Bulletin of the World Health Organization

‘Learning to Fly’ in a world of information overload

The Bulletin interview with Geoff Parcell.


Q: What are the limitations of applying your BP experience of knowledge management at UNAIDS or WHO?

A: I found that the NGOs were incredibly receptive to BP’s approach, it gave them a framework and some of them were doing it anyway. It was much more difficult with UN agencies who feel they are the experts. There are technical and medical areas where you need expert advice. But WHO shouldn’t see itself as the only organization that can offer advice because people in the field have a lot of experience too.

Q: People have vested interests in maintaining expert status and protecting this with jargon that others do not understand. You say we can counter this by appealing to a greater common good?

A: No, you don’t have to be altruistic. A lot of egos get in the way undoubtedly, but you have to accept that people will have their own personal goals and aims. In a business world we try to align those personal goals and aims with business goals and aims. What you must have is a common vision. The ‘3 by 5’ campaign is a good example. You can argue if that was the right goal, but people understood where they were heading by 2005. The problem is that most people haven’t agreed on their destination and I don’t see the mechanisms for defining that destination. Quite often it comes top-down, but a more powerful way is to sit down and agree on the best destination for AIDS. Why are WHO, UNFPA (United Nations Population Fund) and UNICEF (United Nations Childrens Fund) doing things separately? They go into countries where they seem to be competing with each other. If there is a common overarching target, a direction they were heading for that would still permit UNICEF to focus on children, UNFPA on women, and WHO on health care all still on the same track perhaps at different rates using different techniques, they will get to the same destination. Today I don’t think we are aiming for the same place.

Q: What other knowledge management techniques can WHO use to work more efficiently?

A: I would start with self assessment. You give people a range of practices to consider, then they pick what they are really good at and what they need to improve. We already have a framework for HIV/AIDS, and if there were something like this for health, then countries could set their own priorities for the next twelve months as HIV/AIDS and malaria say, and then they would make progress. As it is we are trying to make progress on all fronts and succeeding in few. WHO and its partners are committed to access for health for all as an overriding goal, but cannot always agree on how to make it happen. But if you agree we want fewer people dying and more people to be healthy, perhaps people working for those agencies can be more focused. If everyday, we ask ourselves ‘Is what I am doing helping us get there?’ we would be in better shape.

Q: What prevents people at WHO from feeling a common sense of purpose?

A: One factor is human resources policies. Morale is low, people say they are treated very badly, particularly if they are not permanent members of staff. You can understand in this environment why people are reluctant to share knowledge. One reform at BP was quite brutal at the time. Experts who had been in the central office for 10 years with expertise that was a bit out of date were given two options: to leave and become external consultants or to go into an operational site and refresh their experience and expertise. By connecting with people who had relevant recent experiences, they could pool this. Rather than having one expert or 10 people with 10 experiences, they had 10 people who had shared their experiences and figured out the best way to go forward.

Q: How can stories and anecdotes play an important role for WHO which promotes health care that is based on reliable evidence?

A: I used to find anecdotes told during a meeting to be an incredible waste of time. But now I value them. Anecdotes based on real experiences give people the chance to hear a story they can identify with and extract meaning from for their own situation. Someone is not telling them what to do; they choose which elements of the story are relevant to their own situation, sometimes it will be literal, sometimes metaphorical. Stories give rise to possibilities, not raging certainty. Some of the problems we deal with cannot be solved by avoiding risk but by understanding and managing risk.

Q: Is the mark of a successful knowledge management initiative that it no longer needs to exist because everyone is doing it automatically?

A: BP closed down its core KM team after two years, they said ‘it’s embedded, it’s there’ but in fact that wasn’t true. That’s a good principle to aspire to: you are successful if you do yourself out of business. That that only works in a culture where you think you will have a job afterwards. My experience at BP was there does seem to be an ongoing role for someone maintaining the process, being the champion of knowledge management, reminding people who to connect with whom.

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“Where you have a common goal it’s much easier to help one another get there. It’s like sailing.”