Abigail Moreland has an unusual career goal—she wants to put herself out of a job.
Abigail [BCG 2005–2013, starting in Los Angeles and then working in the London, Paris, Zurich, and Geneva offices] is head of grant portfolio solutions and support with the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
“What if 10 or 15 years from now, we were to have put ourselves out of business by having driven these three killer diseases to a point where they are no longer public health epidemics, but are fully under control? Wouldn’t that be wonderful?” she says.
The Global Fund—a partnership of governments, civil society, affected communities, and the private sector—raises and invests $4 billion a year to support programs run by local experts in countries and communities in need. Since its inception in 2002, it has helped save 22 million lives. As such, it has also helped strengthen local health systems, revitalize entire communities, and improve economies.
Other statistics are no less inspiring: The Global Fund has supported programs in 151 countries. It has provided antiretroviral HIV therapy to 11 million people and anti-tuberculosis treatment for 17.4 million people, and has distributed 795 million insecticide-treated nets to prevent malaria.
Much of this success, Abigail explains, is due to the Global Fund being a “fantastically lean and nimble organization that lets countries drive their own programs.” It’s effective, she says, because it’s agile, responsive, and committed. Indeed, the Global Fund does not have in-country offices, nor does it implement programs on the ground. Its entire staff of about 700 people is based in Geneva, Switzerland, where they are focused on its core business of managing grants and collaborating with partners.
Abigail is proud to be involved.
“I’ve always been interested in global health. Further, I have always been deeply bothered by any form of inequity. My father was a minister, so perhaps watching him work sowed a deep desire in me to take care of people. I grew up in a tiny town in a poor part of Texas and, while I took a keen interest in trying to understand the human experience, I felt my experience to be such a small part of the whole. Maybe that’s what inspired me to think globally.”
Abigail says that she was deliberate in her choice, both to go to business school and to join The Boston Consulting Group. “In public health, there is always a need for people strong in management and with the type of skills you learn at BCG.”
As a result, the small-town girl with the world vision now finds herself in the “perfect job.” “We might be a small organization, but we bring large-scale, positive impact to all parts of the globe.”
To understand how the Global Fund has come to be so effective, Abigail suggests it’s worth taking a look backward. Historically, she explains, individual donor countries would work directly with individual recipient countries with what she describes as “a mindset of paternalistic aid.” “Donor countries were of the attitude ‘we know what’s best for you; here’s what you need to do to get our money.'"
By around the turn of the millennium, it had become clear that existing aid models weren’t working as well as they should. Bi-lateral programs reaching out to countries in uncoordinated and cumbersome ways were inefficient and frustrating for countries. Without country input, programs could overlap or focus on lower-priority areas while critical needs went unmet. There was a dire need for coordination and coherence.
The Global Fund was created so that donors around the world could come together, pool funds, and give aid in a more streamlined way. Moreover, recipient countries were now the ones defining what needed to be done, and taking the lead in determining where and how best to fight diseases, how to respond to broader developmental challenges, and how to coordinate work with international global health partners.
Until that point, the Global Fund would have countries submit written funding requests—with applicant countries competing for money. In those days, she says, any strongly written proposal would be enough to get funds flowing.
“Some countries would submit better-written proposals than others. However, good writing often emanated from countries other than those where the money was most needed.”
Even back in her BCG days, Abigail’s work had already been closely tied to the Global Fund, when, as a principal, she managed the BCG team supporting the transformation of the Global Fund to a new funding allocation model and better grant management approach.
“As part of this new approach, the Global Fund was now sending letters to applicant countries, saying upfront: This is how much money you’re going to get; now tell us how best this amount can be used.”
Beyond the funding model work she was involved with, Abigail has seen a number of key strategic points along the way where BCG has come in to provide guidance and support. “For instance,” she says, “the firm recently wrapped up a project to assess our fitness for the future—looking at ways to make us yet more lean and effective. Much of the work BCG has done throughout the years has helped instill a strong sense that we are an organization that can change, that can adapt, and that can respond to the challenges it faces.”
Abigail left BCG in 2013 to join the Global Fund full time, taking on responsibility for what she describes as the operationalization of the funding model that she had helped to design. “All of a sudden, I was the one sending out those letters telling countries how much money they would get.”
As her career has evolved, she has worked across the entire arc of the grant process—from funding request to review to approval to disbursement—“following the money every step of the way.” Today, she is responsible for negotiating final grant agreements, with a focus on the implementation that needs to happen beyond those earlier steps.
“Now 16 years old, our organization is at that critical period when it must make the shift from startup to maturity. We’re in the midst of that transformation, and I’m excited to be part of it, to see it through as we continue to improve, refine, and simplify what we’re doing.
“I believe in global health. Further, I believe in—and am highly passionate about—the Global Fund mission: to do as much as we can to stop AIDS, tuberculosis, and malaria and to support key affected populations. It boils down to a fundamental question of human rights, and equity, and of treating all people with dignity.”
While she is under no illusion that the fight against these epidemics will be won tomorrow or the day after, Abigail continues to dream. “Over the long term, the Global Fund’s explicit aim is to eliminate these diseases as public health epidemics and to make ourselves redundant. That’s such an important goal.”