“Those people saved my life,” Alice says. It is, in a way, the whole argument she has built a career on: Fix the small clinic, and the rest of the country survives with it. Ignore it, and geography decides who lives.
Alice has spent 20 years chasing that idea across borders, first as a volunteer in Dar es Salaam. She had just returned from the London School of Economics (LSE), hoping to work in a think tank, using economics to influence policy.
She now runs the Beginnings Fund, built with a coalition that includes the Gates Foundation and the Children’s Investment Fund Foundation, to attack what she calls the “core drivers of death” in maternal and newborn health. It has raised $493 million (Sh63 billion) and pushed $199 million Sh25 billion) into 30 grants across six African countries.
“I could do something here that will touch millions of lives on my continent.”
TIME magazine put her on its inaugural TIME100 Philanthropy list this year. Her mother called it, simply, the fulfilment of her dream, the same mother who told a young girl decades ago that she would have to work twice as hard to be taken half as seriously.
What frustrates her now is the pace of change. ‘My struggle is, it’s not moving fast enough.’
You’ve had such a good run, haven’t you?
I would say so. I’m not done yet. But I’m proud of what we have achieved. I say “we” because I’ve had a team.
Do you remember how you stood out, as a young woman getting into this career?
I’m actually an economist by training. After high school I went to Catholic University of Eastern Africa and majored in Economics, then to the London School of Economics (LSE). My dream was to be in a think tank, using economics to influence policy. Somehow I ended up in public health instead, I’d say by accident.
I came back to Kenya from LSE and reality hit. Unemployment. A friend asked if I would consider volunteering for a foundation just starting out in HIV care and treatment as I waited for a full-time job. My parents were frustrated, they had funded my postgraduate studies in London, no small feat, and now I needed money to go and volunteer. Reluctantly, they supported me.
My first stop was Dar es Salaam, thrown straight into the deep end. The more senior volunteers had to fly back to the US, and left me
to convene stakeholders from across Tanzania, government, development agencies, experts, to develop the country’s first national HIV care and treatment plan. I had no office, I was working out of a hotel room, and most people were essentially asking, ‘who are you, what mandate do you even have?’ I did not give up.
Every time I go back today and see people sitting calmly in those clinics, no stigma, getting their treatment, it is so fulfilling.
From there I went to South Africa, a different scale altogether, a government not yet convinced it should support care at scale. Our first attempt failed. I left, joined KPMG for a year, and no sooner had I settled in than my former team lead called to say they were setting up an office in Kenya. I went right back.
Why did you go back, and why economics in the first place?
Because I cherished the experience. The people, the patients, the doctors, former President Bill Clinton himself. But also I realised I could do something that would impact millions of people.
I hear doctors who’ve moved from clinical practice to public health use this analogy: I could see one patient at a time in my clinic, or influence millions at a time. I got drawn into that. At the Clinton Foundation it was, here’s a problem, go solve it, how you get there is up to you. I enjoyed that.
And economics, because I have a problem with the way Africa is described. I strongly believe there’s a place for economic policy to lift people out of poverty.
What’s been the most difficult thing you’ve ever had to do?
As a volunteer in South Africa, convincing the government that it was a moral imperative to provide care and treatment to everyone infected with HIV. Getting people with decision-making power to do the right thing, when you think it’s obvious, but it isn’t.
I see the same today in maternal and newborn health. No woman should die from preventable causes bringing life into the world, but we’ve almost normalised these deaths.
On a more practical level, fundraising. The world has waves and fads. There’s a time HIV was very well funded. We see that too in maternal and child health, these peaks and troughs, when it needs to stay on the priority list for the long haul.
Go back to childhood a little. What do you remember, and what did you want then?
I was born in Nairobi, then my parents moved to Tigoni. My father was a banker with Barclays. Later we moved to Nakuru, to a farm. It was difficult for me because I’d lived in the city. I used to admire air hostesses, wanted to be one, but my father shut that down immediately, said that was no career.
Growing up, what I remember most is struggling with inequities. My parents weren’t rich, but we didn’t lack, we went to public schools, we had meals, the basics. In high school it was in the dormitory, seeing a girl with nothing in her box.
I still remember, from a very young age, struggling with why some children didn’t have shoes, why they looked so ragged.
I believe everything I’ve done since has been toward social justice. I still struggle with it today. You go to some hospitals, find four premature babies sharing one incubator and ask, are these children of a lesser God?
In this season, are there habits you’re trying to unlearn?
I’m trying to stop and smell the roses more. In academics, in my career, I invested everything into the work. Some of my friends say I take life too seriously, that I should stop, celebrate what I’ve done. So I’m doing more of that now.
You’ve a stellar career. What’s one thing you failed at, and what did it teach you?
At the Clinton Health Access Initiative, I was given a programme on prevention of mother-to-child transmission of HIV. We succeeded in preventing transmission at delivery. But mothers still needed to breastfeed, and still carried the virus, and the science for that wasn’t advanced yet. So, in essence, we failed.
Babies born HIV-negative eventually turned positive through breastfeeding. There was the option of infant formula, but that brought complications around clean water, and you could save a child from HIV only to lose them to dehydration and diarrhoea.
That taught me that much as we were the crazy ones who thought we could change the world, and for the most part we did, we needed to bring everyone along. We jumped ahead of the science, assuming the rest would catch up. Ambition must be matched with reality.
Is there anything you’ve always wanted to do but haven’t gotten around to?
I keep saying I want to retire in Nanyuki, on a farm. I think I’m a rural girl now. I haven’t gotten around to finding that place, that solace, and I realise I don’t have so much time left, so I’d better do it. I think of retirement more now, in part because I believe in empowering others to carry the baton. I don’t want to hold it for too long before I hand over.
Are there things you struggle with as a female leader that male leaders of your cadre don’t?
Certainly, we haven’t moved past that. Early in my career, we were supporting the Kenyan government to hire additional nurses and doctors, the money had been put in Treasury but staff hadn’t been paid.
I kept urging the leads to honour that commitment, and one of them told me, ‘young girl, don’t get emotional, it’s normal for doctors and nurses to wait six months for their first salary.’ I said, but the money is already there, we’re failing them by not moving it.
I don’t think if the person raising that concern had been a man, the response would have been the same. As women, especially African women, you have to work twice as hard to earn that level of respect. I’ve sat in a waiting room while someone said, ‘we’re still waiting for your boss’, only for my colleague to correct them, ‘this is the boss.’
What personal fears keep you up at night?
I’m a mum to a 10-year-old girl, and I think about what happens if I’m not there, who takes care of her. And whether she’ll turn out well, whether I’m teaching her the real strokes of life, or sheltering her too much.
Where do you get your affirmation from now?
My family, especially my husband. Even on tough days he’s good at telling me I’m doing a great job. And my mother, a core pillar of my strength. In May, when I got the TIME100 Philanthropy recognition, she told me I had fulfilled her dream. She’s one of my biggest cheerleaders.
What’s your struggle in this season of your life?
Speed. The rate at which I want to see change. I feel it every time I sit in rooms where Africa is described negatively, especially on maternal and newborn mortality. I know the approach of working with governments is the right one, but I want to inject more pace into it.
What’s your love language?
Service. I do gifting too, but acts of service is the predominant one. I believe in showing up.
Is there anything you’d like to share that you thought I’d ask?
Early in my career, leading the Kenya programme, I was on a trip to Beta Point, today’s Homa Bay County, when I felt something creep up my trousers. I’d been stung by a scorpion.
What stuck with me is that health workers at the local health centre treated me quickly, crushed the scorpion, gave me the antidote. My international health insurance didn’t matter in that moment. Those were the people who saved my life.
I tell that story because it’s why I’m such a strong believer in building systems for everyone. That experience grounded me, and it’s part of why I keep chasing equity for all.
If the Level Five hospital is functioning, it’s for all of us. Getting anywhere else for treatment at the time was far-fetched. That grounded me, and it’s part of why I keep chasing equity for all.
If you were reincarnated, what profession would you choose? And what do you do now to unwind?
I think I’d get into large-scale farming, combining another inequity I care about, food security, with the peace and serene life I look forward to in retirement. To unwind I love to travel to peaceful, serene places. Water calms me a lot. I also read, and I take time with friends, and with my daughter.