In the 1990s, global health advocate Dr. Paul Zeitz was living in Zambia on the “frontline” of the Global AIDS pandemic, working to implement HIV prevention programs on behalf of USAID. The disease was so visible that one day, he came across a local aid group selling coffins near the local hospital.
“I thought, how do we let these things happen?” he said during a talk at Dalberg’s Washington DC office last Wednesday. “We need to create a world where human dignity is realized, and we don’t live with the illusion that we are solving the problem, when we are just pretending.”
His presentation, titled “Paradigm-busting Advocacy Strategies,” focused on his experiences over the past twenty years developing, promoting, and implementing programs for HIV/AIDS, child survival, reproductive health, and health systems development around the world. As Founder and former CEO of the Global AIDS Alliance, where he worked between 2000 and 2011, he played a critical role using advocacy to affect change. During this time, he saw The Global Fund to Fight AIDS, Tuberculosis and Malaria established, as well as the implementation of key policy changes in the US, including the creation of PEPFAR and an increased commitment from the Obama administration to treat six million people suffering from AIDS by 2013.
His strategy? Figure out what is needed and ask for it.
“We in the development business need to take a lesson from the Pentagon and say, ‘what do we need to get the job done?’” Dr. Zeitz said. “The AIDS movement is one of the only ones I know of that actually asks and demands what they need to solve the problem, and in this case, make AIDS history.”
However, despite many successes, with just one-third of the demand for lifesaving AIDS treatment fulfilled, challenges remain in the fight against the disease. In his current role as the Vice President of Policy for Act V: The End of AIDS, Dr. Zeitz is working to strengthen the AIDS movement, focusing on mobilizing the resources necessary to achieve universal access to AIDS medication.
This requires a shift in strategy: public and political perceptions around HIV/AIDS have changed dramatically over the past thirty years, and the movement’s opposition now argues that it is too costly to sustain funding for long-term treatment and prevention programs. Changing this perception requires relying on evidence-based policy making, which calls for balancing the tension between science and ideology.
With the rising popularity of celebrity spokespeople and social media outlets like Twitter and Facebook, advocacy efforts need to reconcile traditional tactics with these 21st century approaches. Additionally, advocacy needs to adapt to the changing global power dynamics and institutions.
“We’re moving from a G8 to a G20 world,” he said. “We’re still in an early phase of the transition, learning how to fully engage the 20, and many of these countries still need to master their own architecture before they can look at global development issues.”
Dr. Zeitz’s talk ended with a few words of encouragement.
“There are always challenges that can block you from achieving paradigm-busting advocacy goals,” he said. “For example, this year President Obama is proposing that PEPFAR’s budget be cut by 12%, despite the fact that it’s helping millions of people, and is considered the most successful global health program the world has ever seen.”
Dr. Zeitz said that although paradigm-busting advocacy can be successful, some gains may be short-lived and will always be challenged. Advocates must be bold, strategic, and relentless in the pursuit of ambitious goals that others don’t think are possible, and gear up to overcome each and every challenge. 
Dr. Paul Zeitz visited Dalberg’s DC office as part of D. Talks, an ongoing leadership series that seeks to bring together the development communities in each city where Dalberg is located.
