Pascal Bijleveld
Name: Pascal Bijleveld
Position: Country Director
Location: Rwanda
I am Swiss, but I grew up abroad, traveling in Africa and Asia. I received my undergraduate degree from the Institute of International Studies in Geneva, and a Masters degree from the London School of Economics in International Relations.
During my studies, I spent the equivalent of a year volunteering over the summer months for a number of humanitarian agencies in Africa and Asia. After graduation, I changed direction and joined McKinsey for just over 3 years, which helped me gain invaluable experience. My time at McKinsey also introduced me to public health issues. I was fortunate enough to spend a year helping set up the Global Fund to Fight AIDS, TB and Malaria. It was through that work that I first learned about CHAI. In 2003, I was asked to join the World Health Organization, where I spent three years in Geneva working on the WHO's management reforms. This proved an extremely valuable transition from the world of private sector management to the development world. At heart, I knew I wanted to work in-country, and have a direct impact on the ground, as well as revisit some of the countries that I had lived in as a child and that had first attracted me to this line of work. In late 2006 I reconnected with CHAI to learn about the program in Rwanda, and started working there in February 2007.
CHAI's business model - the non-bureaucratic and unstructured approach, particularly - was what initially interested me. The more I learned, however, the more I wanted to work for a small and nimble, but ambitious, NGO that works deliberately in partnership with governments and existing systems to bring about large-scale and systematic development.
I manage the overall CHAI program in Rwanda, which has three main components. Firstly, there is the typical, core business of CHAI: procurement and lab systems, such as acquiring high-quality drugs at the lowest cost, dealing with distribution issues, and improving testing and diagnostics capacities. We also run a pediatrics initiative supported by our UNITAID donations, and one of the features is a mentoring program for doctors and nurses. Our third program is the rural health care initiative. Together with the government, we've been working with Partners in Health since 2005 and have implemented a comprehensive primary health care model in eastern Rwanda. We are now working at the request of the Ministry of Health to help them scale-up the program across all rural districts of the country. Right now, I spend the majority of my time on that project, particularly in the area of program management: planning, costing, coordination with other partners, and mobilizing resources.
One of the most important things to do in this job is to keep in mind who you are serving: the people and the patients, certainly, and also the government, which makes CHAI distinctive among NGOs. Some of the work we do is unglamorous. Crunching numbers isn't all that exciting, but it is critical to ensure people have access to the necessary treatment. And even when CHAI is a big influence behind the scenes, we like to remain discreet. The government should and does take credit for its successes.
It is hard to escape the internal pressure to deliver. Expectations are high, and sometimes CHAI is not in the position to fully influence the situation at hand. For example, there are a number of treatment targets we are expected to reach, but at the end of the day, other organizations are responsible for putting people into treatment, and our influence is limited. It is tough, but it also helps drive us even harder to do the utmost to support the Rwandan government to reach those targets.
The degree of independence and flexibility we have at the country level is rare. Within a set resource envelope, if we identify a new problem on the ground, we can shift resources and address it. We don't always have to go back up the ladder with requests for approval, which allows us to have fast and consequential impact. The management's high level of trust in the CHAI staff and its high level of expectations are among the best aspects of the organization.
