HRH Policy Advocacy Leaders in Action Interview: Lisa Bos
An interview series with HRH champions in developing countries produced by the HRH Global Resource Center. This part of the series focuses on HRH leaders in policy advocacy.
Lisa Bos is the new Policy Advisor for Health and Education at World Vision where she is responsible for advocacy and government relations duties related to health programs, education programs and appropriations. She works within coalitions and with Capitol Hill to advocate for federal funding for global health and education, and works with the organization’s program staff to explain the work they do, particularly with federal funds.
What is policy advocacy work in the human resources for health field?
A lot of it is getting people to understand that if you don’t have the health systems and people to work with the patients, the money spent on disease-specific programs might not be used as effectively as it could be if you had community health workers to make sure that, for example, patients are taking their medication and that people are getting tested for HIV. It all works together, and you need health systems and health workers on the ground to really be the implementers of this money.
Who do you approach about policy advocacy?
With the Frontline Health Workers Coalition, we have coalesced around getting the [United States] administration to develop a strategy around health workers and health systems. The United States Agency for International Development has strategies in other areas, but there has never been one specifically centered on the health workforce and health systems. As a coalition, we think it is important to develop this so that there is a comprehensive approach and a real dedication at the federal level towards building up health systems and health workers. Much of our work is advocating with the administration, which has been receptive and recognizes that this is an area where the U.S. can play a role in global health programs. We also advocate to Congress because they are the ones who fund federal agencies and authorize programs, so it is a dual approach.
Is funding the primary goal of your policy advocacy work?
One of our challenges right now is that there is an effort on Capitol Hill to reduce federal spending, so this has been a lot more of a focus for us than it has been in other years. In other times, there might be legislation that we want to rally around, but given the current environment, a lot of our advocacy is focused on fighting for the funding for the [health] programs that are so important. Last year, Congress protected funding for global health programs as a result of intense advocacy by the NGO community and we hope that they will continue to recognize how important these programs are.
What are the types of messages that resonate when you do policy advocacy work?
I talk very specifically about how the money is being used, how it is turning around communities and transforming lives. If you have a healthy child, they can go to school, get a job, and contribute to the economy of their country. When a country has economic opportunity, healthy communities, and opportunities for growth, there are tremendous benefits to the United States through stable governments overseas and new trading partners.
I talk about the successes, the work that still needs to be done, and how we are using the current funding effectively. Now that we are in a budget crunch, our messages focus on the cost-effectiveness of the funding and how the dollars that are spent now save money over the long-term. Given the environment that Congress and the administration are dealing with, these messages really resonate.
Why do you concentrate your efforts in Washington?
I work for World Vision U.S., so our advocacy efforts are focused in the U.S. As far as the broader World Vision partnership, we have advocacy efforts in other countries, and that certainly is important. We have large support offices in Australia, in Canada, the U.K., and the national offices also do advocacy effort. I was just in Zambia, and they have a new advocacy and communications person. Our advocacy is very broad and extends to the countries in which we work, but the U.S. is one of the leaders because it plays a large role in making a lot of the financial commitments to programs like the Global Fund for HIV/AIDS, TB, and Malaria.
How does the work of policy advocacy person in your country offices differ?
In some of our national offices, we have people that are tasked with advocacy to work with local governments and ministries of health, because part of developing sustainable programs is making sure that the local governments are invested in these programs. In some cases, the local governments provide funding; in other cases, they are driving some of the overarching policy. We want health policies to come from the communities and from the countries because they know what they need much better than we do. We help as much as we can, but it really needs to be driven from that country level.
How important is policy advocacy work to an organization like World Vision?
It is important, but our priority is making sure that our field work is being carried out effectively, efficiently, and is benefitting the people that we’re dedicated to serving. Advocacy plays a part in the respect that about a third of our funding comes from the federal government, so fighting for funding carries down into the programs. Our work in the field is the most important, but we cannot continue our work in the field as effectively without the right policies and funding at the federal level, so it is tied together.
What would you say you have learned about policy advocacy work in the human resources for health field during your time so far at World Vision?
The biggest thing that I have learned is just how many policymakers and decision-makers still need to be educated, and that is always a challenge with any issue. Members of Congress change, and there are always new people coming to Washington that you need to educate on your issue. It can sometimes seem like a very daunting task, but there is also a real sense that people care about these programs. We are dealing with a challenging budget environment, but members of Congress are sympathetic to our message and have real care and compassion for those in need. It is interesting seeing how policymakers try to balance those two.
How do you see the future of policy advocacy work?
It will always continue to be important. The challenge for staffers on Capitol Hill is that they deal with a lot of issues, and as much as they try to develop an expertise in all of them, there is too much information out there. They have to rely on advocates coming to them with issues that they have not heard about. It becomes a two-way street where I might be requesting something from a decision-maker or policymaker; and they come to us asking for information on a program.
I think it will continue to be challenging as other issues come to the forefront, but we will continue to raise awareness of our issues both this year and post-election. After the election, we might need to educate a new administration and develop relationships with new officials in government agencies. It is cyclical and ever-evolving.