Related Expertise: Global Health, Organization Design

Solving the World’s Problems by Working Together

By Wendy Woods

Imagine a health clinic turning away a child with a serious illness because he was too sick—or not quite sick enough. It sounds unconscionable, but it sometimes happens when even highly committed health organizations work at cross-purposes instead of together.

It happened in Asia, for example, where two organizations were operating two separate provision centers treating child malnutrition. One center focused on treating severe malnutrition by providing a nutritional paste for immediate consumption. The other center focused on children with moderate malnutrition, providing powder supplements that patients could consume at home. Although this patient segmentation and division of labor were logical in theory, they didn’t always work well in practice.

Under this arrangement, a mother could walk her malnourished child for hours through the jungle to the nearest provision center for malnutrition treatment only to have him turned away. If a child was deemed severely malnourished, after being weighed and measured by a center that treated only the moderately malnourished, for example, that child might be sent away without care. Even though some treatment would be better than no treatment at all, the organizations continued to operate in a counterproductive manner.

Both organizations were staffed with skilled, highly capable people who were willing to perform demanding work in difficult circumstances because they care deeply about children. But instead of joining forces, sharing supplies, and working together to take responsibility for all malnourished children, they got caught up in narrow thinking—despite the best of intentions.

In the absence of a shared focus on the overall mission, cooperation, and trust, this pattern repeats itself all too often throughout the social sector. Instead of addressing the problem, nonprofits can, at times, get bogged down in concerns about funding and organizational structure—or in the single-minded pursuit of a specific philosophy about how to deal with social issues.

A Different Approach

To solve the world’s most challenging problems, it is critical that organizations work together in a coordinated manner. We recommend a simple but powerful approach, with three key elements:

  • Alignment on mission. Partner organizations must share a vision about how to solve a problem, and they must define clear goals and priorities that go beyond a narrow, specific philosophy and surpass what each entity could deliver individually. When aligned behind, and focusing on, a larger mission, organizations can make more progress—and deliver greater impact.
  • Cooperation. It’s easy to talk about coordinating efforts but far harder to do so effectively. To succeed, organizations must team up in flexible, adaptive ways that span their boundaries. Just as important is the need to openly and transparently share information, expertise, and knowledge.
  • Trust. True cooperation requires trust, but building trust takes time and must be earned. Start with small, explicit agreements among partners that will help mitigate perceived risks. Then expand the partnership as comfort levels grow. When organizations prove themselves to be reliable by following through on their responsibilities, real, mutual trust begins to emerge. Leaders can also play an important role by setting an example and demonstrating what openness and trust look like.

The Approach in Action

When alignment, coordination, and trust come together, the results can be powerful. We have already seen this in the fight against malaria—a deadly disease spread by mosquitoes.

As recently as a decade ago, malaria was on the rise, killing more than 1 million people a year, mostly in Africa. Since then, the death toll has fallen by 40 percent, and it is still falling. Hospitals that were once teeming with malaria patients are now empty in some places—even at the height of the rainy season, when the disease usually peaks. Progress against malaria is largely the result of a concerted effort by hundreds of organizations around the world, all brought together by Roll Back Malaria (RBM), an overarching partnership uniting the malaria-fighting community.

Although RBM is viewed as a highly effective partnership today, that wasn’t always the case. As one board member noted, the partner organizations used to spend more time tackling each other than tackling malaria, and blaming each other for the failures seemed easier than working together to figure out how to achieve success. RBM’s leadership even considered disbanding the partnership and starting over, but they realized that starting over just meant working in the same way with the same stakeholders with the same biases—a recipe for failure.

Instead, RBM undertook a change initiative that focused on the areas around which the stakeholders shared a common mission. The organizations found ways to work together, began sharing information, and over time built trust. RBM also created the Global Malaria Action Plan, which set specific goals that no organization could achieve alone; they include providing insecticide-treated bed nets to all at-risk populations throughout the world, averting all preventable deaths, and eventually eradicating the disease. All the partner organizations aligned around these global goals, which defined success for all partners and for RBM as a whole—putting the aspirations of individual organizations in the service of the overall mission.

The global plan clearly defined the actions needed to achieve the goals and clarified the specific responsibilities of each partner organization. Although most private-sector companies would view this approach as “business as usual,” it’s important to keep in mind that the fight against malaria involves hundreds of organizations from the private, public, and social sectors—each motivated by different incentives. This strategic plan had to coordinate all of their efforts and identify relative priorities, intersecting responsibilities, activities that were best accomplished by teams, and tasks that were more appropriate for single organizations.

By fostering alignment on mission and cooperation among the partners, the change initiative and the Global Malaria Action Plan also laid the groundwork for trust. Bold and pragmatic leaders spearheaded both of these efforts and were integral to the progress that has been made against the disease.

In an example of leadership at its best, African heads of state and governments have formed the African Leaders Malaria Alliance (ALMA) to keep malaria efforts high on the continent’s agenda and to provide a forum for sharing and deploying best practices. As part of the alliance, the leaders use detailed scorecards to share information gathered by their ministers of health on the status of treatments, financing, implementation, and impact. The consolidated scorecard details on a country-by-country basis where targets have been achieved, where progress is being made, and where efforts are not on track. The willingness of the leaders of these African nations to share this data and reveal their strengths and shortcomings is a testament to the trust that they are demonstrating and that the malaria community has built, and it sets an example for all partner organizations in the global effort.

Despite this progress, there is still much work to be done to attain the ultimate goals of eliminating deaths from malaria and eradicating the disease. Still, the experience of the malaria community has made one thing very clear:  As we fight the world’s toughest problems, we can’t fight each other too—not if we want to succeed. Instead, we must build alignment on mission, cooperation, and trust across the public, private, and social sectors. We must put the larger mission before our individual goals—and hold ourselves accountable for progress toward that mission.

This article is based on a TED talk Wendy Woods presented in October 2013; it was one of a series of talks curated by TED and BCG and presented during two events—The Shape of Change and Reinventing the Rules. Wendy’s talk and all talks from the events can be viewed at TED@BCG on