Dr. Nancy Messonnier began her public health career in 1995 as an Epidemic Intelligence Service Officer in the Childhood and Respiratory Diseases Branch of the National Center for Infectious Diseases. She went on to hold a number of leadership posts across the Centers for Disease Control and Prevention until 2021 when she joined the Skoll Foundation to lead its pandemics and health system strengthening work globally.
We sat down with her recently to hear her thoughts on how philanthropy can be catalytic in pandemics response and prevention, and why COVID-19 presents an opportunity to galvanize cross-sector investment in resilient health system infrastructure.
After working for decades on the frontlines of public health, what brought you here to this role at the Foundation?
Nancy Messonnier: I’m incredibly grateful for my 25 plus years at CDC working with great people, and really making an impact. Like everybody else, I think the pandemic caused me to reassess where I was and what I wanted to do. It seemed like a great time to get off of the frontlines and to think about a different way to have impact.
Bureaucracy moves slowly. What attracts me to Skoll is the ability to move fast, to fill gaps, to be entrepreneurial, and to take risks. I think philanthropy has a unique niche in catalyzing change and I’m excited to explore the possibilities.
What does it mean when public health experts talk about how important it is to “never let a crisis go to waste?”
Messonnier: This pandemic is by far the largest pandemic that we’ve ever experienced in my lifetime, but it’s certainly not the first crisis. When there is a public health crisis, like an influenza pandemic, an Ebola outbreak, a Zika outbreak, the world’s attention is really focused on that crisis and that’s the opportunity to get a commitment to long-term change. But then the crisis passes and the commitment to long-term change isn’t sustained.
My first experience of large outbreaks was actually in 1996, when outbreaks of meningococcal meningitis swept through the African meningitis belt. 350,000 cases in four months in some of the poorest countries in Africa. The ministers of health and the ministers of finance from those countries got together, wrote a big declaration saying ‘never again, we’re going to commit to improve surveillance and response, lab capacity so that we never have another crisis.’ But you look now and you think we didn’t really take advantage of that momentum to make sustainable change. I think if after this worldwide pandemic with this scale and scope, if we can’t commit it’s a real tragedy.
When you look at the big picture of global health infrastructure for pandemic detection and response, what are the big gaps that you see where philanthropy can catalyze change?
Messonnier: A pandemic anywhere is a pandemic everywhere, and COVID has shown the insufficiency of our global coordination. Countries have fractured and dealt with it individually which leads to a suboptimal response. Global financing is really important and there’s also a lack of investment at a country level to do early detection and rapid response. If countries can’t respond individually, then we can’t respond collectively. With a sense of renewed purpose, we must invest in institutions that are going to facilitate global coordination.
We also need to invest locally in the folks most proximate—those closest to the challenges. It’s the folks on the ground, walking the walk in the communities, who really understand how to make change. If they’re not able to do their jobs of detecting and responding, then global coordination can’t work.
Skoll realized early in the pandemic the importance of cross-sector collaboration. With so much work happening in silos, response is much less effective. Skoll for example, funded early the COVID Collaborative, a US-based organization that brings together experts, leaders, and organizations that are really working together in the pandemic space. It is that collaboration, the voices of all those people working together that will have the biggest impact.
How has an erosion of trust in expertise and institutions amplified the impact of this pandemic? How can that trust be rebuilt?
Messonnier: I’ve worked in public health for 25 years, and as much as we talked about the risk of a pandemic, I never imagined that we, the U.S., would be in the situation we are in. I thought naively that a common enemy, a pandemic, would unite us to work together towards a common resolution, but instead I’ve been dismayed this year at how it has divided our society and our country in ways that are disheartening. Part of that certainly is that people have lost trust in organizations that they used to count on to give them valid information, and that is both public health institutions, but also the medical institutions.
If you don’t trust your own healthcare provider and you don’t trust the surgeon general and the health department and the CDC, then frankly, it’s easy to find information that is unreliable, uncurated, and just plain wrong. We’re going to have to find a way to rebuild trust in those organizations and also to try to repair the fractures that we’ve seen in our society. Trust wasn’t broken overnight and it’s not going to be restored overnight.
What keeps you up at night these days and what gets you most excited about this work?
Messonnier: Three or four years ago, some public health experts were asked what kept them up at night and they responded: the threat of a global pandemic of influenza. Now that we’ve actually had a global pandemic of a respiratory disease, it’s interesting to think about what keeps you up now. For me, frankly, it’s worrying about my family and my friends and my community first and how we’re all going to make our way through this pandemic. I also stay up thinking about how as a society, we’re going to heal ourselves after everything we’ve been through and how we’re going to come back together.
I still believe that we can come out of this pandemic stronger than we were before, and that we can rebuild trust in our institutions and our organizations and each other. I believe we can come out of this with that sense that even in our darkest moments, there are people who are going to lift us up. We can commit to be that person for our own communities, and as you move more broadly outward, for our own countries and the world. I believe that it’s within all of us to be part of the solution.
Want more stories of transformational change on the world’s most pressing problems? Sign up for our monthly newsletter.
