This shouldn’t be too difficult. The world has endorsed 17 global goals with breathtaking vision. If they are achieved, add 10 years to your age, and imagine a planet without poverty, malnutrition or preventable death, powered by sustainable sources of energy that have enabled us to avert a climate-induced catastrophe. These global goals are a complex, interrelated network where action on one benefits progress on others, and vice versa.
For example, improvements in education (goal 4), will translate into health gains (goal 3) and economic growth (goal 8); improvements in clean energy (goal 7) will advance climate action (goal 13) and responsible consumption and production (goal 12); and improvements in gender equality (goal 5) will reduce poverty (goal 1), income inequality (goal 10) and conflict (goal 16).
Integrators not only understand this interconnectivity, but they want to design policies, programs, and financing instruments that leverage these connections so they can drive progress to the goals faster and more efficiently. Specialists, on the other hand, prefer to stay firmly within the boundaries of a specific goal, even when they could achieve more with a different approach. Even though generalists can acknowledge the need for integration, they typically don’t have the skills or the incentives to make it happen.
Integrators also understand that big end goals take time. After all, they are trying to alter reality for the vulnerable majority, not for an already-privileged minority. In this context, they don’t place short-term success ahead of long-term impact. Integrators base all of their big decisions on the very best data available. If the data is not there, as is often the case, they make it a priority to get it.
Integrators are most comfortable when they are in constant conversation with a wide array of data from many fields, including the sciences (natural, formal, social), humanities, and professions. They develop a command over the best quality data from each of these disciplines and a facility to combine insights in a way that shines a light onto new solutions. Integrators share a deep aversion to decision-making based on ideology or arguments from analogy (i.e. we should do y because that’s the way we did x).
Above all, integrators share an honest relationship with data. Data is never cherry-picked for marketing or advocacy purposes, but is used to provide a constant check on success or failure. Data that reveals failure is just as valuable, if not more valuable, as data that shows success. Open source, free access data platforms (like the spectacular Global Burden of Disease) are preferred, as integrators acknowledge that the long-term benefits of sharing information outweigh any short-term risks.
The world’s most powerful innovations have always come from people who transgress boundaries and straddle fields, or in Sue Desmond-Hellman’s words, people who “bridge worlds”. With technology, our ability to do that has risen exponentially. The internet and the many platforms that have been built on it now offer vast digital playgrounds where people can collaborate beyond boundaries.
Latest data on internet trends reveals a world on the threshold of global connectivity. There are now 3.8 billion internet users (51% of the planet) connected by devices whose processing power, storage capacity, and platform content are constantly improving. Add to that developments in artificial intelligence, robotics, the Internet of Things, autonomous vehicles, 3-D printing, nanotechnology, and biotechnology and the probability of further breakthroughs keeps improving.
Integrators are constantly developing their mastery of these ever-changing technologies, are on the lookout for new ways to create value and revel in the freedom technology offers to locate and engage new talent. Integrators are particularly adept at using technology to circumvent the complex set of special interests that typically lie between them and their customer/s.
Observe the specialist at work and you will often see a primary loyalty to the groups that confer authority – typically peers or a scientific community or discipline. Observe the generalist at work and you will see a primary loyalty to the person or group who pays the bills – typically the employer or in the case of non-government organizations – the donor. The integrator is different. He/she puts the end-user first, every time. If you work in a company, it’s the customer. If you work for the government it’s the taxpayer or a subset of taxpayers. If you work for an international development organization, it is the citizen of another country, even if you don’t live there.
In finding ever more efficient ways to drive value more directly to the end-user, technology is the integrator’s main ally. Witness some of the world’s best integrators – Elon Musk from Tesla Motors and SpaceX, Jeff Bezos from Amazon, Dominique Crenn from Atelier Crenn, Jean Liu from Didi Chuxing, Dalton Caldwell from Y Combinator, Patrick Brown from Impossible Foods and how the legacy of Steve Jobs – the Great Integrator – echoes in their work. Other fields have a lot to learn from these leaders, especially international development, where it is early days for the integration agenda.
The Bill & Melinda Gates Foundation is one of the few, maybe the only, large development donor with an Integrated Delivery Strategy. It is a partial strategy though – focusing on creating shared delivery channels and reducing fragmentation and wastage on redundant systems. The United Nations (UN) and the large government development agencies have not embraced integration to date and remain heavily invested in some of the largest, single-issue projects – vaccines, polio, AIDS, malaria, education, food security, and energy.
There are some powerful voices crying out for greater integration in healthcare delivery including Jim Kim (former World Bank), Paul Farmer (Partners in Health) and Michael Porter (Harvard Business School). Their demand for a total overhaul of fragmented healthcare delivery to deliver “patient value” in the Lancet should be read by all students of health.
The international NGO, FHI-360, has established an Integrated Development Initiative that is advancing the field at a rapid pace. This initiative includes a review of the evidence as well as instructive tools including Evidence and Adjacency Maps, Case Studies, and Resource Guides.
BRAC has an Integrated Development Programme and Poverty Graduation Program, expertly evaluated by the Poverty Action Lab. The Global Financing Facility to support Every Woman Every Child is a promising recent effort to align the major external health initiatives to make it easier for country governments to harness and align this support with domestic efforts to transform health systems.