and more expertise in your career.

And this is why, especially for your listeners that are just embarking on their entrepreneurial endeavors, people sometimes overwhelm their thinking with complexity. And in the case of vaccinating children in developing and low income countries. It's easy to say, well, you can't really figure out what it takes because you need so many things, you need roads, you need power and energy infrastructure, you need refrigeration and cold chain to protect vaccines, you need enough supply of different kinds of vaccines, most of those vaccines were only being made for rich countries that could afford them.

And there's so many barriers that it's easy to give up and to say, well, let's just do a little bit of what we can and be content with that, as opposed to saying, how do you actually change these systems to achieve the goal of creating an environment where every child on this planet can be protected from easily preventable childhood mortality?

And so that's the power of simple questions is the forced analysis, the forced learning and the forced identification of barriers. Which you then spent years and decades trying to overcome. I think that lesson applies as much to vaccinating kids as it does to stopping pandemics as it does to starting a business that you hope will be transformational in your sector of the economy.


[00:14:48] Hala Taha: is so insightful. Can you give us an example of, let's just use this vaccination example, what was like the complexity and then how did you drill down to like the one simple question in that? 

[00:14:58] Dr. Rajiv J. Shah: The complexity was. It wasn't even complexity, really, just there weren't enough vaccines to reach all these kids.

So it turns out a few years before we had started on this endeavor, vaccine manufacturers had changed the formulations of their vaccines and reduced dramatically the supply base of global manufacturing. So there were only enough vaccines to reach relatively Wealthier countries and kids in those countries.

So to create a vaccine supply base that was three times as large as what was currently manufactured, vaccine manufacturers needed long term contracts. They needed to see that the money was going to be there to buy vaccines at that scale. And they needed to be confident that the demand would, in fact, Absorb manufacturing at that scale.

So we went out and created the world's first social impact bond. We did that holding hands with the United Kingdom and France and a bunch of European countries raised 6 billion through that debt issuance. Restructure the way the world procured vaccines and contracted for them and created a much larger supply base in the vaccine industry.

And then that ultimately became the solution. But without the simple question, basically, what's the barrier? Why are these manufacturers not producing enough vaccines for every child? We wouldn't have gotten there. And frankly, we had to work with those companies. So The other lesson is really about partnership, which I think applies also to private entrepreneurial efforts, which is you got to reach out and hold hands with these partners.

You can't just talk about them from afar. And we sat with these vaccine manufacturers and really studied what would it take to build new plants to get them approved by regulators to dramatically scale up the manufacturing? How much risk can you take? How much risk should we take? And that took years, but ultimately made a huge difference.

[00:16:51] Hala Taha: Yeah. And just like you said, everything that you're saying translates to the business world perfectly. And as I think about like what I do as an entrepreneur, I'm constantly going down the path, down the path. Like how can I actually find out what the problem is that I need to solve, right? And I always tell people that listen to this podcast.

If you want to be successful in any niche that you're in, you need to know every single nook and cranny of that industry and every single problem and every single gap and like really absorb yourself. And that's when I hear you, that's what I hear you saying. Like you really absorbed yourself and figuring out, well, what's the actual vaccine problem.

It's not that we just need to get vaccines to kids. It's that there's actually not enough vaccines for kids. And we have to solve that 

[00:17:33] Dr. Rajiv J. Shah: problem. I love that point because getting really, really smart about an issue. It's sort of step one and a lot of times, especially in the nonprofit space where people want to create all this positive change in the world, it's easy to gloss over the fact that it might take years of deep study analysis and interviewing people to really learn enough to develop the kind of fresh, innovative solutions that are the basis of these big bets.


[00:17:58] Hala Taha: So we're going to get back to some of the strategies. You were able to implement that you talk about in Big Betts, but first I wanna ask you about another one of your big jobs being the administrator for USAID under President Obama. First of all, what does USAID do? 

[00:18:13] Dr. Rajiv J. Shah: USAID is the US Agency for International Development.

It's America's lead, humanitarian and development agency around the world. It's active in 70 to 80 countries around the world with about a 30 billion budget today, and maybe 000 humanitarian and development workers that focus on really making sure opportunity, dignity, public health and democracy are accessible to as many people on this planet as possible, because that is ultimately one of the core priorities.

Ways we keep our own country safe and secure. 

[00:18:53] Hala Taha: Sounds like super important work. Maybe some of the most important work in the whole world. And you were sworn in as an administrator in your first few days on the job and then crisis hits. It was the Haiti earthquake in 2010. I believe I remember that personally, the whole world was in shock.

It was like the biggest catastrophe of our time. It was so many lives lost. 200, 000 people died. What was that experience like, like, take us back to 2010 when you heard that news. What kind of pressure was on you? What were you tasked to do? And how did you tackle it? 

[00:19:26] Dr. Rajiv J. Shah: Well, I was new on the job. As you point out, I'd been confirmed and sworn in just about a week before the Haiti earthquake took place.

Oh, wow. The earthquake itself was the largest humanitarian catastrophe we'd ever seen. And in a moment, 21 out of 22 Haitian ministries and the United Nations buildings in Port au Prince, Haiti collapsed. And so in addition to hundreds of thousands of people being either dead or missing, we lost the leadership on the ground that would normally respond to these types of catastrophes, brave men and women who had been in many tough settings and had real experience.

And in that setting, President Obama actually called me. It was my first time receiving a phone call from the president. And we had blackberries back then. And I sort of was leaning into the window to try to make sure I had good coverage. And he said, Raj, I'm putting you in charge of. America's response.

And this is a deep moral moment for us. So make us proud. And then I actually thought he was going to say a lot more and the line went dead. And I thought, Oh, my gosh, maybe I accidentally hung up on the president, but I didn't. He had ended the call and about 30 seconds later, he was on CNN standing behind the podium at the White House saying, I just spoke to Administrator Shah and I've asked him to do XYZ.

And so I realized this was going to be very fast moving and a very challenging situation. And it really was that. 

[00:20:52] Hala Taha: That's incredible. What do you remember of that time in terms of like what you put in place immediately? Because from my understanding, it was all eyes on the U. S. in terms of how are they going to support.


[00:21:02] Dr. Rajiv J. Shah: I think the first big theme, it was laid out by the president. He basically said, look, at a time when the world questions how America uses its power, especially in foreign affairs. This is an opportunity to demonstrate our morality by serving those who are suffering just two hours from our shores.

So with that charge, it became clear that we're going to do everything we could. And it started for me by creating a sort of data architecture and a scorecard to understand what were the things we needed to do, feed 3 million people, provide clean water to two and a half million people, make sure that we had urban search and rescue teams on the ground to evacuate people from under the rubble.

Within the first 24 to 36 hours, all of the things on a scorecard or checklist, so we could track our progress, but the real breakthrough for us in the quality of our response was the partnership element. We really invited in so many different parts of the U S government and all of American society to participate in the response together, and it just showed me the power of.

Moral persuasion in America, more than half of all American households gave in some form to the Haiti earthquake, more than the number of households that watched the super bowl that year. And I think that tells you about the character of our country, especially when it's tested. 

[00:22:23] Hala Taha: That's absolutely incredible, and I know you're doing very similar work on also really important projects at the Rockefeller Foundation as their president.

I want to get into that, but first, I really want to talk about your new book, Big Bets. So let's start off with a simple question. How do you define a Big Bet? 

[00:22:41] Dr. Rajiv J. Shah: Big Bets are efforts to actually solve and not just make incremental improvements on some of the huge social challenges we face. So it's the difference between saying I want to do charitable endeavors that help a few people get access to vaccines and are protected from diseases versus saying I'm willing to spend decades and I'm going to put the effort in to actually change systems to make sure that every child on the planet gets vaccinated.

It's the difference between saying we're going to help people who are suffering during a pandemic, in this case I write about the Ebola crisis in West Africa in 2014, and saying we're going to do whatever it takes to stop that disease in West Africa before it spreads into other parts of the world and becomes a truly global pandemic that leads to hundreds of thousands of deaths.

It's the difference between saying we're going to have dialogue about race relations in a particular place, versus saying we're going to work diligently to take down the symbols of racial animosity in our community, and I wrote about Mayor Mitch Landrieu and his big bet to remove Confederate statues in New Orleans and New Orleans.

A process that led to a racial reckoning and dialogue across this country. So it's really the boldness of the aspiration and the determination to succeed that differentiates a big bet from a typical effort to do good. And. 

[00:24:05] Hala Taha: I know that earlier we were talking about these aspirational traps, right? Where we're just like, it's so complex.

It seems so hard that we might scratch the surface and kind of like give up because we feel like we're never going to be able to actually make an impact. It's too complex. It's too difficult. The alternative to that is having a big bet mindset, where we feel like we actually can make a difference in this world.

So how do we cultivate a big bet mindset and what are the characteristics of that? 

[00:24:32] Dr. Rajiv J. Shah: I write about three specific ways to cultivate a big bet mindset. The first is constantly search for fresh, innovative solutions. I know entrepreneurs listening to this podcast do this all the time, but never forget that it is that constant search for Innovative and inspiring solutions that actually gives us the ability to make big bets real.

The second is be willing to build alliances. And sometimes that's across really strange potential bedfellows. So I write about bringing Super conservative, faith based Republicans together with very progressive Democrats to pass legislation in the United States to help reinvigorate America's humanitarian fight against hunger around the world, an effort that helped move 100 million people out of poverty and hunger.

Do the hard work to build those alliances. And the third one for me is Be absolutely rigorous about measuring data, measuring data, and looking at the data, learning from it quickly enough to make the changes and course corrections that can help you achieve your goal over time. And to me, those three elements, innovative solutions, bold alliances, and data driven measurement around what success is and looks like, is really important to make a big bet work.


[00:25:52] Hala Taha: talk about So you just talked about building alliances. I'm going to dig into all the things that you just mentioned. Let's start off with taking the help first. It is so important whether you're starting a business, whether you're starting a nonprofit or taking on a big bet like you're talking about.

To actually ask for help and not think that asking for help is a sign of weakness. So talk to us about that and how you did that on the Ebola project. 

[00:26:18] Dr. Rajiv J. Shah: That is so true that asking for help and taking all the help you can get is often the difference between success and failure. When President Obama made a big bet that for the first time in America's history, he deployed nearly 3, 000 American troops to West Africa to fight a disease.

And a hemorrhagic fever, one that was killing seven out of every ten people it was infecting. We actually didn't know what would success look like. We just knew that we had to put troops on the ground, build field hospitals so there was safety for anyone who might have contracted Ebola, and then work to develop solutions.

And in that context, we worked locally with communities to identify what are the solutions that could work. And ultimately, one of these local communities identified the solution that did end the pandemic. And that was building these burial teams around people who had died. It sounds like such a simple idea, but most people were contracting Ebola through the traditional practices in Liberia of washing, hugging, and redressing the bodies of deceased family members.

And you could imagine if an elder person in a family passed away, performing those rituals was very much a part of expressing love and respect for the person who had died. But it was also how kids and other people were contracting Ebola. So we worked with those communities to put together a process where you could put those bodies in WHO approved body bags, have teams that were fully clad in protective equipment go in and perform a ceremony to honor the person who had passed.

But then remove the body before there was further contagion, and we very quickly saw a 70 percent reduction in case transmission, and we knew we'd be on our way to ending the pandemic. In fact, the CDC estimated there'd be 1. 4 million cases of Ebola, including a few hundred thousand in the United States.

It turns out there were only 30, 000 cases as a result of this approach in West Africa. There were only two in the United States, and neither were contracted here, so. Success can happen but you have to be willing to find those solutions and work across the normal partnerships normally you would have said let's go to atlanta or new york or geneva and find experts who could tell us what the solutions are.

Here, the solutions came from local people, not experts at all, but deeply meaningful and understanding their own cultural practices. 

[00:28:43] Hala Taha: I love this example because it goes right back to what we were just talking about. That one simple question, why are people contracting Ebola? Because they're doing these burial practices.

If we can fix that, we've solved most of the problem, right? So it goes back to that. Speaking of creative problem solving, which I personally think is probably one of the most underrated skills. As an entrepreneur, as just like a successful person, I feel personally that my success is just my creative problem solving, right?

So it's very important. Why is experimenting part of this? And can you give us examples of how you experimented to accomplish some of these big bets? 

[00:29:21] Dr. Rajiv J. Shah: Yeah, so, you know, experimentation is really just recognizing you don't have the answers. And searching for what the answers might be in an architecture where there's enough data to tell you what's working and what isn't working and I'll come back to that Ebola example because when we deployed the troops, we thought actually that the best chance of reducing transmission were these building out these big Ebola treatment units, places where people who are positive could go be isolated, be cared for and not transmit to others.

The problem was people would go in and they would die. Thank you And they would never come out things would never come back and their ashes would never come back and so pretty soon nobody would go in and we just didn't know the answer but in order to learn the answer we had to create a data architecture that allowed us to experiment so I wrote about how we did everything we could to do that we recruited a amazingly creative.

Epidemiologist from Sweden, a guy named Hans Rosling. We sent kids out on motorbikes to sort of give visual confirmation of potential cases. We built a little bit of a Wi Fi and technology system so that people could transmit data more quickly. We even transported blood samples on World Food Program helicopters to DOD bioterror labs that we had set up so that we could get the time to confirm a diagnosis down from three or four days to three or four hours.

And that data infrastructure actually gave us the ability to say, okay, these burial teams are working. These Ebola treatment units are not, let's invest in scaling up the burial teams. And that's what I mean by keep experimenting, which is if you're starting a business, Often the data you're going to get are from sales, but sometimes the data you'll get are from other types of experiences.

And you should just constantly have that mindset of what's working, what isn't working, what can I change, what can I make better without being overly wedded to any one solution. 

[00:31:17] Hala Taha: Totally. And it's about monitoring and leaning into the stuff that's working and dropping the stuff. That's not working. So when it comes to tracking all this data, we've got to be reporting out on progress, right?

Keeping a score, having a scorecard, which you say is really important to accomplish these big bets. 

[00:31:34] Dr. Rajiv J. Shah: Well, for a lot of reasons, the first is, believe it or not, a lot of times people pursue their efforts either in business or certainly in the nonprofit space without actually a clear understanding of what they're going to measure to hold themselves accountable to whether they're succeeding or not.

And that's particularly problematic in the government, non profit space. So really having the rigor to measure results and hold yourself accountable is super important to being successful. I'd say the other element of that is many of these examples are about thousands of people from different walks of life and different organizations working together.

When I led the Haiti earthquake response, We had three, four thousand troops from every part of the armed services, but we also had hundreds of other institutions and NGOs and UN agencies all working together. You can't really have a top down command and control structure when you have that kind of a complex group of organizations working together in the midst of a crisis.

So you need to have a clear scorecard. That you can make public that you can communicate and you can tell everybody what we're succeeding on and what we're failing on so they can solve the problems that we identify as failures and I would do that every day I called that over communicating but I remember going you know the white house the minute you left the white house there be a press pool right outside there on the driveway.

And we would just report out the data and some people found it a little mundane, but that's actually how we communicated with thousands of partners that were all trying to help, but didn't exactly know how. 

[00:33:09] Hala Taha: Yeah, exactly. I feel like that would get everybody mobilized. And another way that you can mobilize people that you say is to actually jump in first to lead by example.

Can you share a little bit about that? 

[00:33:21] Dr. Rajiv J. Shah: I mentioned this earlier about the social impact bond for vaccines. But when we realized that the Gates Foundation's commitment of 750 million to help launch an effort to vaccinate every child on this planet was really only a drop in the bucket of what would be needed to achieve that goal, we knew we had to come up with some new financing solution to change the way the world bought, paid for, and ultimately manufactured vaccines.

And we had constructed an idea for a social impact bond where a group of European countries would back a debt issuance, and then if the kids got vaccinated, they would reimburse this Gavi vaccine alliance for the cost of that money. And it was complicated, and it was new, and it was novel. And so when I reached out to partners to say, Hey, do you think we could make this happen?

It was understandable hesitation. So to overcome that hesitation, we said, and I did this, I think I write in the book, uh, one night at a bar at a conference, I basically suggested that we at Gates could guarantee the bond issuance. And we had a big enough endowment at that time to make that guarantee.

viable. And all of a sudden, others said, Hey, if you're willing to do that, then this is going to work. And then I want to be a part of it. And the reality is other countries piled in. And once we had all the countries in our guarantee, wasn't even necessary because they brought their own full faith and credit.

And for a lot of technical reasons, Our guarantee wasn't needed. So I call that jumping first. Sometimes someone has to go first and say, you know what, I will take the risk out of this for you. And if you get lucky and enough people join. You sometimes don't even have to follow up on actually doing it because it's not necessary anymore.

[00:35:10] Hala Taha: Yeah. And I feel like this really is translatable to business because as entrepreneurs, you often have to like take a risk first so that other people will follow, do you have any examples of how entrepreneurs have used this 

[00:35:22] Dr. Rajiv J. Shah: strategy? Oh, I think most entrepreneurs do this almost all the time you're raising money and you're constantly sharing the optimistic vision of what you're able to do and and everybody knows the first big funder in any funding round, for example, makes it a lot easier for everybody else to get in the game.

And so that's an obvious example, but there are so many others. And I, I would just say focusing on who's jumping first and really getting them to go with you becomes critical. And that's why a lot of times most entrepreneurs in this country actually start businesses with their own capital for exactly that reason.

And it shows you have skin in the game. 

[00:36:06] Hala Taha: So I want to go back to teams and recruiting other partners to help you with these big initiatives. How do you go about trusting people? and delegating. How do you, first of all, know who to trust to delegate? Because I feel like that's a big issue with people when it comes to delegation.

And then how are you mentally able to allow yourself to trust other people? Because you can't get big things done without trusting other people. 

[00:36:32] Dr. Rajiv J. Shah: I think part of it is learning how to give up control and just getting comfortable with the idea that You're going to sink or swim with others as opposed to sink or swim entirely based on your own capacities and abilities.

And I really learned that viscerally during the Haiti earthquake response and in the very first Oval Office meeting with President Obama and Vice President Biden, I got to the meeting a little bit earlier than the others in the meeting. And so Obama and Biden were by the window talking and Biden said to Obama, he didn't see me walk in, he said, Are you sure about putting this Rod Shaw guy in charge of this effort?

He's young, he just got to Washington. We have this other guy, Craig Fugate, who ran the Federal Emergency Management Agency, who has more experience, and he'd be great. And then President Obama saw me and so came over and said, Raj, Raj, come in, sit down. And pretty soon everyone piled in and we had a very effective meeting.

But on the way out of that meeting, Craig Fugate was in that meeting. I put my arm around Craig and I said, Craig, I need you. I need your help. I need your knowledge. And I need you to make this work, because I, I don't think I can do this alone. And sure enough, he said, Raj, I'm there. And we went straight back to USAID.

We stood together in our operations center, and he brought his team for the next several weeks, and we did it together. I just think the lesson for me was, I actually called the lesson in the book, Open the Turnstiles, because when we got back to USAID, the folks with USAID badges could get through the gates, but the folks from Craig's team couldn't get through the gates, because they didn't have the right badge.

And we, we asked the security team to just open the turnstiles, keep it open during the first few days of the response. So everybody felt welcome and they felt like they were part of a team. Sometimes it's just about building that culture of trust and really recognizing that you need the help and you're going to take it and let it go 

[00:38:22] Hala Taha: from there.

And that's totally not a sign of weakness, by the way. A lot of people think help is a sign of weakness, but actually you probably looked really polished and on point for knowing exactly who to ask for help. 

[00:38:35] Dr. Rajiv J. Shah: Well, in that case, it was made easy for me by the vice president. But yes, I absolutely, I would just say, I totally agree with you.

Even today with my teams, I look at my various senior leaders and the ones who know how to ask for help, know how to bring other people in and genuinely collaborate, they're the ones who get the big things done. And so I think it's a sign of strength to say, Hey, I don't know this. And I'm going to ask for help and I'm going to give up some control, but I'm going to do this together with others.

[00:39:06] Hala Taha: 100%. So, I want to learn more about your work at the Rockefeller Foundation, and I learned that you were actually involved with supporting COVID testing during the pandemic, which I could imagine must have been a beast to handle. And I also could imagine that you leveraged a lot of your experience with the Ebola crisis in order to help you with that.

Could you talk to us about how you were able to increase production of tests during COVID? 

[00:39:32] Dr. Rajiv J. Shah: Sure. Well, I think we actually felt Like our help wouldn't be needed on the very early end of it because we thought this is America where the country that should be most equipped to fight a pandemic threat like COVID 19.

And it turns out America struggled to set up a testing infrastructure in this country that allowed us to know who was positive quickly. And as a result, COVID spread much faster than it needed to in the first six to eight months of the crisis. And during that time, you might remember that president Trump actually was.

Communicating that we were not going to invest in expanding testing because we'd find more cases and that would create more panic and I saw that also reflected in the Ebola crisis back nearly a decade earlier. So we knew right away we had to work with private industry and local communities to scale up testing on an urgent basis and we brought together experts.

We 40 cities around the country in testing efforts. And we worked with two, three big companies to say, can we develop rapid tests in particular so that we could go from having, I think at the time, two to 300, 000 tests per week to ultimately 30 million tests per week, which was our target. And we did a whole, whole bunch of activities, but over the course of about six months, we did, in fact, cross the 30 million test a week line, which when we put that number out there and the plan to achieve it, it was thought to be wildly aspirational and completely unachievable, but it proved to be a critical way to reopen schools to get workers into health facilities in a safer manner.

And even today, we rely on antigen tests to help us manage recurrent COVID in our country. 

[00:41:19] Hala Taha: Well, I'm super thankful that you did that work. My father actually passed away from COVID. So I'm very thankful that you were able to prevent other people from having that experience. So thank you so much for that.

What other projects and key initiatives are you working on at the Rockefeller Foundation right now? Let 

[00:41:36] Dr. Rajiv J. Shah: me just say how I'm so sorry to hear that about about your dad. Thank you. This country lost too many people from something that could have been prevented had we stood that diagnostic infrastructure up much faster.

So one of the things we do today is we help countries around the world prepare for the next pandemic by sharing data on pathogens that are emerging and by working to improve surveillance and testing and response in countries, particularly low resource countries around the world. Another big bet we're a part of is helping to make sure that we bring renewable electrification to the billion people on this planet who still effectively live in the dark.

It's probably shocking to many of your listeners to hear this, but almost a billion people live with less electricity than it takes to power one light bulb and one small home appliance per person per year. And at that level of electricity consumption, you're basically trapped. In subsistence poverty, you almost certainly experience hunger multiple times a year.

If you're a young girl, you rarely go to school. If you're in one of those families and your chances for a brighter future are severely constrained. And we've learned over the past decade that actually renewable energy, lithium batteries, solar panels, smart meters, text based metering and payment, we have all this technology, artificial intelligence for remote management of these systems.

So that we can finally build out electrification infrastructure to reach the billion people who live in energy poverty. And that is one of our big bets that we're pursuing actively in 22 countries, reaching with projects invested that'll reach 77 million people in just the next few years. 

[00:43:28] Hala Taha: Such incredible work.

You've done so much over your career to just help improve the world. And I feel like so many young entrepreneurs, millennials, Gen Z, We're really all about helping the world I'm really thankful that I, I feel like a lot more entrepreneurs who are going to be aligning to social causes are going to start bubbling up and I'm actually one of them.

I'm an entrepreneur and I'm Palestinian, so I've been fundraising for Gaza and I'm also starting a charity project to really help fight digital oppression and fundraise and just help innocent people, right? Don't want to get into politics. This is not a political show, but I did want to ask you, what advice do you have for entrepreneurs who want to align to a social cause and what skills do you feel like as an entrepreneur really support in the area of a social cause?

And what skills or learnings do you feel like we really need to focus on to improve to do better at this non profit 

[00:44:26] Dr. Rajiv J. Shah: sector work? Well, Hala, first, congratulations on what you're doing. That's exactly the right thing to do. It is to go out there, pick a cause you're passionate about, and use your entrepreneurial skills to do what you do in your day to day work to help make the world a better place on whatever inspires you.

And if you can raise money, raise money. It starts with getting smart on issues, which you clearly are with respect to Gaza and the West Bank, places I've spent a lot of time on when I ran USAID. And I would just say that those efforts require the entrepreneurs that listen to this podcast to be more active and to be more engaged because you're the folks who just say, hey, I see a problem out there and I'm just going to do it.

I'm just going to do something to make a difference. That is absolutely the first step. I'd say if there's one thing I'd suggest that. I tend to see as social entrepreneurs do all this amazing stuff. People can sometimes be very pessimistic about the power of public service and governments. And I would just say, if you can overcome that skepticism, Learn about, work with, lobby, engage elected leaders and the governments that have the sort of authority and the resources to do some of this work at scale, your voice will ultimately be heard.

And I know that's hard to believe. It's easy to sort of look up and say, gosh, that's complicated and that's hard. But I've been in public service for many, many years. We look for your examples and your energy and your inspiration, and it always has an impact. So I would say, use your voice as much as your entrepreneurial talents to influence others, particularly.

In the public sector to get them to do the right thing. 

[00:46:11] Hala Taha: I'm so happy we had this conversation because it was so incredibly timely for me. Cause like I said, I'm starting this organization and certain aspects of it are really easy for me to figure out, like fundraising, starting a community, getting people to take action.

This is all the stuff that I do in my business. But now that I've talked to you, I'm really thinking about what's that simple question. How can I be more creative? Who can I ask for help? And you've just really opened up my eyes to a lot of different things. So I'm really thankful. That we had this conversation and that now I can have a big bet mindset.

And so I wanted to close out this interview by asking you a couple big picture questions. First, you've said that business is its best when it's driven by profits and purpose. So what are some ways that you think we can get the private sector involved in contributing more to the world? And how can we help nudge things in a better direction persuade society and businesses to do the right thing?

[00:47:03] Dr. Rajiv J. Shah: Well, you know we see all of this in the data that Younger folks in the workforce expect their employers to carry forth a set of values about making the world a better place, whether it's on climate, on social justice, on equity, on right and wrong. I think it starts there, that we need people who work in these companies to demand that their companies do the right thing on that range of issues and many others.

I have found in my experience that when you tap into that, amazing things happen. I write in the book about going out to Cargill, getting to know their leadership and some of their employees. And then during a tragic famine in Somalia in 2011, their CEO helped redirect grain shipments that were in the region and put enough food at the port of Mogadishu that they helped reduce the number of deaths.

of children because they brought food into a famine situation with urgency. I mean, people will do those extraordinary things, but usually you need to know them. You need to build those relationships ahead of time, and you have to tap into their sense of right and wrong and moral justice. And I wish we could use that language more in how we interact in the corporate world, because I know everybody wants to have a sense of purpose.

And have that be expressed in their workplace as appropriate and as best they 

[00:48:27] Hala Taha: can. Yeah, I totally agree. And our podcast is called Young and Profiting, right? But more and more, I realize that profiting in life is really not just about money. It's about making a better world. And Also, personally, I feel like to your point, you feel more fulfilled when it's not just about profiting in business, it's about actually profiting and helping the world thrive.

So how has this type of work, Big Bet work, changed your own life and your own perspective on the world? 

[00:48:55] Dr. Rajiv J. Shah: I think a Big Bet mindset has helped me feel like I have the capacity to make change happen. It's helped me avoid this feeling of helplessness and pessimism and helped me feel more optimistic and powerful.

I know you could say, well, hey, you run a large global institution with resources. So of course you feel powerful, but the truth is I have a lot of my peers. We don't always feel powerful against the huge challenges we face. It's the mindset. That creates that sense of yes, we can do this together and it's the sense of collaboration and alliance building that gives you that confidence that let's go try to fight climate change or let's end energy poverty or let's take on a pandemic.

So I'd say it's that that's probably the biggest thing that other big thing on a more personal basis is I have found because I've had a career where I've learned from so many other people who have done this type of work that my friendships and my professional relationships. are deeply inspiring to me.

I get to look around even here at Rockefeller, my colleagues and by our grantees and our partners, most of whom no one's heard of in difficult parts of the world. And I'm inspired by what they do. And I think of their courage, you know, you mentioned Gaza. I used to run USAID, Mercy Corps and World Food Program has so many staff that were there providing services and support under a lot of duress.

And I think about folks like that and it puts a lot of life in perspective for me and it just keeps me inspired if they can do it, we should be able to help. 

[00:50:31] Hala Taha: That's so beautiful. This has been such a wonderful conversation. I always end my show with two questions that I ask all my guests and then I do something fun at the end of the year.

So the first question is what is one actionable thing our young and profitors can do today to become more profitable 

[00:50:46] Dr. Rajiv J. Shah: tomorrow? I would say ask a simple question. Whatever you're working on. Go back to the basics, ask a simple question and really chase it down. 

[00:50:57] Hala Taha: I feel like that was my biggest takeaway from this whole conversation is that now I'm always going to be like, but what's the actual question that we're asking here, right?

I'm always going to think about that now. So thank you so much for that. And what is your secret to profiting in life? And this can go beyond just business. 

[00:51:13] Dr. Rajiv J. Shah: Oh, it's people. I fell into this line of effort and work, but I get to be surrounded by people who are making change happen, who fight for justice and equity, who are just inspiring.

I would say a lot of the book I wrote is about people who I've learned from by working with them, whether they're super famous, like Barack Obama or Hillary Clinton, or whether they're totally unknown, like some of the NGO leaders in Africa that I tried to highlight, surround yourself by people you'll learn from and be inspired by.

[00:51:45] Hala Taha: And where can everybody learn about you, get your new book, Big Bets, and support the Rockefeller Foundation? Uh, 

[00:51:52] Dr. Rajiv J. Shah: well, you can go to our website at rockfound. org and join our effort. We have a community we call the Big Bets Community. You're all welcome to join. The goal is to help people who want to be changemakers get connected, get informed, get support, and get launched on their journey.

Yeah, you can buy the book at Amazon and booksellers near you. Big bets how large scale change really happens and I hope it helps inspire some change in 

our world

. Amazing. Well, thank you so much, Raj. It was such a pleasure to have you on Young and Profiting. 

Thank you.

[00:52:23] Hala Taha: You know, young improfiters, this podcast just feels so serendipitous sometimes. I feel like I always seem to have the exact conversation that I need to have on the exact day. And I don't know if I'm just biased because I tend to just relate all my conversations to what's going on in my life, or if really the stars are aligning and I was supposed to have this conversation on this very day.

But I have to think that maybe there is some serendipity in all of this. And today was such a timely conversation for me. I've been working a lot on social causes. I've been fundraising for Gaza. It's been a super challenging time. I'm starting this project called the Watermelon Project to try to educate people and start a movement.

And it was so great that I got to speak to somebody like Raj, who's so accomplished in the nonprofit sector. And selfishly, I got to ask him all the questions that I was really curious about personally. I loved his optimism. He has a can do spirit. He's got a faith that others can, just like him, overcome all the different aspiration traps that can sideline even the best intentions.

We can. Get the motivation and belief that we can actually make a change. And it's true. Like he says, entrepreneurs and others like us who have business experience are really great for charity work because we know how to do all the things we need to do, identify issues, solve problems, raise money, and find partners who can readily help us become change makers, because in a world like today in 2024, connecting with others has never been so easy.

There's absolutely no excuses. Making that big bet on lasting change starts with betting on yourself. Sometimes you've got to take that first step. Take that first big risk so that others will follow you into battle. And if you can show that you've got focus and passion and some serious skin in the game, others are more likely to follow, whether that's in small business, a charity, or some other endeavor or project.

Raj also had some great tools and tactics for pursuing that big bet. It starts with getting smart on the issues that matter. Absorb yourself in every nook and cranny of your industry or area of interest. And in doing so, cultivate that big bet mindset that Raj talked about. Use your hard won knowledge to find new and innovative solutions that allow you to take things to the next level.

Drill down on the root problem you're trying to solve. And you do that by asking simple questions. And then reach out to the people that will help you accomplish all your goals. Build alliances, even if it means befriending a strange bedfellow in the process. And finally, make sure you befriend your data too.

Rigorous data collection and analysis can help you improve your operation and more nimbly change course so that you can learn what's working and lean into that. We all have the capacity to make a difference in the world and more than we usually give ourselves credit for. 

So young improfters get out there and use your energy and inspiration to make a big bet and to make an impact in the process. Thanks for listening to this episode of Young and Profiting Podcast. Before you make that big bet, why don't you first make a smaller bet on us?

If you listened, learned, and profited from this conversation with Raj Shah, please share this episode with your friends and family. Just hit that share button and text a link to this episode to somebody who you know could benefit from it. It could really help them out and it would definitely help us out.

And if you did enjoy this show and you learned something new, then please drop us a five star review on Apple podcast. Nothing helps us reach more people better than a good review from you. If you prefer to watch your podcast as videos, you can find all of our episodes published on YouTube. You can also find me on Instagram at Yap with Hala and on LinkedIn by searching my name.

It's Hala Ta. And before we wrap, I did want to say thank you so much to my incredible Yap production team. You guys work so hard. so much. And I appreciate all your dedication and passion and all the work that you do behind the scenes. This is your host, Hala Taha, AKA the podcast princess signing off. 

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