Dr. Mirza Jahani is Chief Executive Officer of Aga Khan Foundation U.S.A.

I recently attended the Global Diaspora Forum, hosted by the U.S. Department of State and the U.S. Agency for International Development, which explored the potential to engage strands of the world’s diaspora communities – including Latin American, African, and Asian – in international development. Secretary of State Hillary Clinton said in her keynote address, “We…believe that diaspora communities have enormous potential to help solve problems and create opportunities in their countries of origin, because we believe that, as the title of this conference says, we can move forward by giving back.”

I was struck by the energy gathered at the Forum. Certainly many professionals from diaspora communities have done well in the private sector and have a lot to contribute. We at the Aga Khan Foundation U.S.A. (AKF USA) are keen to collaborate on finding solutions in which diaspora communities support our work—as is already the case in many of our efforts.

Many Aga Khan Foundation supporters belong to a diaspora encompassing Asia and Africa, and are engaged in programs with our National Council, for example connecting physicians in North America to health-care providers in East Africa who need their expertise, via telemedicine. This work has creatively brought technology and experience to bear on important problems. Hundreds of patients in East Africa, for example, have gained access to health care, which would not have been possible otherwise.

However, while private initiative is vital, we have to look for solutions in which there is a greater balance of public-private partnerships. In health care, for example, millions would be left out if we relied only on private-sector responses. How would poor families get good health care in a private-sector approach? The answer lies in a more holistic response in which private citizens, governments and international agencies have roles to play, with multiple responses feeding on the central problem of access to quality healthcare. Part of the answer can be insurance—in which cross-subsidization allows for wealthier and healthier people to contribute to the care of the less fortunate. The Aga Khan Foundation helps remote communities form savings groups for financing where few other options exist. And part of the answer might be charging fees for services; the Aga Khan Foundation also has helped establish midwives in remote parts of northern Pakistan, including giving them the confidence to charge fees for their services. Finally, a crucial aspect of the answer can also be investment by government and by larger outside organizations that can provide the resources for a period of time until poor populations are able to pay their own costs. We need to pursue solutions through both private and public sectors.

Early in my career I spent a good deal of time in Kisumu, in Western Kenya, trying to advance health-care access for the poor through community action—the community-based, primary health care approach. It was not an easy task. We found the attrition rate among community health workers trained by the program was high, rehabilitated government clinics were not maintained, and basic medicines were still not affordable for the vast majority of people. These required the holistic approach mentioned above. Revisiting the area years later, however, I found reasons for hope: water points developed with community participation were still functioning; school health programs where teachers had been trained to promote health messages had continued.

These experiences and approaches suggest to me that dynamic diaspora groups actively engaged with these questions have great promise. By building on local initiatives and priorities with support from communities linked around the world, we can hope to solve these dilemmas. At Aga Khan Foundation U.S.A. we look forward to engaging with other partners who feel the same way.