You’re on Mute! ed. Dr Alex Connock
Awkwardly, the first time I forgot the mute button was on a call with thirty public health and human rights experts, from five continents.
It was mid-May 2020 and we were exchanging tips on how to make sure that gender equity and human rights are at the heart of US$14 billion that will be spent in the poorest parts of the world. Countries were busy scaling up services financed by the Global Fund to Fight AIDS, TB and Malaria (Global Fund) while dealing with the double whammy of escalating COVID-19 epidemics.
And I was busy preparing fresh OJ in a noisy electric juicer. When I noticed the mic had been on, I was red-faced not only because it was obvious that I wasn’t paying full attention, but there was no way I could play the Zoom novice card. In the international development and global health communities, we know Zoom. For many years I’ve been happily making breakfast or dinner with some lengthy international call or webinar as background entertainment. When it came to Zoom – a bug that, by mid 2020, would be in the lives of 300m daily users – this was one epidemic where the global health community was far ahead of the curve.
I’ve worked in global health for over three decades, racking up serious airmiles along the way (and equally serious environmental angst alongside.) In early 2017, I was responsible for the start up of a new global women’s rights movement – SheDecides. Within a few months my Dutch co-Lead and I realised there was little point in her flying back and forth from Leiden every week, or for me to struggle on commuter trains from Brighton to London. We settled on video conferencing.
Most of our daily interactions had us glued to our screens on Blue Jeans (an upmarket alternative to Zoom), noticing that we could be just as effective in different rooms. Our job was to crowd in commitment from politicians and activists in countries across Africa, Asia and Latin America, and to keep brave European and Canadian leaders on board. We were busy plotting novel campaigns, and our first hire was a talented young communications manager living in Melbourne, Australia. Soon she was joined by a seasoned activist in Ireland, a campaigner in Washington DC, and a young leader from Cameroon. This was the quintessential, globally distributed workforce. Eventually we brought all of them to London for chunks of time, but much of our team work was managed through Blue Jeans videocalls and making Slack work for us. As the movement grew we were in daily contact with activists and movement builders in India, Kenya, Malawi, the Philippines, South Africa and Uganda, as well as United Nations (UN) officials in New York and Geneva. Even with my (then) energetic passion for travel, I could never have helped the movement thrive without video conferencing.
For almost a decade I’ve stayed up-to-date on scientific and policy developments on women’s health and HIV by staring at my laptop, and even listening to global updates walking along Brighton beach. Before this pandemic erupted I joined at least one call every week: UNICEF webinars on adolescence and HIV, regular strategy updates with Global Fund colleagues, and monthly sessions with the Every Woman Every Child (EWEC) Advocacy team. Our EWEC call in May 2019 updated over 100 globally dispersed colleagues about campaigns to end Maternal Deaths and Obstetric Fistula, to applaud Midwives and to prepare for World No Tobacco Day. Most of the call was busy discussing the crush of side events scheduled for the 72nd World Health Assembly (WHA) – the annual gathering of Health Ministers that governs the work of the World Health Organisation (WHO) – my previous employer and now a truly household name.
In February 2020 I heard the UN Secretary General on the radio. He was urging Ministers not to fly to New York for CSW (Commission on the Status of Women), the annual gathering to review progress on important resolutions taken 25 years ago. That was the day I knew that this pandemic was out of control. All member states have senior diplomatic representatives to the UN, so in theory there is no need for any travel to happen. Yet every year Ministers and teams of officials flock in from all countries: one big fiesta for each of the specialist agencies, culminating in the General Assembly (GA) jamboree that brings together Presidents and Prime Ministers and creates gridlock in the streets of New York for a week or two every September.
I’ve attended tens of these UN GAs, WHAs, CSWs and the like. It was unthinkable that they could happen on-line. But in 2020 they all have; no-one expects world leaders to fly in to New York in September. Since I no longer work for a government or the UN, I’m not privy to how these meetings went, but I’ll bet they are nowhere near as politically savvy as they should be, and that advances many have battled for over the years will have slowed dramatically. It’s the informal corridor chat where political trading happens – and then it plays out on the floor of the UN or at whatever Board meeting all those leaders have flown in to attend.
Where Zoom gets tricky is when you need to make tough “political” decisions.
When I wasn’t noisily juicing my oranges, the Global Fund Technical Review Panel did great work advising how to spend US$ billions. Still the meetings took almost twice as long as if we’d been (as normal) in lockdown in a Geneva hotel rather than in our individual lockdowns, with Asian and Australian experts offering insights and judgments from kitchen tables at 3am. It took longer in part due to frequently wobbly internet connection for the most distant colleagues, especially in Africa. Less fix-able is the fact that – even with fabulous break-out Zoom rooms – you just couldn’t grab a corridor chat or coffee to worry through some knotty problem and small twist in interpretation, or nip over to the WHO building to ask experts to confirm details of recent technical guidance.
Of course we scrolled through written guidance and information, asked Prof Google, sent pleading WhatsApp messages to colleagues, but the Global Health world functions – like any other sector – on personal connections and trust. It’s not so easy to build that through Zoom.
What is special about all of those various UN acronyms, and the Board meetings of Global Health bodies like the Global Fund, is that much of what happens is based on forging personal connections with people from diverse cultures whose written positions, or professional personae, may seem to be at odds with your own. I have been part of massive shifts in global policy (usually on politically hot topics like sexual rights) smoothed by hastily arranged small dinners, or smartly engineered one-to-one chats at cocktail parties in the margins of the formal meetings. In diplo talk these are known as “brush pasts” and – even for these apparently trivial moments – smart civil servants prepare their Ministers with Talking Points (TPs) listing bullet points under the headings “Lines to take” and “If raised”. It’s a well-established trick of the diplomatic trade – and global health diplomacy is no different. It’s part of why people go to massive professional gatherings like the (20,000+ person) International AIDS Conferences that I was once responsible for.
My successor is now busy with the terrifying task of shifting the next one, originally slated for San Francisco/Oakland in July 2020, into a virtual event, with a side meeting on COVID-19 science (since so many AIDS professionals have been repurposed for a new pandemic). He has to bring it on line and still make enough money to run the organisation. It’s not obvious. Formal scientific papers and workshops can easily be presented on Zoom – and there’s been a global upswing in appetite for on-line learning. But much of that appetite is driven by freebies (I’m currently digging into my second on-line course – happily learning about film making). They’ve sliced the fee in half – but will anyone turn up? And how will on-line schmooze work? The appeal of these massive conferences, and their business model, turns on the rare opportunity to get thousands of like-minded people in the same place for a week. Like trade fairs, these massive global health gatherings are designed to build solidarity, and allow for the focused, quiet chats and connections that never quite happen otherwise.
I’m hopeful that as we move to the next stage of living with COVID-19 (no, we will never be “post-pandemic”) we become much more judicious and thoughtful about when we meet physically. Our domestic stability, physical and mental health will benefit just as much as the planet from reducing flights to the truly essential.
And we’ll hold on to amazing Zoom innovations. This article was edited at my daily “Writers Hour” – a fixed slot where I start the day writing with over 100 people. The London Writers Salon organise it, and writers dial in from all over Europe, India and even Australia. We all notice that we get far more done by being together, writing silently with a backdrop patchwork of others staring at words emerging on the screen. It’s a brilliant event – we chat for 5 minutes at start and end, and somehow that provides the push and motivation we need. Something I would never get just allocating an hour for myself – or hopping on public transport to get there, losing three hours of my day to do it in person.