In Conversation with Jack Fisher
Having graduated from the University of Copenhagen with an MSc in Global Health, Jack Fisher has a variety of experiences working within academia, intergovernmental organisations, non-governmental organisations and industry. Today, Jack works at Bayer in their Consumer Health Division developing initiatives in access to healthcare, climate and health as well as broader sustainability efforts across the company. He has also started a PhD at the Technical University of Munich investigating participatory approaches and meaningful engagement to enhance noncommunicable disease prevention and control in Sub-Saharan Africa. In an inspirational interview with the Youth STEM Matters Team, led by Shayla Basdew and Lizzie Bourn, Jack talks about his work at the World Health Organisation (WHO), climate change and global health, being a disruptor, and the value of lived experiences to improve health outcomes.
Jack Fisher
Shayla: For those who aren't familiar with your title as a Project Manager at Bayer, what does your role involve on a day-to-day basis?
Jack: This role is quite new for me because I recently moved from the UN to my first role within the private sector industry, but I'm currently working for Bayer’s Consumer Health Division, which is the division which sells and makes over-the-counter products – products which do not require you to have a prescription to buy. I'm working in the Public Affairs, Science and Sustainability team, and part of that is looking at Bayer's broader sustainability goals and trying to reduce the environmental impacts of the company. Then there's also the social governance roles of the business as well, looking at big topics like: access to healthcare; self-care; nutrition and food security; maternal and child health; and climate and health. It's about looking at those topics and projects, but also a little bit about coordination – looking at the other divisions within Bayer. There's a pharmaceutical division and a crop science division as well. That, for me, was also one of the big drivers to join this particular company because no other company in the life science and pharmaceutical industry has those areas covered.
Lizzie: Following on from that, you've already mentioned that you wanted to work at Bayer because of the three different sectors they operate in, but what motivated you to work in the global health sector and what pathway did you take to get there?
Jack: When I started university, I wasn't entirely sure what global health was. When I moved from the UK to Copenhagen, what I did know was that when I was growing up in Glasgow, Scotland, I was interested in the holistic perspective to health: whether that was looking at the biomedical model, or looking at the individual living in a social and psychological context as well. When I was doing my bachelors degree in that area, I was creating that framework, which I found interesting. But then, near the end of my four years in Glasgow, I started to work with different communities that are experiencing different health challenges. One of them was in an area called Easterhouse, which is in the East End of Glasgow, and is one of the most socially and economically deprived areas in the whole of the UK. There I was working with people living with chronic obstructive pulmonary disease, which is a very harsh disease on the individual and often their carers. At the same time I saw some amazing resilience of people which, for me, was really inspiring.
So when I had the opportunity to go into global health, I saw that as an opportunity to combine public health and international health, which in itself is a bit more nuanced. That was inspiring because I was then able to learn that some of the challenges that I saw within my own community were happening on a global scale. So for cancer, heart disease, diabetes, and lung disease, we know these are increasing across low and middle-income contexts. At the same time, there is an understanding, even further from that biopsychosocial model, to look at the other global drivers within global health as well. That interconnected nature of challenges is fascinating, and there is a need for intersectional approaches. What I think I am still trying to understand as someone still within my early career is how to be an intentional actor, an ally, to mobilise; acknowledging the wider efforts around decolonizing global health as well. So how can I, my own background, and where I come from, make a meaningful contribution within that ecosystem?
Shayla: Wow, that's a very inspiring answer. Building on that, my next question is: could you explain how social, political, civic and environmental factors are important factors and contribute to health? And with all these factors at play, how does that help us in our approach to improving global health as a very independent type of ecosystem?
Jack Fisher: Yes, it's a really good question, a really big question as well. So I'll answer the first part. I think the challenge we often have historically and, unfortunately, still currently, is that when we talk about health, we look at it through a particular lens. Whether that is often the medical lens, and even within that, there's often just a focus on a specific health challenge or condition. As much as I think public health has made great advancements, and that the clinical view is expanding, I think there are still many challenges to that. That is very much acknowledging that the individual health condition is not a patient, they live most of their lives outside of the clinical setting. They live within societies, they live with their families and their friends, and that environment ultimately has a huge impact on their health.
So, the social part. We know that where you're born will have a huge influence in terms of your health, the education you get, the housing that you live in, and often where you're born as well, even within countries, and beyond countries as well. Unfortunately, or fortunately, depending on which way you want to look at it, health is inherently political. We often know what we need to do, but actually taking action is also in the hands of policymakers, who make decisions based on many different non-health and political reasons. And that can also influence the healthcare we have to access, the social support we need, and even the environments that we live in. So all these different elements, ultimately, shape if we live in an equal and just society.
Then the civic part, which I think is interesting: it really does span so many different aspects. The civic part can consider acknowledging intergenerational trauma and oppression, all the way to the macro level of understanding and wanting to implement a rights-based approach to health. Practising those principles that everybody, everywhere should have the same fundamental human rights. And also, even beyond that, what I find quite interesting is the ability to participate in and shape societies that we live in, but also, importantly, that we leave for future generations. That's much broader than just the health context. And of course, the environment, the air we breathe, the water we drink, the food that we eat, the amount of physical activity we're able to do, how safe we feel within those environments, and again, what education we have access to. All these different elements outside of the clinical setting and out beyond the medical events, all very much shape our health.
“All these different elements outside of the clinical setting and out beyond the medical events, all very much shape our health.”
And how can different global health stakeholders support improving health through this platform effectively? Well, again, I think it involves collaboration, it involves not getting entrenched into those silos, it involves disruptors. Of course, youth is often seen as one of the main disruptors. But I think you can continue to be a disruptor within different hats as you go into your careers and as you get older, as well. I still consider myself to be a disruptor. Ultimately, disruptors are needed throughout, and they can come in all different shapes and sizes, and at different times as well.
Lizzie: That's some really inspirational advice. I am also wondering what I'm going to do in the future, and questioning whether I'd still be a disruptor, but I think it's really inspiring to remember that and still keep thinking about how you can make change in the world.
Next, we wanted to focus on climate change, because we've seen recently how climate change has been affecting healthcare. How can we help make the climate change related public healthcare problems more accessible and understood, and what roles do different stakeholders have to play in this? How can we unite towards this goal?
Jack: In terms of climate change in healthcare, it's been really interesting for me to come back into this space, officially speaking, because I was able to look back and see a really big leap in the connection between climate change and health over the last eight years. We know that historically, health can be quite slow to build the agendas. I think part of the reason for that is because health care and messengers around doctors, nurses, allied health professionals, people whom the public inherently trusts, and politicians rely on very heavily, are very powerful messengers when it comes to this. Having them on board from the start was really crucial.
The second has been around the old adage, which is: what gets measured, gets done. Over these last eight years, the capacity for data analysis, and publishing the results in a coherent way — in a regular way — has really been a very strong driver. Not only for communicating to policymakers and other leading institutions but also communicating to healthcare professionals, who ultimately are evidence-driven and often are very sceptical about topics without having empirical evidence, for better or for worse. So, now we have a lot more data or evidence to back up those concerns which have become true.
But then, there's also this tangible part of what we now see happening. It was going from an annual basis to now effectively a monthly basis – the impacts of climate change on health, on our ecosystems. We know that the media coverage has also been supporting that and backing up in terms of connecting climate and health. But now people, including healthcare professionals, can tangibly feel the impacts of climate change on health alongside the evidence, which is making it more understood and more accessible. So, I think we will continue that and also provide the tools and resources to the healthcare professionals to best support the broader population with these challenges, which will inherently get worse before they get better – best-case scenario, unfortunately. That will be really important for the next 10 to 20 years.
Shayla: Wow, I really agree with what you said about how you have to relate people to different countries, and how we have to support everyone around the whole world in the context of global health.
We know that involving people with lived experiences is really important in your work, and we take a similar approach here at Youth STEM Matters – everything we do is co-designed by youth for youth. So can you tell us a little bit more about how integration of lived experiences can improve health outcomes, and reduce health inequalities, and some of the considerations you need to make when doing so?
Jack: Thanks, Shayla, that's another great question. And I think ultimately, I want to come back to what you just said: how do we support diverse countries around the world wherever we are? And I think part of that is contextualising and adapting your engagement in different health contexts. Obviously, what's right for the UK is not gonna be right for Uganda, for example. So a big part of that is contextualising, adapting it, and global health champions, but improvements still need to be made in that in terms of involving actors at the country level. The model has long passed where it's the high-income actors going to low or middle-income countries, implementing something and leaving. The involvement of country stakeholders, community leaders, and country policymakers as part of that capacity building is really essential. So I think the lived experience component is ultimately involving the people who you want to support, and going back to the rights-based approach. People have a right to participate in their healthcare – it seems like an extension of that global health model.
“People have a right to participate in their healthcare”
To be honest, the actual impact and value of this is something which we're still trying to find out. And it's part of the reason why I'm embarking on some individual research now with the Technical University of Munich to see exactly what it looks like. I know my ex-colleagues who are continuing the work at the WHO are also doing that themselves. So anecdotally, we believe that it has a value added – this is a quantifiable output for this type of inclusion. You can also argue, if I'm just talking philosophically, and not from a quantitative lens, maybe it's just the right thing to do. Again, coming back to the rights-based approach.
The work I was doing at the World Health Organisation, was looking specifically at noncommunicable diseases (NCDs) and mental health conditions. But the principles and the practices that we were drawing upon very much started from the HIV and AIDS challenges in the 1980s. That extended, and those practices and principles were then used in community health settings around maternal and child health in the 1990s and continued to evolve. Unfortunately, many of those practices and principles were developed and applied in high-income contexts. Of course, as many of these things happen, they start there and then they evolve and adapt to low and middle-income contexts. But that's what we now hope to do with the NCD work. So I think, ultimately, what we released in 2023, and what we are going to continue to do in terms of this research, is not necessarily reinventing the wheel: it's building upon that strong foundation.
If I look at some of the core principles, the principles around meaningful engagement – dignity and respect, power equity, inclusivity and intersectionality, commitment and transparency, institutionalisation and contextualization – I would argue that those principles can also be applied to your work when it comes to meaningful youth engagement. Again, the enablers are the same: the financing, the redistributing power, the non-stigmatising practices, the integrated approaches, and really embedding this into the DNA of organisations and institutions. So I think there's a lot of crossover there which is good, because it shows that this is something which has worked in other communities and we can bring to this new community. I think that these principles and enablers also align with that rights-based approach. One of the challenges with working for the WHO at the headquarters is that you're serving 194 countries given the diversity of countries. But ultimately, those principles and enablers are a good first step to then further contextualise and adapt.
Shayla: That's a very sensible way to approach global health problems, I would say.
Lizzie Bourn: I would echo that - I think it's really interesting. And I think that while such things are often the right thing to do, a lot of people want metrics and evidence to measure it by. So it would be interesting to see in the future, with that evidence, if you can actually increase the impact even more.
Looking back at your time at the WHO, what is one thing that you learned, which surprised you when working as a technical officer there? Especially since your work involved engaging with people living with NCDs, mental health and neurological conditions?
Jack: I just want to give some context first. The different parts of the UN are very political, in terms of trying to navigate those elements. You need to try to figure out the system, work around it and work through it, find your allies. Even though the organisation, as I mentioned before, like many institutions, is deeply siloed. So you have one team focusing on one particular health topic, one particular division, which is focusing on a broader set of topics. So you can see how things become quite fragmented and disjointed.
“When we started bringing people together with different health conditions and different lived experiences, we found that there was much more that unites rather than divide them”
However, saying that, one thing that I learned, which surprised me pleasantly, was that even though there are some challenges around putting the full NCD agenda together with mental health conditions, when we started bringing people together with different health conditions and different lived experiences, we found that there was much more that unites rather than divide them. I guess on paper, there are a lot of sceptics to that; in reality, there are many examples, but I think one which will stay with me forever is one of the case studies that we published. It was with an ex-US government official, Paul, who is a kidney transplant recipient and lives with chronic kidney disease. We paired him with Anu from Nepal, who is a community health worker living with rheumatic heart disease. Having those two individuals come together in the case study with shared experiences, and again seeing all those principles – mutual respect, understanding – all the similarities are there. People come from completely different geographical contexts, and different lived experiences, but have so much which unites them.
Lizzie: So moving on to our final question, what advice can you share with young people who want to impact and change the world but are really unsure of what career path to follow?
Jack: A great final question, another big one. Follow your head and heart, you can't really do one alone, it’s got to be a bit of both. And ideally both of them. If your heart is saying “Yeah, this is gonna be great” and your head is saying “No”, then maybe it's a good sign. So ultimately, follow your head and your heart.
Secondly, again, speak to people around you to find your allies and connect, and keep those connections going. I wish somebody had said this to me 10 years ago: imposter syndrome is real. Most people experience it, including me. But the more conversations and connections you have with like-minded professionals and souls, it helps that.
The third thing is this career path because ultimately, with many careers you'll feel very passionate about this area, right? And I struggle to not give 100% all the time, I'm that person - if I’m in, I’m all in, or if I’m out, I’m all out. But it's a marathon, not a sprint, so looking after yourself physically and mentally is essential because without that it's hard to impact and change the world. So having a balance across those three would be my advice.
Lizzie: I think that's some great advice. And I'm sure that everyone who reads this will take something from what you've said, and I know we definitely have. We really appreciate you taking the time to speak to us, thank you!
