Pratik Chhetri, Co-founder, Hive India
Global Perspectives on Healthcare Access
Mitigating health and economic disparities of marginalized communities in Nepal and around the world
Recommended Books:
Best Way to Contact Pratik:
pratik_chhetri@berkeley.edu
Saul Marquez:
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Pratik Chhetri:
Welcome back to the podcast. Today I have the pleasure of hosting Pratik Chhetri. He’s a global health policy enthusiast, a scientist, and entrepreneur and an unapologetic global justice fighter. Originally from Nepal, Pratik has worked with leaders from over two dozen countries primarily on health justice and policy interventions. He is the founder, director of Authentic Leadership Institute, Nepal – ALIN, that focuses on research and policy interventions to mitigate health and economic disparities of marginalized communities in Nepal and around the world. He has had several awards and recognitions including recognition as extraordinary ability individual and global health and biomedical research by the US Immigration Service in 2015. He’s been an invited speaker to events and conferences in Brazil, South Africa, Switzerland, India, Nepal, the US and many more including keynote speaker in under 30 changemakers global summit. Pratik has a Master in Public Health from the University of California Berkeley, a Master’s in Science and Chemistry from Central Michigan University. And today we’re going to dive into the topic of health rather than just medicine for today’s conversation so it’s a true pleasure to have him on the podcast today. Pratik, welcome.
Pratik Chhetri:
Thank you. Thank you. Thanks for the great introduction.
Saul Marquez:
It’s a pleasure man. And so did did I leave anything out in the intro that you want to fill in. Or is it pretty thorough?
Pratik Chhetri:
That sounds that sounds good enough.
Saul Marquez:
Fair enough. So critique what is it that got you into health care to begin with?
Pratik Chhetri:
Like you said you know I grew up in the far right. It’s a low income country. If you go by World Bank standard it’s one of the least developed countries in the world and growing up, I grew up in a lower middle income family in Nepal which by U.S. standards it’s dirt poor and even beyond that I saw things that I thought weren’t supposed to be. For example you know people dying out of diarrhea, people dying out of bleeding or moms dying because they weren’t able to go to the nearest health post on time. And I knew growing up I knew those weren’t right but I was not in a position where I could actually make change or my mind wasn’t developed in a mature enough how I could be a part of that change. But long story short I moved to the United States in 2007 and had great opportunities to join in a couple of non-profits particularly this one nonprofit called universities L.A. for essential medicines that focuses on access to existing medications, life saving medications around the world primarily in low and middle income countries like Nepal, India, parts of Africa, Asia South America and mostly that’s where I actually found my voice. I found even as a student even as someone who didn’t have a lot of degrees I could still be part of this change – global change. So I guess to answer your question, there was already that seed inside me who wanted to work and help and in addressing inequality. But it was not until after I moved to the United States that opportunities popped up and it was clear to me that’s great.
Saul Marquez:
And from early on you saw these things you know you said people dying of things that really they shouldn’t have been dying about. You knew deep down inside there was something wrong about that and you knew you wanted to do something you came to the states then found your on your legs so to speak and your voice and now you’re you’re doing what you do. I think it’s a great story. What would you say today needs to be on the mind of health leaders at the top of the agenda and how are you approaching it?
Pratik Chhetri:
I think largely for health leaders. I would if I could convince people to focus on one thing I would say get out of their disciplinary silos right. There have been a lot of pop ups you know a lot of startups who have started this and that and parts of various parts of the world and they failed. And largely, you know if you look into X Y and Z project why did it fail. It comes down to people not working across the aisle people not thinking ahead what the problems could be you know 2 years, 5 years, 10 years down the line. So if I had a choice I would go these “experts” to be a little interdisciplinary vid. There are a lot of you know online free the resources available and if you are not into reading you know discovering yourself, make friends make friends from different disciplines you know if you’re in sciences like working in the lab all day long, go ahead hang out with your anthropologist friends or your economists friends and try to think have a global mindset of how things are, what things could be, not only right now but 10 years, 20 years, 30 years down the line.
Saul Marquez:
I think that’s great advice and especially today where we’re sort of working hard to try to tackle at least in the states the value based care you know opportunity and globally where we have companies that have technologies that could expand globally what can we do outside of this country. You know I think you bring a nice global approach to discussion here what would you say an example of something that you’ve done an organization you’ve been with to improve outcomes or just improve the overall health of the population?
Pratik Chhetri:
I should, I briefly talked about UAEM – university’s ally for essential medicines and I would say I’m most proud of my tenure within that organization. It’s primarily student-driven organization. Student leaders, you know bachelors up until your PHDs, different levels of the Graduate School across different disciplines you know sciences, medicine, public health, economics, anthropology, English literature you name it. But the idea is around the gap in access to medicines access to existing medicines you know all of these that for example an example of insulin it was discovered in 1922 and we are almost a hundred years past that time. But insulin is still unaffordable in most parts of the world. A couple of three to four large companies own, they don’t even own the patent but they have the monopoly in such a way that other entities cannot infiltrate or if you’re talking about diabetic people from low and middle income countries they just cannot afford it and a lot of times they just die right. So if I’m talking about one of the things that I’m mostly proud of the work that I did within UAEM – couple of things we did was the push for a couple of legislations at WHO – World Health Organization level to push for a new R&D paradigm where we push this funding-based outcome model. So if you look at the current argument why medicines are expensive the go to answer is research is too expensive. And one of the policies that we pushed for at WHO level is why don’t we move out of that that model and why don’t each of the governments around the world put in chip in some money and use that research pool to fund you know X Y and Z to research products like health research. And if we go that route then we don’t have that argument that you know medicines are expensive because we spend this amount of millions and billions of dollars. So what we did at the WHO level, I mean it was not fully passed but a lot of countries a lot of delegates from various low and middle income countries including some of the high income countries learned about that model. And right now they’re finding ways to incorporate that idea into their national legislations. Even if we are not yet did the implementing that at the WHO level. I didn’t go on but that was one of the, I would say successes that I’m proud of within the organization UAEM.
Saul Marquez:
Yeah. That’s that’s that’s definitely big. Going back to the topic of access. I think it’s it’s critical that we take a look at cost models like that. Tell me about a time when you had a setback or failed. What did you learn from that that has made you better?
Pratik Chhetri:
So I will go back about seven years ago. I had just graduated with my bachelors by this. So in 2012 I was still in Michigan, I had graduated with a Bachelors in Biomedical Science Chemistry and Mathematics degree and I had just started my master’s in chemistry and by that time I was already involved with UAEM primarily in an advocacy in low and middle income countries and what you UAEM does greatly is not only focus on the the international level legislations and policies but also pushes for policies at grassroots level at local regional statewide national levels, right. A core part of it is student empowerment, so empowering the next generation to give them some confidence, some encouragement that they can be a major player of this change that we’re talking about right. So at Central Michigan University, it’s relatively unknown it tends to be relatively unknown University in the US sphere. But even within that small university., by that time we had formed a coalition of students faculty, research folks and even including some of the public and which included NATO American members of NATO American tribe. And the idea that came out was let’s move ahead and create a certificate for undergraduate degree social justice and health certificate and which initially when we started working with people from anthropology, business communication you know there are people from science and technology the obvious ones. Initially we thought it would take maybe max of six months. And unfortunately we got such a setback especially from the dean’s level, from the administration level. It took us another six years and you know I graduated, I moved on and you know I had to pass the baton to the next generation. Some of the faculty were still there and eventually the certificated was created and in social justice and global health But I think initially we were too naive and thought you know this is a relatively easy task that we already have people to come on board and design these new courses and put them together. We wouldn’t need that much of a convincing to the upper administration and that’s where we were I think a little naive. What I learned out of it is to be patient, to be resilient especially right now I work with governments. A lot of bureaucrats and to a certain extent academia as well and the levels of patiently waiting at the levels of unnecessary bureaucracy all of those still exist especially in low and middle income countries in Nepal and India where right now I’m working. Yeah yeah. It taught me to be a lot more patient than I was earlier.
Saul Marquez:
Yeah that’s a that’s a good lesson. Just thinking about how long things actually take.
Pratik Chhetri:
Yeah.
Saul Marquez:
Yeah. You know in my mind it seems like health care and academia are probably two of the slowest moving fields and you decided to work on the crossroads of folks. You like pain my friend You like pain. But you know what we need. We need people focused on this and I think it’s critical that you guys laid the foundations for the course. Now it’s up and running. And so kudos to you guys for getting that done. Tell me what an exciting project or focus you’re working at today’s.
Pratik Chhetri:
Sure. So right now I just got back from India about a couple of days ago and I’ll be in Nepal for another less than a month. And part of this, this day what I’m trying to focus on is I’m trying to build on the networks that I’ve made the past couple of times that I came to Nepal, in academia, in nonprofit and business entrepreneurship and in the government and you know it took longer than I thought. But right now one of the projects that I’m really excited about is we’re having this conversation with the National Insurance Board the newly formed National Health Insurance Board in government of Nepal which will be in charge of providing health care to all the Nepalese and marching toward universal healthcare but universal healthcare. And when you say it sounds good. But when in terms of implementation it’s a lot of like my new details, a lot of expertise, a lot of evidence-based decisions that you need to take. So I’m having this conversation with the insurance board and one of the major healthcare non-profit that the government they already have a lot of buy in from the government even on health policy. So I’m trying to build act as a conduit between this nonprofit and the government to try to use some of my skills some of my expertise in and global health policy and health systems to hopefully push the insurance board toward actually creating a path to universal health coverage. And which will take another 20, 25, 30 years down the line but at least to start the framework right. That’s where I’m trying to fill in that gap. So that’s what I’m mostly excited about right now.
Saul Marquez:
That’s great Pratik and definitely takes a lot of work and you’ve got to start somewhere like that course you guys. Hey you guys all eventually get done whether it’s you or the next guy or gal right.
Pratik Chhetri:
Yeah.
Saul Marquez:
Well getting close to the end of our interview here the next part is a quick lightning round so I’m going to ask you a couple questions. You’ll answer with brief answers and then we’ll end with a blood of your listeners. What’s that.
Pratik Chhetri:
They’ll be hard like quick answers. I’ll try.
Saul Marquez:
Yeah. And then from there we’ll will conclude. So here’s the first one. What’s the best way to improve health care outcomes?
Pratik Chhetri:
I think focus on the most marginalized people in society and go from there.
Saul Marquez:
What’s the biggest mistake or pitfall to avoid?
Pratik Chhetri:
Being in your own disciplinary silos and not communicating enough with people across different disciplines different sectors.
Saul Marquez:
How do you stay relevant as an organization despite constant change?
Pratik Chhetri:
Be open to change. Learn. Make friends with people from different disciplines.
Saul Marquez:
What is one area of focus that drives everything in your organization?
Pratik Chhetri:
Justice, fairness, not only from a moral standpoint but a very strong economic standpoint.
Saul Marquez:
What is your number one health habit?
Pratik Chhetri:
Trying to understand what the other person might be coming from and trying to come up with solutions to whatever the question is whatever the problem is from not only from my expert “expert” point of view but also from their point of view. I don’t know if that answers that question.
Saul Marquez:
I think that one falls under my next one which was what is your number one success habit. What would you say your number one health habit is?
Pratik Chhetri:
Empathy trying to be empathetic and I think a lot of times like I need to take a step back and out of my, you know “expert” stance and going back to the community standpoint or different point of views that there might be.
Saul Marquez:
And what book would you recommend to the listeners?
Pratik Chhetri:
The two books that I absolutely adored and changed my life literally are one, Mountains Beyond Mountains. It’s the biography on Dr. Paul Farmer who is a global health guru and the other one is an economics book. The first Mountains beyond Mountains is by Tracy Kidder and the second one is called Poor economics. It’s by Esther Duflo and Abhijit Banerjee. Both are M.I.T. economist at least where at some point.
Saul Marquez:
Very cool. Two good recommendations. So folks if you want to get a link to this interview all of the show notes, links to the books as well as the work that Pratik does. Just go to outcomesrocket.health and in the search bar type in Pratik that’s P r a t i k you’ll find all of that including a full transcript of the interview today there. Pratik, before we conclude I’d love if you could just share a closing thought and then the best place with the listeners could get in touch with you or follow your work.
Pratik Chhetri:
Sure I would just say you know overall today we talked about health right and overall if you look at today and the future you know 10 years, 15 years, 30 years down the line it’s what we are aiming for is a balance between society, economy, and the environment and health is just it’s at the core of it. I would highly encourage you to not only think about right now what are the problems of yourselves right now but what the problems could be for the next generation. And along with that what the solutions could be interdisciplinary transdisciplinary solutions that could be and what good what might your role be in that larger level of solutions. And you know just be positive for any kind of change even if you’re initially hesitant to it and try to have a global set of worldview even if you might work in a very small community level having that global world view. Personally I mean it helped me go through and you know a lot of personal adversity at times as well and other than that I’m on most of these social media you know linkedin, Facebook. I’m not that much Instagram savvy but I’ve recently started doing it. Twitter Yeah. Feel free to send me an email to Pratik_Chhetri@Berkeley.edu or any of those all of those other social media platforms.
Saul Marquez:
Outstanding, Pratik. Thank you so much and listeners feel free to reach out to him. He’s wanting to collaborate with anybody else that’s looking to make a difference on global health. So Pratik, thank you so much. And looking forward to staying in touch with you.
Pratik Chhetri:
Thank you. Thank you so much Saul.
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