Description of the video:

SCARPINO: So, you’re confirmed by the Senate, the program carried the acronym PEPFAR.

TOBIAS: Yes.

SCARPINO: When I talked to Nazanin Ash, she talked about you developing the program, and one of the things that she talked about was focus and developing a rigorous framework; so, gathering data to make it possible to track and compare, which wasn’t usual in government, assessment of outcomes. Could you talk a little bit about how you went about organizing that program?

TOBIAS: Well, the first thing I did was to put together a written strategy. There was a requirement in the legislation that we have a strategy, but the same kinds of people who’d been sitting around that table did not, based on their government experience, did not see a connection between the strategy that we were going to develop and submit to the relevant committees in Congress and what we were actually going to do. They certainly didn’t believe that I was going to spend 8-10 hours a day personally writing that strategy, along with a number of other people, including notably Nazanin and Dr. Mark Diebold, who subsequently followed me as the AIDS Coordinator and was very critical to all of this. But my intent was to put together a strategy that very much looked like a strategy we would have had at Lilly or someplace like that, and that had measurable goals and objectives and had people in place whose job it was to measure outputs and outcomes. So that’s where we started. We started simply, okay, what are we going to do here and how are we going to do it and how are we going to measure the success of what we do?

SCARPINO: But that was not necessarily a customary approach in government.

TOBIAS: I don’t think, no, well, certainly the measurement and accountability wasn’t. The other thing that was probably the biggest change that I personally made in the very early days from what the people who had seen that they were going to be deeply involved in implementing this, from what they had been thinking, was what the role was going to be in Washington and what the role was going to be in the field. Again, building on my experiences at not only AT&T and Lilly, but at Phillips Petroleum and Knight Ridder and elsewhere, I was more focused on a decentralized implementation plan. To put it in very simple terms, my view was that in Washington, we’re going to decide what we’re going to do and, on the ground in the various countries, we’re going to decide how we’re going to do it. Now, we’re not going to decide in Nigeria what we’re going to do, which took a lot of discipline and work and leadership to keep that from happening, but at the same time, we’re not going to micromanage from Washington. As an example, the very distinguished head of Catholic Relief Services, one of the biggest and most successful development organizations, came to see me very early on, selling why I ought to engage Catholic Relief Services to implement the programs for a big piece of this $15 billion. One of the things he said to me was, “Let me just tell you about a health program that we have in,” I think it was in Kenya, “and we’ve been there 26 years and we have a very successful program.” I remember saying, “Ken, stop right there. If you’ve been there 26 years, that’s not what I’m looking for. I’m not looking for people who’ve been there for 26 years, I’m looking for people who want to do what needs to be done and get out of there and train local people and support local people. Sure, we may need to be there a long time to help with technology and money and so forth, but this isn’t what I had in mind.” So, after we got the strategy in place, but within being on the job, after I was confirmed, maybe a couple weeks, two or three weeks, I got the United States Ambassadors to the African countries, communicate with all of them, and, in effect said, “I have a new job and so do you,” and got them together in a room for a couple of days somewhere in Africa and talked about this program and talked about the fact that here’s what we were going to do, but I needed their help to implement the program in their country. Well, they were delighted because this was the biggest thing that they would have had…

SCARPINO: The key part of your organizational strategy was working through those ambassadors.

TOBIAS: Working through those ambassadors was a key part of the strategy, and prior to my arrival, I don’t think that would have been the way it would have been done.

SCARPINO: Well, it also required that each target nation in Africa develop an operational plan…

TOBIAS: Exactly.

Description of the video:

SCARPINO: So, you’re confirmed by the Senate, the program carried the acronym PEPFAR.

TOBIAS: Yes.

SCARPINO: When I talked to Nazanin Ash, she talked about you developing the program, and one of the things that she talked about was focus and developing a rigorous framework; so, gathering data to make it possible to track and compare, which wasn’t usual in government, assessment of outcomes. Could you talk a little bit about how you went about organizing that program?

TOBIAS: Well, the first thing I did was to put together a written strategy. There was a requirement in the legislation that we have a strategy, but the same kinds of people who’d been sitting around that table did not, based on their government experience, did not see a connection between the strategy that we were going to develop and submit to the relevant committees in Congress and what we were actually going to do. They certainly didn’t believe that I was going to spend 8-10 hours a day personally writing that strategy, along with a number of other people, including notably Nazanin and Dr. Mark Diebold, who subsequently followed me as the AIDS Coordinator and was very critical to all of this. But my intent was to put together a strategy that very much looked like a strategy we would have had at Lilly or someplace like that, and that had measurable goals and objectives and had people in place whose job it was to measure outputs and outcomes. So that’s where we started. We started simply, okay, what are we going to do here and how are we going to do it and how are we going to measure the success of what we do?

SCARPINO: But that was not necessarily a customary approach in government.

TOBIAS: I don’t think, no, well, certainly the measurement and accountability wasn’t. The other thing that was probably the biggest change that I personally made in the very early days from what the people who had seen that they were going to be deeply involved in implementing this, from what they had been thinking, was what the role was going to be in Washington and what the role was going to be in the field. Again, building on my experiences at not only AT&T and Lilly, but at Phillips Petroleum and Knight Ridder and elsewhere, I was more focused on a decentralized implementation plan. To put it in very simple terms, my view was that in Washington, we’re going to decide what we’re going to do and, on the ground in the various countries, we’re going to decide how we’re going to do it. Now, we’re not going to decide in Nigeria what we’re going to do, which took a lot of discipline and work and leadership to keep that from happening, but at the same time, we’re not going to micromanage from Washington. As an example, the very distinguished head of Catholic Relief Services, one of the biggest and most successful development organizations, came to see me very early on, selling why I ought to engage Catholic Relief Services to implement the programs for a big piece of this $15 billion. One of the things he said to me was, “Let me just tell you about a health program that we have in,” I think it was in Kenya, “and we’ve been there 26 years and we have a very successful program.” I remember saying, “Ken, stop right there. If you’ve been there 26 years, that’s not what I’m looking for. I’m not looking for people who’ve been there for 26 years, I’m looking for people who want to do what needs to be done and get out of there and train local people and support local people. Sure, we may need to be there a long time to help with technology and money and so forth, but this isn’t what I had in mind.” So, after we got the strategy in place, but within being on the job, after I was confirmed, maybe a couple weeks, two or three weeks, I got the United States Ambassadors to the African countries, communicate with all of them, and, in effect said, “I have a new job and so do you,” and got them together in a room for a couple of days somewhere in Africa and talked about this program and talked about the fact that here’s what we were going to do, but I needed their help to implement the program in their country. Well, they were delighted because this was the biggest thing that they would have had…

SCARPINO: The key part of your organizational strategy was working through those ambassadors.

TOBIAS: Working through those ambassadors was a key part of the strategy, and prior to my arrival, I don’t think that would have been the way it would have been done.

SCARPINO: Well, it also required that each target nation in Africa develop an operational plan…

TOBIAS: Exactly.

Description of the video:

SCARPINO: So, you’re confirmed by the Senate, the program carried the acronym PEPFAR.

TOBIAS: Yes.

SCARPINO: When I talked to Nazanin Ash, she talked about you developing the program, and one of the things that she talked about was focus and developing a rigorous framework; so, gathering data to make it possible to track and compare, which wasn’t usual in government, assessment of outcomes. Could you talk a little bit about how you went about organizing that program?

TOBIAS: Well, the first thing I did was to put together a written strategy. There was a requirement in the legislation that we have a strategy, but the same kinds of people who’d been sitting around that table did not, based on their government experience, did not see a connection between the strategy that we were going to develop and submit to the relevant committees in Congress and what we were actually going to do. They certainly didn’t believe that I was going to spend 8-10 hours a day personally writing that strategy, along with a number of other people, including notably Nazanin and Dr. Mark Diebold, who subsequently followed me as the AIDS Coordinator and was very critical to all of this. But my intent was to put together a strategy that very much looked like a strategy we would have had at Lilly or someplace like that, and that had measurable goals and objectives and had people in place whose job it was to measure outputs and outcomes. So that’s where we started. We started simply, okay, what are we going to do here and how are we going to do it and how are we going to measure the success of what we do?

SCARPINO: But that was not necessarily a customary approach in government.

TOBIAS: I don’t think, no, well, certainly the measurement and accountability wasn’t. The other thing that was probably the biggest change that I personally made in the very early days from what the people who had seen that they were going to be deeply involved in implementing this, from what they had been thinking, was what the role was going to be in Washington and what the role was going to be in the field. Again, building on my experiences at not only AT&T and Lilly, but at Phillips Petroleum and Knight Ridder and elsewhere, I was more focused on a decentralized implementation plan. To put it in very simple terms, my view was that in Washington, we’re going to decide what we’re going to do and, on the ground in the various countries, we’re going to decide how we’re going to do it. Now, we’re not going to decide in Nigeria what we’re going to do, which took a lot of discipline and work and leadership to keep that from happening, but at the same time, we’re not going to micromanage from Washington. As an example, the very distinguished head of Catholic Relief Services, one of the biggest and most successful development organizations, came to see me very early on, selling why I ought to engage Catholic Relief Services to implement the programs for a big piece of this $15 billion. One of the things he said to me was, “Let me just tell you about a health program that we have in,” I think it was in Kenya, “and we’ve been there 26 years and we have a very successful program.” I remember saying, “Ken, stop right there. If you’ve been there 26 years, that’s not what I’m looking for. I’m not looking for people who’ve been there for 26 years, I’m looking for people who want to do what needs to be done and get out of there and train local people and support local people. Sure, we may need to be there a long time to help with technology and money and so forth, but this isn’t what I had in mind.” So, after we got the strategy in place, but within being on the job, after I was confirmed, maybe a couple weeks, two or three weeks, I got the United States Ambassadors to the African countries, communicate with all of them, and, in effect said, “I have a new job and so do you,” and got them together in a room for a couple of days somewhere in Africa and talked about this program and talked about the fact that here’s what we were going to do, but I needed their help to implement the program in their country. Well, they were delighted because this was the biggest thing that they would have had…

SCARPINO: The key part of your organizational strategy was working through those ambassadors.

TOBIAS: Working through those ambassadors was a key part of the strategy, and prior to my arrival, I don’t think that would have been the way it would have been done.

SCARPINO: Well, it also required that each target nation in Africa develop an operational plan…

TOBIAS: Exactly.

Description of the video:

SCARPINO: So, you’re confirmed by the Senate, the program carried the acronym PEPFAR.

TOBIAS: Yes.

SCARPINO: When I talked to Nazanin Ash, she talked about you developing the program, and one of the things that she talked about was focus and developing a rigorous framework; so, gathering data to make it possible to track and compare, which wasn’t usual in government, assessment of outcomes. Could you talk a little bit about how you went about organizing that program?

TOBIAS: Well, the first thing I did was to put together a written strategy. There was a requirement in the legislation that we have a strategy, but the same kinds of people who’d been sitting around that table did not, based on their government experience, did not see a connection between the strategy that we were going to develop and submit to the relevant committees in Congress and what we were actually going to do. They certainly didn’t believe that I was going to spend 8-10 hours a day personally writing that strategy, along with a number of other people, including notably Nazanin and Dr. Mark Diebold, who subsequently followed me as the AIDS Coordinator and was very critical to all of this. But my intent was to put together a strategy that very much looked like a strategy we would have had at Lilly or someplace like that, and that had measurable goals and objectives and had people in place whose job it was to measure outputs and outcomes. So that’s where we started. We started simply, okay, what are we going to do here and how are we going to do it and how are we going to measure the success of what we do?

SCARPINO: But that was not necessarily a customary approach in government.

TOBIAS: I don’t think, no, well, certainly the measurement and accountability wasn’t. The other thing that was probably the biggest change that I personally made in the very early days from what the people who had seen that they were going to be deeply involved in implementing this, from what they had been thinking, was what the role was going to be in Washington and what the role was going to be in the field. Again, building on my experiences at not only AT&T and Lilly, but at Phillips Petroleum and Knight Ridder and elsewhere, I was more focused on a decentralized implementation plan. To put it in very simple terms, my view was that in Washington, we’re going to decide what we’re going to do and, on the ground in the various countries, we’re going to decide how we’re going to do it. Now, we’re not going to decide in Nigeria what we’re going to do, which took a lot of discipline and work and leadership to keep that from happening, but at the same time, we’re not going to micromanage from Washington. As an example, the very distinguished head of Catholic Relief Services, one of the biggest and most successful development organizations, came to see me very early on, selling why I ought to engage Catholic Relief Services to implement the programs for a big piece of this $15 billion. One of the things he said to me was, “Let me just tell you about a health program that we have in,” I think it was in Kenya, “and we’ve been there 26 years and we have a very successful program.” I remember saying, “Ken, stop right there. If you’ve been there 26 years, that’s not what I’m looking for. I’m not looking for people who’ve been there for 26 years, I’m looking for people who want to do what needs to be done and get out of there and train local people and support local people. Sure, we may need to be there a long time to help with technology and money and so forth, but this isn’t what I had in mind.” So, after we got the strategy in place, but within being on the job, after I was confirmed, maybe a couple weeks, two or three weeks, I got the United States Ambassadors to the African countries, communicate with all of them, and, in effect said, “I have a new job and so do you,” and got them together in a room for a couple of days somewhere in Africa and talked about this program and talked about the fact that here’s what we were going to do, but I needed their help to implement the program in their country. Well, they were delighted because this was the biggest thing that they would have had…

SCARPINO: The key part of your organizational strategy was working through those ambassadors.

TOBIAS: Working through those ambassadors was a key part of the strategy, and prior to my arrival, I don’t think that would have been the way it would have been done.

SCARPINO: Well, it also required that each target nation in Africa develop an operational plan…

TOBIAS: Exactly.

Description of the video:

SCARPINO: So, you’re confirmed by the Senate, the program carried the acronym PEPFAR.

TOBIAS: Yes.

SCARPINO: When I talked to Nazanin Ash, she talked about you developing the program, and one of the things that she talked about was focus and developing a rigorous framework; so, gathering data to make it possible to track and compare, which wasn’t usual in government, assessment of outcomes. Could you talk a little bit about how you went about organizing that program?

TOBIAS: Well, the first thing I did was to put together a written strategy. There was a requirement in the legislation that we have a strategy, but the same kinds of people who’d been sitting around that table did not, based on their government experience, did not see a connection between the strategy that we were going to develop and submit to the relevant committees in Congress and what we were actually going to do. They certainly didn’t believe that I was going to spend 8-10 hours a day personally writing that strategy, along with a number of other people, including notably Nazanin and Dr. Mark Diebold, who subsequently followed me as the AIDS Coordinator and was very critical to all of this. But my intent was to put together a strategy that very much looked like a strategy we would have had at Lilly or someplace like that, and that had measurable goals and objectives and had people in place whose job it was to measure outputs and outcomes. So that’s where we started. We started simply, okay, what are we going to do here and how are we going to do it and how are we going to measure the success of what we do?

SCARPINO: But that was not necessarily a customary approach in government.

TOBIAS: I don’t think, no, well, certainly the measurement and accountability wasn’t. The other thing that was probably the biggest change that I personally made in the very early days from what the people who had seen that they were going to be deeply involved in implementing this, from what they had been thinking, was what the role was going to be in Washington and what the role was going to be in the field. Again, building on my experiences at not only AT&T and Lilly, but at Phillips Petroleum and Knight Ridder and elsewhere, I was more focused on a decentralized implementation plan. To put it in very simple terms, my view was that in Washington, we’re going to decide what we’re going to do and, on the ground in the various countries, we’re going to decide how we’re going to do it. Now, we’re not going to decide in Nigeria what we’re going to do, which took a lot of discipline and work and leadership to keep that from happening, but at the same time, we’re not going to micromanage from Washington. As an example, the very distinguished head of Catholic Relief Services, one of the biggest and most successful development organizations, came to see me very early on, selling why I ought to engage Catholic Relief Services to implement the programs for a big piece of this $15 billion. One of the things he said to me was, “Let me just tell you about a health program that we have in,” I think it was in Kenya, “and we’ve been there 26 years and we have a very successful program.” I remember saying, “Ken, stop right there. If you’ve been there 26 years, that’s not what I’m looking for. I’m not looking for people who’ve been there for 26 years, I’m looking for people who want to do what needs to be done and get out of there and train local people and support local people. Sure, we may need to be there a long time to help with technology and money and so forth, but this isn’t what I had in mind.” So, after we got the strategy in place, but within being on the job, after I was confirmed, maybe a couple weeks, two or three weeks, I got the United States Ambassadors to the African countries, communicate with all of them, and, in effect said, “I have a new job and so do you,” and got them together in a room for a couple of days somewhere in Africa and talked about this program and talked about the fact that here’s what we were going to do, but I needed their help to implement the program in their country. Well, they were delighted because this was the biggest thing that they would have had…

SCARPINO: The key part of your organizational strategy was working through those ambassadors.

TOBIAS: Working through those ambassadors was a key part of the strategy, and prior to my arrival, I don’t think that would have been the way it would have been done.

SCARPINO: Well, it also required that each target nation in Africa develop an operational plan…

TOBIAS: Exactly.

Description of the video:

SCARPINO: So, you’re confirmed by the Senate, the program carried the acronym PEPFAR.

TOBIAS: Yes.

SCARPINO: When I talked to Nazanin Ash, she talked about you developing the program, and one of the things that she talked about was focus and developing a rigorous framework; so, gathering data to make it possible to track and compare, which wasn’t usual in government, assessment of outcomes. Could you talk a little bit about how you went about organizing that program?

TOBIAS: Well, the first thing I did was to put together a written strategy. There was a requirement in the legislation that we have a strategy, but the same kinds of people who’d been sitting around that table did not, based on their government experience, did not see a connection between the strategy that we were going to develop and submit to the relevant committees in Congress and what we were actually going to do. They certainly didn’t believe that I was going to spend 8-10 hours a day personally writing that strategy, along with a number of other people, including notably Nazanin and Dr. Mark Diebold, who subsequently followed me as the AIDS Coordinator and was very critical to all of this. But my intent was to put together a strategy that very much looked like a strategy we would have had at Lilly or someplace like that, and that had measurable goals and objectives and had people in place whose job it was to measure outputs and outcomes. So that’s where we started. We started simply, okay, what are we going to do here and how are we going to do it and how are we going to measure the success of what we do?

SCARPINO: But that was not necessarily a customary approach in government.

TOBIAS: I don’t think, no, well, certainly the measurement and accountability wasn’t. The other thing that was probably the biggest change that I personally made in the very early days from what the people who had seen that they were going to be deeply involved in implementing this, from what they had been thinking, was what the role was going to be in Washington and what the role was going to be in the field. Again, building on my experiences at not only AT&T and Lilly, but at Phillips Petroleum and Knight Ridder and elsewhere, I was more focused on a decentralized implementation plan. To put it in very simple terms, my view was that in Washington, we’re going to decide what we’re going to do and, on the ground in the various countries, we’re going to decide how we’re going to do it. Now, we’re not going to decide in Nigeria what we’re going to do, which took a lot of discipline and work and leadership to keep that from happening, but at the same time, we’re not going to micromanage from Washington. As an example, the very distinguished head of Catholic Relief Services, one of the biggest and most successful development organizations, came to see me very early on, selling why I ought to engage Catholic Relief Services to implement the programs for a big piece of this $15 billion. One of the things he said to me was, “Let me just tell you about a health program that we have in,” I think it was in Kenya, “and we’ve been there 26 years and we have a very successful program.” I remember saying, “Ken, stop right there. If you’ve been there 26 years, that’s not what I’m looking for. I’m not looking for people who’ve been there for 26 years, I’m looking for people who want to do what needs to be done and get out of there and train local people and support local people. Sure, we may need to be there a long time to help with technology and money and so forth, but this isn’t what I had in mind.” So, after we got the strategy in place, but within being on the job, after I was confirmed, maybe a couple weeks, two or three weeks, I got the United States Ambassadors to the African countries, communicate with all of them, and, in effect said, “I have a new job and so do you,” and got them together in a room for a couple of days somewhere in Africa and talked about this program and talked about the fact that here’s what we were going to do, but I needed their help to implement the program in their country. Well, they were delighted because this was the biggest thing that they would have had…

SCARPINO: The key part of your organizational strategy was working through those ambassadors.

TOBIAS: Working through those ambassadors was a key part of the strategy, and prior to my arrival, I don’t think that would have been the way it would have been done.

SCARPINO: Well, it also required that each target nation in Africa develop an operational plan…

TOBIAS: Exactly.

Description of the video:

SCARPINO: So, you’re confirmed by the Senate, the program carried the acronym PEPFAR.

TOBIAS: Yes.

SCARPINO: When I talked to Nazanin Ash, she talked about you developing the program, and one of the things that she talked about was focus and developing a rigorous framework; so, gathering data to make it possible to track and compare, which wasn’t usual in government, assessment of outcomes. Could you talk a little bit about how you went about organizing that program?

TOBIAS: Well, the first thing I did was to put together a written strategy. There was a requirement in the legislation that we have a strategy, but the same kinds of people who’d been sitting around that table did not, based on their government experience, did not see a connection between the strategy that we were going to develop and submit to the relevant committees in Congress and what we were actually going to do. They certainly didn’t believe that I was going to spend 8-10 hours a day personally writing that strategy, along with a number of other people, including notably Nazanin and Dr. Mark Diebold, who subsequently followed me as the AIDS Coordinator and was very critical to all of this. But my intent was to put together a strategy that very much looked like a strategy we would have had at Lilly or someplace like that, and that had measurable goals and objectives and had people in place whose job it was to measure outputs and outcomes. So that’s where we started. We started simply, okay, what are we going to do here and how are we going to do it and how are we going to measure the success of what we do?

SCARPINO: But that was not necessarily a customary approach in government.

TOBIAS: I don’t think, no, well, certainly the measurement and accountability wasn’t. The other thing that was probably the biggest change that I personally made in the very early days from what the people who had seen that they were going to be deeply involved in implementing this, from what they had been thinking, was what the role was going to be in Washington and what the role was going to be in the field. Again, building on my experiences at not only AT&T and Lilly, but at Phillips Petroleum and Knight Ridder and elsewhere, I was more focused on a decentralized implementation plan. To put it in very simple terms, my view was that in Washington, we’re going to decide what we’re going to do and, on the ground in the various countries, we’re going to decide how we’re going to do it. Now, we’re not going to decide in Nigeria what we’re going to do, which took a lot of discipline and work and leadership to keep that from happening, but at the same time, we’re not going to micromanage from Washington. As an example, the very distinguished head of Catholic Relief Services, one of the biggest and most successful development organizations, came to see me very early on, selling why I ought to engage Catholic Relief Services to implement the programs for a big piece of this $15 billion. One of the things he said to me was, “Let me just tell you about a health program that we have in,” I think it was in Kenya, “and we’ve been there 26 years and we have a very successful program.” I remember saying, “Ken, stop right there. If you’ve been there 26 years, that’s not what I’m looking for. I’m not looking for people who’ve been there for 26 years, I’m looking for people who want to do what needs to be done and get out of there and train local people and support local people. Sure, we may need to be there a long time to help with technology and money and so forth, but this isn’t what I had in mind.” So, after we got the strategy in place, but within being on the job, after I was confirmed, maybe a couple weeks, two or three weeks, I got the United States Ambassadors to the African countries, communicate with all of them, and, in effect said, “I have a new job and so do you,” and got them together in a room for a couple of days somewhere in Africa and talked about this program and talked about the fact that here’s what we were going to do, but I needed their help to implement the program in their country. Well, they were delighted because this was the biggest thing that they would have had…

SCARPINO: The key part of your organizational strategy was working through those ambassadors.

TOBIAS: Working through those ambassadors was a key part of the strategy, and prior to my arrival, I don’t think that would have been the way it would have been done.

SCARPINO: Well, it also required that each target nation in Africa develop an operational plan…

TOBIAS: Exactly.