Tackling Chaos and Complexity: Health Leadership for a New Era

Special envoy of WHO on COVID-19 David Nabarro speaks at latest webinar

The Sciana Network was delighted to welcome David Nabarro, special envoy of WHO on COVID-19, at its latest webinar.

On November 11, members, senior ambassadors, and foundation staff joined a webinar titled, "Tackling Chaos and Complexity: Health Leadership for a New Era."

Nabarro, who also serves as strategic director of 4SD, shared insights on how network members can develop their capacity for systems leadership in response to the pandemic.

In the final Sciana webinar of 2020, members, senior ambassadors, and foundation staff discussed the qualities and approaches needed by leaders to fight the pandemic and lead change in a post-COVID-19 world.

COVID-19 has triggered one of the greatest crises for health, societies, and economies in recent history. It has exposed significant shortcomings within conventional approaches to addressing health and social challenges, which have often focused on silos in competition with other public policy and government sectors. The pandemic has required cross-sector responses and concerted collaboration and action.

New approaches to leadership are needed to catalyze transformational change in a post-pandemic world. According to David Nabarro, a powerful approach to leading this kind of change exists within "the living systems framework."

Nabarro brings decades of experience at the interface of health, environment, food, sustainable development, and beyond. He spoke about the leadership skills needed to respond to COVID-19 and support the Sustainable Development Goals (SDGs), offering a recovery pathway to build a better and more sustainable future for all and address global challenges.

The relevance of the Sustainable Development Goals

Nabarro began by offering some observations on leadership that emerged from developing the SDGs, which have helped him frame his work on living systems.

In 2012, work began replacing the Millenium Development Goals, eight targets that had shaped the global development agenda since 2000. These goals were seen by many as successful, for example, in channelling development aid that resulted in improvements in mortality and reductions in poverty. But moves to update the goals were challenged powerfully by a view that progress was no longer about lower-income countries catching up with higher-income countries and that higher-income countries themselves were on a trajectory seen as profoundly dangerous. A different approach to global development was needed.

So began a lengthy process involving 193 countries, which took three years. The process resulted in 17 goals and 169 targets. Some countries, including the UK, felt this was too many. But as Nabarro explained, the SDGs are all interconnected because the world's challenges are all linked.

Nabarro believes the SDGs represent an effective plan for the future of the world and her people, with five key characteristics:

• It is a people-centred plan, leaving no-one behind and aiming to reach the hardest to reach first;
• All the elements are interconnected, and it's designed to be dealt with as a whole;
• The goals are universal and apply to everyone around the world;
• Actions taken by governments, civil society, business, the military, and others are to be integrated behind the goals and not run under separate agendas;  
• And everything in the goals is to be pursued through partnership.

Nabarro emphasized the SDG's relevance to the challenges facing countries after the pandemic. He said, "I have advocated its use as a primary direction-finder for anybody working on a major systems issue. Its emphasis on equity and access, and its interdisciplinary nature, is utterly relevant to what we are dealing with COVID."

Overcoming the leadership skills gap

But Nabarro's work with the UN over this period made it clear to him that the UN was unsuited to working on an agenda that saw life in terms of interconnected issues or series of systems. This reflects a broader problem in governments, universities, and many businesses, which approach problems as if they can be dealt with in linear ways: identify a problem, apply a solution, scale and repeat and amplify if necessary. Changing the UN would require shifts in the way people were thinking, working, and leading.  

What are the hallmarks of a "living systems approach to leadership"?

Working with the UN System Staff College, Nabarro and colleagues developed an approach to overcoming the divisions and improving communication between different parts of the UN. This meant understanding three key features of human-operated systems:

• Understanding that people have a strong sense of identity which affects how they work;
• The quality of people's relationships across levels affect every aspect of human systems, even those with strong hierarchical structures;
• If identity is well understood and relationships are strong, it encourages sharing ideas at an earlier stage, which is hugely valuable.

A full grasp of the meaning of human-operated systems means avoiding mechanical or pseudo mechanical concepts, such as "leverage," which may not be appropriate.

The mindset of leaders using a living systems approach

Nabarro set out the skills and qualities that human-centred leadership requires. Fundamental is the ability to hold multiple, competing perspectives in mind simultaneously. Doing this means understanding numerous perspectives are valuable, and that it is important not to exclude people because of a particular view. Other features include:

• Recognizing the strength of your affiliations, values, tribe, professional discipline, and ways of organizing your thoughts, and how this affects your approach to complexity;
• The ability to see the whole system differently from its parts;
• The ability to feel and sense the pace, rhythm, and readiness for change of any system;
• Awareness that no system is the same and that all systems adapt to their environments (particularly the case with health systems);
• And the ability to meet people where they are, not where you want them to be.

To do this well requires several competencies: to be comfortable working inside a political arena, as power structures determine all human systems; readiness to deal with the adversity and conflict that comes with change; and tolerate uncertainty, mess, and a degree of chaos. Nabarro finished his talk by advocating the "four A's" of living systems leadership style: audacity, ambition, authenticity, and willingness to be held accountable.