Mark Rilling Interview 7-8-09
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Interview with Mark Rilling, Chief of the Commodities Security and Logistics Division/USAID
Q:How long have you been with USAID and how long have you been in your current position?
A:I’ve been at USAID since March of ’86 and I’ve been in the Office of Population and Reproductive Health since September of ’89. My current position is Chief of the Commodities Security and Logistics Division, which I’ve held since September, 2001.
Q.Tell me about the career path that brought you to where you are now.
A:Before I joined USAID, I had only one real job since school. I got a bachelor’s degree in Ancient Languages which is basically Greek and Hebrew and I got a master’s degree in Religious and Theological Studies and I thought I might be going on for a Ph.D. and work in academia some place. But plans changed, life changes, and I eventually began working as a lobbyist for a small non-profit grassrootsorganization called The National Peace Academy Campaign. As a result of our work, and the work of lots of other people, the United States Institute of Peace now exists here in Washington.
I wanted to learn something about development and I started, in the Spring of ’86, working for the Office of Education at USAID to strengthen basic education, grade school enrollment, primarily of girls in developing countries. Later, I took a position in the Office of Population and Reproductive Health and I’ve been in the office ever since. All of these steps, basically, came through the guidance and help of individuals who supported me as mentors.
Q:What are your thoughts about the value of bringing people into global health who have not come through the typical career path?
A:I think that the typical career path is important and we need lots of people who come through that path. We need people who come out of a strong bachelor’s program and into a strong master’s program. We need people who come through Peace Corps. We need people who do field research and come in through that sort of typical process.
We also need people who come from other career paths that aren’t typical health career paths because there’s a lot about health that’s about business and there’s a lot about health that’s about finance and public administration and government relations and so on.
Q:Do you have any advice for someone who might be just starting out?
A:It seems to me there are some ideal characteristics when we look to hire somebody so that’s one way to look at it. The kind of person who’s attractive to hire is somebody who’s gotten a really solid, applicable education, plus overseas experience, preferably developing country experience. It’s also really helpful to have people here who speak some of the key languages. So French is important. Spanish is important. Portuguese is important. We also like to hire people who have previous job experience because there’s some value in just getting used to having an office job and the regularity of working in a business environment where there are expectations, performance evaluations and professional responsibilities and conduct. We also get a lot of people who come through Peace Corps – that’s a very useful professional development kind of experience.
Q:Tell me about the main responsibilities of your job.
A:The main responsibilityof my job that would not be true of other people’s jobs in this division is that I have a management component. Then everybody here has responsibilities to improve the availability of contraceptives, condoms, and other health products in field programs. To do this, we manage projects and award, monitor, and evaluate contracts. We communicate with our colleagues in the USAID missionsin the field. We coordinate with our colleagues across other divisions and offices. We coordinate and collaborate with international partners.
We have three main functions in this division. One is to forecast need, procure product, receive orders, manage production and shipments, and report on that whole supply operation. A second function is to manage activities, projectsand initiatives to improve in-countrysupply chains for a range of products that USAID missions are prioritizing for their health programs. Those supply chains typically carry essential drugs and other supplies for family planning, maternal and child health, malaria, HIV/AIDS, etc. The third function in the division is looking more long-term; what kinds of things do we need to do now to strengthen countries’ abilities to achieve and sustain product availability (e.g., policies, financing, systems, capacities, etc.)? Each of us is engaged in that in some way.
Q: Would you give an example of one of the things that come up, unanticipated?
A:We’ll get an email from a colleague in a USAID mission that says they have one month of stock left of condoms or pills or some other product and they need to place an emergency order. At that point a lot of things have to kick into action. We need to see what the funding situation is. We need to see what the production schedule is. We need to see what stocks are in the warehouse. If we have stock to meet that exact need, then we can put through the paperwork to ship our stock to meet that need. If we don’t have enough stock, then we need to look at shipments en route and at other shipments already scheduled to see whether we can divert products to this urgent need. Each urgent orderrequires a lot of logistics considerations in order to meet that unanticipated need.
Q:What is one of the successes in your division?
A:In terms of strengthening public health supply chains, our main project that lives in this division is the USAID| DELIVER PROJECT. An example of a success through that project is improving the availability of family planning and HIV products, including test kits and anti-retrovirals, in Zimbabwe. There has been, for a while, an effective system in Zimbabwe to distribute and maintain the full supply of contraceptives. When funding became available to add HIV rapid test kits and PMTCT drugs, they turned to that same distribution system, because it was effective, to see if it could also handle those commodities. It was effective in reducing stock outs of those commodities from more than 30% to less than 10%. Similar results have been achieved for malaria products as well.
Q:Would you explain the term stock outs?
A:When a product that is critical for service delivery runs out, and there’s no more of that product available, we call that stock out.
Q:Would youexplain what is meant by a supply chain?
A:When we think of a developing country’s supply chain we think of it from the points of manufacture to the points of distribution to the ultimateconsumer. The supply chain begins with manufacturing, continues through a freight forwarder to the port of entry, typically to a central warehouse,then to a regional warehouse, to a district warehouse, to a hospital or a clinic, sometimes to a community worker and finally to consumers.
Q:What challenges remain?
One challenge is related to the big influx of funding for HIV, TB, malaria, new vaccines, neglected tropical diseases, treatments for children, and new energy around maternal health and family planning programs. We believe that the supply chains themselves are not designed or capable of handling the volume and variety of products that are going to be flowing through developing countries ten years from now. So a lot of re-design thinking, re-conceptualization, new procedures, new approaches to transportation, all of that is needed in addition to strengthening what’s there today.
Q:What is it like working with fellows?
A:We tend to work with both fairly junior fellows and mid-level to more senior fellows and there’s nothing unique in a technical sense that fellows bring that we can’t get some other way. But what’s good about being able to have fellows is that because it’s a two-year fellowship, with a possibility to extend, it enables us, as a business practice, to be bringing in people who don’t have USAID ingrained in them and so we get new approaches. We get new ideas. We get people who’ve seen this kind of work done differently who are smart and capable and experienced and don’t have a technical learning curve because they come in with that. Their learning curve is how USAID does it and while they learn how USAID does it, we get to learn how somebody else did it.
Q:So you get another perspective.
A:Yes. I like it a lot. And I know others do too.
Q:What do you find personally most satisfying about your work?
A:One of the things that has kept me in the Office of Population and Reproductive Health so long is the working environment here. There is a lot of energy and passion and commitment about the work andmutual respect among colleagues. Also, the Front Office [of the Bureau for Global Health] has made us responsible for our work and has delegated quite a bit of autonomy and responsibility to us for making decisions and being effective and achieving impact. So that’s great. At the more technical, job level, the things that keep us coming in every day are the sense that we are actually solving mission problems and that we’re troubleshooting their issues; if we do a good job on any given day, a mission program is better because of it, and the mission program is able to offer better services. So it feels like when we do a good job, people benefit.
Q:What do you feel are your own personal characteristics that work in your favor in being successful in your job?
A:Well I don’t like to work as a Lone Ranger and so I like to develop consensus and work in concert with other people – the work seems to me to be improved by being conducted in a communal way. There are additional ideas. There are additional caveats. There are cautions. There are improvements. Work is enhanced through the ideas and experiences of others. Also, I tend to be able to focus on details as well as the big picture, and how the details relate to the big picture and vice versa. To work in a big organization like USAID it really helps to be able to think big picture and little.
Q:How many people are there in your division?
A:We have 13 positions and 12 of them are filled at the moment.
Q:What direction do you see global healthmoving in the future?
A:One of the changes we need to make, and maybe are beginning to do, is to view global health more from the perspective of making the business case. What’s the business case for making that intervention for that health outcome? Given this set of countries, this amount of money, these desired outcomes, what’s the business case for this approach? And I think we’re going to be pushed more and more in that direction. Why that investment? Why that strategic decision?
Q:What is the best piece of professional advice you’ve ever received?
A:I don’t know whether it’s possible to get professional advice from your mom, but I was debating what to do when I was in high school. I was thinking about medicine as a possible career and I was thinking about religion or church as a possible career and I was wondering about international work and she, just in passing one day, said `if it’s important, do it.’ And that’s stuck with me.