Practical Approaches to Leadership and One Health
Many examples of leadership over the centuries have drawn from the military, political, and business realms where a strong leader has some ability to compel others to act in a certain way, to work on a particular product or project, or even to go to war. This approach has often carried over into other areas as we seek strong leadership with the answers we perceive we need. Even in democracies, there is a tendency for political leaders to want to control the actions and messages of others, both within and outside their political party. The power to withhold power and influence from others enforces conformity. The risk adverse may seek to avoid responsibility and then blame others, rather than finding needed solutions.
An increasing challenge is that most of our “wicked problems” for which no one seems to have a specific answer are incredibly complex and often occur at the margins or interface of different sectors, professions, and organizations. One Health concepts and approaches can help us to not lose focus on possible solutions even though they may not be predictable nor within our individual mandates or capabilities. One Health leadership brings collective knowledge and expertise to shared problems in animal and human health, the environment, and the economy. It requires skills in influence, not control; cooperation and collaboration, not compulsion; and building coalitions across disciplines and sectors, not bureaucratic or academic empires. It is a successful leadership approach less familiar to most of us working to plan for and respond to the next pandemic, mitigate and adapt to climate change, or address other wicked problems. It is the combined skills, talents, and resources of the many partners that allow us to have an outcome such as Canada’s success in the 2009 H1N1 influenza pandemic, rather than repeating the errors of severe acute respiratory syndrome (SARS 2003). The what and how of leadership matters.
THE CASE FOR LEADERSHIP
Leaders tend to rise to a situation. Rarely is one leadership style good in all situations. There are many academic and popular press books, articles, and news items on what makes someone a good leader. Winston Churchill was the right leader to bring Britain through World War II, but it did not take long in peacetime for him to be ousted. Abraham Lincoln was the right person for the demanding job of United States president trying to keep the Union together. Sadly, he was assassinated, and we will never know' if that same support would have persisted in the period of reconstruction. Leadership styles following World War I demanded reparations and harsh treatment of the Axis powers, which then influenced the conditions that brought about World War II. Post-World War II leadership created different conditions such that former enemies are now allies.
This chapter is not about the kind of leadership brought about by force, nor what we may think of typically in a military, bureaucratic, or corporate management sense, even though its approaches can enhance effectiveness in those settings. It is about the challenge of leadership in complex situations where others cannot be compelled to work together or share resources, yet where collaboration and sharing are necessary to achieve common ends.
In modern democracies, in the age of the Internet, it is virtually impossible to control information or the message completely as censors have tried in the past. Different political jurisdictions and even departments within those governments can easily find ways to avoid or subvert involvement if they wish or see it in their interest to do so. They must be convinced that not only is it the right thing to do, but that they too can benefit, or at least not lose power, influence, or resources; and the information or story must be both factual and compelling when exposed to public scrutiny. Maturity and experience can help to discern the noise from legitimate criticism, and a measure of humility to accept the importance of changing course or ideas if necessary.
One of the things I tell managers is that it is more important to get it right than to be right; and to surround yourself with smart people willing to tell you w'hat you need to hear, not w'hat you want to hear. Then, you can seek the best ideas and understandings both inside and outside the organization to deal w'ith whatever decisions need be made. The risk is otherwise missing or suppressing solutions, insecurity and poor decisions, or worse, not making intentional decisions for fear of error, which in itself becomes a decision as events carry on.
WHAT DO WE MEAN BY LEADERSHIP?
One can find many a wide variety of lists of the necessary qualities for effective leadership.
BOX 11.1 NECESSARY QUALITIES FOR EFFECTIVE LEADERSHIP
Flexible Adaptive Responsive
Creative Eclectic Clear
Honest Respectful Sensible
Humble Inclusive Transparent
Most would include some or all of what is in Box 11.1. Most readers would recognize these as admirable qualities. The challenge is how to consistently apply them in an understandable way that others can buy into and perhaps emulate.
Two historic leadership examples that have relevance to One Health come out of experiences addressing two national crises in the United States: (i) Abraham Lincoln’s style of leadership which exhibited pragmatic approaches to dealing with complicated issues and (ii) the early 21st century concept of Meta-Leadership following the 9/11 attack on the World Trade Center in New York.
Some Lincoln Lessons
Lincoln was the president of the United States just prior to and during the American Civil War. He demonstrated much of what it takes to lead in a complex system. He was certain when a decision needed to be made, to do so. He surrounded himself and kept in his cabinet those who thought differently than himself, including some of his political rivals, in essence “smart people willing to tell you what you need to hear, not just what you want to hear.” He would delegate to others and expect them to do their best but not without having clear conversations on what was needed and expected. He recognized his ultimate responsibility and would accept it even when the decision that was in error was not his. His focus was on finding a solution, and he would not throw colleagues under the proverbial bus. Lincoln managed to find principled compromise where necessary and used science and evidence as essential to decision-making. He was known as Honest Abe, maintaining his integrity in all things and not lying to avoid responsibility. He also was strategic in finding the right time to push an agenda, working towards a yes, rather than demanding an answer when it almost certainly would be a no. It allowed him to ultimately eliminate slavery, even though many would have hoped he did so earlier, and while that may have been possible, it appeared at the time to be very unlikely to be successful and risked further negative entrenchment.
Meta-Leadership: A Response to Crises
Following the attack on the World Trade Center, it became apparent that some of the national security structures in the United States operated too often in silos, as key information was not shared across departments that may have pointed to proactive opportunities to intervene or respond quickly to the terrorist attack. As a result of the 9/11 experience, the Harvard School of Public Health and the Kennedy School began developing Meta-Leadership as a way of training and working in a way more conducive to work across sectors and departments. While the focus was largely on national security and emergency preparedness and response, their principles and approach have much in common with what is needed in other, important, complicated challenges, or wicked problems. They focused on three dimensions: the person, the situation, and connectivity across both vertical dimensions of hierarchy and horizontally to peers and external partners. It is an approach to breaking down barriers to collaborative responses.
SEVEN LESSONS FROM FAILED LEADERSHIP
There is much to be learned from failed leadership.
1. Loose thinking is not the same as freedom of thought.
One Health leadership is about a well thought out reasoned position and not necessarily just the first thoughts that come to mind. It is about both validating and challenging ideas with others.
- 2. We can spend too much time looking for certainty in decision-making. There is an old expression “Do not let the best be the enemy of the good.” By postponing a decision because we are uncomfortable making it, we risk the decision being made for us or events overtaking us. It is one thing to delay for a specific purpose, such as getting another perspective or evidence; however, at a certain point, the risks of not deciding will far outweigh the risks of making the best decision under the circumstances. For example, debates during the 2009 HI avian influenza pandemic over the ideal guidelines for schools continued up until it was almost time for students to return to school, which risked putting them at greater risk due to a lack of prevention and care guidance.
- 3. Some insist on wanting to win every battle. However, the risk is that you may end up losing the ultimate goal.
It can be strategically valuable to compromise or give in on some less critical areas to gain what is essential. If one is always seen as inflexible, others may be unwilling to collaborate at critical times. What is most critical is to not lose sight of what matters most to partners, so that they too can see benefit in the collaboration.
4. Some leaders are unwilling to admit mistakes, and as soon as they receive a promotion, they are already planning towards their next move.
It is important to stay in a position long enough to see “your own bombs go off,” to learn from them and to fix them. Moving on too quickly leaves the mistakes for those who follow, who then gain the learnings and may resent your poor decisions, as you progress to making more mistakes, but higher levels of impact. I believe that as soon as it is about me. rather than the organization or purpose, I am no longer able to lead as effectively. One should not ignore one’s own needs, but when making a critical choice, it is important to remember there is something more important than oneself. Otherwise it is time for someone else to lead.
5. The rush to follow the decision sequence of “It's an important problem, we must do something, this is something, let’s do this” can lead to erroneous decisions.
For example, during the SARS outbreak, it was decided to set up temperature scanners at some airports. This hasty decision failed to take all aspects of the decision into account, such as the following: (i) affected individuals are not infectious until extremely ill. and unlikely to be mobile; (ii) there are many common causes of fever and taking something to suppress fever could bypass the screening; and (iii) individuals who develop a fever later but do not understand the natural history of the disease may assume that as they were screened; it must not be SARS and therefore may not take appropriate action.
Much better would have been to train border services on who to refer to the quarantine officers, and to provide information to passengers as to what to do should they develop the appropriate symptoms later, as was done during the HI influenza pandemic in Canada. Such an approach would have covered a range of possibilities not just current fever with many false positives, few if any true positives and many false negatives.
6. A particularly frustrating pattern of behaviour in organizations is, “we cannot solve a real problem, because there might be a small side effect... which then will be ours. However, if we don't solve it, it wasn't our problem in the first place."
Nothing is completely without risk and not taking even a calculated risk to improve the situation means not succeeding. For example, some governments’ failure to act on their public health responsibility of harm reduction in response to the opioid crisis resulted in needless premature deaths.
7. There are those who in effect say, “We won’t do anything, but we’ll be damned if we let anyone else. ”
They would rarely say it that way but in effect they choose not to take on or at least partially address an issue; but they then expend more energy fighting others from working on an issue they perceive as their mandate than it would have taken to actually do it.