THE FOREIGN SERVICE JOURNAL
cent—of health programming. Moreover, nearly every element
of the mission was engaged in health—PEPFAR, USAID and the
Centers for Disease Prevention and Control, of course, but also
every one of our 250 Peace Corps volunteers, ultimately our Mil-
lennium Challenge Corporation compact and even our Defense
Attaché Office. I recall commenting at my first meeting with the
country team, “The main thing we do in this country is health.”
But we did face challenges. Our engagement with the Zam-
bian government was in crisis. A recent scandal had poisoned
relations between the government and the donor community.
Despite our enormous life-saving investment in health, we could
not even get an appointment with the minister of health.
We successfully overcame the challenges in Zambia, and our
experience doing so produced the following instructive take-
aways on the value of health programming.
A Game Changer
The sheer size of our health programs presented opportuni-
ties to change the way people think. Our team looked for ways to
break the cycle of mistrust with the Zambian government, and the
PEPFAR programpresented an immediate opening. Our PEPFAR
cycle called for signing a new bilateral Partnership Framework
laying out our plans for the next five years, including planned U.S.
funding. When I signed the deal on Nov. 4, 2010, with Zambian
Minister of Finance and National Planning SitumbekoMusokot-
wane andMinister of Health Kapembwa Simbao, the Zambians
took our action as a renewed American commitment and a public
statement of confidence in the bilateral relationship. All the papers
ran photos of the signing ceremony. Soon we not only had access
to the healthminister again, but Zambian President Rupiah Banda
also opened his door to us.
A Team-Building Tool
While nearly every agency and section of our embassy
worked on health programs, it did not necessarily mean that
they were always in sync. I tried to build a sense of a strong team
by hosting monthly health-cluster meetings of all agencies,
at which we tried to tackle challenges together. But the most
effective tool for team-building came when we were offered the
opportunity to pilot a new program focused on maternal mortal-
ity: Saving Mothers, Giving Life.
U.S. Global Health Initiative Director Lois Quam called me
to propose the pilot, but she also offered our team the chance to
help shape and guide the effort based on the realities we faced in
Zambia. In one of the best team-building experiences I have had
as a diplomat, we built cross-agency teams that fostered on-the-
ground collaboration between key agencies. The leadership of
USAIDMission Director Susan Brems and CDC Director Larry
From left, Ambassador Mark C. Storella, Zambian Minister of Finance and National Planning Situmbeko Musokotwane, and Minister of
Health Kapembwa Simbao shake hands on signing the PEPFAR framework in November 2010.