‘We get a chance to change the world’: CHAI CEO Iain Barton on joining the team

Iain Barton joins the CHAI team as CEO on May 1st, 2020. We recently sat down with Iain to chat about our COVID-19 response, what he is bringing to the organization, and setting “big, hairy, audacious goals” for the future. The interview has been lightly edited for clarity.

Iain, can you introduce yourself for us?

Sure. I’m Iain Barton. I was born in Scotland, hence the accent. My family moved to South Africa when I was eleven years old. I was the youngest of seven kids – five of them sisters. I’m married to Carolyn, who’s a wine industry expert, and we have two kids – Jessica who’s at college studying sustainable agriculture and food security and Thomas who is at high school and seems to be studying soccer and rowing.

After I went through med school here at the University of Cape Town, I spent 10 years in clinical practice. Then, starting in 1997, I started and ran a range of health care businesses until now joining CHAI.

What led you to CHAI and what do you bring to the organization?

I’ve known CHAI since its origins in the Clinton Foundation. Through my business history with PHD, RTT and latterly Imperial and especially because of the businesses’ involvement in the Partnership for Supply Chain Management, we were all engaged in the same space of HIV response since the early 2000s. We have collaborated on assignments and we’ve had staff interchange between organizations over the years.

I first met Ira in 2009 at the start of the South African ART [antiretroviral therapy] rollout. So, I’ve always known the organization and I’ve always admired its culture and its impact. When I was approached a year ago to consider the position of CEO, it was certainly interesting and over the 10 months of process it became a really burning desire to get aboard.

You’re joining us at an unprecedented time in global health. How is COVID-19 affecting our program work, and how do we ensure that work can continue?

I spend a lot of time at the moment asking people to try and partition their thinking into four separate buckets. The first bucket is, how do we protect the base? How do we look after the operations of CHAI that have been there before and will be there after [the pandemic]?

There’s a massive population of patients who are relying on us, not only to support their care and the treatment of their existing conditions but to assist them and guide them to adapt the way they engage with the healthcare system during this crisis. Protecting the base is not just about looking after the existing work, the historic work. It’s also about helping patients adapt to the current environment they find themselves in.

The second partition of thinking is to then say, how do we respond?

We need to be logical, structured, agile, and nimble in assisting governments to develop their response to COVID-19. That means we need to be continually listening to what each government wants, but also learning from our country programs and country teams about what’s working elsewhere and feeding those learnings into planning. None of us have ever done this before and so we have to be continually cognizant of what is being done in other places which could assist our partner governments to respond in the most effective fashion.

The third thing I ask people to think about is how can we leverage all this time, energy, money, and focus around COVID-19 and ensure that the response leads to stronger health systems after the pandemic. So let’s not just respond, but let’s respond in ways that are future proofed for what we believe would benefit the health system after this thing is gone.

And then the last one is preparing for the bounce back. Preparing for when it’s over. Because it will be over, and when it’s over we need to be getting back to the levels of activity, the levels of impact, the levels of drive that we had before.

It’s really important that people have the confidence that this too shall pass. But in the meantime, we have to look after our patients, we have to look after our people, and we have to look after our programs.

What projects are you most excited to take on at CHAI?

Well, first let’s be clear. I’ve got a lot to learn so there’s a lot of watching and listening that I need to be doing. And the other thing is, nothing’s broken. Normally when one moves into the position as CEO, you look around to see what are the burning platforms that need to be fixed pretty quickly. We don’t have those within CHAI.

CHAI’s not actually a big business, but it’s a really complex organization. In terms of the number of people, in terms of the total budget that we go through on an annual basis, it’s not big. But man, if you consider the complexity of geographies, the complexity of programs, the complexity of technical engagements, and the complexity of political environments where we operate, that’s where the real learning comes.

Obviously, there are things that I am looking at that I need to get a handle on quickly. One of those, probably my biggest concern, is the risk of cultural dilution. In an organization that’s growing as fast as CHAI, it’s the biggest risk that we face.

We’ve got to ensure that our values are maintained and that they endure. We have to ensure that our programs are sustainable and able to transition [to governments]. And we have to ensure that we remain catalytic and thought leaders, always pursuing that perfect blend of science and innovation on the one hand, with that passionate commitment to service and the drive toward saving lives and reducing the burden of disease.

If we can continue to drive that value system into all the new people joining our organization, then CHAI will survive its own growth. But we have to be cognizant of it, we have to be focused on it, and we have to be executing against it all the time.

What would you like to see CHAI accomplish in the next five years?

Well, in fact, I’m asking people to consider the next 10 years. Because that’s my plan. I’m here for the decade.

I have this bumper sticker in my mind of ‘seize the decade’. We have a unique opportunity to really influence the outcomes of this decade. A decade is enough time to get stuff done. You really can set goals, drive hard, and deliver against them in a ten-year period. So, I’m challenging people all the time to say, what are your big, hairy, audacious goals for your program? What are your big, hairy, audacious goals in your country? In your mind, tell me what you think 2030 looks like.

I have my own ideas that are developing of what I think 2030 looks like, but I am really spending a lot of time with people in the organization trying to challenge them to think in that way.

One final question for you. What does CHAI mean to you? What makes it unique?

I really feel for people who have to get up in the morning and go and do a daily slog. At CHAI we get to do stuff that really, really matters. We get a chance to change the world. We get to try new ideas. We get to constantly innovate. I just hope that our people understand and always remember how privileged we are.

The Clinton Health Access Initiative is an incredible brand. It’s trusted, it’s respected. People see problems in their space, and they think of us as the preferred partner to help them solve them. We really bring that perfect blend, as I said earlier, of science and innovation and that passion and commitment to service.

I’m just loving being surrounded by incredibly smart, supremely well-informed, and unbelievably hardworking people. I was telling a story the other day about what our teams were doing in our normal programs and the COVID response. The person I was talking to looked at me and nodded and smiled and said, ‘that sounds like CHAI’. That, to me, embodied so much of what we’re about.

People know what they’re getting when they engage with CHAI. People know what they’re in for when they become part of CHAI. That really is what makes CHAI special. That’s what makes CHAI unique: to have that incredible privilege of doing the work that we do and to have everyone in the organization aligned with the goals we are trying to achieve.