This report is a summary of the points made in discussion during the online consultations hold on 6 and 16 December 2021.
The term faith-inspired organization (FIO) is a necessary, if occasionally clumsy, catch-all for a vibrant and diverse sector that contains large multinational aid organisations and small, local faith communities in some of the hardest to reach communities in the world.
Cooperative partnerships between the healthcare industry and faith-inspired organizations (FIOs) of all types are often treated as revolutionary concept, but they should not be. FIOs have long histories of service to effect positive social, economic and political change, and provide spiritual refuge and renewal to millions. They are trusted entities and they are vital to the communities they serve.
As the pandemic and other pressures bear down harder and harder on the most vulnerable people in the world, it is urgent that all FIOs that can do so live up to their fullest potential as partners in the movement for universal health coverage (UHC). Some larger FIOs are already world leaders in this regard, and indeed some smaller ones are exemplary models of best practice in health care provision at community level; but many others that could do more are not.
Likewise, many companies have innovated with funding and partnership structures, environmental, social and governance (ESG) initiatives and other projects to address the needs of the world’s underprivileged populations. But it is fair to say that the health industry has not done all it can to reconcile the profit motive with the need for realistic, innovative, cost-effective and replicable initiatives that help the poorest and most vulnerable, and that working more effectively in partnerships with relevant FIOs would be one clear pathway to doing so.
For over a decade the Ahimsa Fund has emphasized the importance of FIOs in health, particularly at the so-called “last mile”. Throughout that time Ahimsa has also worked to establish and incubate relationships between businesses and faith organisations. In mid-2021, Religions for Peace (RFP) and Ahimsa launched a joint initiative to connect business entities and faith-inspired communities around a series of concrete health projects.
This initiative began with two consultations: the first was a gathering of a small number of companies engaging in conversation with RFP’s regional and national interreligious councils (IRCs). The second was a consultation on the potential relationships between the worlds of business, health and faith within a group comprised mainly, but not exclusively, of NGO representatives.
These are the conclusions of those discussions.
The COVID-19 pandemic, one of the worst global crises for many years, is also a valuable opportunity to rethink accepted ideas and outdated ways of existing and working.
Charitable approaches are crucial when responding to emergencies, but there was a consensus in these discussions around the need to make better and more widespread use of business-oriented relationships to solve the world’s bigger, more structural problems and reduce global inequity in living standards.
But: both history and recent discussions show many gaps between the expectations and goals of FIOs and those of the private sector. The fundamental point may be cultural. Ahimsa must do all it can to make companies understand the expectations and roles of faith communities; to make those communities understand the expectations and roles of companies; and to help the two modify those expectations where mutually beneficial, and work together for the benefit of the vulnerable.
Vision and objectives of the initiative
Many governments and multilateral organisations have been working with faith-based health care providers in some ways for decades, and involving wider faith communities in decision making around health. It should be considered normal and natural for business and industry to do so as well. This project will clarify the ways in which past collaborations can (or cannot) inform FIO-business partnerships in the future.
It should also be normal for businesses, particularly those that wish to sell into resource poor markets, or areas that are home to poor and vulnerable people, to analyse the potential benefits – for communities, FIOs and business – of working with faith communities.
To begin to build this reality, this project will start by identifying and sharing the most important lessons and constraints of previous work in this area. Initially, this effort will consist of:
- Identifying the most successful existing collaborations between FIOs and the healthcare industry and attempting to define models that can be exported to different contexts and organisations.
- Identifying those other collaborations – between FIOs and multilaterals, for instance – that can best inform future partnership between the worlds of faith and industry, and identifying the lessons they hold.
As one participant put it: “think big; start small; begin immediately.”
Strengths of FIOs in health
Faith-inspired organizations comprise a broad and varied group. They include many deeply sophisticated, highly trusted organisations that are very good at what they do, have access to large populations and broad networks, are guided by clear values and effective processes, and are informed by long experience of providing sustained support to the most vulnerable, poorest people in the world. They are deeply rooted in people’s lives, and their leaders can spread important messages better than many alternative channels.
The more experienced FIOS were working on health issues for centuries before the pharmaceutical industry existed, performing expert functions in logistics and primary health care. Long before WHO defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity,” FIOs were providing holistic care that integrated physical health with mental, psychological and spiritual care.
FIOs also provide gateways into wide-reaching portfolios of work that facilitate a universal approach to health incorporating nutrition, access to clean water, and other related fields and issues.
The pandemic has highlighted the interdependence of all parts of our societies, adding to the already-growing recognition of the crucial roles that FIOs can play in health care delivery around the world. International institutions are beginning to advocate for greater partnership with FIOs at national level.
Businesses can provide those faith-inspired communities that would benefit from it with business organisation, insight, training and other assistance. In many cases, businesses’ value chains can be redesigned to be profitable in LMICs so that they are able to meet the needs of currently neglected markets.
FIO healthcare providers around the world have huge potential power as buyers and customers of the products and services of the healthcare industry. If they learn to organise and exert that power, they can begin to shape business and healthcare in far more effective ways.
The nature of FIOs’ relationships with their constituents means they have huge potential to affect issues of stigma, behaviour change and disease prevention, both negatively and positively. This power can be harnessed for positive change.
Areas for work
- It will be crucially important for both industry and FIOs to look systematically, together, at what has happened to health systems during COVID and address the “building back better” opportunity in a strategic manner.
- There is a pressing need to make religious communities around the world more effective on the issue of COVID-19 vaccination (including in preparation for any future pandemics), and more active in relevant partnerships.
- While frameworks for partnerships between business and FIOs need to be beneficial to business, they also need to be aligned with FIOs’ core values of equity and provision of high-quality universal care, and designed in such a way as to help those organizations that need to transition to new, steady, financially viable models of operation. Those models will be needed as a secure foundation for further innovation.
- Many FIOs should be seen as potential investors – some sit on huge quantities of capital, but have mission-driven agendas. Work is needed to persuade FIOs across the world to use their funds not only for projects but also for investment.
Many FIOs cannot provide technical or logistical services like registration, distribution or supply chain management. Their ideological nature can also mean they struggle to cooperate effectively with other groups that hold different values or use different approaches.
Some religious approaches to health and related issues are negative and destructive: these include stigmatizing practices with hugely damaging effects on mental health; dogmatic messaging that works against certain health goals; and those nominally faith-inspired health systems that are insufficiently focused on addressing health inequality and/or improving the wellbeing of the poor.
Industry continues to have its own share of blind spots and shortcomings. The profit motive has historically overlooked the world’s most vulnerable and needy populations. There are many examples at different levels of health – for example, failures to share intellectual property sufficiently quickly or effectively to save the lives of poorer populations with vaccines or medicines, or the fact that very few products for developing country markets are sponsored by bodies from the developing world.
In many contexts a cultural gap exists between the worlds of faith and business, impeding effective partnerships.
- Entrenched attitudes in some parts of both the faith-inspired and business worlds work against true partnership.
- Fighting poverty and changing attitudes mean working on structures, making the many changes required to move people from poverty to wellness over time. This is a large task, affected by huge inertia, that will take time to accomplish.
- Acknowledging that faith organisations add value is one thing, but establishing exactly how to implement that value for the greater good is another. Collaboration must be systemic, moving from ad hoc situations in times of need, or convenient relationships designed to facilitate businesses’ access to markets, towards longer, more substantive programmatic relationships.
- How to do these things while meeting the specific needs and goals of industry is a further challenge.
- Decisions that impact health are often made outside the health sector. It is crucially important to advocate for holistic approaches that account for this, and which ensure that the right people and the right leaders are around the table.
- Promoting partnership between industry and FIOs around equitable inclusion requires careful alignment of all participants.
- FIOs must think strategically about how to position themselves within health – for example, whether they can be most effective focusing on innovation, providing moral and ethical leadership to influence governments, providing care, or something else.
- Those FIOs that do not already do so can help ensure sustainability by adopting business metrics; but that progress needs to be made without them becoming, or being seen to become, appendages of profit-driven business organisations.
- Businesses may need to start with structures that help them sell products into low- or middle-income countries at low cost – but they will need to address a longer-term goal of developing better products for developing markets.
- Currently, a lack of sponsors and interest from big organisations makes it difficult to sponsor products to market. Some local venture funds exist and do good work, but the majority of products are developed for rich markets first then dumped on LMICs later.
Following these initial discussions, and having sought feedback on this report, RFP and Ahimsa will clarify and refine the aims of this initiative and plan next steps accordingly. This planning will prioritise a few key activities:
- Identifying the most successful existing collaborations between FIOs and the healthcare industry
- Attempting to define models that can be exported to different contexts and organizations
Identifying the lessons of other types of collaboration – between FIOs and multilateral organisations, for instance – that can best inform future partnership between the worlds of faith and industry.