Q&A: Meet R4D’s new Market Shaping practice lead
[Editor’s Note: Bhavya Gowda recently joined R4D as senior program director of Market Shaping. She will oversee a global team of 30 staff dedicated to improving access to – and sustainability of – essential, life-saving products and services.]
Hi, Bhavya, welcome to R4D! Thank you for taking the time for this interview. To kick things off, could you share a bit about yourself and what initially drew you to a career in global health, particularly with a focus on market-based solutions?
Bhavya: Thank you for the warm welcome. I’m thrilled to join the team at R4D. I first became interested in global health and market shaping during my junior year of undergrad, when I took a class called “organizational studies.”. The class was primarily based on case studies, and mid-semester we were assigned a case study about a neglected tropical disease, affected populations, and associated treatments. During our lecture, the class debated whether a large pharmaceutical company should charge for the treatment or give it away for free. Much to my surprise, most of the class voted in favor of the pharma company charging – full price – for the drug even though the vast majority of the affected population didn’t have the means to pay! I remember walking out of the lecture hall thinking, “There has to be a way of getting people the medicine that they need – especially when it exists – instead of giving it away for free in perpetuity or charging full price!” This specific case study and the class debate that followed sparked my initial interest in the intersection of global health, business models, incentives and markets.
For our readers who might not be familiar, could you explain what “market shaping” means in the context of global health, and share a project or initiative where this approach made a significant difference?
Bhavya: Over the years, several terms have been used in our field: market shaping, market dynamics, total market approach, market-based interventions, etc. Depending on who you ask, there may be some slight nuance across these terms. But for me, market shaping comes down to influencing a specific market for a product with the goal of improving access to patients or consumers who may need or benefit from that product. Market shaping is often considered a response to a market not working the way that it should.
The pediatric antiretroviral (ARV) market is one that stands out in my memory since I started my global health career in the HIV space. Key market shaping interventions were deployed to dramatically improve access to pediatric ARVs. These included ensuring the products were included in national Essential Medicines Lists (EMLs) and guidelines, reducing the number of product variants to decrease fragmentation, and pooling procurement and coordinating product orders.
R4D’s approach to market shaping is unique because we work to bring health financing and market shaping together. Can you talk about how you plan to build on this approach?
Bhavya: While market shaping provides tools and approaches to increase the accessibility of essential products in a market and ensure quality, availability, and affordability of those products, health financing policy makes sure adequate public funds are available from domestic sources to finance essential health services and products, and that those funds are raised equitably and used in the most effective way. The “handshake” between market shaping and health financing is an underexplored area in health systems that I look forward to building out in collaboration with R4D’s Sustainable and Equitable Health Financing practice.
Collaboration seems to be a key theme in your work. How do you approach building and maintaining partnerships with various stakeholders, including local organizations, donors, and industry partners?
Bhavya: For starters, listening, listening and listening (something that I am always working on!) Establishing strong collaborations and respectful partnerships starts with understanding the needs and challenges of stakeholders – from their point of view (as opposed to my own perspective or conscious/unconscious bias). Listening to each other also builds mutual respect and trust which are key building blocks for co-creating, deploying, or implementing innovative solutions or market-based interventions.
What attracted you to Results for Development?
Bhavya: So many things! But two things really stood out to me:
I am inspired and invigorated by the fact that local change agents are at the center of R4D’s vision and organizational strategy. So many organizations are talking about localization, but… it’s still only talk. R4D is actually walking the talk – thoughtfully and with intention.
Additionally, I love that R4D is transparent about its values including seeing “each other as whole people”. In speaking with former and current R4D-ers, I repeatedly heard that employees were seen as human – first and foremost. This element of R4D’s organizational culture really resonates with me because I believe in bringing my whole self to work (and want others to do the same) in order to deliver on our mission.
What does “authentic leadership” mean to you?
Bhavya: I love this question! It’s also a challenging one to succinctly summarize. When I reflect on what qualities I associate with authentic leaders, several words and phrases come to mind: vulnerability, integrity, courage, humility, awareness of one’s shortcomings, and creating space to try, stumble, and learn from experiences.
I recently attended an “Authentic Leadership” workshop hosted by Women Lift Health (WLH), a community that I’m deeply grateful to be part of. The definition presented by the WLH leadership development team struck a chord with me, and I’d like to pass it along to others: “Authentic leadership is discovered through a life-long exploration of yourself and your purpose while building on the awareness of and trust in your abilities. This exploration enhances the insight, energy, and resilience that is key to leading as the truest and most impactful version of yourself.”
Looking ahead, are there areas in global health (and specifically, market shaping) that you are particularly excited about or challenges that you believe need more attention and innovation?
Bhavya: So many health and product areas need more attention and innovation, and there will continue to be competing priorities. However, as I reflect on needs and emerging threats, I’m excited to dive into exploring the antimicrobial resistance (AMR) space which causes over 1 million deaths per year. The vast majority of those deaths occur in low- and middle-income countries. Establishing a healthy market is a critical component for tackling AMR which continues to evolve and grow. This ecosystem is ripe for improved supply and demand side market interventions (along with strengthening other key contributing factors detailed in this CDG report), and I’m looking forward to leveraging the lessons learned from R4D’s amox DT efforts to dive into this space.
On a personal level, what keeps you motivated and inspired to continue working towards global health equity, especially during challenging times?
Bhavya: In December 2012, I was living and working in Lesotho and experienced a serious health event. Despite seeking care from multiple health providers in Lesotho and South Africa, no one could quite figure out what was wrong with me. I already had plans to return to the US for the year-end holidays; upon arrival, a medical team with the right diagnostic technologies and resources quickly identified the issue, and I was able to receive care immediately.
This life-threatening experience drove home the consequences of global disparities in access to quality and timely health products and services. While my circumstances were frightening, I recognize my privilege – I had the ability to travel to the US where I could afford and access care. After this incident, I am even more driven to ensure that people around the world have greater choice and access when it comes to quality health care and products in the places where they live.
