Perpetuated by the media, Covid-19’s onslaught on global health, socio-economic standing, infrastructure, and every sector worldwide can be defined by many through one image repeated again and again, that of PPE-clad health care professionals in a hectic clinical environment. This, of course, is a good thing; frontline health care providers around the world have gone too long unrecognized and uncompensated, and only through a global pandemic have their efforts become widely valued as critical not only to physical and mental wellbeing, but the health of our economies and wider sectors. Yet our frontline workers, critical though they are, are not the only cogs in the wider global health machine. Global health has been defined as “a collaborative trans-national research and action for promoting health for all”. The word collaborative here is key. The many, many professionals working behind the scenes are not only supporters of the frontline work visible in global media, but also enablers and facilitators of health promotion for all. Take a policymaker’s strongest, evidence-based decisions, a researcher’s qualitative and quantitative findings, an implementers standard operating procedures, an engineers biomedical services, an educator’s robust clinical curricula, and the world’s state-of-the-art medical facilities, and you get, temporarily, a picture of a robust health system. Yet without project management bringing this all together, the quality and success of this system cannot be sustained. Project management, defined as “the application of knowledge, skills, tools and techniques to project activities to meet project requirements”, is the golden thread to all health infrastructure, the foundations to timely management to meet the critical triple projects constraints of deadlines, quality standards and costs. Project managers serve as the liaison between all parties, overseeing optimum performance of the teams, services, and technologies affecting project outcomes. The intersection of project management and global health becomes more relevant in the face of crises the world has seen and continue to face such as malaria, flu outbreaks, Ebola, and now Covid-19 - which place unprecedented strains on processes that are built to run on a certain capacity, and serve a certain purpose. When these processes are compromised, new processes and adaptations are required, which inevitably becomes the deliverable of the project manager. Professional project managers are expected to turn ideas into reality, and inputs into outcomes. The project managers you inevitably find working behind-the-scenes in any health organization are agile people, because they have to be. Unexpected changes in delivery happen frequently; cuts to funding, change in project scope, shifting priorities, the movement of staff, and other issues beyond control. Project managers can help untangle these threads to develop tangible actions and deadlines for all involved parties - and in the cases where patients are involved, their work is lifesaving. Project deliverables at the majority of global health projects track number of patients enrolled in a certain program, reduction of mortality rate, number of case reductions, and patient numbers lost to follow up - allowing health workers to optimise their approach to ensure treatment is administered until a patient’s condition improves. When it comes to human lives, mismanagement of deliverables and timings is fatal. Covid-19 has forced all organizations, governments, ministries of health and centers of disease surveillance and control to timely think and act creatively about interventions, programs and projects that can be tailored to contain the spread of the virus and, ultimately, reduce life loss. Covid-19 has taught us many things, critically, that governments need to find pathways to continue effective, evidence-based implementation of projects and programs to maintain and expand health and medical education infrastructures for future resilience. A project manager’s role should be considered intrinsically entwined to this growth and adaptation. At the University of Global Health Equity (UGHE), a global health sciences university in Rwanda, project management is embraced within all operations, from the university’s inception to fighting Covid-19, to laying the groundwork for its future development. To grow and diversify the student body (the future equity driven health workforce), the infrastructure needs to expand accordingly, materializing in large-scale development projects both within its existing campus in Northern Rwanda, and globally. Conceptualizing, planning, execution and engaging with stakeholders as critical components to future growth is underpinned by robust project management. In the here and now, there is no greater need than now to sustain education for the next generation of health leaders. Covid-19 has had a grave impact on educational facilities globally - forcing widespread closure leaving students suspended from study. Existing IT and learning management platforms, rolled-out long before the crisis, meant that the majority of taught curricula were seamlessly shifted online and virtually delivered to students. UGHE leveraged its flexible campus infrastructure to ensure everyone had the option to self-isolate. Project management has always quietly sat at the crux of educational innovation but, at times like these, its value is magnified when classrooms are closed, and curricula compromised. Yet if project managers are critical to health care delivery and education, and the foundational support for global health activities globally, why are there so few? There are just over a million active certified project managers globally, a few hundreds of these are on the African continent. 18 out of 280 project management charters lie in sub Saharan African. In Rwanda, there are approximately less than 60 certified project management professionals serving a population size of over 12 million. In an effort to address this gap, Rwanda’s first project management Institute Chapter was established this year, aligning with the country’s strategic development agenda that puts emphasis on developing its human capital. Recognizing the value of robust health system project management, UGHE incorporates project management skills, seen by some traditional medical institutions as ‘softer skills’, within all UGHE curricula, so that graduates are not only equipped to deliver health care, but also optimize health infrastructure to drive large-scale change in health systems. Through its staff career development support, universities ought to encourage their staff to grow their career in project management. It is critical that, for the crises we will inevitably face in the future, global health organizations see project management as a vital discipline behind the successful outcomes of global health projects. Organizations, governments, and institutions that embrace project management discipline from the onset of project planning to its final execution will maximize value and return on their investments, inject sustainability into services and infrastructure, and make meaningful transformation within the societies they serve. The author is the Director of Infrastructure at the University of Global Health Equity (UGHE)
