Lessons Learned from My Time as Executive Director of the G4 Alliance

When I first stepped into the role of Executive Director at the G4 Alliance, I viewed it as a calling, an opportunity to have a lasting impact in global surgery and improve the lives of millions of people. Over those years, I’ve had the privilege of helping steer a coalition of global advocates, clinicians, NGOs, and, under my tenure, corporations toward a future where access to safe, timely, and affordable surgical and anesthesia care is a reality for all. What follows is a look back on lessons I carry forward and a reflection on how these experiences shape what I hope to bring next.

1. Embrace the “Big Tent” — partnerships beyond the familiar

One of the boldest decisions our leadership made was to open the G4 Alliance to corporate membership, and the first to join was Butterfly Network, Inc. (See Link). This move was not without internal debate, but it encapsulated a core belief: if we want to shift systems, we need to work across sectors, not just within them.

Butterfly’s handheld, chip-based ultrasound tools and global health program align with our mission to democratize access to diagnostic imaging. Their technical capabilities, combined with a commitment to affordability, made them a suitable partner for this project. That first corporate membership ushered in new conversations about how health innovation, private capital, and health equity can coexist and collaborate to create synergies and have a positive impact. 

Lesson: Transformative impact often demands we welcome new voices, even if they require transition, alignment, or renegotiation.

2. Data is not neutral. It’s power. Use it with humility

From day one, G4’s work lived in the realm of advocacy, policy, and narrative. But we had long known that to influence ministries of health, ministers of finance, and international agencies, we needed evidence, not just stories.

That conviction led us to co-develop the Operative Encounter Registry (OER), in collaboration with the World Health Organization (WHO), built on the DHIS2 platform. The registry is designed to enable surgical and anesthesia teams to routinely collect standardized data on operative care delays, outcomes, and access barriers. (See Link) When the WHO and G4 Alliance officially launched the OER module in Geneva in May 2024, it sent a resounding signal to all the stakeholders in global health: we were not satisfied with advocacy alone; we wanted to embed accountability, quality, and continuous improvement into systems.

That said, data systems don’t just get built; they must be leveraged to improve outcomes on the ground. That’s why we paired OER with a Community of Practice (CoP) (See Link) and a partnership with Project ECHO (Extension for Community Healthcare Outcomes) to build ongoing peer learning, technical support, and collective problem-solving. (See Link) The most challenging part often wasn’t designing the registry; it was creating momentum by working with a variety of stakeholders to build it, and then trust it, sustain it, and own it.

Lesson: Even the best data platform is meaningless unless clinicians, managers, and leaders see it as theirs. The role of leadership is to steward ownership, not merely to deliver software.

3. The world notices when you sign a WHO MoU—but only if you act on it

In August 2024, we signed a three-year Memorandum of Understanding between the WHO and the G4 Alliance. (See Link) It was a milestone: a formal acknowledgment that operative care is integral to universal health coverage, and that WHO saw value in aligning with a civil society coalition on that front.

But for me, the real test came afterward, not in press releases or announcements, but in what followed. We committed to:

• Accelerate dissemination of the WHO’s clinical registry and quality improvement tools;

• Embed operative data collection into national systems;

• Support advocacy and fundraising aligned with system uptake; and

• Strengthen data collection, monitoring, and accountability in LMICs.

Any MoU can become ornamental. We needed to translate that document into pilots, national dialogues, capacity building, and stakeholder alignment. That meant focusing less on prestige and more on execution.

Lesson: Signings are moments of permission. What defines legacy is what you build after the ink dries.

4. Leadership is about paradox and persistence

If there’s a theme threading through my time at G4, it’s this: leading a global coalition means holding paradoxes. You must:

• Be grounded in mission, but flexible in tactics.

• Be rigorous with data, but compassionate with partners.

• Push for scale, but protect local ownership.

• Welcome bold innovation, but manage risk.

An example: when skeptics questioned opening membership to for-profit entities, I leaned into listening, engaging council members, clinicians, and ethics advisors—not to negotiate away the mission, but to clarify the guardrails.

What I carry forward—and how this shapes my path ahead

If I were to distill three convictions that emerged from this journey:

1. Networks, not silos, will change health systems. The G4 Alliance taught me that no single actor can carry the load; we succeed when we build coalitions of trust across sectors, geographies, and disciplines.

2. Data must be human-centered. Behind every datapoint is a patient, a surgical team, a resource-constrained system. Design systems that serve people, not just dashboards.

3. Sustainability lives in local ownership. True scale occurs when hospitals, national ministries, and clinicians view programs as their own—not as gifts.

As I move forward to the next chapter, I carry with me gratitude, humility, and a fierce conviction that equity in surgical care is achievable. I bring with me lessons of partnership, strategy, iteration, and a belief that the accurate measure of leadership is not the titles held, but the seeds planted and sustained beyond one’s tenure.

If you’d like to explore how these lessons might inform your health initiative, foundation, or strategy, I hope you’ll reach out and continue the conversation.