Stanford social innovation review spring 2018 by Emmie Kio

Stanford Social Innovation Review

THE NEXT PHASE OF BUSINESS SUSTAINABILITY By Andrew J. Hoffman

THE CIVIC SCIENCE IMPERATIVE By Elizabeth Good Christopherson, Dietram A. Scheufele & Brooke Smith

FOUR STRATEGIES FOR LARGE SYSTEMS CHANGE By Steve Waddell

Anniversary Issue SPRING 2018 VOLUME 16, NUMBER 2

Making Founder Successions Work / The Next Phase of Business Sustainability / Four Strategies for Large Systems Change / The Civic Science Imperative

MAKING FOUNDER SUCCESSIONS WORK BY JARI TUOMALA, DONALD YEH & KATIE SMITH MILWAY

D I S P L AY U N T I L M AY, 2 0 1 8

Spring 2018 / Vol. 16, No. 2

$12.95 U.S. and Canada

The Mastercard Center for Inclusive Growth advances sustainable and equitable economic growth and financial inclusion around the world. We are pioneering the practice of data philanthropyâ&#x20AC;&#x201D;leveraging data and analytics to advance social good. One of our initiatives, Donation Insights, works to help close the critical information gap nonprofits face. Access the latest report:

partners.mastercard.com/donation-insights/ mastercardcenter.org @CNTR4growth The Mastercard Center for Inclusive Growth

Stanford Social Innovation Review / Spring 2018

Published by the Stanford Center on Philanthropy and Civil Society SPRING 2018 / VOLUME 16, NUMBER 2

F E AT U R E S

26 34 40 46 Making Founder Successions Work

The Next Phase of Business Sustainability

Four Strategies for Large Systems Change

BY JARI TUOMALA, DONALD YEH & KATIE SMITH MILWAY

BY ANDREW J. HOFFMAN

BY STEVE WADDELL

The era of corporations integrating sustainable practices is being surpassed by a new age of corporations actively transforming the market to make it more sustainable.

To create systems of societal change, we need to become clearer about the archetypes of societal change strategies, their strengths and weaknesses, and their interactions.

Conventional wisdom suggests that a “clean break” is the best way to transition a founder. But many nonprofits actually benefit when they carefully plan an extended role for founders who step down.

O N T H E C O V E R : Illustration by Jessica Fortner

The Civic Science Imperative BY ELIZABETH GOOD CHRISTOPHERSON, DIETRAM A. SCHEUFELE & BROOKE SMITH

At a time of rapid scientific advances, philanthropy has a vital role to play in building a culture of “civic science”: one in which scientists take active roles as citizens, and citizens engage with scientific research and its implications.

Stanford Social Innovation Review / Spring 2018

, The social enterprise and social entrepreneurship approach is founded on neoliberal ideology: a belief that markets produce the best outcomes.

—FROM SOCIAL ENTERPRISE IS NOT SOCIAL CHANGE, P. 59

D E PA R T M E N T S 4 5

VIEWPOINT

EDITOR’S NOTE SSIR’s 15th Anniversary

55 Taps and Toilets for All

Microfinance for water and sanitation enables people to find their own solutions.

SSIR ONLINE Online Series / Design Rethinking / Give and Take

15 W H AT ’ S N E X T Algae for Food and Green Jobs / Digital Natives Collect Community Needs / Taking Kids Off the Streets in Nigeria / Free College FIELD REPORT

57 Let Refugees

15 Building

Be Their Own Solution

Community by Sharing Books

Little Free Libraries draw neighbors together on street corners, on school campuses, and in police stations. BY COREY BINNS

11 Waging Lawfare

to Save the Planet

Client Earth has taken a US-style legal strategy of protecting the environment across the Atlantic and found surprising success. BY ALICIA CLEGG

13 A Space for Refugees

An ambitious community project is helping Amsterdam’s newest residents find both dignified work and a social network.

BY GARY WHITE & MATT DAMON

Better policies in host countries can enable refugees to rebuild their lives and contribute to host economies. BY EMILY ARNOLDFERNÁNDEZ WITH BRIAN RAWSON

18 C A S E S T U D Y Raising Opioid

64 R E S E A R C H

Addicts from the Dead

North Carolina’s Project Lazarus has brought harm-reduction principles to Appalachia. Although its practices saw immediate impact and have saved lives, the opioid crisis continues to claim victims in the region and beyond. BY TANA GANEVA

BY MÉABH MC MAHON

59 Social Enterprise Is Not Social Change

Solving systemic social problems takes people, politics, and power— not more social entrepreneurship. BY MARSHALL GANZ, TAMARA KAY & JASON SPICER

61 Reproductive Health Care by Mail

It is time to give US women the convenience, confidentiality, and autonomy of birth control and abortion pills that women elsewhere enjoy.

BY FRANCINE COEYTAUX, ELISA WELLS & SOPHIA YEN

Nonprofit Crime Reduction / Teaching to the Life Test / Workplace Volunteering Culture / Gender and Social Ventures BOOKS

68 A Revolution

in Science Collaboration? Barry Bozeman and Jan Youtie’s The Strength in Numbers REVIEW BY SUKRIT SILAS & KALI ALLISON

69 Organizations for All

Naomi R. Lamoreaux and John Joseph Wallis’ Organizations, Civil Society, and the Roots of Development REVIEW BY JONATHAN LEVY

72 L A S T

LOOK Year of the Woman

SSIR-Frontiers-FullPageAd-2018-Q1-R6.pdf

2/1/18

9:02 AM

CMY

Every two years, Stanford Social Innovation Review—the leading global publication bridging theory and practice on critical social-change issues—brings together senior leaders from around the world for two days, to discuss, debate and develop solutions that address the most pressing global challenges.

Join us for Frontiers of Social Innovation and explore some of the most important emerging forces impacting the world and society, including: AI’s Human Impact

Democracy and the Growth of Social Movements

Modern Slavery and Global Income Inequality

Systems Change and Impact

Social Innovation and the Fourth Industrial

Inclusion and the Rise of Societal Equity

Revolution

ENGAGE with other global

LEARN from leading academics

SHARE your unique

leaders working to improve

and scholars at the forefront of

experience and perspectives

the world

social change theory

on critical issues

For more information on sessions and speakers and to register, visit ssir.org/frontiers.

Stanford Social Innovation Review / Spring 2018

SSIR’s 15th Anniversary his issue marks the 15th anniversary of Stanford Social Innovation Review. Our goal remains essentially the same as it was in the spring of 2003, when we published the first issue of SSIR and wrote, “SSIR is dedicated to presenting usable knowledge that will help those who do the important work of improving society do it even better.” The fundamental way that we seek to accomplish that goal also remains essentially the same: to provide a forum where social-change leaders from all sectors of society can come together to put forth new ideas and practices, critique existing ones, and learn from one another. There are, however, a few things at SSIR that have changed since we started. One of these is that we reach many more people in many more ways. Fifteen years ago we only produced a quarterly print magazine. At a time when many print magazines have

ERIC NEE Managing Editor

Senior Editor Senior Digital Editor Assistant Editors Art Direction Copy Editor Website Designers Interns

folded, I am proud to say that we still publish an award-winning print magazine, but we also do much more. Nearly a quarter million people come to our website each month to read SSIR articles, and we reach another quarter million people every week through our e-newsletter and social media. But SSIR does more than publish articles. Every year we produce more than a dozen webinars and several conferences, bringing together thousands of people online and in person. We also produce podcasts and videos that reach others who prefer to learn by listening and watching. The second big change that has occurred over the last 15 years is that SSIR is now financially self-sufficient. Like most other nonprofits, we relied in our early years almost entirely on donations and grants, and in our case financial support from Stanford University, to fund our operations. During the last few years, however, we have generated enough revenue from earned income (through subscrip-

JOHANNA MAIR Academic Editor

David V. Johnson Jenifer Morgan Justine Drennan, Eden Stiffman David Herbick Design

MICHAEL GORDON VOSS

Publisher

Publishing and Marketing Manager Publishing and Marketing Associate Events Manager

Brian Karo Shayani Bose Veronika Roger

Elissa Rabellino

Advertising

Jeremy Davenport, Involved Media

Arsenal, Hop Studios

Sponsorship

Cynthia Lapporte, Oak Media

Jenna Garden, Madeline Musante, Eliza Steffen, Lisa Wang SSIR ACADEMIC ADVISORY COUNCIL

Paola Perez-Aleman, McGill University; Josh Cohen, Stanford University; Alnoor Ebrahim, Tufts University; Marshall Ganz, Harvard University; Chip Heath, Stanford University; Andrew Hoffman, University of Michigan; Dean Karlan, Yale University; Anita McGahan, University of Toronto; Lynn Meskell, Stanford University; Len Ortolano, Stanford University; Francie Ostrower, University of Texas; Anne Claire Pache, ESSEC Business School; Woody Powell, Stanford University; Rob Reich, Stanford University STANFORD CENTER ON PHILANTHROPY AND CIVIL SOCIETY

Faculty Codirectors Executive Director PACS Team

Paul Brest, Woody Powell, Rob Reich Kim Meredith Christina Alfonso, Lucy Bernholz, Danielle Carattini, Valerie Dao, Palak Joshi, Heather Robinson, Annie Rohan, Nadia Roumani, Laura Seaman, Christian Seelos, Priya Shanker

STANFORD CENTER ON PHILANTHROPY AND CIVIL SOCIETY ADVISORY BOARD

Chairman Members

Laura Arrillaga-Andreessen Herbert A. Allen III, Jean Case, Somesh Dash, Ted Janus, Shiv Khemka, Xin Liu, Carter McClelland, Jeff Raikes (ex officio), David Siegel, Darren Walker

tions, webinars, conferences, supplements, license fees, advertising, and other sources) to cover just about all of our expenses. The third significant change is that SSIR has become much more global. Today, more than 40 percent of the people who come to our website to read articles live outside of the United States. The five countries with the largest audiences are Canada, India, the United Kingdom, Australia, and the Philippines. But there is also a long tail. Last month, people from 192 countries visited our website, including ones such as Yemen, Cuba, Oman, Micronesia, and Kyrgyzstan. But there are many people around the world engaged in social innovation who do not read English. To begin to reach those people, SSIR has partnered with organizations in China and Turkey that are translating and distributing our articles in those countries. Our Chinese partner, Leping Social Entrepreneur Foundation, is publishing a Chinese print version of each issue of SSIR, including our cover illustration. We also have discussions under way with an organization interested in translating and distributing SSIR articles in South Korea. Each of these changes—reaching more people in more ways, achieving financial sustainability, and becoming more global— has helped SSIR become what it is today: the leading publication in the field of social innovation. —ERIC NEE Stanford Social Innovation Review (ISSN 1542-7099) is published quarterly by the Stanford Center on Philanthropy and Civil Society, a program of the Institute for Research in the Social Sciences at Stanford University’s School of Humanities and Sciences: 559 Nathan Abbott Way, Stanford, CA 94305-6042. Phone: (650) 7243309, Fax: (650) 725-9316. Letters Send letters to the editor to editor@ssir.org. Subscription Prices (One Year) Personal, $54.95 U.S./Canada and $74.95 international for print and digital, $44.95 for digital only. Libraries, $240 U.S./Canada and $260 international. Subscriber Services Stanford Social Innovation Review, PO Box 426, Congers, NY 10920-0306. Call 888-488-6596 (toll free) or 845-450-5202 (outside U.S.). info@ssir.org Article proposals, advertising, and reprints go to www.ssir.org Postmaster Send address changes to Stanford Social Innovation Review, Member Services, PO Box 426, Congers, NY 10920-0306. Volume 16, Number 2. Spring 2018. Stanford Social Innovation Review and the Stanford Center on Philanthropy and Civil Society are part of Stanford University’s tax-exempt status as a Section 501(c)(3) “public charity.” Confirming documentation is available upon request. Stanford Social Innovation Review was established in 2003 by the Center for Social Innovation at the Stanford Graduate School of Business. The founding publisher is Perla Ni. The former academic editors are Stephen R. Barley, James A. Phills Jr., Robert Scott, David Brady, and Chip Heath.

Stanford Social Innovation Review / Spring 2018

ssir.org

O N L I N E S E R I ES Our five-part series from the University of Toronto’s Institute for Gender and the Economy at the Rotman School of Management highlights some of the most critical issues related to gender and economic development and offers approaches to address them. Read the first two pieces: ■ Holding Up the Sky: Achieving Women’s

Empowerment Requires Working with Women and Men: ssir.org/working_with_women ■ The Mantra of Meritocracy: ssir.org/articles/

mantra_of_meritocracy

P O D CASTS PolicyLink President Michael McAfee shares how he lives the work of equity by promoting just and fair inclusion to help form a society in

R EA D E R CO M M E N TS Design Rethinking In their Winter 2018 article “Design Thinking for Higher Education,” Clark G. Gilbert, Michael M. Crow, and Derrick Anderson argue that many universities are stuck in their ways. Focusing on the experiences of their own institutions, Brigham Young University-Idaho and Arizona State University, the authors suggest that more institutions should both redesign their teaching and research programs to provide better value for students and expand their focus to draw in new students through types of offerings such as online learning. READERS RESPONDED:

“

I found it surprising that there was no evidence of the process of design thinking in this article. The authors cite adaptations in the design of institutions’ core functions, but there is no evidence of efforts to gain an empathetic understanding of the student/faculty/staff/community experience of higher education. What efforts were made to frame the user-focused problem? Were

which all can participate, prosper, and reach their full potential. Sarah Kearney and Scott Burger talk about their Winter 2018 cover article, “The Investment Gap That Threatens the Planet,” and how philanthropists can help invest in new solutions to address climate change. Listen to these and other conversations and talks: ssir.org/podcasts

B O O KS In Leading from Within: Conscious Social Change and Mindfulness for Social Innovation, Global Grassroots founder Gretchen Ki Steidle discusses how mindfulness can help us become more effective social-change leaders. Read more excerpts and reviews: ssir.org/books

alternative solutions considered? What was the process for arriving at the final solution?” —Stephanie Doscher, founding associate at the Global Learning for Global Citizenship initiative at Florida International University

“

What an amazing article showcasing where the future of higher education should be headed towards. While the world is changing very fast the structures are struggling to keep up, especially in education. ASU and BYUIdaho are fantastic examples of how to internalize this frame of a fast-changing world within the leadership and the core strategy, as well as how to best respond to these changes by inclusivity, affordability, design thinking, and more. … We have to look at students as people with special powers to empathize, to create, to care, to collaborate, to change. The role of educators should be to facilitate the process of students realizing this power inside of themselves and putting that power to good use.” —Mentor Dida, senior intrapreneur at Ashoka Read more: ssir.org/design_

thinking_higher_ed

Give and Take In their December 5, 2017, article, “Paid in Full,” Dorian O. Burton and Brian C.B. Barnes, cofounders of TandemEd, ask philanthropic leaders to step back and reconsider how they work with underprivileged communities. At some point “we started referring to communities as ‘those people’; we stopped saying their names and started saying the numbers given to us by evaluators,” they write. To reverse that trend, they suggest a range of strategies to help leaders give communities more power to determine their own outcomes and invest in long-term solutions that address neighborhood problems holistically.

“

READERS RESPONDED:

Really excellent article. Intergenerational poverty remains one of America’s gravest challenges. Today’s growing income inequality is only worsened by increasingly limited social mobility, especially across urban communities. In my own

Follow SSIR Online View an e-book of this issue online or download a complete PDF.

work, I see the failures of ‘institutions’—public education, criminal justice system, housing policy— and concur with the authors that real change can only come through exceptional community leadership and collaboration. We don’t lack for visionary leaders or local commitment or even solutions for these complex issues. The deficits are the luxury of long-term community planning, extended resources for collective problem solving and action, and ‘compassionate coordination.’ My experience suggests many locally led CBOs are open and eager to collaborate, but the bigger challenge is to encourage the grantmaking community to be similarly coordinated to pool together necessary resources—both government and philanthropic—to make real change real.”

“

—Bertina Ceccarelli, CEO of NPower

Thank you, Dorian and Brian. There are many structures manifesting with collaborative frameworks that simply do not have the appropriate strategies to not only act, but to act effectively. Meetings to note and discuss issues become a symptom and cyclical rather than a force for incubating action plans with all the ingredients noted in the Paid in Full strategy. Culture eats strategy, and until we meet the readiness level to act in a meaningful and collective way that allows all the parts (with their possible constraints on broad approaches) to be a part of the system as a whole, our investments will remain effective in numbers only … but not represent scale and greater impact.”

—Alfred M. Mays, program officer for Diversity in Science and Science Education at Burroughs Wellcome Fund Read more: ssir.org/paid_in_full

Stanford Social Innovation Review / Spring 2018

! EnerGaia’s spirulina photobioreactors operate on the rooftop of the Novotel Siam Square Hotel in downtown Bangkok, Thailand.

FOOD

Algae for Food and Green Jobs BY KRISTINE WONG

rowing the blue-green algae spirulina, an increasingly popular “superfood,” doesn’t just yield a nutritious dietary supplement. It also combats climate change and, due to advances in the way it’s produced, can give individuals with limited resources a new way to generate income. “Spirulina is packed with protein, vitamins, and minerals, and can make a real impact on food security and sustainability,” says Saumil Shah, the founder of EnerGaia, a company that grows the microalgae in more than a thousand bioreactor tanks across Thailand, Singapore, and India. “We want to democratize spirulina awareness, production, and consumption.” EnerGaia produces three tons of spirulina a year, processes it, and sells it, mostly to food manufacturers, who use the microalgae in their products. The company also helps farmers set up their own bioreactors to produce spirulina for personal consumption and sales. The goal is to make the nutrient-filled algae, which looks like a dark green paste in wet form or a powder when dried, more accessible and affordable. Shah, an American engineer who lives in Bangkok, was inspired to start EnerGaia in 2009 when he learned that farming the algae—which requires only carbon dioxide, water, added nutrients, and sun-

light to grow—was an effective way to take the greenhouse gas out of the atmosphere. Shah’s first large-scale effort to do so used emissions directly from a rice mill. But when the facility was demolished in 2011, the company struggled to find another way to source industrial carbon dioxide in a way that was economically viable. Instead, Shah adopted a more flexible approach, moving the bioreactors that the company used to grow the algae to a range of underused or abandoned industrial and urban spaces that filtered carbon dioxide from the air and helped businesses and landowners get more value out of their property at the same time. While most producers grow spirulina in open ponds, EnerGaia has made the process more efficient by custom-designing its

own bioreactors—sets of interconnected white barrels that aerate and pump the algae and fluids between them. The process is automated, meaning that the grower can monitor it from a smartphone and be notified immediately if growing conditions (such as temperature) stray from ideal settings. Automation frees up time for the grower to take on other jobs. “No one has ever brought automation technology to the spirulina growing process before,” Shah says. In Thailand, where the bulk of EnerGaia’s operations are located, the company has set up its bioreactors on three rooftops and one “farm” that formerly housed a timber yard. Later this year, EnerGaia plans to start growing at a hospital in Singapore and to give the facility 10 percent of the spirulina produced to feed patients. Although interested individuals must purchase their own bioreactors, EnerGaia offers on-site training at no charge. The company is also working with various NGOs to set up microfinancing programs. Shah says that with

the help of these programs, a grower could pay off the cost of 10 to 20 bioreactors in two to three years (assuming earnings of about $1,100 a year from sales). In India, the first group of farmers using EnerGaia’s equipment is currently producing algae in 64 tanks for their own consumption. Eventually, however, EnerGaia hopes to help them scale up operations to 1,000 tanks and purchase the leftover harvests. This will help EnerGaia meet increased demand for spirulina products, which surged in the past year as more people became aware of its health benefits, Shah says. “The algae product market is expected to reach over 44 billion [dollars] in the next five years,” says Monica Jain, a business consultant who founded Fish 2.0, an international business competition for emerging sustainable seafood and aquaculture startup companies. “It’s being recognized as a superfood. Producing algae for food is strategically a great place to be because it’s high value— higher than when used in biofu-

PHOTOGRAPH BY JULIA SOLANO VIA HUMANITAS AI

NEW APPROACHES TO SOCIAL CHANGE

PHOTOGRAPH COURTESY OF ENERGAIA

Stanford Social Innovation Review / Spring 2018

KRISTINE WONG (@wongkxt) is a journalist based in the San Francisco Bay Area who reports on energy, the environment, food, and sustainable business. She is a contributor to The Guardian US/UK, Modern Farmer, Sierra, Civil Eats, and other publications.

els or for pharmaceuticals.” EnerGaia’s socially oriented business model reflects a growing awareness that marine products such as algae offer underexplored opportunities for positive social impact, she adds. Bangkok resident Manasak Nipanprasat is the site manager

JAMIE STARK (@jamiestark) is a freelance journalist and cofounder of Farming Hope, a social enterprise based in the San Francisco Bay Area.

! Humanitas AI co-founder Aravindh Shankar discusses his app with students at Emrawa Secondary School for Girls in Irbid, Jordan.

Last fall, Humanitas partnered with the Queen Rania Foundation’s Madrasati education initiative to pilot the app and youth engagement strategy through student clubs in six Jordanian schools. Every Saturday morning, 120 middle and high school students, including Tarawneh and her classmates, met for a 10-week program called Masahati (“my space”). They learned design-thinking concepts from the app and college-aged volunteer tutors, and developed social-change initiatives around challenges such as improving nutrition in schools and reducing stigma associated with disabilities. Given that about 70 percent of Jordan’s population is under age 30, digital natives provide a great vehicle for communicating ideas about social change, Chow says. “For a lot of the youth, they literally can’t help but share the work that they do with their peers, like on Facebook,” he says. “Can we channel that energy?” To do so, Humanitas felt it was important to develop its own app for youth to share and coordinate social projects rather than

use existing platforms such as Facebook and Twitter. Sarab Matarneh, a 22-year-old accounting student at Mutah University, helped mentor Tarawneh’s group as part of the pilot. As she puts it, “Facebook is full of other things.” But with the Humanitas app, “the purpose is clear.” Chow expects to be able to provide meaningful data to funders when the app reaches 100,000 users. He says the company is on track to reach that point after the app’s public launch this year, because of collaborations with the Queen Rania Foundation, the World Bank, and government agencies in Jordan and the United Arab Emirates. “In philanthropy, we often talk about things that are not necessary for the community,” says Xin Liu, a board member of the Stanford Center on Philanthropy and Civic Society and president of the Enlight Foundation, which funds Humanitas. Too often, “whatever they desperately need, we don’t offer,” but organizations such as Humanitas are changing this trend, she says.

for growing operations in Phra Pradaeng, EnerGaia’s largest location in Thailand. “I wasn’t able to go to college,” the 24-year-old says. “But by working at EnerGaia for the last four years, I learned how to solve many problems in growing spirulina. Now I am able to teach others the same skill.” n

CIVIC ENGAGEMENT

Digital Natives Collect Community Needs BY JAMIE STARK

l Yamama Tarawneh barely had time for a 20-minute phone interview. She was busy with homework, family time, and her newfound role of community organizing. Tarawneh and five fellow high school students are arranging for local college students to teach their neighbors Arabic at a local community center. “We wanted to leave an imprint on our own community,” says Tarawneh, a 10th-grade student at Al Hussainiyah secondary school in Karak, Jordan. She and her classmates conducted a broad survey of their community’s needs and identified 17 individuals interested in Arabic classes. They were mostly mothers, including one of the students’ moms, who had never found time to learn how to read and write while caring for their families. To design and implement the project, Tarawneh and her classmates worked with Humanitas AI, a company that combines a social media smartphone app with in-person train-

PHOTOGRAPH BY JULIA SOLANO VIA HUMANITAS AI

PHOTOGRAPH COURTESY OF ENERGAIA

ing to help young people in Jordan and beyond lead change in their communities—and to collect data from those efforts to help funders make better grantmaking decisions. Through the app, students can complete surveys that encourage them to empathize with their community’s needs, share updates, exchange project ideas, and report valuable grassroots data about those they hope to help. Once Humanitas has collected enough data from this process, it will market a data dashboard on community needs to philanthropists and governments and give free access to certain grassroots organizations and researchers, says Philip Chow, who cofounded the company in 2015. Organizations also will be able to use the app to pose questions to supporters, such as, “What are the most interesting things we could do to help the environment?” (Noting potential privacy concerns, Chow says the app collects data only from those who choose to share it.)

Stanford Social Innovation Review / Spring 2018

Humanitas’ current partners appreciate that the organization is encouraging students both to be active in their communities and to lift up their voices. “Sometimes, foundations impose certain solutions on communities,” says Tala Sweis, director of the Madrasati education initiative. “But when you poll young people, they inform these solutions. They tell you what would work or not.” Of course, social good can happen without apps and NGOs. What Chow hopes Humanitas can do is amplify those effects. “People already have that in them—we are just a catalyst,” he says. n

LINUS UNAH is a freelance journalist based in Lagos, Nigeria. His work has been published in The Guardian, IRIN News, BRIGHT Magazine, and The Christian Science Monitor, among other publications. He writes about global health, conflict, technology, agriculture, and development.

, Street Priests founder James Okina promotes the value of education to a group of children and teenagers at a February 2017 outreach program in Calabar, Nigeria.

NONPROFITS & NGOS

While other NGOs have seen limited success helping street kids, Street Priests has an advantage because its young leaders can relate directly to their experience. The NGO’s founder, 18-year-old James Okina, himself turned to a gang for a sense of belonging after his parents separated when he was 8, but he later abandoned street life under the positive influence of a cousin. “I felt compelled to change [street kids’] lives when I met a street kid one evening in 2014 who spoke good English but looked disheveled and had to dance in bars to survive,” says Okina, who studies at the University of Calabar. So he

Taking Kids Off the Streets in Nigeria BY LINUS UNAH

oshua Daniel was 7 years old when, after a fight with his mother, he left home in the Nigerian port city of Calabar and began living on the streets. For six years, Daniel traipsed through the city scavenging for corrugated scrap metal to eke out a living. “You have to play the tough guy to survive,” says Daniel, who is now 15. “We slept at a store every night after the storekeeper locked up and left.”

Daniel has now returned to school and stays at a hostel provided by a local church. He is among hundreds of former street kids who, thanks to a group of eight teenagers, are receiving shelter and help to attend school. Since 2015, the youth-led nonprofit known as Street Priests has worked to address these children’s most pressing needs: food and shelter, education, protection from abuse, and skills training and mentorship.

Helping organizations get more value from data. It’s who we are. At Teradata, we enable high-impact business outcomes. Our success is rooted in proven capabilities that span technology, people and methodologies.

Reshaping the world through data. Now, through a focus on data philanthropy, we’re helping charitable organizations around the world change the way they do business. Because when we all lend a hand to solve tomorrow’s challenges… humanity wins and organizations flourish. Teradata.com/community-relations

Doing Good WIth Data™ Teradata and the Teradata logo are registered trademarks of Teradata Corporation and/or its affiliates in the U.S. and worldwide.

PHOTOGRAPH BY LINUS UNAH

Stanford Social Innovation Review / Spring 2018

PHOTOGRAPH BY LINUS UNAH

COREY BINNS (@coreybinns) is a journalist based in Northern California. She writes about science, health, and social change.

gave up his job as the marketing manager of a local fashion brand to launch the nonprofit. As a first step, Street Priests’ staff visit Calabar’s alleyways and simply sit and talk with street kids for hours about how they can make a life off the streets. The NGO partners with other organizations to offer free tutoring, a nutrition program, and information about substance abuse. It also has reunited several children with their parents and arranged for the adoption of more than a dozen more. “The smallest thing you do for these kids can have a big impact on them,” says 18-yearold Godwin Ovat, Street Priests’ head of partnerships and a sophomore at the University of Calabar. Worldwide, an estimated 100 million children live on the streets, according to the UN children’s agency Unicef. In Nigeria, 10.5 million children do not attend school—the most of any country. These kids—who leave home for reasons such as poverty, neglect, or the death of a parent—largely miss out on education and are vulnerable to exploitation and abuse. They also face social stigma. People in Calabar call them by the nickname “Skolombo,” a derogatory term for criminal urchins, and

accuse them of attacking and stealing from commuters. Negative views of street kids have hampered past efforts to help them and made launching Street Priests difficult, Okina says. “We couldn’t even use public spaces for our campaigns, and there was no acceptance from the community,” he says. Street Priests now seeks to change perceptions of these children; its Facebook page regularly features street kids’ personal stories. “They grow up to be tough and rough because they see the adult world as a constant threat, and they believe that people hate them,” says Okina. Most of the NGO’s money comes from its team members’ personal contributions, donations from charitable individuals, and, most recently, ticket sales for a performance that Street Priests organized in Calabar Mall, the city’s largest shopping center. There, young people performed poems, songs, and dances on the theme of street kids’ lives. “James [Okima] and his team have been successful in rehabilitating and mentoring street children, and significantly reducing the rate of crime that street kids and teenagers tend to commit on a daily basis,” says Grace Ihejiamaizu, who teaches sociology at the University of Calabar and manages iKapture Networks, a

social enterprise that provides after-school education and services to students and out-ofschool youth in Nigeria. She adds that Street Priests has inspired other young people to launch similar projects. Meanwhile, the NGO is looking to expand to other parts of Nigeria and hopes to reach tens of thousands of children. Joshua Daniel, the former street kid, will start junior high school next year and beams with pride as he talks about the future. “I hope to become an actor one day so I can influence a lot of people and help them to do good things,” he says. n E D U C AT I O N

Free College BY COREY BINNS

ildlife biologist Dena Emmerson was one of nearly 5,000 new students to register at City College of San Francisco last fall, after she decided to learn marketing so that she could launch a public outreach campaign to promote conservation. That semester, she took four marketing classes for less than the cost of a lunch in the city’s Financial District. CCSF’s publicly funded Free City program fully pays

for students’ tuition, minus the cost of books, a $17 health fee, and $3 for online registration. Savings can add up to $552 per semester for a full-time student. Students don’t have to earn a certain grade point average or fall into a specific income bracket to be eligible. Emmerson only had to provide proof of her San Francisco address. “We all get stuck in our little bubbles at work and where we live,” Emmerson says. “But because I took these classes, I had conversations with people that I wouldn’t have spoken to otherwise.” The program’s tuition funds come from a real estate transfer tax on all commercial and residential buildings in the city sold for more than $5 million. “We really consider Free City access an opportunity in social justice. It’s leveling the playing field,” says Free City program director Leslie Milloy. More than 70 percent of City College students are eligible for state financial aid. “We definitely have a population that is not wealthy,” Milloy says. Since Free City’s launch last fall, CCSF has doled out more than $2 million for tuition, and enrollment has spiked 17 percent. The appeal of free tuition accounts for some of this surge. Some is also due to CCSF’s resurgence following a very public five-year battle to keep its accreditation, when it lost 30,000 of its 90,000 students. After administrators announced in early 2016 that the college would stay open, student enrollment jumped significantly at a time when it was down at most other community

Stanford Social Innovation Review / Spring 2018

colleges in California and many across the country, says Milloy. Although it’s too early to determine student satisfaction with Free City, faculty say many students in their classes would not be there if not for the program. Other students who enrolled at CCSF in the past can now benefit from Free City after hitting a cap on state aid. Rafael Mandelman, a CCSF trustee who is running for the San Francisco Board of Supervisors, hopes to beef up stipends in the next year. “The program is still a work in progress,” he says. He’s dissatisfied that currently some undocumented students do not receive a tuition break and that all

students must still pay tuition during the summer session. Even with Free City, lowincome San Franciscans are likely to struggle financially to attend college, says Michelle Miller-Adams, a research fellow at the W.E. Upjohn Institute for Employment Research. Free City—like the Excelsior Scholarship in the State University of New York (SUNY) system—subtracts need-based grants such as California Promise and Pell grants from the tuition coverage it awards. “This means that for low-income students, a twoyear college program like Free City does not bring much new money to the table,” she says. As a result, many students still can’t

afford to take the time off work to attend class and study. That policy stands in contrast to other programs in the growing movement of place-based scholarships, including one of the first, the Kalamazoo Promise, which since 2005 has covered full tuition for Kalamazoo, Michigan, public college students without subtracting state or federal grants. While CCSF’s program falls short of Kalamazoo’s in this way, they share the same goal, Miller-Adams says: “to help those just above the Pell cutoff know that they can afford at least a two-year degree, and to promote messaging around the benefits of some kind of postsecondary education.”

Indeed, unlike the SUNY program, for which students must fall under a $125,000 household income threshold to quality, Free City places no income cap on eligibility. In initial reports, Milloy and her colleagues have seen an increase in students like Emmerson, who already hold bachelor’s degrees and may come from middle-class backgrounds but want to boost their career prospects or make a career change. “It’s a way to enhance economic growth for San Francisco overall, because more people have more opportunity to move forward with their financial and their educational goals,” Milloy says. n

Advance Your Career Earn an undergraduate data science degree or a graduate analytics and modeling degree.

Gain the power to change the world through data.

Bachelor of Science valpo.edu/data-science Master of Science valpo.edu/data-on-purpose

Stanford Social Innovation Review / Spring 2018

$ James Thornton, founder and CEO of ClientEarth, speaks at a climate change march in central London in May 2016.

PROFILES OF INNOVATIVE WORK

Waging Lawfare to Save the Planet ClientEarth has taken a US-style legal strategy of protecting the environment across the Atlantic and found surprising success. BY ALICIA CLEGG

PHOTOGRAPH COURTESY OF CLIENTEARTH

magine you are an American activist attorney newly arrived in Great Britain. You would like to work with local environmentalists, but the major organizations prefer to campaign rather than use the courts to hold lawbreakers, be they governments or corporations, accountable. Do you compromise on your principles and join a corporate law firm, or do you take a gigantic risk by starting a legal nonprofit and setting your own agenda? That was the dilemma that confronted James Thornton before he founded ClientEarth, so named because it treats the Earth as its legal client. The nonprofit is a cultural transplant: a scrappy US-style public interest environmental law group grafted onto Britain’s centuries-old legal system. From a single employee in 2007, the organization has grown to 100 staff, including 60 lawyers qualified in a dozen legal jurisdictions. It has opened offices in Brussels and Warsaw, and within the last year alone it forced the UK government to publish revised plans to tackle air pollution, blocked the construction of a controversial giant coal-fired power plant in Poland, and obtained an emergency ban on logging in the country’s ancient Białowiez˙ a Forest. Thornton moved to the United Kingdom in 2001. The laws on residency meant that it was easier for him to settle in

Britain than for his British-born husband, the writer Martin Goodman, to live in the United States. Having retrained in the UK’s legal system, he planned to practice law in a strategic role in a large environmental organization. It took only a few meetings to establish that this was unrealistic. In the United States, Thornton had spent nine years at the Natural Resources Defense Council (NRDC), a lawyer-led nonprofit environmental organization, fighting industrial polluters. In Europe he discovered to his astonishment that the NRDC had no real counterparts. “Throughout Europe, there were only a handful of lawyers working full-time for environmental charities, mostly on work that emerged from the [campaign] work of the organization rather than from a strategic analysis of where the law could be pushed forward to protect the environment,” Thornton recalls. ClientEarth’s programs cover climate change, biodiversity, ocean management,

forestry, access to justice, and human health. Though best known for its legal challenges, the organization devotes many hours to briefing legislators and advancing an environmental viewpoint in backroom committees that shape policy. “Once laws are written, companies spend vast amounts of resources trying to push their implementation in their own direction. The only way to safeguard the intent is for the environmental community to bring to the table the same level of expertise and legal sophistication [as big business],” Thornton says. Karin De Schepper, cofounder of CleanAirBXL, a citizens’ platform, describes the work of ClientEarth as “very valuable” to citizens who stand up to authorities that disregard the law. She says that governments come down hard on individuals but “are not at all ashamed” to breach their own laws designed to protect public health. With four fellow citizens, De Schepper is a co-plaintiff with ClientEarth in a case to force the Brussels regional government to practise robust air quality monitoring and bring nitrogen dioxide pollution in the city within legal limits. “Without the legal expertise and financial sponsorship of ClientEarth, we couldn’t have taken the government to court, because we would have been reliant on our own resources,” says De Schepper. SETTING PRECEDENTS

ClientEarth opened its UK office in 2007 with seed investment from the McIntosh Foundation, a US family-owned philanthropy. Its support sparked interest among European funders who were curious to learn more but hesitant to commit to a model that was locally unproven. Other donors soon followed, including the Esmée Fairbairn Foundation, a leading independent UK grantmaking body. Not everyone was receptive, however. In Client Earth,

Stanford Social Innovation Review / Spring 2018

ALICIA CLEGG (@aliciamargclegg) is a freelance writer based in the United Kingdom. She contributes regularly to the Financial Times and has also written for The Guardian, Management Today, and Oxford Today.

the eponymous book about the nonprofit, Goodman and Thornton write about a sense within the environmental movement that ClientEarth was “inappropriately transporting a foreign model into the system without understanding the local soil.” Though European environmentalists sometimes resorted to law, this step was mostly for tactical purposes, such as delaying a local infrastructure project, rather than for advancing environmental rights. “One of our organizational values is being bold and unafraid to take on the big issues,” says Karla Hill, director of programs at ClientEarth. “That may have ruffled a few feathers.” Since the biggest environmental threats are worldwide concerns, it was clear that ClientEarth would need to work internationally to achieve its ambitions. But how does a small nonprofit—in 2016 ClientEarth had an income of £7.3 million ($9.6 million)—achieve international impact? This is where adopting a strategic approach has paid off. Rather than fight isolated cases opportunistically, ClientEarth weighs the environmental importance of each proposed action and its potential to create precedents that can be leveraged. Take, for example, the slew of cases it is waging across Europe to enforce the 2008 Ambient Air Quality Directive, which sets legal limits for air pollutants. In making air quality a flagship policy, ClientEarth chose a target that combines opportunities to attract media headlines and galvanize public support. Issues such as climate change can feel far removed from people’s lives, but no parent wants their child to grow up breathing polluted air. Exposure to pollution has been shown to stunt lung development and has been estimated by the European Environment Agency to cause around half a million premature deaths in the European Union each year. Tony Long, a Brussels-based environmentalist, was director of the European Policy Office of WWF (the European equivalent of the United States’ World Wildlife Fund) when ClientEarth began a UK court action in 2011 to force the UK government to

bring nitrogen dioxide pollution from diesel exhaust within legal limits by 2015. He says that in focusing on enforcement ClientEarth has struck at “the Achilles’ heel” of European environmental policy—the tendency of member states to pass good laws and implement them incompletely, or not at all. The UK High Court dismissed the case, as did the Court of Appeal. Undeterred, ClientEarth appealed next to the UK Supreme Court and obtained a ruling that the government was indeed breaking the law. The Supreme Court then referred the case to the European Court of Justice (ECJ), which ruled in November 2014 that national courts have a duty to enforce the directive and to review the adequacy of national air-quality plans. Armed with this judgment, ClientEarth has proceeded to initiate air-quality actions in Belgium, Germany, Italy, the Czech Republic, Poland, Bulgaria, and Slovakia. “What the air quality project is proving is that if you use litigation strategically, you can achieve effective change,” says Ugo Taddei, a Brussels-based lawyer at ClientEarth. NEED TO INTERNATIONALIZE

ClientEarth entered Europe as a disruptive innovator with an American-inspired model of legal activism. But for the model to take root and scale up, it has had to adapt to the idiosyncrasies of national cultures and court systems. That has meant working through transnational institutions such as the ECJ to establish broad legal principles and precedents, while collaborating locally with nonprofits, citizen groups, and lawyers. By choosing to partner rather than to establish a large network of offices, ClientEarth is able to bring more actions, more rapidly, and achieve greater impact. “The national NGOs have a better understanding of local issues,” Taddei says. “And we have the knowhow from our litigation across Europe to provide a good legal strategy.” ClientEarth has amply demonstrated the power that shrewd legal strategy can bring to campaigning. However, there is no guarantee that courtroom victories will

translate into robust environmental protections, at least not quickly. A case in point is the court-ordered air-quality plans that the UK government published in July 2017 and which environmentalists argue still fall short of the comprehensive remedies needed to clean up the country’s air. Yet that does not detract from what ClientEarth is attempting, says Jenny Bates, air pollution campaigner at Friends of the Earth. “Were it not for the legal actions that ClientEarth has taken, the government would not have produced even the weak air-quality plans that we have today.” As an organization, ClientEarth has reached a crossroads. Until now, the United Kingdom has been the pivot in its strategy of taking precedent-setting legal actions that can be built upon internationally. However, after Brexit, London will lose its strategic value as a gateway into the European court system. “Even though we have a Brussels and a Warsaw office, I think that if our headquarters remain in London, there may be a tendency for Europeans to see us as a UK organization,” Thornton says. To protect the environment more broadly, ClientEarth will need to internationalize further and work in countries that lack the mature environmental movements and legal institutions of Europe and the United States. Though it is early days, some of this strategy is taking shape. At the invitation of Chinese authorities, Thornton spent part of 2015 training judges in how to handle environmental cases and advising Chinese prosecutors on how to design court actions on behalf of Chinese citizens when officials break environmental laws. In Ghana, Republic of the Congo, Gabon, Liberia, and Ivory Coast, ClientEarth is working with local lawyers and civil society representatives to reform and enforce laws on forest management and strengthen local capacity. “What we’re trying to build through our work in Europe and beyond is a society in which there is transparency in government and a culture of compliance with law—the type of society in which you would like your descendants to live,” Thornton says. n

PHOTOGRAPH COURTESY OF REFUGEE COMPANY

Stanford Social Innovation Review / Spring 2018

! Three trainees at A Beautiful Mess restaurant inside Refugee Company review a food order.

A Space for Refugees An ambitious community project is helping Amsterdam’s newest residents find both dignified work and a social network. BY MÉABH MC MAHON

PHOTOGRAPH COURTESY OF REFUGEE COMPANY

ara Said was 6 years old when she first heard the word “war.” Now based in Amsterdam, the chatty Syrian talks passionately about how she long wanted to travel the world. “I always lived in a shaky place, financially, socially, and ecologically,” Said says, “but I didn’t think I would go this way.” Equipped with her backpack, her iPhone, and hopes of a whole new world, the 26-year-old fled a dangerous Damascus back in the fall of 2015. A yearlong journey took her through nine different countries and ended with a nine-month stint at a refugee camp in the south of the Netherlands, which, “like everyone else there, I despised,” she says. “The picture we get in the Middle East is that Europe is this utopian place, where there

is no racism, no discrimination, where everyone loves each other, and then you come here and millions of people hate you,” Said says. But Said did have one positive experience in the camp: She met Fleur Bakker, the director and cofounder of an Amsterdam-based social enterprise created to provide fulfilling, dignified work for refugees. Bakker offered Said the chance to participate in projects with the social enterprise and helped her resettle in Amsterdam. “I never went back to my camp,” Said says with a grin. Today, Said works with Bakker’s organization, Refugee Company, as a visual artist. She helps design textiles that the company sells, leads workshops, and is working to organize a refugee artists’ network. Back in 2016, her name went viral after the Amnesty International-sponsored organization Refugee Nation commissioned her

to design a flag for the refugee team participating in the Rio Olympic Games. The orange-and-black flag, which resembles the life vests worn by thousands of refugees, including Said, is now on display at London’s Victoria and Albert Museum. Along with architect Femke Bijlsma and entrepreneur Michiel Lensink, Bakker came up with the idea for Refugee Company in the summer of 2015, the year when more than one million refugees arrived in Europe and more than 2,200 lost their lives on the way. “First, we started an emergency shelter in Amsterdam, where we connected people who were almost suicidal with temporary jobs or at least meaningful activities during the days, and then it grew and grew,” Bakker says. As the organization took off, the organizers also coordinated children’s activities and provided Dutch classes. Today, Refugee Company is a sleek, modern events hub where migrants can make new friends, network, participate in skills training workshops, and gain job placement support from staff and volunteers. A social entrepreneur by trade, Bakker learned the importance of creating both social and professional networks for refugees from previous work with shelters and refugee assistance programs. The majority of new arrivals desperately want to improve their skills and knowledge and to feel worthwhile again, she says. So far, Refugee Company has helped more than 200 newcomers find work as computer programmers, furniture upholsterers, metal sculptors, and hairdressers. It has also linked job seekers to companies and organizations such as Heineken, Philips, AkzoNobel, and 216 Accountants. In addition to these connections to outside companies, Refugee Company itself employs refugees at its own in-house enterprises: a restaurant, a coffee shop, and a clothing line. “We have a really holistic approach,” Bakker says. Refugee Company staff look at what refugees did in their home countries, what they studied, and how they see their future. “We could also start a job agency, but by working together and creating a nice atmosphere, the community building starts,

Stanford Social Innovation Review / Spring 2018

MÉABH MC MAHON (@Brusselsness) is an Irish TV and radio reporter based in Brussels. She covers the European Union, NATO, and Belgium for the 24-hour news channel France24 and for Radio France International. She also produces and presents a weekly English show on Belgian TV, BRUZZ.

and from there you can build to the next step,” Bakker says. NEW SKILLS AND A NEW NETWORK

Refugee Company is based in the former launderette of one of Amsterdam’s most notorious prisons, the Bijlmerbajes. Situated in a rough but up-and-coming neighborhood in the south of Amsterdam and known for its six high-rise towers, the facility ceased to be a prison in June 2016 and two months later began sheltering asylum seekers. Today, 600 people reside in its concrete former cells. At least half have used the services of Refugee Company, which is a colorful, artistic hub of activity that would turn any hipster’s head. Upon entering the social enterprise’s doors, visitors are greeted by a trendy coffee bar decorated with eclectic art. Hip-hop music pumps through the industrial building. A hallway leads to a vast restaurant open to the public that is run by refugees with the guidance of one friendly Dutch man. The day I visit, the restaurant staff are preparing for barbecue night and planning to feed a full house of more than 70 people. “Before, this was just a dirty laundry room that was left for a long time. Nobody used it,” says Hayder al Saadi. The 29-yearold is a former bar owner from the south of Baghdad and is now the Refugee Company eatery’s floor manager. “All the decoration was done by a Syrian architect.” He adds that he has gained all the skills he uses in managing the restaurant since coming to Refugee Company. “I had no training until I came here, and I have since learned all about food and how to deal with people,” he says. Hayder speaks perfect English and conversational Dutch, languages he did not know before arriving in the Netherlands in 2015. The serious young man, who now lives in the heart of Amsterdam with one of his brothers, was traumatized by the hardships of his journey to Europe and has no intention of returning to Iraq. Although he misses his parents and other siblings, including another brother who is fighting against the so-called Islamic State, he is pleased to have found such fulfilling work in Amsterdam.

“It is amazing here. I love it,” he says. “It feels like home.” Now that the restaurant has gotten off the ground, Refugee Company will turn its focus to expanding its in-house fashion studio. Its online shop already features a range of T-shirts and hoodies designed and produced by refugees. “There is no manufacturing or textile industry here in Holland, but we see a lot of tailors and machine workers coming over—people who cannot read or write but that make beautiful productions, as they have been working in factories since they were 11,” Bakker says. She hopes that these migrants can help bring a tradition of craftsmanship back to the Netherlands, which currently imports most of its clothing. Thanks to funding from the municipality and various foundations in the Netherlands, Refugee Company now employs 10 full-time staff to oversee its administrative operations and programs, not including those it employs in its restaurant, coffee shop, and fashion studio enterprises. (Its staff includes a mix of Dutch citizens and migrants.) Ultimately, the hope is that it will become financially selfsustaining, Bakker says. “Every day at Refugee Company is different; every meeting or new connection is unique,” says Katia Verreault, the organization’s social and psychological counselor, who works one-on-one with refugees who have experienced trauma and helps them find fulfilling activities that match their interests. “We create a sense of family, a support network, and a place to rediscover oneself,” Verreault says. She runs through a long list of people she has worked with who have gained new skills in areas such as cooking, sewing, baking, and singing. “I suppose we facilitate this process of finding a meaning, a new sense of hope that long asylum procedures and heavy bureaucratic systems have often shattered.” HELPING MANAGE A CRISIS

Onerous bureaucratic systems and European governments’ slowness in relocating and integrating newcomers have made life challenging for refugees and migrants. The migrant crush and the social tensions it has

stirred up among Europeans put enormous stress on newcomers. That is why Europe needs more initiatives like Refugee Company, says Katharina Bamberg, migration and diversity analyst at the European Policy Centre, a Brussels-based think tank. “Projects such as the Refugee Company contribute greatly to opening up the labor market and thereby creating opportunities for the integration of refugees to the benefit of both sides—refugees and host societies,” she says. Bamberg laments that most refugees have to take jobs below their skill level because there are not enough services to help them find suitable employment. She commends organizations that are addressing this problem, such as Refugee Company and DUO for a Job, a Belgian program through which experienced professionals mentor young job seekers from migrant or refugee backgrounds. These two organizations are among the many refugee integration efforts that have sprung up around Europe since 2015, says Jens Mueller, the Brussels-based president of the refugee assistance nonprofit Refugees Are Not Alone. In the face of the crisis, he says, citizens, NGOs, and companies have been doing the work that would usually fall to governments— from handing out emergency aid in the streets to helping refugees find work and a place to stay. Although governments have regrettably not stepped up, the gap has encouraged private organizations to pioneer creative approaches to refugee integration, he says. My visit to Refugee Company ends with dinner in the restaurant. A board meeting has just come to an end, and the crew is tucking into an array of Middle Eastern delights from hummus to tabbouleh. The room is chilly, as the vast former launderette is not so easy to heat, but the atmosphere is warm. Fleur Bakker and her board are exhausted but highly motivated about Refugee Company’s future. The staff waiting our table are beaming from ear to ear and providing excellent customer service despite the busy night. “It is safe space here,” Yara Said turns to me to say. “We are artists, doctors, chefs, plumbers, women, and children. We are family.” n

PHOTOGRAPH COURTESY OF LITTLE FREE LIBRARY

Stanford Social Innovation Review / Spring 2018

! Children review book offerings at a Little Free Library in Mountlake Terrace, Wash., on their way home from school.

Building Community by Sharing Books Little Free Libraries draw neighbors together on street corners, on school campuses, and in police stations. BY COREY BINNS

PHOTOGRAPH COURTESY OF LITTLE FREE LIBRARY

hen families walk into any bustling Los Angeles Police Department station to report a crime, they pass a brightly painted box full of children’s books. Kids poke through the collection and sneak in a fairy tale while their parents speak to officers working the front desk. The books offer a welcome distraction for children and a healthy buffer against further trauma. The precinct libraries are just one arm of the Kids, Community & Cops program run by Todd Bol and his nonprofit, Little Free Library (LFL). Bol’s mom was a schoolteacher and loved putting books into children’s hands. In 2009, Bol built in her honor a box that resembled a miniature schoolhouse out of an old garage door in his Hudson, Wisconsin, front yard. He filled it with books he wanted to share with neighbors and hung a sign: “free books.” A year later, he held a garage sale. But instead of buying his old stuff, people took selfies next to his little library. So he built and gave away 30 more. Today, more than 60,000 Little Free Libraries stand around the world, in all 50 states and in 80 countries. The organization estimates that people share 43.8 million books through LFLs each year and expects the number of libraries to reach 100,000 this year. Most sit in people’s front yards, just like Bol’s first miniature schoolhouse. “The libraries took off because it made local heroes and because it brought people together,” Bol says. “People discover the Little Free Library and it makes neighbors feel good about themselves.” Each little library has a shingle on its tiny door that says,

“Take a book—return a book.” The organization encourages volunteer librarians, called stewards, to pay $40 to register their libraries in the LFL network and to receive an engraved charter sign. Essential to LFL’s philosophy is a lack of rules and restrictions. Stewards can buy or build and decorate their libraries to suit their fancy, they can curate their book collections any way they choose, and they can plug into the larger LFL community online. “It’s everybody’s canvas,” Bol says. “Everybody gets to use it the way they want in every neighborhood.” LFL’s success in inspiring a love of reading and building community has earned it several honors, including the National Book Foundation’s Innovations in Reading Prize, Library Journal’s Movers & Shakers Award, the Library of Congress Literacy

Award, and “Top-Rated Nonprofit” status by GreatNonprofits. “Little Free Library offers an opportunity for students to have greater access to books in their homes and neighborhoods,” says Michael Todd, the national director of marketing and communications for Reading Partners, a national nonprofit that mobilizes community volunteers to work one-on-one with struggling readers. “The more opportunities students have to read and explore books, and the more awareness they have of the importance of literacy, the greater their chances for future success.” BUILDING A NETWORK

Scrolling through photos of Little Free Libraries on Instagram feels like flipping the pages of a magical children’s book. “We love to share photos of unique Little Free Libraries from around the world and showcase the creativity of their stewards, who have made Little Libraries that look like everything from rocket ships and robots to tugboats, Victorian mansions, movie theaters, and more,” says Margret Aldrich, who works on LFL’s media and programming. She retweets and reposts photos that friends and fans share on their personal Twitter and Instagram accounts.

Stanford Social Innovation Review / Spring 2018

COREY BINNS (@coreybinns) is a journalist based in Northern California. She writes about science, health, and social change.

She also shares moving testimonials from individuals who have received no-cost LFLs through the organization’s Impact Library Program. In one post from Columbus, Ohio, Anya Trujillo reported that she hears gunshots at night and finds used shell casings sprinkled on the sidewalk. But she’s noticed a change since LFL donated a nearby book box. She sees neighbors stand around their Little Free Library and chat as they browse through books. “It’s an overall tool bringing the neighborhood together,” she says. Articles about LFL pop up in newspapers and on blogs and radio shows about 40,000 times a year. But the picturesque libraries’ popularity actually may pose a challenge for the organization. “The clear risk of Little Free Library’s approach is that others can adopt the core concept without joining the community, which could over time dilute our strong identity,” says Jeremy Hillman, director of corporate communications for the World Bank Group and a Little Free Library board member. Still, the team chooses not to assert copyright over other, similar grassroots book-sharing communities. “As an organization that is passionate about spreading the values of literacy, community building, and creativity, we welcome this organic growth whilst we balance the need to maintain a viable national, and now global, presence,” Hillman says. To help maintain its brand identity, the LFL team has worked to strengthen the value of membership for stewards who pay to register their libraries with the organization, Hillman says. Little Free Library now hosts book giveaways, free downloads, and other special offers on its private Facebook group, where stewards from all over can connect with each other. “It’s a perk for us to have such an easy communication channel with our stewards, too,” Aldrich says, “as we’re able to bounce ideas off of these folks who are often our most valuable advisors and champions.” Stewards meet others online with whom they would otherwise never cross paths: a lower-income family in Cleveland, a well-off retiree in San Francisco, a school

administrator in New Orleans, a police officer in Minneapolis, a community organizer in Italy. An active member of the Facebook group from Sudan named Malaz recently posted that she is establishing a thousand LFLs in her home country. FROM PRODUCTS TO PARTNERSHIPS

Unlike most nonprofits, LFL runs almost exclusively on earned income. The organization hires woodworkers in Minnesota and Wisconsin to handcraft high-quality, beautiful LFLs. Sales of these libraries, charter signs, and related products account for about 95 percent of annual revenue and fund a $2.6 million operating budget, supporting other LFL initiatives such as the Impact Library Program and Kids, Community & Cops. The organization also receives occasional grants for specific projects. But with a staff of only 11, Bol says he’s struggled to find time to seek out funding and plans to hire consultants to help. Fielding proposals from philanthropists who reach out keeps him busy enough, he says. One grant from the Hudson Hospital Foundation, however, has already helped launch a set of LFLs focused on health literacy in the Hudson, Wisconsin, school system. The partnership with the foundation and the local school district supports a set of physical libraries, a selection of books, and a set of health-focused Action Book Clubs modeled after LFL’s Action Book Club Program, which combines reading with community service. Bol and Aldrich hope that such initiatives will help attract more donors and partners; ultimately, Bol wants 60 percent of the budget to come from earned income and 40 percent from donations. Boosting donations will be important as the nonprofit continues to expand its focus from distributing physical products to building partnerships and community programs, says LFL board member Margaret Bernstein. Many of these partnerships and programs are already showing success. Los Angeles police report that since the launch of the Kids, Community & Cops program,

many children who have visited an LFL in an LAPD station have joined the department’s free Cadet Program and Police Activities League, where officers mentor young people on issues ranging from health to finance to community service. Some parents also now volunteer at the stations. In December, the LAPD and LFL began stocking squad cars with books provided by local nonprofits that cops can give kids while patrolling. “Our goal through youth programs is to expose children to opportunities that they would not have otherwise, based on their circumstances,” says LAPD Sergeant Heidi Stoecklein, who runs the department’s Community Safety Partnership Program in the Newton area. “The Little Free Library shares the same vision, and we are so thankful for their partnership to ensure children have access to books and are building positive relationships with the community and police officers.” Girl Scouts have also teamed up with LFL and built more than 500 Little Libraries in their communities—an activity that now earns scouts a patch. Additionally, about 600 public libraries around the country use LFLs as catalysts for community outreach. In California, the Monterey County Public Library system has set up 29 mini branches in neighborhoods that are far from a public library. Obviously, LFLs cannot offer all the services that public libraries do, but they can complement them, Aldrich says. Now LFL’s executive director, Todd Bol didn’t grow up a reader. He struggled with dyslexia, and spelling bees brought tears to his eyes. When he accepted the Women’s National Book Association Second Century Prize in front of a crowd in New York City last summer, he held up his second-grade report card. He had earned an “E” in spelling, and that E didn’t stand for “excellent.” “I didn’t come out at the end like a star, but I came out pretty well,” he says, laughing. “A Little Free Library can be a spark for a kid, one boy, one girl. We can encourage their parents and their neighborhood, and capture their wisdom and their creativeness. And it enriches all of us.” n

Align Profit + Purpose Technology for your companyâ&#x20AC;&#x2122;s greater purpose

1.800.443.9441 hello.blackbaud.com/CSR

Stanford Social Innovation Review / Spring 2018

AN INSIDE LOOK AT ONE ORGANIZATION

Raising Opioid Addicts from the Dead North Carolina’s Project Lazarus has brought harm-reduction principles to Appalachia. Although its practices saw immediate impact and have saved lives, the opioid crisis continues to claim victims in the region and beyond. BY TANA GANEVA

n a chilly November morning in North Wilkesboro, N.C., a town of 4,266 in the foothills of the Blue Ridge Mountains, I sit with two young women at the town’s opioid-addiction treatment clinic. The previous month, President Donald Trump had declared the opioid crisis a public health emergency, six years after the U.S. Centers for Disease Control and Prevention formally declared an opioid epidemic. Since 1999, more than 200,000 Americans have died from prescription opioid overdoses, leading many in the media to compare the crisis to the height of the AIDS epidemic. The two women, Amanda and Danielle, are meeting with Brooke Stanley, a peer counselor. The pair have been off oxycodone (or “roxies”) for half a year. They live in a two-bedroom apartment with their three kids. Amanda is looking for work, and Danielle takes care of the children. Brooke tells Amanda that she saw a job opening at a diner close to their house and encourages her to apply. Brooke then gently probes them about how they’re doing. “For the first time in my life, I have a spatula and spoons!” exclaims Amanda, a tall, thin blonde with short hair tucked under a black beanie. She slouches in a gray hoodie with “Appalachian” written across the front. “And I didn’t have to scrub any burn marks off any spoons!” interjects Danielle. Being the proud owners of kitchenware without burn marks is not a small victory. Danielle, who describes her childhood as “tough,”

has been shooting up for a decade. “I was raised a Jehovah’s Witness, and right after I got out, I got into drugs,” she says. Half a year into their three-year relationship, Danielle developed an infection from using dirty needles and ended up in the hospital with septic ruptures up and down her arms. When the infection spread, doctors had to cut out a large chunk of her lung. When she woke up, she injected drugs into her IV, which confounded doctors, so she got sent home, where Amanda found her half-dead. “By that point, I weighed less than 100 pounds,” Danielle says. “And we still went back to the drugs, after they took a third of my lung.” Thanks to Stanley’s tireless work, the methadone that Danielle and Amanda get at the clinic, and their own pluck and resolve, they’ve stayed off of black market drugs so far. When Amanda’s ex-boyfriend tried, once again, to get her back by giving her some roxies, Amanda held on to them for a night, not sure whether to take them, tell Danielle, or throw them out. She ended up flushing them down the toilet. Stanley—who herself had struggled with opioid addiction— knows how hard it is to stop using and how far they’ve come. “Now they’re sitting in their beautiful apartment, with their beautiful children,” she says. “When I’d gone to visit them, they’d just finished up making play dough. And so it was just a big difference.” In a place where crime, addiction, and poverty are so intertwined, getting someone on methadone instead of black market pills they might cook down and shoot up is essential. It’s also just the start. Even the everyday activities and luxuries many people take for granted—like, say, having a car to drive to their job—can be out of reach for people who have struggled with addiction for years.

PHOTOGRAPH BY RICHARD LAUTENS VIA GETTY IMAGES

Stanford Social Innovation Review / Spring 2018

PHOTOGRAPH BY RICHARD LAUTENS VIA GETTY IMAGES

! Project Lazarus promotes the distribution of naloxone kits like this one to opioid addicts to prevent overdose deaths.

Stanley works for Project Lazarus, a small, innovative nonprofit devoted to preventing overdose deaths from opioids and helping addicts get their lives back. Since its inception in 2007, the organization has worked with medical professionals, law enforcement, schools, and researchers to achieve the seemingly impossible: bringing harm-reduction policies one might associate with Canada or the Netherlands to a conservative Southern county. While critics question whether such policies exert an immoral influence on the addicted, its leaders claim a deeply moral purpose that is grounded in Christian compassion and ambitious enough to help turn around a national health crisis and save countless lives. COLLABORATING WITH INDUSTRY

“You can’t rehabilitate a dead person,” the organization’s founder and CEO, Fred Wells Brason II, says as we drive through Wilkes County— which, by 2007, had the third-highest per capita overdose death rate among counties in the nation. Brason is a nondenominational

Christian chaplain and a rapid-fire talker with a shock of white hair and bright blue eyes. The organization’s name comes from a story in the Gospel of John, in which Lazarus, one of Jesus’ followers, dies and is raised from the dead by him. But while Jesus’ work was a miracle, Project Lazarus depends on naloxone, a drug that swiftly reverses the deadly effects of an opioid overdose. If administered in time, the drug binds to the same brain receptors engaged by heroin or opioid pain pills. It jolts the user awake, reversing their high and throwing them straight into withdrawal. It’s an unpleasant experience for the user, but it saves lives—if it is administered in time. But not everyone has the steady hand of a trained emergency medical technician. And for a first responder to show up, someone has to witness and correctly identify an opioid overdose, call 911, and wait for an ambulance to come. What if a child finds a parent passed out and is worried about getting him or her in trouble with the cops? The notifier also has to trust police enough that he or she

Stanford Social Innovation Review / Spring 2018

TANA GANEVA (@TanaGaneva) is a reporter and editor covering criminal justice, drugs, and politics. She has written for The Washington Post, Vice, Glamour, Rolling Stone, the Huffington Post, and Gothamist.

doesn’t hesitate to call the authorities for help. What if a fellow addict notices an overdose in progress but is scared that he or she will go to jail or lose access to public housing? “In an opioid emergency … seconds count,” notes a website for Evzio, the producer of an injector for naloxone that is so easy to use, even a child could administer it. The device talks the user through the process. “This trainer … contains no needle ... or drug,” a Siri-like voice says. “If you are ready to use ... pull off the red safety guard. To inject, place black end against outer thigh; then press firmly and hold in place for five seconds,” it instructs. “Five ... four ... three ... two ... one ... injection complete.” The device doesn’t have a visible needle, so it’s less intimidating to non-medical professionals. And in the politically conservative Southern county, the less a program conjures stereotypes about drug use, such as needles for shooting up, the more likely it will go over well with local lawmakers and authorities. Project Lazarus’ primary goal is to save the lives of opioid users, with no moral judgments about addiction and what it might drive people to do. One of the organization’s most important, and controversial, projects in their fight to curb overdose deaths in the county has been to make naloxone as widely available as possible. In 2007, Brason and others testified to the North Carolina Medical Board on the lifesaving powers of naloxone. As Brason recalls, board members admitted to being skeptical at first. They quickly changed their minds after seeing the presentation and issued an official statement of support. “The prevention of drug overdoses is consistent with the board’s statutory mission to protect the people of North Carolina,” it said. “The board therefore encourages its licensees to cooperate with programs like Project Lazarus in their efforts to make naloxone available to persons at risk of suffering opioid drug overdose.” To realize that vision, Project Lazarus has even partnered with Purdue Pharma—the company that, thanks to its development and marketing of OxyContin, is widely blamed for fueling the opioid epidemic—to provide naloxone to the county’s opioid treatment program, which Project Lazarus helped found, free of charge to patients. The organization has also received grants from drugmakers Zogenix and Kaleo, and Ameritox, a drug-testing company, has also contributed, the Washington Examiner has reported. It’s no secret that corporations use philanthropy to whitewash past (and present) sins. Is a Faustian bargain worth it if it saves lives? “We certainly have taken the hits and criticism for such engagement, which keeps us guarded to ensure any relationship is [of] the utmost integrity,” Brason says. “I am a patient advocate, so to ensure all hands on deck to address the entire issue, everyone needs to be at the table,” he says. “In that light, we engaged industry with ‘no strings attached’ and them knowing full well the expectation to reduce opioid prescribing and engage more of the modalities for pain treatment that could be utilized.” Ultimately, Brason notes, his personality is more suited to diplomacy than confrontation, an approach that shapes the work of the

organization. “As long as we see mutual collaboration at the table within industry—seeking only patient care, treatment, safety, and being responsible—we feel comfortable continuing,” he says. “Industry is not going away, so let’s build the right relationships with mutual goals.” DEATHS OF DESPAIR

Wilkes County so perfectly embodies the blight of rural America that it has become a prime destination for reporters looking for insight into Appalachian decay. A 2016 New York Times article, set almost entirely in a vape shop, rankled locals who pointed out that the reporter ignored people such as the hard-working staff of Project Lazarus, devoted to bettering people’s lives. In 2016, PBS also went to Wilkes County to ask, “What do people living in poverty want the presidential candidates to know?” It’s not hard to see why reporters go there to document American decline. The widely reported 2015 study by economists Anne Case and Angus Deaton, “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century,” which found that white rural Americans were dying at record rates from “deaths of despair” such as by suicide, drug overdoses, and alcohol poisoning, could have been set in Wilkes County. In 2015, thanks to lowered life expectancy, it ranked in the bottom third in North Carolina for health outcomes, in a state ranked in the bottom third nationwide. Driving through the forested hills, you catch glimpses of trailer parks, isolated family grave plots, and churches. There are billboards advertising exotic travel and nice jewelry, but those luxuries are more aspirational than realistic for many of the county’s residents. Almost half of Wilkes’ households make less than $30,000 annually, according to a report by the North Carolina Poverty Research Fund. Close to a quarter of Wilkes County residents live below the federal poverty level, $12,060 for individuals and $16,240 for a family of two. A sign on the side of the road pointing the way to the Tyson chicken-processing plant reflects the true reality. Tyson is the county’s largest employer and one of the few that haven’t gone out of business or left the region. Pulling the bones from raw chicken all day is taxing work, but for many people there aren’t alternatives. Wilkes County has seen a steep decline in a short time. For much of the 20th century, it boasted thriving textile and furniture industries. Lowe’s Companies home improvement and Lowe’s Foods started in the county, and there are retired older people who live in big houses thanks to the kind of salary people used to make working in corporate for Lowe’s. Much of the manufacturing disappeared in the 1990s. Lowe’s Companies transferred its headquarters to a suburb of Charlotte in 2003. “In quick succession, a seismic shift occurred in the county, shrinking its economic base to a fraction of what it had long been,” write Gene Nichol and Heather Hunt in “Mountain Poverty and Resilience,” a report published in 2017 by the North Carolina Poverty Research Fund, focused on Wilkes County. “Then the great

PHOTOGRAPH COURTESY OF PIEDMONT COMMUNITY SERVICES

Stanford Social Innovation Review / Spring 2018

! Project Lazarus founder and CEO Fred Wells Brason II leads a seminar on his organization’s model at the New College Institute in Martinsville, Va., on March 9, 2016.

determinants that drive substance use, because there’s no other way to cope,” Brason says. “That’s some people’s source of income here,” Greta Ferguson, a Wilkes County anti-poverty advocate, says about selling pills. “They can go to the pain clinic, get them to trade them off for other people’s food stamps.” According to the sheriff’s office, pills used to go for $1 a milligram. Now it’s $2. That can add up to a lot for people struggling economically, further fueling the market in opioids.

PHOTOGRAPH COURTESY OF PIEDMONT COMMUNITY SERVICES

MISSIONARY ZEAL

recession hit,” they write. Median income in Wilkes dropped from $47,992 in 2000 to $33,398 in 2014, a 30 percent decline, according to a report by the Pew Charitable Trust, making Wilkes second in the country for most dramatic income loss. This was yet another reason for the thriving black market in pain pills. “It’s not surprising our problem is with pain pills,” Brason observes. “They cure pain.” Brason caught the first glimpses of the opioid crisis in 2004. He was working as a chaplain in hospice care when he noticed that his patients’ pain pills seemed to be disappearing. As a chaplain who’d comforted dying people for years, he was trusted in the community. So he set about trying to find out what was going on. One terminally ill woman confided that she was funneling her meds to her grandkids so they could sell them to make much-needed money. Many of Brason’s patients said that family members stole their pills, to take or peddle. Opioid painkillers were in such high demand that one dying man was scared to fill his prescription because he thought people would break into his house to steal them. Over the next few years, Wilkes County’s opioid problem exploded, a harbinger of a national crisis. By 2009, people in Wilkes were dying from overdoses at four times the state average. “When a community is that hard hit—hopelessness, depression, [a lack of] viable opportunities for work—we just have a lot of social

Project Lazarus’ offices are attached to Brason’s house. The group has only seven employees. It’s the kind of energetic organization where everyone does a little bit of everything. Program director Donna Parks Hill, for example, recently got certified to teach about addiction in Wilkes County schools. The morning I visited, she was also fielding phone calls from child protective services about a client. “We work closely with the [North Carolina] Department of Social Services, Wilkes County Children’s Services, SAFE [a shelter for victims of domestic and sexual violence], both housing authorities, and many more,” she says. Project Lazarus’ work is supported by a wide array of partnerships and sources. They’ve received grants from the federal government, state agencies, and private foundations. They also rely on individual donations and contributions from people and businesses in the community. “The philosophy has always been to bring everyone to the table, as all need to be part of the solution,” Brason says. The organization has partnered with the Mountain Area Health Education Center (mahec), recipients of federal funding through the US Centers for Medicare & Medicaid Services. They’ve worked with Community Care of North Carolina (ccnc), a nonprofit that seeks to improve health care in the state—they, in turn, are partly funded by the Kate B. Reynolds Charitable Trust. The funding that Project Lazarus gets from ccnc is matched by the North Carolina Office of Rural Health, a state agency. Brason was also a 2012 recipient of a $105,000 grant from the Robert Wood Johnson Foundation. Tax filings for Project Lazarus in 2016 show that they received $432,258 in contributions and grants, up from $376,291 the prior year. In a region buffeted by economic crisis and high rates of mental

Stanford Social Innovation Review / Spring 2018

illness, Brason and the rest of the Project Lazarus staff have their work cut out for them. Brason seems up to the task. He has devoted much of his life to missionary work, including stints at orphanages in Mexico. He helped build a high school on an island in Belize. He and his wife, Karen, spent five years in the late 1990s in Northern Ireland. So he accepts a very low ratio of hand wringing to problem solving in any given crisis. “You get one meeting to complain about a problem,” he says. “Then every meeting after that should be about solutions.” When Brason first realized the severity of the opioid epidemic in Wilkes County, he looked around to see what treatment was available. There wasn’t any. So in 2009, he collaborated with Mountain Health Solutions, an Asheville-based opioid treatment program, to bring a medication-assisted treatment (MAT) clinic to Wilkes. Today, more than 600 people circulate through the North Wilkesboro Comprehensive Treatment Center, which now dispenses methadone or Subutex, a brand of buprenorphine, depending on patient need. Methadone, an opioid, prevents the symptoms of withdrawal, and with far more muted effects of a high—it’s harder to fatally overdose on methadone alone. Yet, in a twist that aptly illustrates the complexity of the opioid crisis, if a person taking methadone suffers a relapse, he is more likely to overdose if he piles on other opioids. This is one of the many reasons why Project Lazarus continues to promote wide distribution of naloxone, the drug that revives a person having an opioid overdose. Subutex is a partial opioid antagonist—it blocks opioids by attaching to the same receptors without activating them. It prevents withdrawal symptoms and reduces cravings for opioids like black-market painkillers or heroin. At 7:30 on a Wednesday morning, most of the 50 seats in the treatment center’s waiting area are filled, in some cases by multiple generations of the same family. There’s a semi-messy children’s play area in one corner, outfitted with Legos and brightly colored chairs. Clinic director MeLane Childress Barber underscores how much the once-controversial facility has gained acceptance in the community, thanks to the work of Project Lazarus. “The other day, a church asked me about the best time to come bring biscuits to people waiting to get treatment,” Barber says. Cops used to stalk clients at the clinic for easy arrests, but after a few toured the facility and learned more about the work done there, they seemed more openminded, Barber says. Probation officers, tired of having people on their rolls die from overdoses, are starting to come around as well. Barber describes her job as emotionally draining but “never boring.” And seeing results day in and day out has made her a firm believer in harm-reduction principles, which support the provision of resources to ongoing addicts, such as medication and clean needles, with the goal of treating them and minimizing the harm their addiction may cause. “A harm-reduction approach focuses on strategies that have proven effective at reducing overdose and other harms that can flow from drug use, as well as harms that flow from ineffective drug policies themselves, such as mass criminalization,”

says Maria McFarland Sánchez-Moreno, executive director of the advocacy group Drug Policy Alliance. “We are in a period where we’ve got to embrace harm reduction,” Barber says. “When people say, well, you’re trading one drug for another … or, well, even if you’ve got somebody who’s not doing well. ... Are they using less? That’s harm reduction. But we tend to think about this differently than a lot of people in town.” The clinic’s doctor, Jana Burson, started out as a harm-reduction skeptic. “I was tricked!” the petite brunette half-jokes, recalling that she got into addiction treatment covering for a doctor at a methadone clinic when he went on vacation. “I would tell the patients stupid things, like, why are you on this? When will you get off it?” she says. “Then I saw the changes that happened in these patients, and I thought, there’s something to this. You see someone on their first day, they look like they’d been drug through a hedge backwards,” she says. “Then you see them get a little bit of color in their face. Then they say, I found a job. Another month and they buy a new truck. I never saw those changes in primary care. I never saw diabetics get better; I never saw my hypertensives get better. But here, people actually improve,” she says. Project Lazarus staffers also work closely with the clinic to help people struggling with opioids to get their lives together. That might include anything from securing custody of their kids to providing them with a gas card so they can drive to get treatment. Staffers set up pill drop-off at the sheriff’s office, so that people can dispose of their pain meds safely. And they train doctors in safe prescription practices. That’s crucial, because there are people who need pain meds and aren’t prone to addiction, and they shouldn’t be denied pain relief because of doctors’ concerns about fueling the opioid crisis. Once you make sure that someone is alive and on the road to better health, you figure out what the person needs and work to help him or her get it. The group’s philosophy is simple and drawn from Brason’s work as a chaplain. “If people are hungry, you feed them. If they need clothes, you clothe them,” Brason says. “If they’re addicted, you help them.” THE MODEL

Although Project Lazarus was born in Wilkes County, its model for addressing the opioid crisis is designed to be more widely applicable. The ethos of the organization is that all communities have unique resources that can be marshaled to bring evidence-based solutions to address the opioid crisis—and unique challenges. With the help of the Office of Rural Health, ccnc, and the Kate B. Reynolds Charitable Trust, the model has been applied in communities across North Carolina as different as a Cherokee Nation reservation and a military base. The Pennsylvania State Legislature recently passed a bill establishing a Project Lazarus commission to develop better community-based efforts to prevent overdoses. Project Lazarus conceives of its model as a wheel with a hub of three essential principles: public awareness, coalition action, and

Stanford Social Innovation Review / Spring 2018

data and evaluation. To raise public awareness, the organization’s members work to challenge unhelpful assumptions about opioid addiction. Then they try to inform and inspire different institutions to fulfill their unique roles in finding solutions to the crisis. “What I learned early on was that if the individual or group I was speaking with did not know, or see, how they were part of the problem and could be part of a solution, they were less apt to be engaged,” Brason notes. So the organization emphasizes communicating the following: “Why am I needed? What do I need to know, and what needs to be done?” That could mean anything from a presentation on how to use naloxone to residents of Wilkes County’s small public housing complex, to talking to church groups about how they can support members suffering from addiction, to holding presentations to groups of doctors about how to treat their patients safely. Project Lazarus saw early success in training medical providers in Wilkes on safer prescribing practices. Using the Project Lazarus Medical Care Provider Toolkit—developed in conjunction with Northwest Community Care Network—they helped medical providers in Wilkes learn how to manage patients’ pain without facilitating addiction. By 2011, the overdose death rate in the county had dropped by 69 percent; and notably, none of the dead that year had gotten their prescriptions in Wilkes. Educating the public about opioids is no easy task, given the misinformation that continues to swirl in the media. One of Brason’s biggest pet peeves is headlines that talk about “addicted babies.” “Babies can’t be born addicted,” he fumes. While babies can suffer withdrawal symptoms from being exposed to opioids in utero, addiction requires deliberate use despite the harms. Recently, there’d been rumors floating around, fueled by national media and politicians, about naloxone parties (or, in North Carolina, “Project Lazarus parties”). That’s when addicts allegedly get as high as possible, then revive themselves with naloxone. Brason points out how absurd this is. “Let’s say you’ve spent your last dollar on drugs to get high. The last thing you want to do is go into instant naloxone withdrawal,” he says. “Our focus groups with users clearly indicate no such desire or practice for such a party.” The second core value in the hub is coalition action. First, highlevel stakeholders in a community must get on board with solving the crisis. “The fundamental point is to get the decision makers from the key sectors involved,” the Project Lazarus website explains. They should hold a forum “designed to share information with the broader community about the issues of prescription medication misuse, diversion, and overdose.” That should be followed by the formation of a steering committee or “a group of liaisons delegated from each sector along with the most active community representatives.” That’s followed by a working coalition. After that comes a community plan of action. “Establishing a community plan generally happens through a series of workshops. Workshops begin by having coalition members divide into groups by sector—such as clinical care, public health, law enforcement, schools, faith community,

general public, and local government—with at least one member of the steering committee in each group.” It sounds complicated, but it’s not. “It’s door-to-door grassroots,” Brason says. “Going where people were already meeting as they normally would and drawing them into coalition membership and participation.” Each community might have different resources to tap into in order to build useful coalitions. That brings us to the third principle, data and evaluation. In his quest to persuade authorities in Wilkes County and across North Carolina to embrace harm reduction, Brason says, he’s developed a great relationship with numbers. “You learn to love data, because that’s what convinces people,” he says. Project Lazarus guides adherents on how to collect data and gauge the success or failure of different strategies. Radiating out from Project Lazarus’ core hub are seven spokes that might take different forms, based on community need. These are: community education, provider education, hospital emergency department policies, diversion control, pain-patient support, harm reduction, and addiction treatment. It might seem strange that harm reduction is a spoke rather than an integral part of the core hub, given that so many of the strategies the group pursues are informed by harm reduction. But harm reduction can emerge only from the community’s prior commitment and understanding. “Ten years ago, the understanding of harm reduction, especially in rural areas, was not known or even understood,” Brason says. “Obviously, Project Lazarus desires to reduce harm, as evident in every spoke,” he continues. “The spoke started out just to be naloxone, and I changed it to harm reduction to allow for the eventual addressing of all harm reduction modalities: naloxone, syringe exchange, safe injection sites, etc.” This is “revealing the changing landscape of the issue—all aspects are continually in development in order to meet changing needs.” In Wilkes County, the main problem has historically been with pain medications such as oxycodone. The county’s geographic isolation has prevented heroin and fentanyl from polluting the black market in drugs—so far. So in Wilkes, it makes sense to emphasize diversion control, which involves educating the public about how to safely dispose of their pain meds, so that the drugs don’t end up on the black market. The Project Lazarus mantra regarding pills is, “Take Correctly, Store Securely, Dispose Properly, Never Share.” They’ve promoted these core concepts through a community tool kit (funded in part by Purdue Pharma and in part by the Mountain Area Health Education Center). The tool kit is designed to be shared as widely as possible: in town hall meetings; by way of specialized task forces; in public information campaigns on billboards, the radio, and television; and in presentations at colleges, community forums, churches, and schools. The campaign is a good example of the positive relationship that can be created between public information and coalition building. In 2013, the message to dispose of pills safely was bolstered when two

Stanford Social Innovation Review / Spring 2018

secure drop boxes came to Wilkes: one in the Wilkes County Sheriff’s office and another in the North Wilkesboro Police department. The photo from the opening shows a group of Wilkes County stakeholders beaming, including Brason; Linda Creek, chairperson for Crime Stoppers; J.L. Chappel, a probation officer; and Sheriff Chris Shew. While diversion works in a rural area, it might not make sense as a priority in an urban area that’s already been overrun by heroin and fentanyl. Yet, in both contexts, arming as many people as possible with naloxone should still be a priority, since the drug can save the life of a pill addict and a heroin user. If heroin spiked with fentanyl makes inroads in Wilkes, as it has in parts of the country closer to drug smuggling routes, ensuring that potential users and their family members have naloxone on hand should save lives. It all comes back to the nonprofit’s primary goal: to lower the rate of preventable deaths caused by opioid addiction, whether that’s through giving out naloxone, educating doctors on safe prescription practices, getting someone to the Wilkesboro treatment center, or figuring out how they can cope with the stressors that might drive them to drug use in the first place. “Everybody dies, but there are good ways and bad ways to die,” Brason says, recalling his time working as a chaplain in hospice care. “You can die well.” When he counsels older people and their families, it’s a whole different process than when a young person drops dead from drug use. “Most older people don’t regret what they did. They usually want to restore their relationships with their families. Through death, we restored a lot of families,” he says. “But when a 22-year-old overdoses and dies, the family is devastated. It’s a totally different grieving process.” It’s not always easy to work with people affected by addiction, but Brason doesn’t expect human beings to be perfect. “You have

to meet people in their present condition,” he says. “Not where you wish they were.” THE SHERIFF’S OFFICE

Meeting people in their present condition has proved to be difficult. Lawmakers, police, and service providers have resisted harmreduction policies, such as MAT, because they violate intuitive norms about addiction and personal responsibility. “Critically, harm reduction does not insist upon complete abstinence, but rather accepts that in any society, some people are going to use drugs, and instead tries to reduce associated harms,” says Drug Policy Alliance’s Sánchez-Moreno. “For some people, who have been taught that the goal of drug policies should be complete abstinence, it can be hard to accept the basic premise of harm reduction: that some level of drug use is going to happen in society, and so we should try to reduce the harms associated with it.” Let’s take needle exchanges. The best way to help addicts who are not ready to quit may be to give them a clean needle. That might seem like enabling bad behavior. But if they have clean needles, they are less likely to get sepsis and die. It also prevents the transmission of HIV and hepatitis. Parents can then worry less about dirty needles discarded in parks, and law enforcement can rest a little easier about getting pricked by a dirty needle. Studies have consistently shown that injection drug users are even more likely to end up in treatment if they have access to a needle exchange program, because they are more likely to encounter social workers and other professionals who can help them. A 2000 study in Seattle found that injection drug users were five times more likely to enter methadone treatment if they participated in a needle exchange.

PHOTOGRAPH COURTESY OF CORKY ELLIS (CORKYELLIS.COM)

Stanford Social Innovation Review / Spring 2018

PHOTOGRAPH BY CARLYLE ELLIS COURTESY OF PROJECT LAZARUS

% People remember those lost locally to addiction at the Jimi-Jon Jam II concert hosted by Project Lazarus in North Wilkesboro, N.C., on September 30, 2017.

Needle exchanges are now legal in North Carolina. But Wilkes County currently doesn’t have one because they remain controversial. Change happens slowly. Tessie Castillo, a North Carolina Harm Reduction Coalition staffer based in Raleigh, says that even though the state as a whole is starting to embrace harm reduction, momentum is stalled by the institutional prerogatives of the criminal justice and medical systems. “In North Carolina and the United States, we still treat addiction as a criminal justice issue and not a health issue,” she says. “We’re still spending a lot of money on law enforcement, exacerbating the problem. People are embracing the language of public health, but the wheels are turning very slowly. The criminal justice system and the medical system are behemoths and entrenched in the way they’ve been for a long time. Diverting funds from one area to another is extremely difficult.” Yet Brason, who has excellent relationships with key stakeholders in the community, has slowly won over law enforcement to some facets of harm reduction. The Wilkes County Sheriff’s office is well versed in the deaths of despair documented by the 2015 Deaton-Case study. Almost every single day, someone calls in threatening suicide. “We had one yesterday, the day before, the day before that, I don’t know how many days in a row,” Sheriff Shew says. Shew also blames rampant crime on addiction rates. “The domestic violence, the assaults … if it wasn’t for them, our crime rate would be really, really low.” He also doesn’t bother hiding his unhappiness about the pointlessness of arresting and releasing the same addicts and dealers over and over. The deputy sheriff adds that the black market in pills is linked to the county’s economic woes. “When you got elderly folks that are selling their pills to make a few dollars…” Prior to becoming sheriff, Shew worked narcotics for decades and put many dealers behind bars. “But, there was always someone to take their place,” he says. “We can’t arrest our way out of this.” But even as law enforcement is starting to acknowledge the limits of treating addiction with incarceration, the Wilkes County jail remains filled with addicts. “Sometimes we can’t even get in touch with our clients,” Brason says as we drive past the jail, a low-slung building with a razor-wired outdoors. That’s a very big problem, especially since if people haven’t been doing drugs in jail, they’re much more likely to overdose and die when they get out. A study conducted in Washington state found that people released from prison are 13 times more likely to overdose than the general population in the two weeks after release. Shew’s bottom line is that his job is to enforce the law. Police aren’t social workers. Still, his work means that he encounters addicted people almost daily, and he doesn’t understand what motivates them. “I’ve spent countless hours talking to these people trying to figure it out,” he says. He describes a young woman who went to jail for breaking into a house to feed her habit. Her friend had just died. “She was shooting up, she got sepsis, and it killed her,” he says. The woman didn’t seem perturbed by her friend’s death. She told the sheriff that she had to do drugs or she’d get sick.

“She got to where she didn’t want to talk anymore, and I said, ‘You just don’t care if you live or die, do you?’” says Shew. “She perked up and looked at me and said, ‘No, I really don’t.’” She was in her early 20s. WILKES RELAPSES

Despite such struggles, the solutions that Project Lazarus has brought to Wilkes County have arguably saved many lives. But the crisis persists. In fact, overdose deaths have climbed since the county’s banner success in 2011, and addicts are still dying in stark numbers. The data for opioid overdose deaths in Wilkes compared with the rest of the state demonstrates its success as well as the depth of the problem. In 2006, 26.7 percent of deaths in Wilkes County were from opioid-related accidental poisonings, including prescription pills, heroin, and fentanyl, according to the North Carolina medical examiner’s office. That’s as compared with 7.7 percent in the entire state. Between 2006 and 2016, opioid deaths in Wilkes fluctuated, even as deaths in the state ticked up consistently. For example, opioid fatalities in Wilkes jumped to 30.5 percent of total deaths in 2008 and 37.6 percent in 2009. In 2011, four years after Project Lazarus was founded, they dropped to 11 percent. The drop is likely due to Project Lazarus’ early success in training county medical providers in appropriate prescribing practices. That year, none of the people who died from a fatal opioid overdose had gotten their prescription from a medical care provider in Wilkes. Yet, that drop wasn’t permanent. Over the next two years, opioid fatalities in the county stubbornly crept back to around 20 percent and thereafter settled into the 30 percent range. Despite the group’s hard work, Wilkes County has consistently shown higher death rates than the rest of the state, which speaks to the complexity of addiction in the county. There is also the question of what part of Project Lazarus’ model was responsible for the dip in overdose deaths. Nabarun Dasgupta, an epidemiologist at the University of North Carolina at Chapel Hill who consulted with Project Lazarus, completed a study of its approach. He found that medical care provider education helped reduce mortality. Dasgupta and Brason blame the arrival of heroin for the uptick, although the evidence for this is anecdotal. But both men insist that Project Lazarus’ work is still making a big difference. Without the interventions orchestrated by Project Lazarus, the death toll in Wilkes might be much higher, had it continued on the same trajectory. Asked if the death toll in Wilkes would have been higher without the interventions of Project Lazarus, Dasgupta said, “Easy, the answer is yes.” “This further validates the necessary interventions and preventions pertaining to the demand side of substance use,” Brason says. “Wilkes has for many years now eradicated most of direct local access to prescription medications which changed the supply side. Unfortunately, the demand in Wilkes and other communities is due to the social determinant factors, such as environment, culture, poverty, trauma, and abuse. I shudder to think where we would be locally if the 600 people were not in direct opioid-addiction treatment.” n

Stanford Social Innovation Review / Spring 2018

Conventional wisdom suggests that a ‘clean break’ is the best way to transition a founder. But many

, nonprofits actually benefit when they carefully plan an extended role for founders who step down.

Making Founder Successions Work BY JARI TUOMALA, DONALD YEH & KATIE SMITH MILWAY

E Illustration by JESSICA FO RTNER

very year, thousands of nonprofit boards face the daunting task of hiring a successor to replace the seemingly irreplaceable: the long-serving, beloved founder. The transition is fraught with anxiety and attracts standard advice about how to cope. “Make a clean break” goes the warning. “Founders and successors are managerial oil and water. They just don’t mix.” In the world of corporate startups, four out of five founders are forced out by their boards.1 And search-firm executives cite how rarely CEO successors call on former bosses.2 Although some social sector research supports keeping founders involved, clean breaks tend to be the rule.3 Yet, is a clean break really the best way to ensure a successful founder succession? Our research at The Bridgespan Group has found that the answer is often no. To a surprising extent, transitions that extend the role of a nonprofit founder yield the best results. In fact, nearly half of all founders who step down continue to bring their knowledge, relationships, and passion to bear for the organizations they started. We conducted an in-depth, quantitative study of nonprofit founder transitions drawing on GuideStar’s IRS Form 990 database. A random sample of 2,000 organizations yielded 106 cases of founders transitioning. In addition, we joined with BoardSource and GuideStar to survey board members and nonprofit leaders, which resulted in 538 responses and 202 organizations that had experienced a founder tran-

Stanford Social Innovation Review / Spring 2018

sition. To get firsthand accounts of how founder transitions actually unfolded, we interviewed 49 individuals at 31 organizations about their experiences, including trios of founders, successors, and board chairs at organizations whose experience felt particularly instructive. The results offered three valuable lessons. First, far more nonprofit boards work out a continuing role for founders (45 percent) than pursue an amicable clean break (31 percent). Moreover, among organizations where founders stayed, most reported that founders made positive contributions, and 75 percent thought the benefits of a continuing founder role justified the complexity. Nearly half of the organizations where the founder did not stay said the transition would have gone better had the founder played a role. Second, transitions that paired a founder in a continuing role with a successor from inside the organization proved to be the most successful of all transition models we examined, based on revenue growth through the transition, retention of the successor, and self-reported performance. (See “When the Founder Stays On” below.) Examples from organizations large and small show the power of this model. What’s more, the same lesson holds true for non-founder long-term CEOs when they step aside: When they play an extended role post-transition, their organizations do better. (See “When the Long-Term CEO Stays On” on page 29.) Third, transition work is not easy; it requires preparation. The board needs to help the founder to define an appropriate role in support of the successor and the mission. It also must shepherd the process, anticipating bumps and developing processes to mitigate them. We identified several functions where founders were able to contribute after their tenure, feel satisfied, and deliver value to the organization. These included fundraising, ambassadorial visits, advocacy, and mentoring the successor.

JARI TUOMALA is a partner in The Bridgespan Group’s New York City office.

KATIE SMITH MILWAY is a senior advisor to The Bridgespan Group and former head of its knowledge practice.

DONALD YEH is a manager in The Bridgespan Group’s New York City office. The authors thank colleagues Neha Kukreja and Roger Thompson for their contributions.

Our research indicates that an extended founder role, when done right, can be the best path to maintain funder, board, and staff loyalty, while allowing the new leader to benefit from the founder’s capabilities and knowledge. Everyone wins, including the organizations and, most important, their beneficiaries. THE ‘CLEAN BREAK’ MYTH

With so much at stake, we set out to better understand the types of transitions, their frequency, and the factors influencing success or failure. Our research identified four types of founder transitions. We found that three out of four involve an amicable decision for the founder to either walk away or stay and work with the successor in an extended, but different, role. (See “Four Types of Founder Transitions” on page 30.) Involuntary (founder is forced out or fired) accounted for 24 percent; amicable clean breaks (founder retires fully or moves to another opportunity), 31 percent; amicable transitions with significant founder roles (founder stays on in staff or board role), 23 percent; and amicable transitions with light founder roles (founder stays on in a consultant, advisor, or interim role), 22 percent. Transitions where the board ousts a founder are least likely to succeed. However, our interviews revealed that the board often waited until the situation was critical to step in. One founder was “so crispy fried that she was barely functional,” recalls the successor. Inaction led to significant staff discord and souring relations with the board. Awkwardness, even painfulness, is inevitable in such departures. But early intervention Organizations where the founder stays on to help an internal successor have a has benefits all around. The board can higher probability of success than all other founder transitions. preempt organizational atrophy, pave Percentage of organizations with Percentage of organizations Percentage of organizations the way for a successor’s strong start, revenue growth above control group reporting successful transitions with successor tenure more than three years and provide the founder a graceful exit. 100% (See “Seven Signs That the Founder Has Stayed Too Long” on page 31.) 88% The clean break appeals to successors 80 who prefer to start with clear authority. This fresh-start approach also provides 73% 69% boards with the broadest pool of candi60 65% dates. For founders, the clean break can be attractive for personal reasons: Older leaders may be ready for full retirement, 47% 40 younger leaders may feel burned out and 39% ready for change, and others may simply have an entrepreneurial urge to do 20 something different. For every two amicable clean breaks, there are three transitions where found0 ers extend their roles. Sometimes foundFounder stays on with internal successor All other transitions ers want to stay for the wrong reasons: Source: Form 990 sample, Bridgespan / BoardSource / GuideStar survey They don’t know what to do next, they

When the Founder Stays On

Stanford Social Innovation Review / Spring 2018

haven’t planned for their retirement, their identity is with the organization, or they don’t think the organization can Organizations with non-founder long-term CEOs have a higher probability of success survive without them.4 Even when foundwith transitions when the CEO stays on post-transition. ers want to stay for the right reasons, the Percentage of organizations with Percentage of organizations Percentage of organizations journey can be complex. Boards rightly revenue growth above control group reporting successful transitions with successor tenure more than worry about the real and perceived conthree years 100% fusion around roles and responsibilities that an extended stay may create. Hence, the care and caution that needs to accom87% 80 pany any such undertaking. 80% From our extensive interviews, we distilled four conditions to guide an orga67% 60 64% nization that is considering an extended founder role: First, the founder has the capability and desire to stay engaged. Sec40 ond, the board perceives clear value from 39% the founder staying involved. Third, the founder is willing to play a different role 20 24% and genuinely wants the successor to succeed. And fourth, the successor is willing to work with the founder. All require both 0 founder and successor to sublimate ego. Exiting CEO stays on CEO does not stay on Consider the founder of Communities Source: Form 990 sample, Bridgespan / BoardSource / GuideStar survey In Schools (CIS), Bill Milliken, a visionary who pioneered the coordinated delivery of community services in schools in order to catch and support students in ENGINEERING A SUCCESSFUL TRANSITION danger of dropping out. After almost 25 years, the organization’s severe Our data clearly show the potential value of extending a founder’s stay. But what exactly did organizations do to make such a relationgrowing pains convinced the board and Milliken that CIS needed a “setship work? We turned to our survey and interviews for answers. tler” to follow their “pioneer.” Because Milliken remained committed Many interviewees mentioned a cluster of traditional practices to the mission and to fundraising for it, the board persuaded him (with on managing leadership transitions. These guidelines included the some outside counseling and a couple of false starts) to move up to a board role and stay involved in fundraising and advocacy. following: Start early because successful transitions often take sevThis cleared the way for his executive vice president of field opereral years to plan, invest in developing internal successors, establish ations, Dan Cardinali, to take the reins, restructure the organization, frequent interaction between the successor and board chair, and and refresh its strategy. It worked, Milliken says, because “Dan could encourage active participation by the board throughout the process.5 keep his ego [in check] and help me keep [mine] from getting out of In addition, we surfaced five recommendations that more directly place.” He added that their talents complemented each other: With address the practical aspects of managing an ongoing role for a Milliken anchoring the heart and soul of the movement, Cardinali founder. While our data show that transitions with an internal became the data-driven mind that created a winning strategy in a successor and a role for the founder tend to be the most successcrowded youth-development market. “By partnering with Bill and ful, the practices apply to any organization that seeks to extend leveraging his moral authority to validate the organizational change the founder’s stay. strategy, we had an amazing opportunity to drive change,” says CarFirst, limit the founder’s new role to specific areas of high interest dinali, who is now president of Independent Sector. and capability. Founders have a choice among a number of extended Indeed, a board will want to assess the founder’s and succesroles. Some are well-focused assignments with timetables and clear sor’s ability to work together. With internal successors, the reladeliverables, such as starting a new program. Others tap the foundtionship is typically well established. At Family Promise, launched er’s capabilities, such as fundraising or serving as an ambassador to in 1988 to provide shelter, meals, and assistance to help homeless affiliates. (See “Founder’s Post-Transition Role” on page 32.) But and low-income families back to independent living, founder Karen whatever the role, it’s important for the founder, the board, and the Olson worked with Claas Ehlers, the director of affiliate services, successor to set clear expectations. At the Toronto-based NGO Right To Play, founder Johann Koss for 12 years before urging the board to appoint him as her successor in 2014. With external successors, the board needs to make clear and incoming successor Kevin Frey took this advice to heart. Over 15 during the search process that the founder intends to stay on in a years, Koss, a four-time Norwegian Olympic gold medalist in speed specific capacity, contingent upon the rapport that the founder and skating, built Right To Play into a $54 million global organization that trains teachers and coaches in a child-centered, play-based successor establish during the vetting process. Whatever the founder’s role, final approval needs to rest with the successor. approach to learning. Today, it operates in 18 countries and reaches

When the Long-Term CEO Stays On

Stanford Social Innovation Review / Spring 2018

1.9 million children around the world. To sustain such a far-flung organization, Koss traveled up to 300 days a year, an exhausting schedule that took its toll. He wanted to step back from day-to-day operations but stay involved. Board Chair Rob MacLellan decided to consult a corporate transition expert. “You’re doomed to failure because you’re not making a hard transition between founder and CEO,” the expert said. Koss and Frey moved forward anyway but took the precaution of working with third-party advisors to write up an agreement. Dubbed the “Magna Carta,” it stipulated who did what during a twoyear transition that began in August 2015. The agreement gave Frey authority to manage the staff, while Koss maintained relationships with funders and influential partners and played a role in strategic planning. These tasks were well suited to Koss’s new position as a board member. Frey also made it clear that he valued Koss’s continued commitment and was eager to work with him. “I can’t do this by myself,” he told Koss. In the end, the expert’s dire warnings motivated Koss, Frey, MacLellan, and the rest of the board to rally around a common goal: making the transition work. Founders who transition to board positions are most successful when focused on core board functions, such as fundraising and setting organizational strategy. In our research, the value of founders in program-related roles, or in mentoring their successor, proves significantly lower when they serve as board members. Wendy Kopp, founder of Teach For America (TFA), relates a cautionary tale. When she left to head up the international organization Teach For All, she also took on the role of TFA’s board chair. Ostensibly, this would allow her to mentor her internal co-successors and evolve the board from an unwieldy 38 members to a more strategic governing body. But the structure proved wrong. “I shouldn’t have been the board chair, because I couldn’t do what needed to be done,” Kopp says. “They needed a chair who could assert themselves … but when I asserted myself, I ran the risk of being perceived as the overbearing founder who was overshadowing the CEO.” The position also made Kopp effectively her successors’ boss and made it more challenging for her to play the role she felt was most valuable: mentoring the incoming leaders. Second, engage in regular coaching to help navigate the operational and emotional aspects of transition. The journey from founder to a redefined supporting role can be fraught with tricky decisions and separation anxiety. Research has shown that a coach can increase the chances for transition success.6 At Right To Play, the board hired a coach to meet with the founder and successor both separately and together over a six-month transition period. The coach focused on how to help smooth the transition process without taking sides, thus avoiding a two-against-one situation. Having a coach on call proved worthwhile. For example, founder Koss started taking time off after successor Frey arrived, “which is what we all wanted him to do,” says MacLellan. “But then he’d come back to the office, and some of the old habits would surface. People would come to see him, and he would jump back into his old role. So we had to get back into doing some more coaching and some more communication.” For their parts, both Koss and Frey say that meeting with their coach before the transition allowed them to raise and resolve potential areas of conflict in theory and avoid traps in practice.

Four Types of Founder Transitions Three out of four founder transitions involve an amicable decision for the founder to walk away or to stay on in a different capacity. 13% Board member

23%

31%

7% Full-time staff

Significant founder role

Amicable clean break

3% Part-time staff

22%

24%

Light founder role

12% Paid advisory or consulting role

Involuntary break 8% Unpaid advisory role AMICABLE TRANSITIONS

2% Interim position

Source: Bridgespan / BoardSource / GuideStar survey

Coaching also played a key role in the transition at Citizen Schools, a large youth-development nonprofit that provides adolescents with opportunities to work side-by-side with experts to explore new fields, learn new skills, and build a foundation for their future. When the CEO, an external hire who succeeded founder Eric Schwarz, resigned after a rocky 19 months at the helm, he offered to stay for six months to help his own successor, insider Emily McCann, learn the ropes. The board hired a coach to smooth the handoff. “She led the two of us through this transition in a way that allowed us to feel like our relationship was on solid ground, and that we were able to put any frustrations or pain or anxiety aside for the sake of the organization,” says McCann, who moved up from her six-year role as president of the organization. In the two weeks leading up to the transition, McCann and her predecessor met several times with the coach. “It was like therapy,” McCann recalls. “Yes, it was intense, but it was really important because when you have a lot of unresolved feelings about an organization or about a person, and you’re about to lead a transition, those feelings can show up in unexpected ways if you don’t have a handle on it.” The coach turned an awkward situation into a productive one. Third, anticipate conflict and agree to a process to mitigate it. Leadership transitions are inherently complex, all the more so when a nonprofit’s founder stays on. As part of transition planning, boards need to work with the founder, successor, and, ideally, their coach to establish a conflict resolution process. After Frey accepted the CEO position at Right To Play, just such an approach to conflict resolution was defined with the board and Koss (facilitated by their coach). If founder Koss and Frey disagreed, the process escalated decision making to the board chair. If still no resolution ensued, it would go to the board’s HR committee and, in a deadlock, to the full board. While Koss and Frey periodically disagreed, “we never had an issue go to the board,”

Stanford Social Innovation Review / Spring 2018

and ask for an approval,” Pullen explains. “We needed to figure out Koss says. “Everything came back to our own decision making and communication.” how to introduce the board to the concept, talk about why this might At the Oasis Institute, which promotes healthy aging through lifebe the right time, and talk with the board about what a transition set long learning, active lifestyles, and volunteer engagement, founder of actions and activities looks like so that we ensure this is successful.” Marylen Mann made clear to successor Marcia Kerz that she wanted They agreed on a plan that called for First to transition to executive director in February 2016 and take charge of most of Kerz to handle the business side of the organization as she moved the external-facing work that Wartzman had done, as well as to a new role as chair of the board. “She was very open and very manage and coach the staff. But it eased First into fundraising. honest about that from the beginning,” says Kerz, who joined the foundation in 2000 as chief operating officer. Two years later, Kerz Wartzman continued to interact with donors, but he included First transitioned to president, a post she held until May 2017. in the conversations to transition those relationships. Wartzman Initially, Kerz and Mann had no agreed-upon process to mitigate also negotiated an arrangement to continue as a paid advisor to conflict, leading to confusion. “Marilyn is creative, full of wonderful complete two major projects in which he was deeply invested: the revamped Drucker Prize and the Drucker Index, which aims to ideas, always wanting to start something new, to take the organization assess through publicly available data how effectively a company is further,” Kerz says. “The biggest challenge we always had was balancmanaged. The index project led to the creation of the Center for a ing her ideas with the impact on the organization.” To manage this tension, Mann and Kerz agreed to a simple rule: Mann would run all Functioning Society, a new arm of the Drucker Institute, and after a year ideas through Kerz before taking them to staff members. “That’s how Wartzman transitioned from paid advisor to director of the new center. The entire transition plan unfolded without dustups, albeit she had always done it,” Kerz says. “It was really just understanding with some suspense regarding Wartzman’s next calling. “There and being clear on what each of us was responsible to do.” really haven’t been any conflicts,” Wartzman says. Fourth, transition board, funder, and staff loyalty in logical order. Founders often develop intense loyalty among staff and board Fifth, create initial separation to allow the successor to settle in, parmembers, many of whom may be personal friends. And funders ticularly if the founder’s new role is substantial or long-term. A successor are likely to identify more closely with the founder than with the needs time to establish herself as the new leader, a period that may organization. It is therefore critical to shepherd these loyalties to include staff restructuring or changes in strategy. While the succesnew leadership. With an extended transition, organizations have sor may consult with the founder, it’s important for the founder to the benefit of sequencing such transitions over time, often with maintain a low profile during the early months of transition to avoid staff and board management transitioning immediately, and funder confusion about who is in charge. In transitioning from Drucker Institute executive director to relationships transitioning as the founder introduces the successor around and builds her credibility. senior advisor, Wartzman essentially flipped roles with his successor. Such was the case for Executive Director Rick Wartzman and his “We spent a lot of time thinking through how we wanted to handle associate, Senior Managing Director Zach First. The pair worked the transition,” says First. For optics, First moved into Wartzman’s closely for nearly a office space. “Rick came decade to launch and into the office probably establish the Drucker once every six to eight Institute, an organiweeks when he needed zation that builds on to get together with a Peter Drucker’s mancouple of team memagement wisdom and bers working on the n Founder is slowing down due to poor health or lack of energy. applies it to contemponew programs,” says rary issues. Eight years First. “Other than that, n Founder has more energy for outside projects than for in, Wartzman declared he worked remotely. stewarding the organization. in 2015 his intention to That was something step down as founding that was really importn Staff support for founder is declining. executive director and ant, we both felt, for just considered First his nathelping the team adjust n Founder is increasingly in conflict with the board. to me as the new execuural successor. tive director.” Wartzman and First n Organization has grown significantly without any change Stepping back from lost no time working out to organizational structure or processes. day-to-day operations a detailed transition plan that they presented to didn’t come as easily for n Organization’s core funding base is stalled or shrinking, board Chair Curt Pullen Right To Play founder Koss, but some of the for quick approval. But not growing. same tactics used by Pullen hit the brakes. Wartzman and First “In my experience, you n Organization has reached a stage where it requires skills that never land a big change helped. On the first day the founder and senior staff lack and are not developing. on a board at a meeting of the transition, Koss

Seven Signs That the Founder Has Stayed Too Long

Stanford Social Innovation Review / Spring 2018

moved out of his office and successor Frey moved in. Koss also stopped attending executive team meetings and simply read the minutes to stay up-to-date. But when the Right To Play headquarters moved, the value of creating distance between founder and successor became palpable. Koss and Frey initially had side-by-side offices in the new building. “It was really tough for the staff,” Frey says. The confusion over their roles led the board chair to counsel Koss to spend less time in the office. He also agreed to relinquish his office space, which was converted into a founder’s lounge. With Frey unambiguously at the helm, affiliates and funders turned to him with the tough strategic questions, and Frey has used his first two years to rethink organizational strategy. Meanwhile, Koss became the leader of social and environmental impact at an investment firm in the fall of 2017, two years after stepping down as CEO, further focusing and bounding the hours and ways he supports Right To Play. PLANNING AHEAD

Concern about managing founder transitions emerged more than a decade ago when several studies predicted a wave of retirements among nonprofit leaders, up to half of whom were founders or longterm executives.7 An Annie E. Casey Foundation 2005 report, Founder Transitions: Creating Good Endings and New Beginnings, warned, “People and communities rely on the services and programs provided by founder-led organizations. If these organizations falter or fail following a founder’s departure, many of our communities’ most vulnerable citizens—children, recent immigrants, the frail, and the poor—will suffer.” 8 That warning rings no less true today. Many nonprofits still struggle to manage founder transitions, as evidenced by the high percentage of involuntary changes in leadership revealed by our research. The time to start planning for a leadership change is long

Founder’s Post-Transition Role Percent of respondents who reported that founder post-transition had positive impact performing given function (across all positions)

Fundraising

87%

Spokesperson or ambassador

80%

Policy & advocacy

79%

Mentoring the incoming ED

71%

Mentoring other staff

67%

Setting org strategy

62%

Programrelated role

60% 0

Source: Bridgespan / BoardSource / GuideStar survey

80%

100%

before it happens. Every nonprofit led by a founder (or long-term executive) can take at least four steps to put scaffolding in place for a successful transition, whenever it occurs. Step 1: Invest in internal talent development. The benefits justify the expenditure. Not only does the executive team get stronger, but the chances increase that the next executive director can rise from the ranks, rather than from an outside hire, and ease succession planning. The data are abundantly clear that internal successors are far less likely to fail in the first three years. At BELL, the $20 million education nonprofit known for its effectiveness in preventing summer learning loss among lowincome youth, founder Earl Phalen groomed Tiffany Cooper Gueye as a possible internal successor for several years via stretch assignments, promotion to COO of field operations, and exposure to board and funders. “It was very clear that whatever responsibility was put in front of [Gueye] she fulfilled quite well,” says Laurene Sperling, BELL’s board chair. To help Gueye succeed as the new leader, Sperling mentored her. “You’re going to be completely supported through this,” Sperling recalls telling Gueye, adding that the best way to work with the board was with no surprises and frequent check-ins. Eight years later, Gueye’s own successor, who took charge in June 2017, also came from inside the organization with years of preparation for the job. Unfortunately, BELL’s success is not the norm. Strikingly, only 30 percent of key leadership roles in the nonprofit sector were filled by internal promotion in a recent Bridgespan survey—about half the rate of for-profits.9 Our new research also highlighted another reason to look inward for talent: The most successful leadership transitions paired an internal successor with an extended role for the founder. Sometimes the right internal candidate needs a nudge to fill a founder’s big shoes. When Schwarz stepped down as CEO of Citizen Schools in 2014, McCann, then president, was his inside candidate for successor, with 10 years’ experience across programs and functions. But Percent reporting positive impact McCann wasn’t sure she was by founder’s post-transition position ready to balance caring for her young family with leading Board Advisor or Staff member consultant member the organization, especially given Schwarz’s constant 82% 96% 79% travel in the role. It took a short-lived stint by an out74% 92% 67% sider to convince her that her cultural fit, combined with 81% 86% 67% her skills and experience, had prepared her. “I realized 58% 75% 80% I could lead on my own terms and in a way best suited to the 59% 81% 60% needs of the organization at its current stage of growth,” 74% 67% 36% McCann says. Step 2: Make succession 47% 69% 67% planning a point of regular discussion. A number of circumstances afford a suitable

Stanford Social Innovation Review / Spring 2018

weaknesses before the leadership change. At one education nonprofit, for example, board meetings gave the founder a platform “to hold court We created three data sets for this study: (1) IRS Form 990s for 2,000 organizations, and talk to the board about how great the orga(2) a survey that received 538 responses, and (3) interviews with 49 board members, nization was,” says one insider. This complicated founders, and successors. the transition, because the board was unaware of operational issues that the founder’s successor had FORM 990 SAMPLE to address. Nor was it accustomed to playing the GuideStar provided data on 20,563 organizations established after 1975 with revesupportive role needed by the new leader. nue exceeding $3 million. The data set excluded higher education, hospitals, sports In contrast, at Family Promise, the founder, leagues, and membership benefit organizations. We analyzed a random sample successor, and board chair all recognized the need of 2,000 organizations within the GuideStar set, and supplemented the Form 990 to strengthen board oversight to enable a strong data with publicly available information that characterized founder roles, succestransition. This involved bringing on new board sor choice (internal versus external), and successor tenure. We found 106 organimembers as well as changing the passive culture of zations that experienced founder transitions between 2009 and 2015, 161 organithe board to one that actively discussed key issues. zations that experienced long-term (more than 10 years) CEO transitions, and 340 This helped pave the way for a successful transition that experienced short-term CEO transitions, all for the same period. from the founder, Karen Olson, to the successor, Claas Ehlers, with Olson staying engaged as an SURVEY WITH BOARDSOURCE AND GUIDESTAR ambassador to affiliates. BoardSource, GuideStar, and Bridgespan disseminated the survey via email and Step 4: Set aside a transition fund to address conreceived 538 completed responses, of which 474 had experienced one or more tingencies. Transitions can generate unbudgeted transitions. Fifty respondents experienced two transitions for a total of 524 tranexpenses, such as the cost of hiring a coach, paysitions. The sample included 202 founder transitions, 110 long-term CEO transiing a search firm, offering severance, or covering tions, and 212 short-term CEO transitions. added compensation during a period of overlap between the outgoing founder and the successor. INTERVIEWS The Drucker Institute, for example, tapped its Bridgespan conducted interviews with 49 individuals from 31 organizations reserves to keep founder Wartzman on the payroll drawn from the Form 990 sample, survey respondents, and high-profile founder as a senior advisor for more than a year after he transitions. We interviewed the founder, successor, and board chair at five organistepped down as executive director. “The organizations, and two individuals at six additional organizations. zation bought Rick [Wartzman] and me a year to find our footing in our new roles,” says First, his successor. “All of this was possible only because we had healthy cash reserves.” venue: the executive director’s annual performance review; during a strategic planning process; at tenure milestones, such as a leadThese four steps can help any nonprofit and its board to plan for er’s 10th or 20th anniversary or her 60th birthday; or contingency a successful leadership transition. While they require significant planning to address a prolonged health crisis or sudden departure. effort over an extended period of time, they lay the foundation for Our data show that the probability of a founder transition peaks at stronger organizations better able to serve their beneficiaries. n two points: at the 10-year mark and after 25 years. Boards should N OTE S be particularly proactive about succession planning leading up to 1 Noam Wasserman, “The Founder’s Dilemma,” Harvard Business Review, February these milestones. 2008. But the best board practice, based on Bridgespan’s more than 35 2 Thomas J. Friel and Robert Duboff, “The Last Act of a Great CEO,” Harvard Business engagements helping organizations to build their bench of future Review, January 2009. leaders, makes CEO-succession planning an annual topic of dis3 Mark Leach, Table for Two: Can Founders & Successors Co-Exist So Everyone Wins? cussion. Making succession a routine topic for the entire executive Management Assistance Group, 2009. team renders the probing less personal, while focusing the board’s 4 Tom Adams, Founder Transitions: Creating Good Endings and New Beginnings, Annie E. Casey Foundation, 2005. attention on the organization’s ongoing leadership needs. See 5 Tom Adams, The Nonprofit Leadership Transition and Development Guide: Proven At the Drucker Institute, founding executive director Wartzman Paths for Leaders and Organizations, San Francisco: Jossey-Bass, 2010; and Don told First, “I’ve done this for seven years. I could probably do it for Tebbe, Chief Executive Transitions: How to Hire and Support a Nonprofit CEO, seven more years. But somewhere around the 10-year mark, I feel it Washington, D.C.: BoardSource, 2008. starts to do a disservice to the organization to have the same leader 6 Frances Kunreuther and Stephanie Clohesy, The Long Goodbye: Advice, How-Tos, and Cautionary Tales for Extended Leadership Exits, The Building Movement Project, in place for any longer than that.” 2016. Step 3: Shore up weaknesses in board oversight. Our research 7 Thomas J. Tierney, “The Nonprofit Sector’s Leadership Deficit,” The Bridgespan revealed common weaknesses among boards of founder-led organiGroup, 2006. zations: lack of founder performance reviews, weak oversight of pro8 Adams, Founder Transitions. grams and finances, and insufficient independence from the founder. 9 Libbie Landles-Cobb, Kirk Kramer, and Katie Smith Milway, “The Nonprofit LeaderOrganizations with the most successful transitions addressed these ship Development Deficit,” Stanford Social Innovation Review, October 22, 2015.

Research Methodology

Stanford Social Innovation Review / Spring 2018

The era of corporations integrating sustainable practices is being surpassed by a new age of

, corporations actively transforming the market to make it more sustainable.

The Next Phase of Business Sustainability BY ANDREW J. HOFFMAN Illustration by James O'Brien

usiness sustainability has come a long way. From the dawn of the modern environmental movement and the establishment of environmental regulations in the 1970s, it has become a strategic concern driven by market forces. Today, more than 90 percent of CEOs state that sustainability is important to their company’s success, and companies develop sustainability strategies, market sustainable products and services, create positions such as chief sustainability officer, and publish sustainability reports for consumers, investors, activists, and the public at large. This trend will not abate anytime soon. Surveys show that 88 percent of business school students think that learning about social and environmental issues in business is a priority, and 67 percent want to incorporate environmental sustainability into their future jobs. To meet this demand, the percentage of business schools that require students to take a course dedicated to business and society increased from 34 percent in 2001 to 79 percent in 2011, and specific academic programs on business sustainability can now be found in 46 percent of the top 100 US master of business administration (MBA) programs. For all this interest, we should expect the world to become more sustainable. But problems such as climate change, water scarcity, species extinction, and many others continue to worsen. Sustainable business is reaching the limits of what it can accomplish in its present form. It is slowing the velocity at which we are approaching a crisis, but we are not changing course. Instead of tinkering around the edges of the market with new products and services, business must now transform it. That is the focus of the next phase of business sustainability, and we can see signs that it is emerging. The first phase of business sustainability, what we at the University of Michigan’s Erb Institute call “enterprise integration,” is founded on

a model of business responding to market shifts to increase competitive positioning by integrating sustainability into preexisting business considerations. By contrast, the next phase of business sustainability, what we call “market transformation,” is founded on a model of business transforming the market. Instead of waiting for a market shift to create incentives for sustainable practices, companies are creating those shifts to enable new forms of business sustainability. Enterprise integration is geared toward present-day measures of success; market transformation will help companies create tomorrow’s measures. The first is focused on reducing unsustainability; the second is focused on creating sustainability.1 The first attends to symptoms; the second attends to causes. The first focuses primarily inward toward the health and vitality of the organization; the second expands that focus to look outward toward the health and vitality of the market and society in which the organization operates. The first will help future leaders get a job in today’s marketplace; the second will help them develop a target for a lifelong career. The first is incremental, the second transformational. Changing the way we do business is essential to addressing the challenges of environmental degradation. The market is the most powerful institution on earth, and business is the most powerful entity within it. Business transcends national boundaries, and it possesses resources that exceed those of many nation-states. Business is responsible for producing the buildings we live and work in, the food we eat, the clothes we wear, the automobiles we drive, the energy that propels them, and the next form of mobility that will replace them. This does not mean that only business can generate solutions, but with its unmatched powers of ideation, production, and distribution, business is best positioned to bring the change we need at the scale we need it. SUSTAINABLE BUSINESS 1.0: ENTERPRISE INTEGRATION

In its first incarnation, business sustainability represents a market shift. Market pressures bring sustainability to business attention

Stanford Social Innovation Review / Spring 2018

through core management channels and functions. This began with Nixon-era government regulation and grew to include insurance companies, investors, consumers, suppliers, buyers, and others through the 1980s and 1990s.2 Such market pressures can emerge from numerous sources: coercive drivers—from domestic and international regulations and the courts; resource drivers—from suppliers, buyers, shareholders, investors, banks, and insurance companies; market drivers—from consumers, trade associations, competitors, and consultants; and social drivers—from nonprofit organizations, activist groups, the press, religious institutions, and academia.3 While corporate social responsibility (CSR) is one response to such pressures, companies have sought to improve competitive positioning by linking sustainability and corporate strategy. This involves translating the issue into the core language of business management: operational efficiency, capital acquisition, strategic direction, and market growth. In each case, the firm has an established model that it can use to conceptualize the issue and formulate a response. In this way, sustainability becomes much like any other business threat, where market expectations change and technological developments advance, leaving certain industries to adapt or face demise while others rise to fill their place. For example, when insurance companies apply sustainability pressures on the firm, the issue becomes one of risk management. When competitors apply such pressures, it becomes an issue of strategic direction. When investors and banks do so, it becomes an issue of capital acquisition and cost of capital. When suppliers and buyers do so, it becomes an issue of supply-chain logistics. When consumers do so, it becomes an issue of market demand. Framed in such terms, much of the specific language of sustainability recedes and is replaced by standard business logic. Therefore, companies can remain agnostic about the science of particular issues (such as climate change) but still recognize their importance as business concerns. The successful company can perform this translation process and integrate sustainability into its existing structures and strategies. Take Whirlpool, for example: It has improved appliance energy efficiency because it has watched energy efficiency move from number 12 in consumer priorities in the 1980s to number three, just behind cost and performance, today. Whirlpool and others expect those concerns to continue to grow.4 One signal of this growth is the LOHAS consumers (Lifestyles of Health and Sustainability), a segment that considers environmental attributes in purchasing decisions and was estimated to be a $355 billion market in the United States in 2016 and a $546 billion market worldwide. Another signal comes from impact investors, who consider environmental, social, and governance (ESG) factors in their investment criteria. The sector reached $8.72 trillion of professionally managed assets in the United States in 2016, or one-fifth of all investment under professional management. But it is not just a specialized sector; this past May, financial advisory firms BlackRock, Vanguard, and State Street cast votes in opposition to ExxonMobil management and called for the company to disclose its climate change impacts. These are all signs that the market has shifted and continues to shift. Today, consumers can buy sustainable products, stay in sustainable hotels, eat sustainable foods, and use sustainable cleaning products. While this greening of the market is a good thing, it is not actually solving the root problems it was meant to address. Our world continues to become less, not more, sustainable.

ANDREW J. HOFFMAN is the Holcim (US) Professor of Sustainable Enterprise at the University of Michigan. He is also a faculty affiliate and past director of the University of Michigan’s Erb Institute for Global Sustainable Enterprise.

The author would like to thank Terry Nelidov and Allison Burtka for helpful feedback on an earlier draft of this article.

SUSTAINABLE BUSINESS 2.0: MARKET TRANSFORMATION

While business sustainability has been going mainstream, the world has witnessed unprecedented human impacts on the natural environment that threaten the viability of life on Earth. To mark this shift, scientists have proposed that we have left the Holocene and are now entering the Anthropocene, a new geologic epoch that acknowledges the enormous influence of the world’s 7.5 billion people (to be nearly 10 billion by 2050) on the planet. 5 To measure that influence, they have identified nine “planetary boundaries” that represent “thresholds below which humanity can safely operate and beyond which the stability of planetary-scale systems cannot be relied upon.” 6 These are what Lancaster University management professor Gail Whiteman has called the “key performance indicators” (KPIs) of the planet, many of which are not doing so well. While one (ozone depletion) is on the mend, scientists believe we have overshot the boundaries of three: climate change, biodiversity loss, and biogeochemical flows (nitrogen and phosphorus cycles). Further indicators are also blinking red, such as ocean acidification, freshwater use, and deforestation. The remaining two boundaries— chemical pollution and atmospheric particle pollution—require more data to assess. All of these disruptions are the result of system failures created largely by our market institutions. They will have to be remedied by those institutions. Fortunately, capitalism can be quite malleable. It is designed by human beings in the service of human beings, and it can evolve to meet the changing needs of human beings. This has happened throughout its history to address issues such as monopoly power, collusion, and price-fixing. Today’s pressing need is sustainability— particularly to address climate change—and legislators are not the only ones who can shift course. Many companies recognize this challenge and are pushing for new market models. In the words of Unilever CEO Paul Polman, “We are entering a very interesting period of history where the responsible business world is running ahead of the politicians” and taking on a broader role to “serve society.” The next phase of business sustainability calls for a transformation of the market, discarding such outdated notions as treating the environment as a limitless source of materials and sink for waste, seeing economic value as the only measure of nature’s worth, encouraging unbridled consumption, and considering perpetual economic growth as even possible. Corporate decision makers have a key role to play in facilitating this transition. Instead of accepting the rules of the market as given, they must change them to incorporate the planet’s KPIs. For example, to turn around the KPI of climate change, the market must go carbon neutral and eventually go carbon negative. We don’t yet know how to do that, but we know that it cannot be done by one company or one product. It requires a change in the overall market. Real sustainability is a property of a system.7 For example, the notion of an energy company installing a wind farm and calling itself sustainable makes no empirical sense. A more sustainable energy system incorporates the whole grid, encompassing generation, trans-

Stanford Social Innovation Review / Spring 2018

mission, distribution, use, and mobility. We can already see signals of this change happening as new energy sources, distributed energy, demand-side management, smart appliances, and smart meters are beginning to transform our conceptions of energy. Already, jobs in the clean energy sector have exceeded those in oil drilling. But the energy renaissance goes further. Electric vehicles have the potential to change the grid, leveling the electricity demand curve by charging at night and providing storage capacity during the day for intermittent energy sources like wind and solar. Already, a Nissan Leaf automobile owner in Japan can buy a transformer to power the house off the battery pack during a power failure. Research is under way to scale this concept and allow consumers to rent their batteries to utilities while their car is parked. Electric vehicles are also transforming the auto industry. Who could have predicted 20 years ago that new entrants like Tesla would enjoy a larger market capitalization than General Motors? And as the shift to driverless cars continues, IT companies such as Apple and Alphabet have entered the fray, shifting success factors in the auto sector from hardware to software, and with them our conceptions of personal mobility. For example, as incumbents such as Ford Motor seek to become mobility providers, they must learn to operate like the airline industry, where profits increase when their cars spend minimal time idling. Given that today’s personal car is parked 95 percent of the time, driverless cars can result in fewer cars on the road (at least in urban centers) as people purchase mobility services rather than own cars. Fewer cars on the road means repurposing unneeded roads, parking lots, garages, and service stations. SYSTEMIC CORPORATE STRATEGIES

As we see with the energy and transportation sectors, the potential scope of market transformation is vast. To help flesh this out, we can conceive this sustainability revolution as proceeding from two initial phases. First, corporations rethink their business strategies to play a stronger role in guiding the sustainability of the systems of which they are a part. Second, the business model itself undergoes reconceptualization. The first phase includes at least four new ways of conceiving their approach to operations, partnerships, government engagement, and transparency. New conceptions of operations | Market transformation calls for optimizing supply-chain logistics to reduce risks from numerous factors such as disruptions due to increased storm severity caused by climate change; current and future resource availability and price volatility; accelerating emissions and concerns for public health and the environment; and the future resilience of business and civil society. These risks can directly affect assets and operations, availability and costs of inputs, regulation of sourcing and distribution, workforce availability and productivity, and stakeholder reputation. For instance, Nestlé, Coca-Cola, Cargill, and General Mills have all faced threats to supply chains due to the decreased availability of water, a once-plentiful resource now scarcer because of climate change and overconsumption. To better manage such operational systems, companies are moving away from linear models in which items are created, used, and disposed of once they reach their end of serviceable life, and toward circular models, where items are created, used, and then either restored or reprocessed to recover energy or materials that can be used again. One key to this new vision of a circular economy is that

it is regenerative by design; it is organized to keep products, components, and materials at their highest utility and value at all times. For example, industrial and consumer products company Ricoh has concluded that by 2050, there will be an insufficient supply of many reasonably priced raw materials to support its manufacturing needs. As a result, the company is revising its business model using life-cycle analysis as the basis for decision making and establishing a series of what it calls “Resource Smart Solutions” for product design and manufacturing, reuse, collection, maintenance, and materials recovery. To change the system around it, the company is also helping its customers reduce energy use, carbon footprint, and virgin material use while also expanding its own opportunities for product refurbishing, recycling, and new designs. Targets include reducing virgin resource use by 25 percent by 2020 and 87.5 percent by 2050. In adopting circular economy thinking, Ricoh is striving to move beyond incremental efficiency goals to more ambitious “net zero impact” business operations.8 New conceptions of partnerships | Going beyond the supply chain, companies also look to novel partnerships outside standard modes of shifting the market, including nonprofit organizations, the government, competitors, and seemingly unrelated companies. For example, as Ford increased its research and development in hybrid and electric drivetrains, it saw an opportunity in how customers would live more electrified lifestyles overall. Together with Infineon, SunPower, Whirlpool, and Eaton, Ford developed the MyEnergi Lifestyle program, exploring ways in which hybrid electric vehicles, solar power systems, energy-efficient appliances, and home design can be integrated to reduce the total carbon footprint. Similarly, Toyota Motor is seeking a broad array of partnerships to achieve its goal of going “beyond zero environmental impact” by eventually eliminating CO2 emissions from vehicle operation, manufacturing, materials production, and energy sources by 2050. New conceptions of government engagement | Very few business schools offer courses on collaborative and constructive lobbying. Indeed, the public perceptions of lobbying are generally negative. But lobbying is basic to democratic politics as governments seek guidance on how to set the rules of the market and usher reforms as needed. Forward-thinking companies are looking for ways to participate constructively in policy formation. For example, Intel was instrumental in calling attention to the horrors of tin, tantalum, tungsten, and gold mining in the Democratic Republic of Congo. While the company could have simply stopped sourcing such conflict minerals from the region, it did not want to create additional hardship for legal mining operations. Instead, it helped create provisions in the Dodd-Frank Act that require the tracking and disclosure of such mineral sourcing within the broader electronics industry. This is not unusual. Companies are also working with governments to phase out heat-trapping HFC chemicals and setting new efficiency standards on trucks. The Paris Agreement on climate change would not have been possible without the powerful business interests that helped broker a deal. In each of these examples, business took a responsible position in bringing about a sustainable shift in the market through policy. New conceptions of transparency | The only way that market transformation will be successful is through trust, and trust can be gained

Stanford Social Innovation Review / Spring 2018

only through greater transparency. The expansion of corporate influence in society, particularly as it relates to government, will make some justifiably uneasy. But robust reporting mechanisms can help allay those fears and also help protect companies from the effects of misconduct, including legal liability and penalties. To be sure, companies are already disclosing numerous sustainability indicators through established standards, such as the globally recognized Global Reporting Initiative or Carbon Disclosure Project. But transparency goes further as companies face increasing demands for data, for both internal management and external validation, under the watchful eye of activists, investors, suppliers, buyers, employees, and customers. The gathering and dissemination of such information can open up new awareness of supply-chain risks and opportunities. For example, IBM and partner companies are experimenting with blockchain technology to transform visibility and traceability in complex, often opaque, global supply chains. In 2017, IBM piloted supplychain blockchain with Walmart to address food safety in its global supply and distribution network and plans to roll it out further with nine global agricultural companies. In another example, Nestlé conducted an internal investigation of its Thai fish supply chains in 2014 and found forced labor and brutal treatment of workers. But in a dramatic shift from standard practices of privacy and nondisclosure, the company posted the report online, imposed new requirements on suppliers, and commissioned outside auditors to assure compliance. This public disclosure compelled other companies that source fish in Thailand to follow suit, shifting the competitive dynamics of supply-chain logistics. NEW WAYS OF DOING BUSINESS

Market transformation not only compels more systemic business strategies but also challenges traditional ways of conceiving business itself. It demands new conceptions of corporate purpose, notions of consumption, and models and metrics of business success. New conceptions of the corporation’s purpose | The dominant idea of the purpose of the corporation as simply to make money for its shareholders took hold within business in the 1970s and 1980s. But the narrow pursuit of shareholder value leads to excessively short time horizons for investment planning and measures of success. It also leads to a focus on only the type of shareholder who is less interested in sustainability efforts and, in the words of Cornell Law School professor Lynn Stout, is “shortsighted, opportunistic, willing to impose external costs, and indifferent to ethics and others’ welfare.” 9 New ideas of corporate purpose are beginning to grow within business practice and education. For example, benefit corporations are one type of innovation that seeks to integrate a broader array of objectives than simply profits into its forms of organizing, governance, and legal statement of purpose. And other companies are watching closely, sometime mimicking them. This trend has caught on among MBA students who challenge conventional thinking around capitalism and corporate purpose. At the Harvard Business School, an immensely popular course called “Reexamining Capitalism” explores “the evolution, power, and limitations of our current capitalist systems” and “how the ‘rules of the game’ by which capitalism is structured should change” to address the social and environmental issues of our day. New conceptions of consumption | Is “sustainable consumption” an oxymoron? The World Business Council for Sustainable Development

doesn’t think so, calling on businesses to “abandon the existing consumption paradigm” and move toward “transformations in mainstream lifestyles and consumption patterns.” 10 Several businesses and activists have sought to put such an idea into practical use. For example, Patagonia, through its Common Threads Initiative, encourages people to buy used Patagonia products on eBay before going to the store to buy them new. Adbusters has long promoted its “Buy Nothing Day,” what it calls a “24-hour moratorium on consumer spending” as a counterpoint to the Black Friday spending spree that traditionally follows the holiday of Thanksgiving. The outdoor lifestyle retailer and co-op Recreational Equipment (REI) closes its 149 stores on Black Friday as part of its “#OptOutside” program. In 2016, Subaru, Google, Meetup, Upworthy, and competing outdoor brands such as Burton, Keen, Yeti, and Prana chose to partner with the effort. In the end, resource use must be reduced at the source, and that means developing new models of consumption. New conceptions of business models and metrics | Market transformation requires a compelling new business model to replace traditional ones that dominate business thinking. For example, neoclassical economics and agency theory employ dismally simplified models of human beings as driven primarily by selfishness, where those running the company (agents) will shirk or even steal from the owner (principal) if they do the work and the owner gets the profits. But behavioral economists have argued that real humans don’t behave as neoclassical economics suggests we do, and legal scholars argue that managerial motivations are far more complex than a simple principal/agent relationship and instead involve thousands of shareholders, executives, and directors with more socially positive motivations. And new models have arisen, such as positive organizational scholarship and appreciative inquiry, that move beyond standard cynical conceptions of human behavior to understand how and why people are motivated to devote their work toward improving the world around them and learn how to create the organizational conditions that will foster that activity. These models are gaining increasing interest in business teaching, research, and practice as a way to create a more committed and effective organization. Other models are also beginning to gain recognition. Doughnut economics11 is a model of economic growth that links social justice to efforts to stay within the planetary boundaries of the Anthropocene epoch. Shared value is aimed at redefining capitalism by arguing that the competitiveness of a company is closely tied to the health of the communities in which it is embedded.12 Conscious capitalism is a model of business that serves the interests of all major stakeholders—customers, employees, investors, communities, suppliers, and the environment. And regenerative capitalism reimagines capitalism in terms that are self-organizing, naturally self-maintaining, and highly adaptive to produce lasting social and economic vitality for global civilization as a whole. Each of these models is seeking an amended form of capitalism that is sensitive to the constraints of the Anthropocene. Closely related to models of business behavior are the metrics used to define success, many of which lead to unsustainable outcomes. For example, discount rates are used to capture the time value of money—the fact that a dollar today is worth more than a dollar tomorrow. But a common discount rate of 5 percent leads to a conclusion that everything 20 years out and beyond is worthless. When gauging the response to climate change, is that an outcome

Stanford Social Innovation Review / Spring 2018

that anyone—particularly anyone with children or grandchildren— would consider ethical? London School of Economics professor Nicholas Stern answered no with an argument that used an unusually low discount rate when calculating the future costs and benefits of climate change mitigation and adaptation.13 Another problematic metric is gross domestic product (GDP). This measure of national economic health fails to distinguish between financial transactions that add to the well-being of a country and those that diminish it. Any activity in which money changes hands will register as GDP growth, even money spent on recovery from natural disasters and pollution cleanup. To examine alternatives, former French president Nicolas Sarkozy created a commission, headed by Nobel laureates Joseph Stiglitz and Amartya Sen. Their 2010 report recommended a shift in economic emphasis from the production of goods to a broader measure of overall well-being that would include measures for categories such as health, education, security, and sustainability.14 RESHAPING POLITICS TO RESHAPE THE MARKET

A discussion of market transformation and the corporation’s shifting role in society cannot be complete without a discussion of the current political and social climate and what impact it has on this agenda going forward. The Trump administration denies the science of climate change and has embarked on an agenda of loosening the regulatory environment to stimulate economic growth. This is a similar script to that employed by President Ronald Reagan more than 35 years ago when he appointed Ann Gorsuch Burford to lead the US Environmental Protection Agency, James Watt to head the US Department of the Interior, and Rita Lavelle to run Superfund, the program for cleaning up the country’s most polluted sites. Reagan’s appointments set about slowing or stopping environmental enforcement, but they ultimately led to scandals and created a critical public backlash: In 1983, all three were removed from office, and in subsequent years, Congress went on to strengthen numerous environmental regulations, and environmental groups increased membership and budgets. In the words of former Sierra Club executive director Carl Pope, Reagan “reinvented the environmental movement by his contempt for it.” While President Trump’s approach to the environment bears similarities to Reagan’s attempts to roll back environmental regulations and likely faces a similar backlash, there are several key differences. First, some of the backlash this time will come from businesses that are leading on greenhouse gas reductions and not fighting government-led environmental policies, as they did in the 1980s. Indeed, recent surveys show that 85 percent of business executives believe that climate change is real (well above the national average of 64 percent), and many see the associated market risks and benefits. General Mills CEO Ken Powell was not alone when he told the Associated Press, “We think that human-caused greenhouse gas causes climate change and climate volatility, and that’s going to stress the agricultural supply chain.” Cargill executive director Greg Page warns of food shortages if we do not act. Such concerns represent a strong and growing perspective within the corporate sector that we have a problem and government inaction will only make it worse. While those who lose in a carbon-constrained world (such as fossil fuel interests) will continue to resist acknowledging climate change, most companies see the long-term trajectory of this issue and do not

see the current administration’s position as the long-term future. The market is shifting with or without the US government, as other national governments as well as many US state and city governments continue to set policies. Many companies are part of global markets and see the US withdrawal from the Paris Agreement as ceding US leadership but not stopping the market transformation that is under way. Some markets may slow, but some may just move to other parts of the globe, such as Germany, India, and China, where heavy investments in renewable energy and alternative drivetrains (such as electric and hybrid) are viewed as the future of the energy and mobility sectors. The public is also moving in favor of sustainability. Already, public opinion polls show that an increasing number of Americans believe climate change is real. Some even show that a majority of Republicans—including 54 percent of self-described conservative Republicans—now believe that the world’s climate is changing and that human beings play some role in the change. This is a marked shift from 2009, when just 35 percent of Republicans believed that climate change was real. The truth is that many Republican politicians, congressional aides, lobbyists, and staff believe in the science of climate change as well but are waiting for the right political cover to voice their views. Concern for the environment is a long-term interest of the American public, one that is more latent than urgent and top of mind. While surveys show that it ranks low on election issue topics—number 12 in one poll, behind the economy, terrorism, foreign policy, and health care—it is also driven by saliency, and it will awaken when threatened. That awakening can be triggered by any number of levers. If history is any indication, smart business leadership will read these signs, anticipate the market shift, and seek to take advantage. n N OTE S

1 John R. Ehrenfeld, Sustainability by Design: A Subversive Strategy for Transforming Our Consumer Culture, New Haven, Conn.: Yale University Press, 2009. 2 Andrew J. Hoffman, From Heresy to Dogma: An Institutional History of Corporate Environmentalism, Stanford, Calif.: Stanford University Press, 2001. 3 Andrew J. Hoffman, Competitive Environmental Strategy: A Guide to the Changing Business Landscape, Washington, D.C.: Island Press, 2000. 4 Andrew J. Hoffman, Getting Ahead of the Curve: Corporate Strategies That Address Climate Change, Arlington, Va.: Pew Center on Global Climate Change, 2006. 5 Paul Crutzen, “Geology of Mankind,” Nature, 415, no. 23, 2002. 6 Will Steffen et al., “Planetary Boundaries: Guiding Human Development on a Changing Planet,” Science, 347, no. 6223, 2015. 7 John R. Ehrenfeld and Andrew J. Hoffman, Flourishing: A Frank Conversation about Sustainability, Stanford, Calif.: Stanford University Press, 2013. 8 Terry Yosie, “Moving the Circular Economy from Concept to Business Strategy and Operations,” The Conference Board, September 25, 2017. 9 Lynn A. Stout, “The Problem of Corporate Purpose,” Brookings Institution, 2012. 10 WBCSD, A Vision for Sustainable Consumption, Geneva, Switzerland: World Business Council for Sustainable Development, 2011. 11 Kate Raworth, Doughnut Economics: Seven Ways to Think Like a 21st-Century Economist, Chelsea, Vt: Chelsea Green Publishing, 2017. 12 Michael E. Porter and Mark R. Kramer, “Creating Shared Value,” Harvard Business Review, January-February, 2011. 13 Nicholas Stern, The Economics of Climate Change: The Stern Review, Cambridge, UK: Cambridge University Press, 2007. 14 Joseph E. Stiglitz, Amartya Sen, and Jean Paul Fitoussi, Mismeasuring Our Lives: Why GDP Doesn’t Add Up, New York: The New Press, 2010.

Stanford Social Innovation Review / Spring 2018

To create systems of societal change, we need to become clearer about the archetypes of societal

, change strategies, their strengths and weaknesses, and their interactions.

Four Strategies for Large Systems Change BY STEVE WADDELL

Stanford Social Innovation Review / Spring 2018

reenpeace, The Nature Conservancy (TNC), the Forest Stewardship Council (FSC), and Unilever all tout their commitment to change in support of the natural environment. But a look at their websites reveals big differences in how they translate this into action. In July 2016, Greenpeace’s homepage featured a huge “resist” banner attached to a construction crane with activists rappelling down, and the words “The Summer of Resistance starts with you— Bring resistance to your community!” The Nature Conservancy’s showed serene fields and “Help us protect cherished landscapes that unite us in all 50 states.” The FSC’s described its commitment to

! Marriage-equality supporters rejoice outside the US Supreme Court after its historic ruling on June 26, 2015. Different change strategies worked in concert to win same-sex marriage rights.

the “environmentally appropriate,” “socially beneficial,” and “economically viable” with pictures of forests, Forest Champions, and businesses. And Unilever’s showed a picture of a farmer in a developing country and the words “Sustainable Growth: Value + Values. We are changing the way business is done.” Responding to a difficult challenge such as environmental sustainability can produce a wide range of actions. How can diverse change efforts that aim for a similar outcome be thought of comprehensively? What are their relationships? How do they interact most powerfully to speed change? These questions led me to conceive of all the diverse efforts to create change on a difficult issue such as climate change or poverty, collectively as a “societal change system.” Such a system comprises all those initiatives and programs that are working to change a situation or issue. Seeing the whole of this system—through mapping, data visualization, and other methods—yields unique insights about how to create coherence; identify gaps in effort; exploit synergies; and reduce duplication, conflict, and inefficiencies. FOUR CHANGE STRATEGIES

Economist Joseph Schumpeter’s famous description of the “creative destruction” of capitalism is instructive for change more broadly. There is a natural tendency among those who work for societal change to focus on the creative part of the task—developing the new. But change also involves destroying the old, whether it be institutions, relationships, or ways of doing things. Schumpeter’s insight into the continuous churn of free markets forms the basis for proposing one dimension for distinguishing change strategies: destruction to creation. Extreme destruction might be depicted as the collapse of civilization; less extreme forms might include the rejection of a traditional social value or the breakup of a company. The extreme of creation is captured by the birth of a whole new societal order, while a less extreme form of creation might be the formation of a company or the adoption of a new social practice. A second dimension is confrontation to collaboration. The extreme of confrontation is war, but there are many less confrontational actions, such as those of Greenpeace activists. At the collaboration extreme, consider the facilitation of deep mutual respect and common commitment in a group to work together to realize a change goal through transcendence of diverse perspectives, similar to the FSC’s work. These two dimensions form the basis of a matrix that captures four kinds of change strategy. (See “Change Strategies” on page 43.) Each quadrant is named for the archetype of change it reflects. I have developed this model over 20 years of work on large systems change internationally—for example, on poverty in Guatemala, global corruption, renewable energy, and the financial system. How do we transform a group of well-intended but collectively incoherent change initiatives into a powerful societal change system? The matrix serves as a device to raise valuable questions and spark insights for understanding change strategies or initiatives holistically. All change initiatives reflect some mix of the two dimensions. Photograph by Alex Wong/Getty Images

Stanford Social Innovation Review / Spring 2018

Although a particular change initiative may shift position within a quadrant as it evolves and its emphasis on particular dimensions changes, moving to a different quadrant would transform its core logic—its rationale, principles, and capacities. To further explore this model, I also offer a table that describes each quadrant generically and then addresses our two examples of societal change. (See “Characteristics of Change Strategies” on page 44.) Let us first examine each of the quadrants generically, then turn to the two cases. Doing Change: The Entrepreneurs | The upper-left quadrant is that of entrepreneurs who are out to create a new approach that defies the prevailing logic and ways of operating. This often takes the form of a social or commercial enterprise. The entrepreneur can be an individual, but for societal impact it is more often an organization or movement. Social innovation labs, Ashoka Fellows, and Impact Hubs all specialize in nurturing this type of activity. In business, this category covers entrepreneurs who are causing radical change, such as M-Kopa (providing solar energy in Kenya through innovative financing) and Revolution Foods (bringing healthy food to K-12 schools). Entrepreneurs are not fixated on destroying the old, although that is typically the effect of their innovation. Their energy is devoted toward creating the new. These change agents usually face substantial skepticism and resistance by incumbents. This, problems with scaling, or simply the inadequate power of the invention may make the entrepreneurs unable on their own to bring about broad societal change. Forcing Change: The Warriors | Activists as warriors are the archetype of the lower-left quadrant. They are the energy pushing for widespread change, trying to influence others through their pressure and advocacy. They must be willing to risk harm—perhaps only breaking windows, perhaps forcing a business to close and lay off workers, perhaps breaking the law. They focus on gathering strength through followers and supporters often associated with social movements. However, in the same way that social activists can attempt to force change through warrior-like tactics, capitalists can withdraw investment in the name of change, and governments can use the power of the state to incarcerate and fine resisters of change. The danger for this quadrant is failure to gather sufficient support and power to emerge from the margins—which leads some to become more violent and can even result in civil war. Directing Change: The Missionaries | Those who are in positions of power and authority and are committed to change have a particularly challenging position. They can use that power and authority to secure change, but that often requires fundamental disruption in the structures that give them power and authority in the first place. They typically have a missionary’s zeal often associated with charisma for pursuing transformation, since such work involves overcoming immense inertia to break up and reinvent organizations and structures to become something very different. Their energy can easily be suppressed by status quo interests and skepticism that arise from trying to create something that no one has yet seen or experienced fully. Unilever CEO Paul Polman is an example of someone grappling with this change strategy to create a new business model that does not just do “less bad” but contributes positively to all aspects of society. Cocreating Change: The Lovers | This is the popular but complicated strategy of “Let’s get all the stakeholders in the same room and figure out how we’ll work together for change.” It can be described

STEVE WADDELL has spent more than 30 years working on large systems change and transformation. He does this through personal leadership, community organizing, writing, education, consultation, and research.

as the “lover” strategy, because it is based on the proposition that people want the same thing and are willing to work together to get it. It depends on the willingness of everyone to change, since almost always every participant is part of a transformational problem—it’s not just others that have to change, but we all hold values, beliefs, and ways of understanding that have to change. Along the way, however, a more powerful or well-resourced stakeholder may induce others to settle for less change than is needed, resulting in co-optation. THE GERMAN ENERGY TRANSITION

To illustrate these four archetypes of change at work, let us turn to Energiewende in Germany, the first of two case studies of largescale societal change that help to flesh out the model. The term “Energiewende” was introduced in 1980 by Germany’s Institute for Applied Ecology (Öko-Institut e.V.) as a call to abandon nuclear and petroleum-based energy. Translated as “energy transition,” it describes Germany’s commitment and ongoing transition to a sustainable energy future. In 2016, about a third of energy consumed in Germany came from renewables. (By contrast, about 15 percent of US energy consumption came from renewables, with a large amount of that from hydropower.) On one auspicious day in April 2017, Germany received a whopping 85 percent of its electricity from renewables. As a change challenge, the case is distinctive for the important role of technology. In terms of change strategy, Energiewende illustrates the role of cocreation. Such an approach is part of the core post-World War II logic of Germany more broadly, as seen in joint labor-management boards for companies and in coalition governments. In the energy sphere, this approach was demonstrated in the 1980s with collaborative experimental work on alternative energy by the science, engineering, and industrial communities. Although there have been some shifts in strength, there has been broad support publicly for the change. The ongoing collaborative approach must be understood in contrast to the United States: In Germany there is no oil and gas industry, so the main question was how to achieve sustainable energy technologically, financially, and pragmatically, by transitioning (destroying) traditional forms of power generation. Along the way, more widespread collaborative strategies for implementation have included broad public consultation and engagement around specific aspects of Energiewende, such as development of new transmission-line corridors. This cocreation logic supported a directing-change approach reflected in 1991 national legislation called the Feed-In Tariff Act (FITS). It comprised two key elements: one requiring electric utilities to purchase electricity from renewable energy sources at minimum prices higher than the electricity’s real economic value, and the second requiring consumers to carry the financial burden. This approach also supported a doing-change movement for energy transformation that pushed more decentralized energy generation. Farmers became solar and wind farmers, as well as agricultural producers; subsidies for solar panels led to widespread generation by homeowners. This doing-change activity became critical following the

Stanford Social Innovation Review / Spring 2018

legislation, as a myriad of small producers of solar and wind energy arose. Individuals who earlier had thought of themselves simply as farmers or homeowners became energy producers as they installed wind turbines and solar panels. Individuals who were traditionally consumers combined energy production for sale through solar installations on their properties to become “prosumers.” This has had wide-ranging implications for other directing-change actions, such as the decision in 2014 by Germany’s top utility, E.ON, to sell off (a form of “destruction”) its traditional coal and nuclear power businesses entirely, in order to focus on clean energy, power grids, and energy-efficiency services. The distinctions among the four strategies can be blurred. For example, the city of Munich is working with the utility it owns to become, by 2025, the first city of more than a million residents to use 100 percent renewable energy. Given the city’s ownership of the utility, this can be seen as a directing-change strategy. But it also can be seen as a collaborative strategy, considering that it is a product of multiple stakeholder groups working with the producer and owner. And it is a doing-change strategy, considering that a geographic location has decided to simply go ahead and create the new system. The energy transition is not occurring without resistance. But the main questions concern how to transition—with traditional energy generators and energy-intensive industries being the primary losers, who were largely bought off by the structure of FITS. As the new energy producers grew in number, they became key advocates for pushing ahead with the transition when it looked as if it might falter. Political mobilization was critical as a forcing-change strategy, leading to the Green Party joining a coalition government (1998-2005) that reinforced the original path with strengthened legislation in 2000. With local public utilities providing an important portion of the country’s energy, local elections also became periods of (re-en)forcing change with demonstrations and other actions to press forward with the energy transition.

challenges were by doing-change entrepreneurs. Individuals did not have to have someone “approve” their marriage to consider themselves married, and the United States has an individualistic tradition. Gays and lesbians simply lived as married couples, minus the legal recognition. In the 1980s, this increasingly became associated with commitment ceremonies of various forms, with those supportive of them present. Gay couples often brought children into their family from traditional marriages, through adoption, through surrogates, or simply through extended family. They became defiant role models. On the streets, warriors took action by the public assertion of gay identity. In 1969, when policed applied routine harassment practices on homosexuals at the Stonewall Inn bar in New York City’s Greenwich Village, a riot ensued, and from this tiny, isolated protest a powerful gay rights movement grew. In 1979, between 75,000 and 125,000 individuals participated in the first national LGBT march on Washington, D.C. Gay parades became annual events in major cities, promoting gay pride and civil rights. In the 1980s, protests and aggressive actions were organized around the AIDS crisis. This experience provided a firm base for similar organizing tactics when the issue of marriage equality came to the fore in the 1990s. It became a dominant theme in the annual parades and fueled protests for legislative action. Attempts to secure a directing-change strategy through legal rules started early. In 1970, the first legal challenge by a same-sex couple against the restriction of marriage rights to heterosexual couples was filed. The US Supreme Court dismissed it without a hearing. Gay activists took up the issue in the 1990s as the AIDS crisis forced more people out of the closet and more gays and lesbians decided they wanted the legal benefits associated with marriage. Eventually, legal victories piled up, beginning with arguments under state constitutions. In 1999, the Supreme Court of Vermont held that excluding same-sex couples from marriage was unconstitutional, prompting the legislature to create “civil unions” as marriages in all but name. The Massachusetts Supreme Judicial Court in 2003 issued the watershed ruling that made marMARRIAGE EQUALITY IN THE UNITED STATES riage between same-sex couples legal for the first time in an American In 2015, in an ultimate directing-change move, the US Supreme jurisdiction. In 2012, voters in four states supported marriage equality Court ruled that marriage between through referenda—after 32 referenda had been lost around the country. same-sex couples was a constitutionThese victories built on cocreally protected right. Today 62 percent ating change strategies of coalition of Americans support it, according to The four basic approaches to societal change building. Religious coalitions were the Pew Research Center. But only a T A I especially important, given that half century earlier, every American O E N R C opposition to same-sex marriage was state had laws that criminalized some form of same-sex sexual intimacy; until often claimed on religious grounds as 1973 homosexuality was described as being against the will of God. At the turn of the millennium, the Religious a “mental disorder” by the American Doing Cocreating Psychiatric Association; and in 1996 Coalition for the Freedom to Marry in Change Change President Bill Clinton signed the Massachusetts included more than Defense of Marriage Act, prohibiting 1,000 clergy, congregations, and orgasame-sex marriage. The victory of marnizations from 23 faith traditions. LobForcing Directing riage equality in the United States is bying in a warrior tradition grew into Change Change new coalitions cocreating change as arguably one of the most rapid changes Democratic Party leaders and legisever for a core social institution and for lators came on board. fundamental values. Perhaps predictably, given the In the background, a huge shift took DE very personal yet cultural quality of place in business: By 2013, 67 percent of ST R U C T I O N the issue and its US setting, the first Fortune 500 companies offered health O N TAT I O

B O R AT I O

NFR

LLA

Change Strategies

Stanford Social Innovation Review / Spring 2018

Characteristics of Change Strategies The roles, rationales, and tactics of the four approaches to societal change DOING CHANGE

FORCING CHANGE

DIRECTING CHANGE

COCREATING CHANGE

n Creation

n Destruction

n Creation

n Confrontation

n Collaboration

Archetypical Role

Entrepreneur

Warrior

Missionary

Lover

Dynamic

n Inventing

n Mobilizing

n Reinventing

n Collaborating

n Growing

n Challenging

n Breaking

n Coevolving

Necessary Conditions

Willingness to start small and face naysayers

Willingness to risk incurring harm

Willingness to take on tradition and power structure

Willingness of everyone to change

Danger

Irrelevance

Marginalization

Suppression

Co-optation

Relationship to Traditional Power

Outsider

Insider

Question

What does living the new look like?

How do we press the old to become the new?

How can the old change itself into the new?

How can we work with the old to develop the new?

Archetypical Tactics

n Startups

n Community organizing

n Policy changes

n Multistakeholder forums

n Intentional communities

n State force

n Organization breakups

n Public engagement

n Strikes (capital, labor)

n Rights legislation

n Social labs

n Demonstrations

n Legal cases

Components

n Media campaigns

benefits for same-sex couples. The earliest significant examples were more experimental in a doing-it tradition, in industries that had a disproportionate number of gay employees and a more liberal workforce where employees could come out. There was a mix of concerns about fairness and ability to attract and retain employees. The early adopters gave way to a more directing-change strategy as businesses became convinced through lobbying and example setting that they should support their gay and lesbian employees. The environment that led to this monumental shift was supported by a similar move by media companies. They started with a doingchange strategy of very occasionally bringing gay lives into popular entertainment. But this grew into a directing-change strategy, whereby the regularity of gays and gay marriage in popular entertainment became a message about what should be accepted as the new â&#x20AC;&#x153;normal.â&#x20AC;? One of the first media breakthroughs on gay issues in general came in 1971 with an episode of the leading television sitcom All in the Family, which featured sympathetically two gay men. More direct issues of partnership, love, and commitment between two men were featured in the highly acclaimed 2005 hit movie Brokeback Mountain; the toprated sitcom Modern Family, which premiered in 2009, included a gay couple with a child; and in 2012 Marvel Comics gave one of its superheroes a homosexual wedding, ensconcing it as a new norm to support. SIX LESSONS OF SOCIETAL CHANGE

Applying the framework to the two cases not only helps to clarify the strategies and logic at work, but also offers more general insights about the process of societal transformation and the workings of societal change systems. Six lessons, in particular, stand out. Each of the four strategies can contribute critically to one transformation. All four strategies play an essential role in both cases. The energy case provided individuals with a way to realize their ideals as prosumers, to advocate in various forums their beliefs and values, to develop collaborations with the existing system to create

change, and to access power in institutions to support and direct the change. In the same-sex marriage case, doing change was reflected in individuals living as though they were married; forcing change provided a chance for supporters to demonstrate their position publicly; cocreating with early adopters such as supportive clergy provided important ways to pressure the establishment; and as supporters grew in legislative and judicial forums, they created a directing-change legal environment. This suggests that the strategies are collectively important for providing a range of ways of supporting transformation, since different people and organizations have different roles in the change process. Property owners in Germany became doing-change leaders when they became prosumers; others supported the effort by being warrior activists. In the fight for marriage equality, only gay couples were capable of doing change, whereas non-couples and the broader community could participate in forcing change through demonstrations, parades, and referenda; cocreating-change efforts were particularly important for developing more sustained interactions among institutions that were early marriage-equality supporters; and the directing-change activity gave supporters a way to create change within their own institutions and in society more broadly. Particular transformations emphasize a particular strategy. The four strategies were not of equal importance in the cases. For Energiewende, the directing-change legislative strategy was particularly important. Its salience arose in the context of broad agreement about the end, the value of the change, and the need to focus on the means to realize carbon-free energy. Under such circumstances, the ease of doing change through modest solar and wind energy commitments by individuals was also important; this group grew in power to become particularly strong advocates to offset the influence of resisters such as major industrial electricity users and private power companies. The marriage-equality example makes more balanced use of all the strategies, although the directing-change action was the result.

Stanford Social Innovation Review / Spring 2018

The doing-change strategy was critical for bringing gay relationships into the open and creating discussions among friends and family to challenge the traditional definition of family; forcing-change activities created space for a broadening number to express their support; building coalitions across traditional religious perspectives was critical to challenging religionâ&#x20AC;&#x2122;s role in the debate; but it was state legislation and finally the US Supreme Court rulings that were critical to ending the debate in the face of a still-divided public. As a transformation progresses, the comparative importance of each strategy changes. Energiewende really took off with a cocreating-change strategy generated by broad support, which opened space for a shift to the directing-change legislative action. Legislation, in turn, enabled the doing-change strategy of individuals pursuing their own renewable energy production; forcing change provided secondary support for the overall transformation. In this case, all the strategies continue to interact as the transition continues. Doing change was the original strategy for gay couples. But this was highly marginal, until the forcing-change activities associated with the assertion of lesbian and gay equality and demands for AIDS services created space for similar marriage-equality forcing-change activities. This produced directing-change actions first by some municipalities, states, and corporations, and eventually through the final resolution by the US Supreme Court. The particular circumstances and environment that a transformation confronts determine the order of the strategies and their interaction. In our two cases, there is a notable diversity in stage order, and there is no obvious pattern. This suggests that characteristics of the cases themselves determine interactions between the strategies. The most obvious question is why people do not simply start in an organic fashion, with the doing-change strategy growing into widespread adoption and a new dominant way of organizing and acting. This seems to have been the case for marriage equality. However, that case demonstrates that realizing an enabling environment for doing change usually first requires some forcing-change work. An important precursor to doing-change commitment ceremonies was elimination (or at least lack of enforcement) of laws against sex acts between members of the same sex. This required substantial forcing-change action by gay activists, although their efforts started with a desire to be left alone rather than to be married. Qualities of the change issue itself can make a doing-change strategy on its own highly problematic. There were certainly early solar and wind energy entrepreneurs, but a doing-change Energiewende strategy was destined for irrelevance in the traditional operating environment, since developing technologies at scale requires substantial investment and change in rules governing energy transmission. However, in this case a cocreating strategy of collective education was the predominant predecessor of the creation of an enabling legal environment. Therefore, there seems to be a dual lesson on strategy interaction: In permissive enabling environments, there can indeed be an organic change process that emphasizes doing change. These are environments where legal structures and norms provide the basis for, rather than impede, experimenting and innovating culturally, technologically, and philosophically. But in the absence of such an environment, forcing change is not the only strategy possible: Cocreating change can provide an important avenue if there is broad agreement that change is needed.

Enabling environments support experimentation and the creation of networks. The fourth lesson suggests important qualities of an enabling environment to ease transformation. There is particular value in structures and traditions that support exploration: the ability to try out new lifestyles, technologies, and values associated with transformations. Institutional rigidity, narrow definitions of what is acceptable, large interdependent structures where change requires complicated coordination, and weak processes for developing broad consensus about change directions all contribute to a brittleness that is associated with more problematic transformations, such as the United Statesâ&#x20AC;&#x2122; transition to sustainable energy. Part of this is a question of political systems and the beliefs associated with them. Both cases involve political democracies. However, the multi-party German parliamentary system is more change friendly, as demonstrated by the important role of the Green Party. The range of options in the one-party Chinese system, for example, would be very different. However, an enabling environment is not simply one of passive acceptance of diversity. The marriage-equality case demonstrates the importance of creating networks and adopting forcing-change strategies as well. The German case represents the importance of creating large-scale conversations and experimenting with transformational challenges to promote a cocreating-change strategy. Each strategy requires distinct competencies. This article began by observing that different change organizations tend to be associated with different strategies. The cases illuminate the distinct tactics associated with each strategy, which in turn implies that they require different competencies. Experimenting with doing change is associated with entrepreneurial startup talent; forcing change emphasizes abilities to attract and organize mass numbers of people to take demonstrative action; cocreation focuses on facilitation and group-process skills; and directing change requires management, policy making, and enforcement capacity. This point about competencies further suggests that an organization is unlikely to be good at more than one strategy. Yet, the two strategies build off each other. Sustainable energy, for example, can be seen not just as a technological question within the current power structures, but also as an opportunity to create more just and resilient societies. But within the latter, broader vision, negotiations are needed for how to get there. This also suggests the importance of one change initiative being able to hand off the change work to another. BEYOND CLASSIFICATION

This typology of change strategies promises far more than simply a system of classification. More important, it can inform an overall strategy of change for any particular issue in a societal change system. It can also guide the development of resilient societies, by illustrating the qualities that help address and resolve large change challenges. This strategy analysis leads to important questions about processes for supporting productive interactions between strategies. For those working on change initiatives, the focus shifts from questions about how your initiative can be successful to how you can best serve the needs of the societal change system as a whole. Are there synergies, gaps, redundancies, or conflicts between your change initiative and othersâ&#x20AC;&#x2122; that should be addressed? The very concept of a societal change system suggests that whatever particular strategy your initiative adopts, there will be a need eventually to adapt to a cocreative strategy for the change system as a whole. n

Stanford Social Innovation Review / Spring 2018

At a time of rapid scientiﬁc advances, philanthropy has a vital role to play in building a culture of

, “civic science”: one in which scientists take active roles as citizens, and citizens from all walks of life

engage with scientiﬁc research and its social and ethical implications.

The

Cıvıc Scıence Imperative

BY ELIZABETH GOOD CHRISTOPHERSON, DIETRAM A. SCHEUFELE & BROOKE SMITH Illustration by Michael Waraksa

cience, backed in part by philanthropic funding, has made great gains in the global fight against malaria. The World Health Organization estimates that since 2001, these efforts have prevented 6.8 million malaria deaths. What if they all could be avoided? Some 429,000 people still died from malaria in 2015, most of them children. What if we could engineer the extinction of a few species of mosquitos to prevent more deaths? What if doing so required a technology that could, in the wrong hands, be reversed to make mosquitos into new kinds of biological weapons, carrying new kinds of diseases? What if in the future no one needed to wait for an organ transplant? As of last summer, more than 116,000 people in the United States were waiting for an organ. Twenty die every day while waiting. What if the organs needed to end this continual shortage could be grown in pigs? Would animals that were edited to be “human” enough to serve as sources of organs also have enough human cells in their brains—as some ethicists have argued—to have partially human consciousness? What if a person with the mutated gene that causes Huntington’s disease—inevitably, devastatingly, fatally—could have the gene edited and avoid the disease? What if people could make the edit in the genes passed to their children and so eliminate the disease? What if people could also eliminate less damaging traits or add desirable ones? For instance, what if they could make themselves and their children more intelligent? Should they be allowed to? Who would

do it? Only wealthy people? People in some countries and not others? Who would decide? Those who have been following the rapid development of the new gene editing technique called crispr/Cas9 (or simply “crispr”) know that steps have been taken toward all of the possible futures described above, although some seem within reach, while others are, at this point, purely speculative. A nonprofit research consortium called Target Malaria is using crispr—a kind of molecular find-and-replace function—to develop Anopheles mosquitos that can only produce non-biting male offspring and that can spread this trait throughout a mosquito population, eventually causing the population to collapse. Earlier this year, researchers at the Salk Institute in San Diego used crispr to grow a functioning rat pancreas, heart, and eyes in a mouse embryo. They also generated human cells and tissues in an embryonic pig, which is the right size to host human organs. We are still far from knowing how to modify genes to produce complex traits such as intelligence. But researchers, using mice, were able to edit the mutant Htt gene that causes Huntington’s disease, nearly eliminating the toxic protein that causes the breakdown of cells during the course of the disease. And in August, scientists at Oregon Health and Science University reported successfully editing a gene responsible for heart failure in a human embryo. These advances are remarkable examples of the miraculous discoveries of contemporary science. The immensity of the radical new kind of power that crispr represents has led it to be compared—even by the scientists who invented it—to atomic energy. Like any powerful technology, it can be used for purposes that most of us would applaud or for purposes that most of us would condemn. And there is a lot of gray territory in between. Only a few years old, crispr has put humankind on a path that is unmapped and uncharted—not just scientifically, but also ethically, socially, and legally. Instances of discrimination, eugenics, and persecution based on genetic traits are part of a troubling strand of medical history. Will

Stanford Social Innovation Review / Spring 2018

our new ability to edit the human genome create new pressure for some populations to be genetically edited, perhaps against their will? Will it increase discrimination against those who choose not to? What other challenges will emerge? Many of the questions crispr raises are not scientific or technical, nor do they have “correct” answers that scientists can provide. crispr represents a type of emerging science that within the lab has manageable technical risks but outside it generates ethical, political, and other societal dilemmas that only become clear once we begin to consider concrete applications. As with human genome editing, issues raised by stem cell research, synthetic biology, nanotechnology, and artificial intelligence fall squarely in the category of “wicked problems” 1—those that require a careful weighting of different known and unknown consequences and the connections among them. Ideally, we will determine how to handle these issues through what the editors of The Lancet recently called “exhaustive and effective” public engagement about their scientific potential alongside the moral, political, and societal trade-offs involved. 2 The fact that we are in uncharted territory in so many areas of science opens up tremendous opportunities to re-envision how we as a society debate and guide the development of new knowledge and technology. Philanthropy has a vital role to play in fostering the discourse necessary to navigate these opportunities successfully. A GROWING MANDATE FOR PUBLIC ENGAGEMENT

Some in the scientific community have long embraced the idea of engaging the public in broad discussions about emerging technologies and their implications. Writing in 1948 in the Bulletin of the Atomic Scientists, a publication founded by Manhattan Project scientists who “could not remain aloof to the consequences of their work,” J. Robert Oppenheimer urged greater dialogue between scientists and nonscientists. The “father of the bomb” described a growing consciousness among physicists about the implications of their work, a result of “the experiences of this century, which have shown in so poignant a way how much the applications of science determine our welfare and that of our fellows, and which have cast in doubt that traditional optimism, that confidence in progress, which have characterized Western Culture since the Renaissance.” 3 At the beginning of the 21st century, Alan Leshner, now CEO emeritus of the American Association for the Advancement of Science (AAAS), called for an “honest bidirectional dialogue” about the risks and benefits of emerging science. Scientists, he wrote, “need to respect the public’s perspective and concerns, even when we do not fully share them, and we need to develop a partnership that can respond to them.” 4 Yet scientific culture does not typically nurture public engagement by scientists, and often discourages it. The guiding mantra for most scientists’ careers is “publish or perish.” Scientists must focus on writing grants, doing research, publishing, and teaching. Even if scientists want to take part in civic dialogues, many universities do not adequately incentivize engagement, and professionals who enable effective communication about science often lack adequate support. However, several recent developments, including the emergence of crispr, are contributing to a shift in culture. University of California, Berkeley, biologist Jennifer Doudna, one of crispr’s pioneers, is also a leading voice for broader societal conversations with social scientists, faith-based communities, regulatory and political

ELIZABETH GOOD CHRISTOPHERSON is president and CEO of the Rita Allen Foundation, a venture philanthropy organization that enables early-career biomedical scholars to do pioneering research, seeds innovative approaches to fostering informed civic engagement, and develops knowledge and networks to build the effectiveness of the philanthropic sector. Civic science is a growing area of research, investment, and coalition-building for the foundation.

Morgridge Institute for Research. His research deals with the interface of media, policy, and public opinion. He vice-chaired the National Academies of Sciences, Engineering, and Medicine committee that recently issued the report “Communicating Science Effectively: A Research Agenda.”

BROOKE SMITH is the director of public engagement at The Kavli Foundation, which is dedicated to advancing science for the benefit of humanity, promoting public understanding DIETRAM A. SCHEUFELE is the John E. Ross of scientific research, and supporting scientists Professor in science communication and Vilas and their work. From 2005 to 2016, she was Distinguished Achievement Professor at the the executive director of COMPASS, a leading University of Wisconsin-Madison and in the science communication nonprofit.

actors, and the general public “on how those technologies could, and should, be used.” 5 Recent survey data suggest that many citizens agree. People want to be involved in discussions about crispr, regardless of their views of it. These views vary in part based on respondents’ religious background, their understanding of the technology’s technical risks and benefits, and the degree to which they or their family members are affected by diseases that crispr may be able to cure.6 The public seems ready for such discussions about crispr and other emerging technologies, and so do scientists. However, the urgent need for inclusive and constructive debates comes at a less-than-ideal time in our political history. Decreasing levels of political involvement by individual citizens have gone hand-in-hand with a decline in what some term “social capital,” as fewer community organizations and other institutions integrate citizens into the social and political fabric of their communities.7 Recently, this social fabric has been strained even further by an increasing polarization of the electorate8 and changing, sometimes distorted, media systems that rely more and more on online channels. Personalized news environments have enabled a new type of hyperselectivity among audiences. Social scientists have long observed that people lean toward consuming information and news that fit their preexisting beliefs.9 News aggregators such as Google News, Flipboard, and Feedly now allow people to permanently firewall their news diets against certain sources, topics, or viewpoints. With close to 7 in 10 Americans today reporting getting at least some of their news from social media,10 this problem is becoming even more acute. These effects are compounded when we deal with complex and emerging scientific topics that bridge traditional disciplines. As scientific information and analysis no longer reliably reach large cross-sections of the population, audiences are better able to shield themselves from information that does not fit their preexisting beliefs. Even when reading about uncontroversial topics such as nanotechnology, experiments have shown that audiences gravitate toward scientific news from sources that fit their own ideological leanings, regardless of the story’s headline or content.11 To find productive societal responses to emerging science, we need to escape these cycles of polarization, and for that we need more than scientific information. We need to engage in and support the messy, complex work of civic discourse and negotiation. FIVE WAYS PHILANTHROPY CAN FOSTER CIVIC SCIENCE

A society that embraces both scientific progress and democratic decision making will weigh important possibilities—for example,

Stanford Social Innovation Review / Spring 2018

the prevention and treatment of diseases—against regulatory, moral, and societal considerations. At times, these considerations may lead to curtailing what is possible for the sake of what is wise. We can only develop scientific breakthroughs responsibly if we can engage in societal dialogue about their potential and the complexities of introducing their applications. The way forward, we argue, lies in advancing a culture of civic science. By civic science, we mean broad public engagement with issues that arise at the many intersections between science and society. In communities that embrace civic science, scientists play active roles as citizens, people from many walks of life access science as part of their decision-making processes, and the environment in which people communicate about science is an inclusive space for public problem solving and discovery.12 There are useful models and promising examples of how to build an infrastructure for civic science, but a great deal of work is yet to be done. A crucial early step will come from catalytic investments by philanthropic organizations, which can galvanize new civic science initiatives, scale up existing efforts, and encourage other organizations to do the same. In designing these investments, philanthropists have a critical opportunity to draw on findings from communications research and pilot efforts by adopting five broad approaches: 1. Support effective science communication and engagement. | Many people who set out to communicate about science, including scientists, operate from a set of intuitive ideas about effective communication that research has shown to be wrong. This “knowledge deficit model” of communication goes something like this: This science is complex and new. I will take pains to explain it very carefully, and repeat myself, and use different metaphors, until you understand the facts. The assumption is that simply knowing the facts will lead people—and society—to scientifically sound decisions, such as vaccinating children and investing in renewable energy. Many scientists continue to use this model in spite of decades of research in the social sciences having produced very limited support for this approach.13 It turns out that trying to change long-held beliefs with scientific evidence is difficult, even when the audience is scientists themselves. While promoting a better understanding of scientific facts can help alleviate unfounded concerns in some contexts, it may be completely ineffective when science confronts preexisting beliefs or when scientific developments present problems without scientific answers. For example, computer scientists were able to develop artificial intelligence that could learn the language of social media and participate in it. But, as Microsoft programmers discovered when their Twitter chatbot Tay learned bigotry from human users and had to be shut down within a day, participating in a respectful, constructive way requires a different kind of knowledge about culture and values. A simplistic focus on communicating scientific facts may not only be ineffective—it can also backfire. A recent study showed that among some parents opposed to vaccinating their children, receiving more comprehensive information about vaccinations only made them less willing to follow recommended vaccine schedules.14 A number of science communication training programs—including those of compass, founded by the ecologist Jane Lubchenco; the Alan Alda Center for Communicating Science; and the Leshner Leadership Institute for Public Engagement with Science at the American Association for the Advancement of Science—are working to

overcome intuitive yet inaccurate beliefs such as those behind the deficit model. Equipped with approaches for active listening and research on what audiences care about, scientists can become more effective “bidirectional” communicators. More universities and philanthropies are investing in communication and engagement training for scientists they support, and they are creating public information offices that encourage and facilitate scientists’ connection with the public. Additional investments in this area are likely to fall on fertile ground, especially for fields of research that deal with wicked scientific problems. Recent surveys among leading scientists in fields such as epidemiology, stem cell research,15 and nanotechnology16 show an interest in and openness toward engaging with public audiences, and reflect an overall shift away from academic culture’s traditional discouragement of public outreach. Since the 2016 presidential election campaign, science communication training organizations and academic institutions have been reporting a surge in demand. “I think scientists have tended to roll their eyes when people say, ‘I don’t believe it,’ rather than roll up their sleeves,” Denis Wirtz, vice provost for research at Johns Hopkins University, said in July 2017. “[But now] I see faculty come to my office, come to our federal relations office, asking, ‘How do I communicate to Congress, how do I communicate to people?’ There is a sea change.” 17 Many of those who are leading emerging efforts to better communicate science are eager to incorporate findings from empirical social science about what approaches are likely to be effective. To meet increasing demand, philanthropic investments in science communication will need to intensify. Particular opportunities for widespread philanthropic influence lie in developing a useful and accessible body of applicable social science research, as well as encouraging public engagement by scientists and universities through funding, convening, and communication of cultural expectations. The Kavli, Moore, Packard, and Rita Allen foundations have begun a new effort to understand what an effective support system for scientists’ communication and engagement could be, by convening professionals who support effective communication along with researchers and systems designers to share insight and develop collaborative work. (One of the authors is president and CEO of the Rita Allen Foundation; another recently joined The Kavli Foundation after serving as executive director of compass.) 2. Capitalize on the strength of diverse coalitions. | The scientific community cannot make this shift toward engagement alone. Dialogue cannot be confined to what researchers in a field such as gene editing see as the most pressing issues. Identifying emerging challenges and opportunities and enabling meaningful social dialogue requires participation from community groups, political actors, media organizations, industry, journalists, and the broader public, as well as researchers in both the social and natural sciences. Philanthropy can promote coalitions among all of these groups, as well as connections across race, class, culture, geography, and ideology. Coalition-building can come from within the academic system. In 2006, for instance, the US National Science Foundation funded two Centers for Nanotechnology in Society to study the ethical, legal, economic, and policy implications of the emerging field. The centers, based at Arizona State University and the University of California, Santa Barbara, were interdisciplinary efforts, spanning the social, natural, and engineering sciences. They deployed creative

Stanford Social Innovation Review / Spring 2018

approaches to bring scientists and societal stakeholders together— for instance, organizing city tours for experts and the public to spark dialogue about nanotechnology in specific urban environments. Collaborative civic science organizations and movements can also exist outside of institutional settings. Genspace, a community lab in Brooklyn, connects science enthusiasts, high school students and teachers, professional scientists, artists, designers, and a variety of nonprofits. People not formally trained in science might work on projects side-by-side with trained scientists—for instance, developing a biosensor that provides real-time data on pollution in Brooklyn’s Gowanus Canal. With support from the Richard Lounsbery Foundation, Genspace hosts a series of community lectures and conversations about contemporary issues in genomic research alongside opportunities for anyone to use lab equipment to investigate the DNA of everyday materials—enabling people to identify fish from the market and backyard weeds, for example. In addition to providing support for coalitions, philanthropists can catalyze promising connections by supporting gatherings of disparate groups and providing seed funding for new collaborations. For example, the Rita Allen Foundation and other partners are supporting multidisciplinary, cross-sector convenings at the National Academies of Sciences, Engineering, and Medicine, including the recent Sackler Colloquium on the Science of Science Communication. (One of the authors was an organizer of the Colloquium.) These events, which focus on contentious and emerging topics such as artificial intelligence and human genome editing, are beginning to show results in new partnerships between social scientists and science communicators in governmental and scientific institutions. They also engage philanthropists themselves as active participants and encourage them to listen for opportunities and contribute ideas. 3. Build capacity to deal with moving targets. | Given the rapid emergence of new science and technology—not to mention unexpected crises such as the Zika virus outbreak in 2015—we must build into civic science qualities that allow it to quickly adapt to new topics and circumstances. Breakthroughs in crispr technologies, for example, leave scientific and policy-making communities with little time to discuss the potential need for new regulatory frameworks—even as researchers around the world begin to work on early human trials. “I’ve never seen science move at the pace it’s moving right now,” crispr biologist Doudna said at a University of California, Berkeley, meeting last summer. “Which means we can’t put off these conversations.” 18 Doudna’s call to action echoes the concerns of University of South Carolina ethicist George Khushf over a decade ago: We are already approaching a stage at which ethical issues are emerging, one upon another, at a rate that outstrips our capacity to think through and appropriately respond. Whether we have already reached this stage or not, I am not sure, but of this I am certain: On the immediate horizon arises a point at which the traditional way we have addressed ethical issues fails, because it does not and cannot keep up with the rate at which new challenges emerge.19 The “moving target” problem arises not only from rapidly emerging areas of science, but also from the similarly disruptive, simultaneous transformations of our information, media, and civic

environments noted earlier. These shifts complicate our ability to think through the intended and unintended consequences of emerging scientific issues and raise their own sets of questions. If trust in news media continues to decline, who, if not journalists and scientists, will be the arbiters of facts in public debates surrounding science? If we do hope for professional journalists to play that role, how can we make quality news environments financially sustainable? What opportunities exist in current and emerging online environments to foster the kind of deliberative spaces that have declined in our offline, face-to-face interactions? Civic science philanthropy can begin to address moving targets by incorporating openness and flexibility into grantmaking approaches. Grantmakers should be willing to see projects change based on new circumstances and understanding, provide funding that isn’t earmarked for particular uses, open routes to funding for new ideas and organizations, and speed up review processes when necessary to meet timely opportunities. Building capacities that can be flexibly applied in new situations among individuals, organizations, and sectors is also key. Investments in a civic science system that is resilient and responsive might include, for example, helping equip scientists to speak about their own work as it develops; supporting intermediary organizations to build relationships among scientists, journalists, and policy makers; and creating lifelong learning opportunities to improve the public’s ability to assess the quality of new scientific information. While education in a school setting is the rightful focus of much philanthropic effort, it is essential to understand that exposure to scientific topics happens primarily outside of school—especially for emerging topics such as human genome editing and nanotechnology.20 Rapid change and unexpected crises also can be an inspiration for civic science innovation. The nonprofit Public Lab, which now serves as a hub for collaboration on do-it-yourself environmental science tools and community-led investigations, began in the days following the 2010 BP oil spill in the Gulf of Mexico. When reliable official information wasn’t available about the extent of the spill, community members from diverse professional backgrounds collected aerial images of the coastline using cameras launched on balloons and kites, and they combined them using an open-source platform they created. Since then, tools developed by Public Lab have been used for community science projects around the world, such as locating stray patches of invasive water chestnut for removal in Massachusetts’ Pioneer Valley, monitoring an open landfill adjacent to wetlands and residential areas near Boston, and guiding wetlands restoration around Lake Pontchartrain, Louisiana. 4. Focus on shared values. | Despite disagreement on key issues such as climate change, GMOs, and vaccine safety, Americans largely support and trust science and scientists. In fact, confidence in the scientific community is higher than for most other institutions in the United States, second only to the military. Eight in 10 American adults say in surveys that science has made life for most people easier.21 Even in a polarized age, civic science presents opportunities for nonprofits and philanthropists to help find solutions to complex problems and forge connections across divisions of geography, ideology, race, and culture around a common interest in discovery and progress. For this to succeed, however, it is critical to identify and connect with shared values. Climate change can be described in the context

Stanford Social Innovation Review / Spring 2018

of the need for new regulations and environmental protections, which are likely to appeal to people who identify as liberal, but not to those who identify as conservative. On the other hand, a discussion of climate change centered on the value of investments in alternative energy sources, with an eye toward energy independence and competitiveness in global energy markets, has the potential to draw more conservative agreement. While conservative Christians are less likely to believe that global warming is caused by human activity, the climate scientist Katharine Hayhoe, an evangelical Christian, is trying to change attitudes through presentations to Christian audiences that include in-depth discussions of the different roles that science and faith play when considering climate change and what to do about it. “For Christians,” Hayhoe says, “climate change directly intersects with mandates to be responsible for creation, to love others as Christ loved us, and to care for the poor and needy,” as climate change disproportionately affects the poor. We know from decades of research in linguistics, 22 sociology, 23 media effects, 24 and psychology 25 that the way information or choices are presented or framed can change how audiences interpret them.26 Framing helps us make sense of complex issues by connecting them to existing mental schemas27 and potentially channeling them through one ideological or value-shaped interpretive pathway instead of another—especially in the case of highly complex scientific issues that can be interpreted in a variety of ways. In building civic science, we cannot simply “stick to the facts” or— even worse—to frames that are likely to alienate particular audiences. We need to understand that people’s values, along with evidence, are central contributors to their decision making. Some religious audiences will use their faith to help inform their decisions about human genome editing, for example; parents who are carriers of Huntington’s disease might make the health of their future children the primary basis of their choices and views. There is no one correct way of looking at the issue. Ongoing interpersonal and societal debates can help us identify values that we can agree on and allow us to make regulatory and ethical choices with broad public support. Philanthropists can contribute to these conversations by communicating the core values that drive their own support of science, civic life, and their intersection. They can also fuel dialogues about science and values—in person, in the media, and in digital spaces. The Alfred P. Sloan Foundation’s program to promote public understanding of science, technology, and economics provides an example of multifaceted philanthropic support of science-related media, theater, film, and, recently, virtual reality that appeals to shared values. The program has supported works of popular nonfiction including Hidden Figures: The American Dream and the Untold Story of the Black Women Mathematicians Who Helped Win the Space Race, the book by Margot Lee Shetterly that was turned into the widely acclaimed film. Doron Weber, who directs the program at Sloan, noted the success that Hidden Figures had in challenging damaging stereotypes about who scientists are, and at the same time resonating with people across the political spectrum. “Works of art can bring people together,” he said. “And when they do that, you can walk out of the theater and maybe … it expands your understanding of other people.” 28 Experimentation in science-related visual media as a means to promote shared values has ample room for growth. A recent Pew study found that 45 percent of Americans get their science news

from documentaries and other science video programs, making these the second most common source of science news after general news outlets. Videos are also among the most trusted sources of science news—second only to science museums. 5. Build trusting relationships through applied research and feedback loops. | To ensure that people who may be affected by emerging de-

velopments in science and technology can participate in productive dialogue around these issues, we must establish a baseline of trust and familiarity between scientists and community members. Philanthropy can encourage this process by supporting the development of new pathways for scientific research that are more responsive to societal needs across many fields. Social science has a distinctive role in this system: It can examine and improve how we build connections between science and public stakeholders, and offer key insights for philanthropists who want to maximize their effectiveness. Sociologist Duncan Watts of Microsoft Research recently used the term “solution-oriented social science” to describe growing areas of research that are designed and communicated in ways that allow their findings to be more easily applied to real-world problems. Given that incentive systems in universities rarely encourage solutions-oriented social scientific research, philanthropists can step up to incentivize more use-inspired solutions thinking within the social sciences, including work to help develop more robust positive feedback loops between various scientific disciplines and communities they affect. Positive civic science feedback loops would increase knowledge through scientists and nonscientists seeking, sharing, and responding to information about the discoveries and practices of science as well as information about social and cultural dynamics and how scientific practices and discoveries affect them. These feedback loops would look different depending on the science and communities involved and might involve formal structures, such as public comment processes, and informal ones, such as conversations hosted by community groups. What’s important is that they would be an iterative process based on mutual benefit and learning. Even in ideal circumstances, these cycles of engagement could not involve every scientist and community member, but they would be sufficiently vital to spread information throughout scientific and public communities. Philosophers of science, going back at least to Francis Bacon, have stressed the importance of such exchanges. Philosopher Kwame Anthony Appiah summarizes this line of thinking: “The advancement of learning is the work of communities, groups of people in communication.” 29 Developing such feedback loops can create opportunities to address distinct issues of trust within particular populations and on particular issues. While scientists are highly trusted overall, trust within some communities and on some issues is lower, often because of historic or contemporary experience. For example, the infamous “Tuskegee Study,” in which researchers withheld treatment of rural African-American syphilis patients without their consent between 1932 and 1972, continues to fuel distrust in science and the health care system among African-Americans. 30 It is particularly in communities where trust in scientific institutions is lower that philanthropy has an opportunity to support civic science. Attuning scientists to the needs and experiences of these community members is a crucial step in laying the groundwork for timely dialogue, avoiding further disenfranchisement, and ultimately earning trust.

Stanford Social Innovation Review / Spring 2018

Philanthropy can contribute to the formation of new ties among scientists, scientific institutions, and diverse stakeholders directly, as well as to bodies of knowledge to make them more effective. Funders can also model more robust feedback loops in their own work. Feedback Labs and the Fund for Shared Insight are relatively new coalitions that provide resources for funders investigating the potential of greater listening and responsiveness to beneficiaries and other stakeholders in the social sector. We are eager to gather in a similarly collaborative fashion with others interested in engaging in the challenging process of building a diverse, widespread, and resilient culture of civic science. THE FUTURE IS HERE

Civic science is not merely about scientists seeking dialogue with the public. It is not just about creating regulatory processes with as much public input as possible. A culture of civic science requires both of these—and much more. It requires contributions from the academic community, from organizations that have made it their mission to enable a better dialogue between science and society, from patient groups and other affected stakeholders, from religious groups, from diverse populations, and from policy leaders. It requires a difficult, broad-based negotiation of moral, financial, and other societal trade-offs alongside a collective investigation of scientific potential. And to succeed, a culture of civic science requires investments from philanthropic organizations to seed and sustain work with inclusive engagement across sectors and communities. Of course, these discussions will be difficult, and they will be imperfect. Scientific progress will continue to push boundaries and challenge our understanding of what we as a society find acceptable or desirable. By fostering a culture of civic science, philanthropy can support meaningful deliberation on how best to manage the technical and social risks of emerging technologies in light of their potentially immense benefits. At a summit on human gene editing hosted by the US National Academies of Science, Engineering, and Medicine two years ago, after a long discussion about the ethical and societal dilemmas surrounding the issue, a woman who had been listening from the audience was called on for the final question. In the room were hundreds of ethicists, scientists, patient advocates, and representatives from think tanks and government agencies. Her name was Sarah Gray, and she spoke through tears. “I am the mother of a child who died because of a fatal birth defect,” she said. “He was six days old. And he suffered every day. And the look on his face was like, ‘Mom, what’s going on?’ He had seizures every day. We donated his body for research. If you have the skills and the knowledge to fix these diseases, then freaking do it.” The audience broke out in applause. We all have a stake in a future that reflects the best of scientific discovery, benefits humanity, and reflects our values and ideals. There is little room for hesitation. The future is here. n N OTE S

1 Horst W. J. Rittel and Melvin M. Webber, “Dilemmas in a General Theory of Planning,” Policy Sciences, 4, 1973, pp. 155-169. 2 “Genome Editing: Science, Ethics, and Public Engagement,” editorial, The Lancet, 390(10095), 2017, p. 625. 3 J. Robert Oppenheimer, “Physics in the Contemporary World,” Bulletin of the Atomic Scientists, 4, no. 3, 1948, pp. 65-68.

4 Alan I. Leshner, “Public Engagement with Science,” Science, 299 (5609), 2003, p. 977. 5 Jennifer A. Doudna and Samuel H. Sternberg, A Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution, New York: Houghton Mifflin, 2017. 6 Dietram A. Scheufele, Michael A. Xenos, Emily L. Howell, Kathleen M. Rose, Dominque Brossard, and Bruce W. Hardy, “U.S. Attitudes on Human Genome Editing,” Science, 357 (6351), 2017, pp. 553-554. 7 Robert D. Putnam, Bowling Alone: The Collapse and Revival of American Community, New York: Simon & Schuster, 2000. 8 Pew Research Center, “A Wider Ideological Gap Between More and Less Educated Adults,” Pew Research Center, April 16, 2016. 9 Ziva Kunda, “The Case for Motivated Reasoning,” Psychological Bulletin, 108, no. 3, 1990, pp. 480-498. 10 Elisa Shearer and Jeffrey Gottfried, “News Use Across Social Media Platforms 2017,” Pew Research Center, September 7, 2017. 11 Sara K. Yeo, Michael A. Xenos, Dominique Brossard, and Dietram A. Scheufele, “Selecting Our Own Science: How Communication Contexts and Individual Traits Shape Information Seeking,” Annals of the American Academy of Political and Social Science, 658, no. 1, 2015, pp. 172-191. 12 Jonathan A. Garlick and Peter Levine, “Where Civics Meets Science: Building Science for the Public Good through Civic Science,” Oral Diseases, 23, no. 6, 2017, pp. 692-696. 13 National Academies of Sciences, Engineering, and Medicine, Communicating Science Effectively: A Research Agenda, Washington, D.C: National Academies Press, 126, 2016. 14 Brendan Nyhan, Jason Reifler, Sean Richey, and Gary L. Freed, “Effective Messages in Vaccine Promotion: A Randomized Trial,” Pediatrics, 133, no. 4, 2014, pp. e835-e842. 15 Hans P. Peters, Dominique Brossard, Suzanne de Cheveigné, Sharon Dunwoody, Monika Kallfass, Steve Miller, and Shoji Tsuchida, “Interactions with the Mass Media,” Science Communication, Science, 321 (5886), 2008, pp. 204-205. 16 Elizabeth A. Corley, Youngjae Kim, and Dietram A. Scheufele, “Leading U.S. Nanoscientists’ Perceptions About Media Coverage and the Public Communication of Scientific Research Findings,” Journal of Nanoparticle Research, 13, no. 12, 2011, pp. 7041-7055. 17 Nick Roll, “Science’s Communication Problem,” Inside Higher Education, July 13, 2017. 18 Brad Jones, “CRISPR Co-Discoverer: “I’ve Never Seen Science Move at the Pace It’s Moving Now,” Futurism, 2017. 19 William S. Bainbridge and Mihail C. Roco, eds., Managing Nano-Bio-Info-Cogno Innovations: Converging Technologies in Society, Springer: Dordrecht, the Netherlands, 2006, pp. 255-278. 20 John H. Falk and Lynn D. Dierking, “The 95 Percent Solution: School Is Not Where Most Americans Learn Most of Their Science,” American Scientist, 98, no. 6, 2010, pp. 486–493. 21 See Dietram A. Scheufele, “Communicating Science in Social Settings,” Proceedings of the National Academy of Sciences, 110 (Supplement 3), 2013, pp. 14040-14047; and Cary Funk and Brian Kennedy, “Public Confidence in Scientists Has Remained Stable for Decades,” Pew Research Center, 2017. 22 George Lakoff and Mark Johnson, Metaphors We Live By, Chicago: University of Chicago Press, 1981. 23 Erving Goffman, Frame Analysis: An Essay on the Organization of Experience, New York City: Harper & Row, 1974. 24 Shanto Iyengar, Is Anyone Responsible? How Television Frames Political Issues, Chicago: University of Chicago Press, 1991. 25 Daniel Kahneman and Amos Tversky, “Choices, Values, and Frames,” American Psychologist, 39, no. 4, 1984, pp. 341-350. 26 Dietram A. Scheufele, “Framing as a Theory of Media Effects,” Journal of Communication, 49, no. 1, 1999, pp. 103-122. 27 Dietram A. Scheufele and Davide Tewksbury, “Framing, agenda setting, and priming: The evolution of three media effects models,” Journal of Communication, 57, no. 1, 2007, pp. 9-20. 28 “Doron Weber: The Story of Science,” interview by Alexander Heffner, “The Open Mind,” WNET, May 13, 2017. 29 Kwame Anthony Appiah, Lines of Descent: W.E.B. Du Bois and the Emergence of Identity, Cambridge, MA: Harvard University Press, 2014. 30 Vicki S. Freimuth, Sandra C. Quinn, Stephan B. Thomas, Cole Galen, Eric Zook, and Ted Duncan, “African Americans’ Views on Research and the Tuskegee Syphilis Study,” Social Science & Medicine, 52, no. 5, 2001, pp. 797-808.

Are you using your All Access subscription to SSIR? Your All Access subscription entitles you to SSIR’s entire digital archive of over 2,500 articles! Register now if you haven’t already. HOW TO REGISTER

Find your account number on your mailing label

2 Go to ssir.org/account/register

You will have full access to all of Stanford Social Innovation Review’s content! Need Help? Contact the Customer Service Department: 888-488-6596 (toll free) or 845-450-5202 (outside US) | info@ssir.org

Introducing the next generation of one of our most popular and critically important efforts,

(Impact India logo by David Herbick Designs.)

A digital destination on SSIR.org. The latest information on social innovation in the worldâ&#x20AC;&#x2122;s most populous democracy.

Visit ssir.org/impact_india and explore it for yourself. (Illustrations by Pierluigi Longo)

SSIR-ImpactIndia-FullPage-R2.indd 1

2/1/18 10:47 PM

Stanford Social Innovation Review / Spring 2018

INSIGHTS FROM THE FRONT LINES

Taps and Toilets for All Microfinance for water and sanitation enables people to find their own solutions. BY GARY WHITE & MATT DAMON

ILLUSTRATION BY ROB WILSON

lobally, 844 million people still lack basic water service—a drinking water source that is accessible within a 30-minute round trip from their home. Even more people, 2.3 billion, still do not have access to basic sanitation—a toilet or latrine that is not shared with other households. All human beings share the need for drinking water and sanitation, and the people with least access to them pay a steep price in health, wealth, and dignity. But there is another side to this story: Many people who lack access to water and sanitation know exactly how to solve their problems. They may just need to connect to an existing water system, buy a toilet, or set up a rainwater harvesting system using readily available labor, technology, and materials. Their solutions are in plain sight. They just need a financial bridge to reach them. Nureni was one of these people. Nureni lives in Jakarta, Indonesia, with her husband and son. Not long ago, with a small amount of credit, she was able to have a water tap installed in her own kitchen. This saved her from a lifetime of having to fetch contaminated water from a stream shared with animals, or pay the exorbitant prices of a local water truck. Having safe water in her home enabled Nureni to start her own business: Each morning, she fills her pots with water from her tap in order to prepare a traditional rice and coconut dish, which she then sells to neighbors and passersby. The money Nureni makes from this business is helping put her son, Rhian, through school to become a motorcycle mechanic. He will soon graduate and start an internship at the local motorcycle manufacturing plant.

Plenty of people have water on tap in their kitchens. Why didn’t Nureni’s family, until recently? She couldn’t afford to pay for the connection in a single payment. But Nureni could make smaller payments over time, and with a little affordable credit, she invested in her own solution and changed her family’s lives. There are an estimated 565 million other people like Nureni, who, with access to affordable financing, could solve their own water problems immediately. Understanding this should trigger a fundamental shift in thinking. People in need are no less diverse than any other group of people, and they require similarly diverse pathways out of difficulty. Some suffer from inequities so great that they need immediate help and subsidies to access the basics of life. But there are hundreds of millions of others who are prepared to find and fund their own solutions to satisfy their needs. We can dramatically shift the balance of

those needing aid and charity by serving those who can participate financially with affordable household credit. FINANCING SMALL SOLUTIONS

When we met in 2008, we had been working independently on water issues. Gary had cofounded WaterPartners International, which worked with local NGOs to provide water and sanitation solutions. Matt had cofounded H2O Africa to raise awareness about the global water crisis. We both knew the overwhelming size of the problem. We witnessed, across many different countries, the crippling cycle of poverty that the lack of access to clean water and sanitation perpetuates. Collecting water is a major activity each day. Adults leave work to walk to the local community tap and then spend hours in line waiting to fill their containers. Children—mostly girls—are forced to leave school to spend their time collecting water, their future choices narrowing with every bucket filled. We saw firsthand how the smallest, most practical solutions can change lives. A toilet in the home means that children spend time on homework rather than finding a safe place to defecate. A tap means that a woman can take up sewing to earn money with the hours she once spent collecting water. Multiply these small changes by the millions, and they hold globally transformative potential. We observed that people, despite abject poverty, were making huge financial sacrifices to try to change their water situation, turning to informal credit markets— loan sharks—to do so. We learned that people earning as little as $1.25 a day were willing to access financing for water and sanitation if they could overcome the obstacles that stood in their path. We asked, what if we could facilitate small,

Stanford Social Innovation Review / Spring 2018

GARY WHITE is the CEO and cofounder of Water.org and WaterEquity, nonprofits dedicated to empowering people in the developing world to gain access to safe water and sanitation.

MATT DAMON is cofounder of Water.org and WaterEquity, and an Academy Award-winning actor, screenwriter, and producer.

affordable loans for water and sanitation access? Microfinance was enabling poor people to generate income by creating their own micro-businesses. Could we add microfinance to the tools we had available to provide the poor with access to safe water and sanitation? The answer was yes. Our organization, Water.org, now works with microfinance providers to extend affordable financing solutions for safe water and sanitation to the poor. We use our capital to offset startup costs and provide technical assistance to help microfinance institutions to build water-based loan portfolios. Our microfinance partners utilize financing from banks and capital markets so that they can disburse loans to their clients, who include both individuals and small communities. Their clients then hire contractors and use retailers to improve their own water and sanitation. We call this WaterCredit. We have disbursed nearly two million loans totaling more than $602 million through our partner institutions, to those living at the base of the economic pyramid. These institutions work closely with their customers’ communities, and they have built-in flexibility that enables their borrowers to define their own water needs and solutions. The program has seen tremendous success: Despite 60 percent of WaterCredit borrowers earning less than $2 a day, repayment rates are more than 97 percent. Wherever we can empower people to solve their own water and sanitation problems, they can break the poverty cycle. These people are not just investing in clean water and toilets, they are buying back time so that they can spend it caring for family members, going to school, and earning more money. This latter point is significant: Only 53 percent of WaterCredit borrowers in India were earning $47 per month or more before they took out a loan, but after financing their own water solutions, 97 percent of borrowers were achieving this level of income. During a recent trip to the Philippines, one of the women that I (Gary) met in San

Mateo, a suburb of Manila, was Leneriza Guerrero. She had recently connected to the water utility through a loan from ASA Philippines, a Water.org partner. Guerrero is now paying about $4.50 per month for her water tariff. Before connecting to the water utility, she had to purchase water from a local water vendor and pay to have it delivered to her home. This cost her about $60 per month. Her loan payments are about $5 per month, and it will take her 46 weeks to repay. This is an immediate net gain of more than $50 a month that she can use to improve her life and that of her family. We believe that if this approach—supporting small, sustainable solutions through affordable credit—is magnified, it will finally liberate the hundreds of millions of people whose lives are dominated by lack of clean water and sanitation, and empower them to better their circumstances. MORE ACCESS, FASTER

Among the 17 Sustainable Development Goals established by the United Nations is an ambitious yet achievable goal for water and sanitation: Ensure availability and sustainable management of water and sanitation for all (Goal 6). The World Bank estimates that meeting this goal by the 2030 deadline will take worldwide investments of $114 billion a year. Current aid for water and sanitation across all areas (including infrastructure, supply, and access) only adds up to $8 billion a year. If we continue to limit our thinking to aid and traditional development assistance, then the difference between these numbers is insurmountable. However, the problem becomes more solvable if we consider targeting charity to those who need it most and using financing to empower others to achieve their own water solutions. Interventions like WaterCredit unleash the latent demand and problem-solving power of our borrowers. Each repaid loan goes on to enable the next family. Investors reinvest their returns. The gap narrows. The problem of scale is paramount when there are more than two billion people left

to reach. Microfinance has the power to reach more people, faster. Water.org, for its part, aims to reach 60 million more people over the next five years. To do this, we will diversify the types of financial institutions delivering affordable loans, and we will work with partners throughout the water-service supply chain to pioneer new methods of delivering financing. We know that this five-year target is achievable, but we also know that it matches only 10 percent of the estimated demand for affordable financing. There needs to be far more support through better policies and an increase in capital injected into the system to encourage other microfinance institutions to enter this sector. Water.org’s programs have demonstrated that clean water and sanitation is a viable market, and we are not alone in understanding its potential. The Bill & Melinda Gates Foundation estimates that the global market for microfinance in water is $12 billion. Deloitte’s Monitor Inclusive Markets estimates a $10 billion to $14 billion market for toilets in rural India alone. The demand exists, as does the approach to meet it. Now we are beginning to see the missing piece: the investment capital that will catalyze the process. To tap into this new source of capital, Water.org recently launched WaterEquity, a fully dedicated and staffed impact investment manager. WaterEquity creates the opportunity, through a series of investment funds, for accredited investors to put their capital to work to achieve extensive social impact, while also producing financial returns. For some people, getting fresh water is as easy as turning the handle on a spigot. For others, it is a daily struggle that dominates their lives. This inequality demands action. But the actions we take will not be enough to end the crisis if we define people only by their needs. Nureni and Leneriza are agents of their own solutions; their needs, in comparison, were straightforward and achievable. With simple access to microfinance, people like them are ready to bring the water and sanitation crisis into its final years. n

ILLUSTRATION BY ROB WILSON

Stanford Social Innovation Review / Spring 2018

Let Refugees Be Their Own Solution Better policies in host countries can enable refugees to rebuild their lives and contribute to host economies. BY EMILY ARNOLD-FERNÁNDEZ WITH BRIAN RAWSON

ILLUSTRATION BY ROB WILSON

met Heba (not her real name) and a few other Syrian refugee women in Mafraq, Jordan, in January 2015. They were supposed to be in the Zaatari refugee camp six miles to the east but had escaped. “We thought it would at least have roads,” Heba said about Zaatari. She instead found a dusty plain with temporary buildings made of metal or plastic that couldn’t stop the blowing sand. Heba had left behind an urban, middle-class lifestyle in Damascus; Heba’s husband was a lawyer. She spoke of courtyards where fountains and plants created lush havens from city life. More than 22 million people today are refugees, having been forced to flee their countries due to war, violence, or persecution, according to the UN Refugee Agency (UNHCR). The average duration of a protracted refugee situation—defined as at least 5,000 people displaced for at least five years without a permanent home—is now 26 years. Refugees in camps may live for decades or generations behind barbed wire, often sharing communal bathrooms or kitchens and indefinitely dependent on aid. Our systems for temporary assistance have become warehouses, in effect, where refugees are kept in perpetual limbo. Once Heba entered the camp, she—like the other 80,000 refugee residents—was not permitted to leave. So she and her husband took matters into their own hands. They cut through the barbed-wire fencing and paid a man to smuggle them across the desert sands in a 4×4 off-road vehicle. Each of the Syrian women I spoke to in Mafraq had a similar story of escape. They had joined the ranks of the majority

of refugees who today live outside of camps. But I couldn’t help but wonder: What did they escape to? Less than 1 percent of the world’s refugees each year are resettled to wealthy countries such as the United States, Germany, and Australia. A full 86 percent of refugees today make their “temporary” home in middle- and low-income countries such as Jordan, Lebanon, Ethiopia, and Pakistan. Local contexts vary greatly, but most host countries make it difficult or impossible for refugees to participate safely and equitably in economic, social, and civic life. Work is illegal or unprotected, offering no way to contest exploitation such as wage theft by employers or workplace sexual assault. Refugee children are barred from enrolling in school, or doing so exposes their parents to arrest. Discriminatory laws and practices make local health care,

banking, and social welfare systems unavailable. Meanwhile, aid budgets cannot keep pace with even basic needs, pushing refugees further and further into poverty, desperation, and illicit activity. The scale of crisis in the Middle East brought to the world’s attention a problem that had been long simmering. But even as the world scrambles to find better solutions, a central powerful idea too often is overlooked: Refugees themselves are the solution. Refugees like Heba have the drive, initiative, and vision to build a viable life in the countries that host them. THE BENEFITS OF ACCESS

My human rights nonprofit organization, Asylum Access, began in 2005 with the conviction that all refugees deserve a fair chance at a new life. Over the past decade, we’ve worked intensively in a range of countries that host large refugee populations— Ecuador, Mexico, Malaysia, Thailand, and Tanzania—and are now partnering with organizations in other countries, such as Lebanon, to expand our impact. As a group of lawyers, we started by helping refugees in these countries to navigate the legal processes to get documents and work permits, enroll children in school, and access services such as health care and banking. But in too many places we saw that no integration processes existed. Refugees had no way to take the steps needed to build a stable life, even with a lawyer’s help. Everywhere we brought our services, we faced skepticism that we could make change there. But in every country where we work, we’ve fought to create a more enabling environment. Asylum Access staff—who are local citizens advocating for change within their home country—have worked closely with refugees to help them rebuild

Stanford Social Innovation Review / Spring 2018

EMILY ARNOLD-FERNÁNDEZ (@EDAsylumAccess) is the founder and executive director of Asylum Access. BRIAN RAWSON (@thebrianrawson) is Asylum Access’s associate director of advocacy and communication.

their lives and identify where barriers exist. To date, we’ve won legal documentation, work permits, education access, and other rights for more than 100,000 refugees, and changed national laws and policies that affect more than two million. An enabling environment is one that lets refugees enter, live safely, and move freely within the country; work lawfully without fear of exploitation or abuse; access education, health care, and financial services; and have recourse to justice when needed. Such rights cannot practically be guaranteed or enforced by international actors such as the United Nations, but rather become meaningful only when implemented and safeguarded by refugee-hosting governments through their national laws, policies, and practices—what we call the national governance framework. In Ecuador, we started work around the same time that the 2008 Constitution granted refugees equal work rights with Ecuadorian nationals. Gabriel, a Colombian refugee, came to us for help in understanding how he could hire other refugees in light of the new legal framework. He had started a small bakery selling pastries from a window, but a few years later, with our help, he was employing more than a dozen people, both refugees and citizens, in a large sit-down shop with multiple counters. In Tanzania, Asylum Access identified an underused legal provision that enabled a few refugees to live and work in Dar es Salaam instead of remaining confined in rural camps. We also helped groups of refugees set up community savings and loan associations. One refugee borrower invested $300 in mobile phones to sell around town; he eventually grew his enterprise into three shops and a motorcycle taxi service. Another has a line of clothing and accessories. Several run restaurants. Almost all employ Tanzanians alongside refugees. We’ve seen that when a country creates an enabling environment for refugees to participate in the economic, social, and civic life of their communities on equal terms with other residents, everyone benefits. A growing body of research suggests that when refugees

can participate freely, they tend to start new businesses, grow existing markets, and create new jobs. For example, a 2016 European Commission study, “The Syrian Refugee Crisis: Labour Market Implications in Jordan and Lebanon,” found that new Syrian-run businesses expanded the economy and saw little evidence that these businesses have displaced those run by nationals. And when refugees can safely and equitably participate in lawful formal-sector work, they’re far less likely to choose illicit or exploitative options, thus decreasing crime, relieving downward pressure on wages and working conditions, and lessening security risks, among other benefits. In the time since I met Heba, the Jordanian government has opened a few options for refugees to access lawful work. This is a significant step forward, but only a preliminary one. Jordan’s work permits generally bind refugees to a single employer—a system that is considered exploitative in other contexts. Some of the work opportunities require refugees to leave their families and communities for a different part of the country where they lack a support system or protection against abuse. Some solutions haven’t yet been considered, such as enabling refugees to easily obtain work permits for the work they are already doing under the table in the informal economy. Jordan’s experience and the concerns it raises underscore the importance of protections for refugee workers, free movement, workplace rights, access to banking, and other prerequisites of refugees’ safe, fair participation in the economy and society of their new homes. Experiments such as those in Jordan should be seen as important first steps upon which advocates—including Asylum Access and its partners, as well as UN agencies, aid donors, and civil society organizations—can build and improve through advocacy and incentives. A YEAR FOR ACTION

At the time I visited Jordan, the outflow of Syrian refugees had gripped the world’s attention and brought the displacement crisis

to Europe’s doorstep. In the last three years, the crises have continued—with one million South Sudanese fleeing to Uganda in the past year, and more recently 650,000 Rohingya fleeing Myanmar to Bangladesh. Tomorrow may well bring additional crises. The global community must act. This year is particularly critical for global action. By the end of 2018, the United Nations and world leaders are expected to deliver on two major commitments: a new Global Compact on Refugees and a complementary Global Compact on Migration. We urge decision makers to seize this moment to prioritize refugee participation in the economic, social, and civic life of their host countries. To promote refugee self-reliance, reform of national governance frameworks must be adopted as a necessary component alongside humanitarian aid and long-term development assistance. Host countries should be recognized and treated as having power and responsibility to pursue these reforms. But they cannot carry the responsibility alone. All nations, particularly wealthy nations and those hosting relatively smaller percentages of the world’s refugees, must take far greater responsibility for ensuring effective solutions for refugees and the countries hosting the largest numbers. Finally, we as globally engaged individuals all have a role to play. We can monitor governmental progress toward inclusive policies using sites such as our recently launched RefugeeWorkRights.org, which maps and scores access to safe, lawful work in nearly 30 countries. We can also promote access to existing opportunities. In Mexico, for example, the Ruta de Hospitalidad initiative (motto: #AquiNoHayMuros, or “No walls here”) brings together community groups, organizations, the private sector, and local governments to direct refugees to locations where they can receive a warm welcome, basic services, and opportunities for work and education. Through such actions, the international community can ensure enabling environments for refugees to rebuild their lives through exercising agency, participating in the economy, and contributing to society. n

ILLUSTRATION BY ROB WILSON

Stanford Social Innovation Review / Spring 2018

Social Enterprise Is Not Social Change Solving systemic social problems takes people, politics, and power—not more social entrepreneurship. BY MARSHALL GANZ, TAMARA KAY & JASON SPICER

ILLUSTRATION BY ROB WILSON

ocial enterprise and social entrepreneurship (SEE)—a business-inspired approach to solving social problems—has exploded across the United States and the world in the last decade. It has entrenched itself within a broad spectrum of fields, from economic development and urban planning to health and education policy. Since the Harvard Business School established the first “Social Enterprise Initiative” 25 years ago, SEE has rooted itself in more than 100 colleges and universities, anchored by endowed chairs and new courses in elite universities such as Stanford, Yale, Penn, Columbia, Duke, and the University of California, Berkeley. These institutions have helped turn SEE into an industry, funded by $1.6 billion in foundation grants since 2003. However, SEE has done little to solve the systemic social problems it purports to address, many of which have actually gotten worse. In fact, SEE’s rise distracts from and undermines the critical role of an organized citizenry, political action, and democratic government in achieving systemic social change, by offering itself as a private, market-based alternative. SEE is founded on neoliberal ideology: a belief that markets, not government, produce the best social and economic outcomes. SEE advocates construct social problems as knowledge problems that can be solved by technical innovation driven by competition among individual social entrepreneurs, operating through for-profit, nonprofit, or hybrid enterprises. In contrast, a political approach sees social problems as power problems. Dealing with them requires collective political action by organized constituencies that use the

power of democratic government to overcome resistance to structural social change. Successful examples of this approach include the social movements that fought for abolition, public education, agrarian reform, labor rights, civil rights, women’s rights, and environmental protection, in the United States and elsewhere. SEE’s incompatibility with collective, democratic political action is clear in the way its proponents frame their approach. First, they claim that “heroic” individuals are the key to broad social change. As explained in the SEE organization Ashoka’s promotional materials, “Just as entrepreneurs change the face of business, social entrepreneurs act as the change agents for society, seizing opportunities others miss to improve systems, invent new approaches, and create solutions to change society for the better.”

Second, they assert that the organizational form best suited to achieving social change is the entrepreneurial firm, offering organizational flexibility, efficient service delivery, and consumer choice between competing services. SEE firms, however, compete not for “customers” but for private sector donors or “investors” on the promise that they will satisfy the needs of their “end users” (beneficiaries) and “do good” by “doing well.” Third, SEE promoters seek to minimize government. John Whitehead, a former Goldman Sachs chairman who funded Harvard’s Social Enterprise Initiative, was explicit: “I’m always looking for opportunities to expand the nonprofit sector of our economy to have nonprofits take over functions that are now performed by the government. ... [I]n the work of public schools, charter schools are an example of how the private sector can do it better, or nonprofits can do it better.” We are not suggesting that SEE never has positive effects, but that its capacity to deal with major social problems is woefully inadequate. The SEE approach turns over major public policy domains to private sector organizations, for-profit or nonprofit, replacing democratic accountability with market discipline. But doing so makes little sense when addressing truly systemic social problems such as economic, racial, or gender inequality; or health care, education, or criminal justice. Entrepreneurial capitalism relies on market-based competition among firms for customers and can reward innovation with economic success. No comparable consumer-based reward system exists for SEE, meaning that even successful SEE initiatives rarely scale up. In fact, effectively scaling solutions to social problems usually requires the kind of government engagement that SEE eschews. SEE as a field has gotten to scale not from

Stanford Social Innovation Review / Spring 2018

MARSHALL GANZ is a senior lecturer in public policy at Harvard Kennedy School.

JASON SPICER is a PhD candidate in MIT’s Department of Urban Studies and Planning.

TAMARA KAY is associate professor of global affairs and sociology in the Keough School of Global Affairs at the University of Notre Dame.

market success but by building a vast network of ideological support and funding for its projects, including attracting talented college students and graduates. POPULARITY WITHOUT PROOF

Funding for SEE proliferates in spite of staggeringly little empirical evidence that it can create meaningful social change. Unlike public sector organizations, whose interventions and actions are often identified and tracked, SEE organizations are not subject to stringent regulations and transparency disclosures, and we find little evidence that they engage in rigorous assessments of their own impact, as many nonprofits do. The popular impact reporting and investment standards (IRIS) and social return on investment (SROI) tools promoted by SEEs are not based on rigorous research methods. Although affiliates of EMES International Research Network have attempted to address some of these concerns, the fundamental problems remain. In the absence of such disclosures or evaluations, most of SEE’s numerous failures go unreported. Among the exceptions, however, are two cases that do receive wide attention: US charter schools overall have not only failed to reduce educational inequality but have been shown to increase it—and yet significant financial support for them remains widespread. Internationally, a much-hyped South African company’s effort, backed by US and UK SEE funders, proposed to use children’s play on special merry-go-rounds to pump water in African villages but proved poorly adapted to many areas and inferior to existing solutions. Five years after the project launched, PBS Frontline found that many “PlayPumps” were unused or broken, having diverted resources from broader water-access solutions. SEE’s unimpressive track record in many such cases is ironic because its proponents cite government programs’ lack of accountability and efficacy as justification for promoting SEE in government’s place. In developing countries, the SEE model aspires to help dysfunctional postcolonial governments with

limited resources meet the requirements of multilateral institutions such as the World Bank and the International Monetary Fund. And yet SEE efforts—such as PlayPumps— themselves remain partially dependent on public funding, tax-exempt foundation grants, and procurement contracts. Given SEE’s poor track record, what accounts for its popularity? Its rise is linked to the dramatic renegotiation of the relationship between private wealth and public power over the last 40 years. The consensus view of democratic capitalism that emerged after World War II was that inequality of wealth could only be moderated by equality of political voice among citizens. Democratic government’s role was not as a “safety net” for the unfortunate few, but as a publicly accountable institution that could advance the common good in domains as diverse as education, health care, research, and national defense. It was the only mechanism that could employ the rule of law to rein in the power of private wealth. Since the 1980s, however, elites hostile to constraints on private wealth have succeeded in promoting a neoliberal ideology that rejects government as instrumental in solving social problems and instead casts it as the source of most problems. In this view, efforts should focus not on improving how democratic government functions, but on replacing it with private sector groups. This minimization of government’s role undermines the power of ordinary citizens, democratic politics, and the deployment of public resources to solve social problems. Citizens become customers, and, in the absence of constraints on spending, politics becomes a form of marketing. As a result, organizing the citizenry to demand public solutions to public problems grows increasingly challenging. There are known solutions to most social problems; what is missing is the capacity to put them to work. A global body of knowledge exists on how to reduce inequality, educate children, address climate change, improve our cities, and make decent health care available to all. Absent is the political will to restore labor rights, fund schools

equitably, disincentivize carbon production, provide adequate urban housing and transit, and control health care quality and cost. SEE fails to name, much less address, these core political problems. RECLAIMING PUBLIC VOICE

SEE’s construction of social problems as deriving from a lack of technical knowledge, rather than from a power imbalance, has serious political implications. Economist Albert Hirschman argued that in a system undergoing dynamic change, members can, in return for loyalty to a shared purpose, use their voice within the system to affect the trajectory of its change, or they can exit the system in search of another that can better meet their needs. The SEE approach promotes both individual and collective exit from the public sphere in favor of private approaches to social problems. SEE thus rejects innovation in how to employ collective voice and generate the social power needed to redirect public institutions to solve what are fundamentally political problems. In doing so, it undermines citizens’ commitment to political engagement on which democracy is based. In a democracy, creating social change requires sustained interaction between the state and a vigorous civil society. SEEs, however, redefine civil society as a space in which to create parallel, private institutions that circumvent the state and citizens’ claims to its resources. Constructing the disadvantaged as clients or customers, rather than citizens, undermines development of an active, engaged citizenry that can use its voice to participate in public institutions and democratic processes that reflect its will and needs. Real change and equality that all citizens deserve, and that the public good requires, can be achieved only when citizens can effectively use their political voice and do not exit the public sphere. The neoliberal assault on democratic government creates an opportunity to renew our democracy—if we can put aside distractions like SEE, step up, and join our fellow citizens to do the educating, organizing, and mobilizing that are needed to reclaim the power of public voice. n

ILLUSTRATION BY ROB WILSON

Stanford Social Innovation Review / Spring 2018

Reproductive Health Care by Mail It is time to give US women the convenience and autonomy of birth control and abortion pills that women elsewhere enjoy. FRANCINE COEYTAUX, ELISA WELLS & SOPHIA YEN

ILLUSTRATION BY ROB WILSON

hile the uterus is commonly revered as the miraculous womb of life, it comes with inconvenience, costs, and stigma for many women. Some of the challenges are unavoidably physical—monthly cramps and decades-long exposure to pregnancy risk. But many others result from social and political constructs that stigmatize women’s bodies and create barriers to accessing reproductive health care. No other body part is as highly regulated as the uterus. In 2011, a year after antichoice candidates swept state elections in the United States, more than 1,100 bills were introduced regarding women’s health and rights. While some ground was regained during the Obama administration—most notably the coverage of contraception under the Affordable Care Act, which resulted in more than 57 million women getting contraception without a co-payment—the Trump administration is systematically eroding this progress. State legislators across the country continue to introduce laws to restrict essential reproductive health services. In such a political climate, it is critical to find ways of making both contraceptives and abortion more accessible to those who need them. The right to obtain and use contraception and access abortion is part of the fundamental right to privacy guaranteed by the US Constitution. Nearly half of the six million pregnancies that occur each year in the United States are unintended. There is no reason to force women to go without convenient access to these safe and effective options. Technology may afford a way around the current challenges to reproductive health access. Just as Amazon and Airbnb are using

creative delivery and technology solutions to increase access to goods and services, new channels have arisen for accessing health services. Today’s reproductive generation consists of digital natives who are attracted to and demand client-centered design and convenience. Our organizations, Pandia Health and Plan C, answer their need for better options. THE POTENTIAL OF TECHNOLOGY

About three years ago, coauthor Sophia Yen learned that one of the top three reasons women don’t take their birth control pills is because they don’t have them on hand. Yen and Pandia Health cofounder Perla Ni knew they could solve this problem: just ship the pills to women and keep shipping them (automatic refills) until the women said to stop. They would provide a delightful user-friendly experience instead of the current slow, painful

pharmacy experience. However, when Yen and Ni ran ads for “free birth control delivery,” they found that about 60 percent of women didn’t have a prescription. As a doctor, Yen realized she could write the prescriptions. Thus, the idea of their organization was born. (Note: Ni was the founding publisher of Stanford Social Innovation Review.) Pandia Health currently provides convenient, confidential, and reliable prescription birth control delivery in California, and it is raising funds to serve more states. Pandia Health increases access for women who live hours away from the nearest pharmacy or doctor, and delivers prescription birth control (the birth control pill, patch, or ring) to wherever women have Internet access and a mailbox. By delivering the medications to their mailbox, Pandia Health saves women the time and transportation costs they would have incurred by refilling their prescription at the pharmacy every month. It also spares them the potential embarrassment they may face as their neighbors see them in line or the pharmacist announces aloud, “You’re here for birth control again?” The potential for technology to deliver convenient reproductive health services to women does not stop with prescription birth control. Coauthors Francine Coeytaux and Elisa Wells recognized that the same technology-based model could be used to expand access to mifepristone and misoprostol, the two medicines that constitute the highly effective abortion pills, also called medication abortion. For more than 10 years, women around the world have been able to selfdiagnose their pregnancies and order highly effective and safe early-abortion pills online or obtain them from a local pharmacy, often without a prescription. Services such as Women

Stanford Social Innovation Review / Spring 2018

FRANCINE COEYTAUX is cofounder and codirector of Plan C. She is known internationally for her work on new reproductive technologies and has pioneered the use of acceptability research to give voice to women and include their perceptions in the shaping of public health agendas.

ELISA WELLS is cofounder and codirector of Plan C. She specializes in introducing and evaluating emerging technologies and developing innovative programmatic approaches to meet women’s reproductive health care needs.

SOPHIA YEN is a physician and CEO and cofounder of Pandia Health. She also serves as a clinical associate professor of pediatrics in the Division of Adolescent Medicine at Stanford Medical School.

on Web, Women Help Women, and, more recently, safe2choose offer online consultations and express delivery of abortion pills directly to women in their homes, all without a physical exam. These sites also offer information and support to women about what to expect during the abortion process. Not surprisingly, research has found that women value the convenience and privacy of online services. Research has also demonstrated that the safety and effectiveness of this model are comparable to those of services delivered through clinics. Unfortunately, none of the services that supply pills in other countries will ship them to the United States, despite receiving nearly 10,000 requests per month from women here. These pills are the same ones given to women who choose a medication abortion at Planned Parenthood and other abortion clinics. But because abortion is so highly politicized in the United States, access to these pills has been severely restricted since the day that mifepristone (RU-486, also known as the French abortion pill) was approved by the US Food and Drug Administration in 2000. Unlike the vast majority of medications, which clinicians prescribe and patients pick up at a pharmacy, mifepristone can only be shipped to doctors who have specially registered with the manufacturer. This unusual FDA requirement was not established because mifepristone poses risks or requires special clinical expertise to provide—it is safer than Tylenol. Rather, the politics surrounding abortion and the strength of the US anti-choice lobby successfully restricted this safe, new technology. The hope had been that having an abortion pill could de-medicalize the abortion experience and expand the availability of abortion services beyond surgeons and into the hands of primary care providers. Advocates also envisioned pharmacy or over-the-counter access, which could have greatly diffused the stigma of both providing and seeking abortion and enabled a homebased private abortion experience. Instead, 18 years later, the only approved access in

the United States to these easy-to-use and very safe pills is still through registered abortion providers, who are becoming fewer and farther between. So Coeytaux and Wells created Plan C— an effort to spread the word about safe and effective pills for those who miss a period and do not want to be pregnant. Since early 2016, Plan C has been helping frame the national dialogue around self-managed abortion, publicly sharing information about the safe and effective pills that exist; mobilizing a generation to take action and demand access; and laying the groundwork for putting these pills directly in the hands of those who need them most. In California, following Pandia Health’s innovative approach, Coeytaux and Wells have rallied researchers to test a new model of care. Ushma Upadhyay, associate professor at the University of California, San Francisco, is launching the California Home Abortion by Telemedicine (CHAT) Study to demonstrate and evaluate a medically supported online service delivery model similar to those used internationally. By harnessing the power of new communication and Webbased technologies and shipping the pills to people’s homes, Upadhyay hopes that women can avoid the arduous steps currently required to obtain an early abortion. CHAT Study participants will request abortion services using a HIPAA-certified online or mobile platform. After answering relevant medical history questions (including the gestation of their pregnancy), they will have the option of chatting online with a provider to discuss any questions or concerns. If approved for the service, they will receive abortion pills via express delivery to their doorstep and follow-up medical support through the mobile platform and/or telephone communication with a provider, as needed or requested by the user. And like the user-friendly Pandia Health model, the CHAT study user experience will be simple, straightforward, and user-driven. Unlike other telemedicine models, which require a patient to appear in person at a clinic and/or schedule a specific appointment time, both

models provide users with home-based services at their convenience. IN WOMEN’S HANDS

The Pandia Health model of service delivery has already proved very popular. Indeed, a few similar services have launched and are adding coverage in other states as the excitement and demand grow. Similarly, the CHAT Study, if successful, could radically alter abortion services throughout the United States, providing universal access to abortion care and enabling those who need services to circumvent the barriers and stigma that have plagued abortion services for decades. Together, these Web-based, medically supported models of medication distribution by mail are demonstrating a new means of service delivery for reproductive health care that greatly increases access and puts convenience, confidentiality, and control in users’ hands. But a coordinated effort is needed to realize their full potential. These startup models need funding, particularly for expanding into more rural areas where the need is acute but the incentive is less compelling for for-profit enterprises. Philanthropists can play a role through social-impact investing or low-interest loans. Similarly, state governments that want to improve public health and decrease costs could fund pilot programs and change legislation that restricts access to this type of telemedicine. Finally, the public needs to know that taking birth control and abortion pills is neither risky nor complicated. Access to these effective family planning methods is limited because of politics, not health concerns. We have very safe, very effective methods that medical research and decades of use by millions of women have proven do not need much medical oversight. We also have the technologies to help people access quality reproductive health care—convenient, inexpensive, and ubiquitous mechanisms for ordering, shipping, and delivery. It is time to use these technologies to disrupt the nation’s restrictive reproductive health policies and put reproductive health medication into the hands of those who need it most. n

Professional Development, Practical Skills, Committed Experts! What attendees are saying about Stanford Social Innovation Review Webinars

“Very inspiring. I am just kicking off a design thinking grant program to incentivize crosssystem collaboration around improving health care access. The principles outlined today reflect my own. Right on!” “I found this webinar to provide a wealth of ideas as grounding and conceptual framing for the stories and cases that were shared. This melding of practical and theoretical was powerful. More importantly, I found myself finding language for some of what I have been learning to live in my work. I’m grateful to hear of others’ work. Thank you all! I look forward to more.” “Very nice presentations. Good balance of concept and case study.”

To view our entire library of exceptional webinars and for upcoming webinars www.ssir.org/webinars

Stanford Social Innovation Review / Spring 2018

HIGHLIGHTS FROM SCHOLARLY JOURNALS

CITIES

Nonprofit Crime Reduction BY CHANA R. SCHOENBERGER

ver since violent crime rates tumbled in American cities from the 1990s to the 2010s, researchers have been trying to figure out why. They have proposed many different causes— including shifting demographics, lead exposure, policing, and criminal justice policy—that tend to involve independent or external forces acting on urban areas. But until now, few have considered the actions of communities themselves in organizing to drive out crime. In a new paper, a team of sociology researchers from New York University—Patrick Sharkey, Gerard TorratsEspinosa, and Delaram Takyar— look at community groups launched in response to neighborhood violence. The study finds a causal link between the prevalence of these organizations, “local nonprofits formed to confront violent crime and build stronger communities,” and the decline in violence. The more neighborhood nonprofits a city had, the more the crime rate fell, they found. “Drawing on a panel of 264 cities spanning more than 20 years, we estimate that every 10 additional organizations focusing on crime and community life in a city with 100,000 residents leads to a 9 percent reduction in the murder rate, a 6 percent reduction in the violent crime rate, and a 4 percent

reduction in the property crime rate,” they write. The data on local nonprofits included groups with a wide variety of missions, everything from “business improvement districts, to after-school programs, to substance abuse and addiction treatment, to programs that run services for people returning from prison, to boys and girls clubs,” Sharkey says. The researchers found that organizations focused on substance abuse and workforce development have the largest impact. Rather than argue for or against any of the existing theories for why the level of violence fell, the study draws attention to the additional factor of successful efforts by local communities to defend their neighborhoods against crime by organizing themselves, Sharkey says. There are several potential explanations for the nonprofits’ effect on crime, says Harvard University sociologist Mario Luis Small. The local organizations could have an impact on how police enforcement is conducted in their communities. They could wield political influence. Or they could build connections among families in ways that deter violence, he says.

“When you build community locally, give young people things to do, target substance abuse in a serious way, and treat it as a condition rather than an excuse to lock people up, it leads to lower violence for everyone,” says Small. The main limitation of the study, Sharkey says, is that he and his colleagues pooled the organizations together at the national level. The analysis is complicated because of the different types of nonprofits studied. That makes it impossible to identify which kind of group is best at fighting or deterring violence in a neighborhood, he says. “There’s not a single program that you can point to as being the key to reducing violence,” says Sharkey. As a next step, Sharkey says, researchers should look at which type of community organization offers the best method of confronting violence. Other studies have found evidence that summer jobs programs, schoolbased programs using cognitive behavioral therapy to help students change their behavior, and local initiatives that convert vacant lots into useful facilities are all helpful, he says.

This study is among the first to prove that local community organizations can reduce crime, Small notes. “Many of us doing field work on local organizations would not be surprised to see this, but it’s something that for a number of reasons has been hard to demonstrate on a large scale, and this is one of the first to demonstrate it in a reasonably convincing way,” he says. The breakthrough, Small says, is that the researchers amalgamated data that wasn’t previously available with sufficient granularity to find nonprofits’ effect on violence. “What they’ve done is combine the data sources that have been accumulating for the last few years,” he says. The study’s results could be relevant to today’s policy debates about urban crime and quality of life, Sharkey says. “We’re at a point right now where the longstanding model for confronting violence, which typically relies on the police and the prison system, has broken down, and some of the costs have become more clear over the past several years.” As cities look for new ways to control violence, local organizations can play a larger role in ensuring residents’ safety. Government and philanthropists can also help nurture these groups. “We should go city to city, block to block, figure out where there’s not that foundation of institutions in a community, and those are the communities that are most vulnerable to a rise in violence,” says Sharkey. n Patrick Sharkey, Gerard Torrats-Espinosa, and Delaram Takyar, “Community and the Crime Decline: The Causal Effect of Local Nonprofits on Violent Crime,” American Sociological Review, 82, No. 6, 2017, pp. 1214-1240.

ILLUSTRATIONS BY ADAM McCAULEY

Stanford Social Innovation Review / Spring 2018

CHANA R. SCHOENBERGER (@cschoenberger) is a journalist based in New York City. She writes about business, finance, and academic research.

E D U C AT I O N

Teaching to the Life Test BY CHANA R. SCHOENBERGER

ducation researchers have analyzed the effects of individual teachers on students’ grades and standardized-test scores. But a large body of data suggests that noncognitive skills, such as resilience and selfdiscipline, are far more important for determining the longterm success of students. Is there a way of tracking the ability of teachers to instill these skills in their pupils, and if so, what would this mean for educational assessment? A new study by Clement Kirabo Jackson, a professor of human development and social policy at Northwestern University, examines student outcomes that are not related to academic performance, to see how teachers can affect their students’ lives in other ways. His research shows that teachers’ influence on test scores is only weakly correlated with their impact on other student behaviors and choices. What’s more, teachers who demonstrate success in improving students’ noncognitive abilities and boosting their chances to graduate are not just the teachers whose students achieve high test scores. “Relative to using only testscore measures, using teacher effects on both test-score and noncognitive proxy measures more than doubles the variance of predictable teacher impacts on longer-run outcomes,”

ILLUSTRATIONS BY ADAM McCAULEY

Jackson writes in his working paper for the National Bureau of Economic Research. Today, we measure school quality primarily by how students perform on standardized tests. But test scores aren’t always a useful predictor of how students will do in life, Jackson says. If teachers and schools are affecting skills other than those measured on the tests, and we’re not seeing those effects, then we could be evaluating teachers incorrectly and missing out on important teacher-retention goals. “We do a poor job of finding effective teachers and schools using only test scores, and we would do a much better job if we measured soft skills,” says Jackson. Jackson, a labor economist, brings an econometrics approach to education data. His study considers all public school ninth graders in North Carolina from 2005 through 2012, using educationdepartment data on their test scores and grades as well as other factors. His model looks at cognitive and noncognitive skills, and measures the latter by quantifiable data such as absences, suspensions, course grades, and on-time grade progression. From such data, he constructs a “behavior index” that indicates how students are performing outside of their academic progress. The analysis shows that an individual teacher who raises a student’s performance on the behavior index—what

Jackson calls noncognitive value-added—by one standard deviation increases a student’s chance of high school graduation by 1.47 percentage points. If the teacher raises the student’s test scores by the same amount, the student’s graduation chances go up by just 0.12 percentage points, he found. Jackson identified the same effect on a range of outcomes for students, including being promoted to the next grade, whether a student takes the SAT, senior-year GPA, and plans to attend a four-year college. Jackson chose ninth graders to study because the first year of high school is when many students drop out or decide they soon will. “If you can just get a bunch of those kids to stay, you change the trajectory of their education forever,” he says. And since the students get different teachers in the next

grades, it enables researchers to assess the value-added effect of ninth-grade teachers. The paper offers compelling evidence that teachers have an effect on outcomes other than test scores that are important to society, says Steven Rivkin, head of the University of Illinois at Chicago’s economics department. “It’s really important to recognize that teachers can influence a lot, not just how much math someone knows, but can help to shape a student’s social and emotional skills in a positive or a negative way,” Rivkin says. Although Jackson’s findings are intriguing, turning them into a way to measure teacher quality directly would be difficult, he and Rivkin agree. “It’s not clear that it would provide incentives to educators to do the things that would be helpful to long-term outcomes,” Rivkin says. At the end of the paper, Jackson offers some policy suggestions, including identifying teaching practices that improve student behaviors and using incentives to encourage such practices. The findings also don’t allow educators to look backward and identify which characteristics set apart teachers whose students later go on to have good outcomes, with a goal of training teachers to act in a conducive way. More research is needed, Jackson says. n Clement Kirabo Jackson, “What Do Test Scores Miss? The Importance of Teacher Effects on Non-Test-Score Outcomes,” NBER working paper, April 15, 2017

Stanford Social Innovation Review / Spring 2018

MARILYN HARRIS is a reporter, writer, and editor with expertise in translating complex or technical material for online, print, and television audiences.

BUSINESS

Workplace Volunteering Culture BY MARILYN HARRIS

olunteers play a vital role in society. People who donate their time and expertise to alleviate societal concerns are a critical resource for nonprofit organizations. Over the past 13 years, volunteering work undertaken by Americans is estimated to have had a value of $2.1 trillion, contributing to helping 670,000 homeless people, 48 million hungry people, and 46.2 million people living in poverty in the United States alone. Although overall rates of volunteering have been declining, corporate programs that encourage employees to donate their time and efforts are growing. In fact, the number of company employees volunteering is increasing at the fastest rate in the volunteerism sector. What are the conditions that foster corporate volunteering, and what lessons can be drawn for the sector as a whole? A corporate volunteering climate depends as much on the shared commitment of employees to the cause as on management’s support, according to research published in the Academy of Management Journal. Jessica B. Rodell, a professor of management at the University of Georgia, wanted to understand to what extent and how management-driven topdown incentives helped nurture a climate in which employees

perceive volunteering as worthwhile. Such efforts may risk alienating employees, who “may feel they don’t have an option,” she says, “which they refer to as ‘voluntolding.’” In previous research, Rodell studied individual employees’ motivations to volunteer. In her new work, she examined the role of corporate culture. “I was curious to see whether a company’s effort to coordinate volunteering was effective or detrimental compared to grassroots efforts among the employees,” she says. Rodell and her three coauthors worked with United Way Worldwide to identify and survey several hundred employees from 50 companies that participated in the organization’s programs. Employees surveyed included those who volunteered and those who did not. To encourage employees to participate in their programs, companies may provide resources such as time off work, transportation, and material goods. These “artifacts” of the company’s underlying culture, the researchers write, are “a manifest way of signaling latent company values to its employees.”

They measured the impact of this corporate volunteering climate by asking volunteer and non-volunteer employees to rate their perceptions of several factors, such as their collective pride in the company’s value system regarding volunteering programs, how this climate affected their sense of belonging, and their intent to participate in company programs or volunteer outside them. The researchers found that company-provided benefits encouraged a volunteering climate, as did employees’ belief in the cause. In turn, that climate influenced employees’ feelings of belonging and of pride in the company—whether or not the individual employee participated in the volunteering program. “This is an important study showing that a climate of corporate volunteering can foster a sense of pride in and commitment to the company—even among employees who don’t volunteer,” says Adam Grant, a professor of both management and psychology at the University of Pennsylvania’s Wharton School who has written on prosocial attitudes in the workplace. “The researchers have moved the needle in an important way to provide more incentive for corporations to invest in encouraging volunteerism,” says Christine Letts, Rita E. Hauser Senior Lecturer in the Practice of Philanthropy and Nonprofit Leadership at Harvard Kennedy School. “That non-volunteers can be affected will help the proponents of programs within

companies to argue for the wider benefits of such programs to the company.” The study also revealed a significant connection between the resources a company put behind its volunteering program and its employees’ belief in the cause. The relationship supported the idea that those two forces can act as substitutes for each other, the researchers found: “In the absence of company-provided resources, employee belief has a significant relationship with a corporate volunteering climate, and vice versa.” Of the two factors, however, employee belief is more important. “Alone, a company’s topdown initiatives are less effective, though it does not appear to be harmful,” Rodell says. “But these efforts are best realized when done in conjunction with employee passion.” “From a practical perspective, it won’t surprise anyone that corporate volunteering programs are more likely to flourish when companies put more resources behind them,” Grant says. “But it’s big news that resources matter less than how much employees believe in the cause, and that belief is enough to fuel a climate of corporate volunteering even when the resources aren’t there. Corporate volunteering doesn’t have to be championed from the top down; employees can drive it from the bottom up.” n Jessica B. Rodell, Jonathan E. Booth, John W. Lynch, and Kate P. Zipay, “Corporate Volunteering Climate: Mobilizing Employee Passion for Societal Causes and Inspiring Future Charitable Action,” Academy of Management Journal, 60, No. 5, 2017, pp. 1662-1681.

Stanford Social Innovation Review / Spring 2018

SOCIAL ENTERPRISE

Gender and Social Ventures BY MARILYN HARRIS

he social sector has traditionally relied on noncommercial means, such as donations, grants, and volunteers, to pursue civic goals. But over the past three decades, as charitable resources have dwindled and social problems have grown, so-called hybrid ventures, which incorporate revenue-producing activities with nonprofit work, have become increasingly popular. Such ventures are the subject of debate and research, but until recently, their relationship with gender norms has not been carefully studied. Women have disproportionately been associated with work that advances social welfare, while commercial activities have been stereotyped as male. How do evolving gender norms in society and the business world influence social ventures? Are newly launched nonprofits with female founders less likely to pursue commercial activities as part of their missions? Stefan Dimitriadis, a doctoral candidate in organizational behavior at Harvard University, and three coresearchers investigated hybrid social ventures through the lens of gender. They wondered whether cultural norms about gender made female social entrepreneurs less likely to found hybrid ventures. They also wondered whether local

community factors, such as a greater prevalence of female business leaders, might dampen such a cultural influence. “The creation of a hybrid social venture by a woman still requires breaking some gender stereotypes,” Dimitriadis says. “We were intrigued to understand the extent to which this was happening.” The researchers hypothesized that the presence of female business owners in a community would have a positive impact on how women in business were viewed in that community, and that this attitude, in turn, would increase the likelihood that female social venture founders would create hybrid, rather than non-revenue-producing, ven-

founder or past leaders unduly influencing its current leader. In creating a model for analysis, each startup studied was coded according to the degree that it used commercial activity, and each community was scored according to the prevalence of female business ownership. Control variables included the local availability of alternative funding sources, the area of social action that the venture addressed (some sectors might be more amenable to commercialization than others), whether the founder was a member of a team, and whether the project could draw on local beneficiaries. The founder’s work experience, education, and race were also controlled for.

tures. To explore their theory, they analyzed a data set of 584 nascent US-based social ventures and their founders, spanning 104 communities in 44 states, during 2007 and 2008. Each venture pursued an explicit social mission, was independent, and was less than two years old. By focusing on newly launched ventures, researchers could avoid survivorship bias, such as the decisions of an organization’s

The data set revealed that social ventures with any degree of commercial activity were more likely to be founded by men. But it also indicated that the presence of female business owners in the local community correlated positively with a greater number of female hybrid-venture founders. In fact, as the proportion of female business owners increased, the probability that

a female-founded social venture would incorporate significant money-making activities increased substantially. “This suggests that women who operate commercial ventures play an important role as role models and standard setters for women who launch noncommercial ventures,” says Susan Coleman, the Ansley Chair of Finance at the University of Hartford. “Having a higher percentage of women business owners bends the curve in terms of what is ‘normal’ and acceptable in a given community—suggesting that, at the local level, context trumps culture.” The researchers also tested for the potential effect of the presence of women in noncommercial leadership positions in the local community, such as female congressional representatives. But they found no evidence of an effect. “It was quite surprising that the presence of women in a different sector, in this case the business sector, could influence how gendered behaviors play out in the social sector,” says Dimitriadis. “The robustness of the findings gives added credence to the authors’ conclusions and opens a door to further research on the ways in which culture and context influence the launch, structure, and survival of womenowned social ventures, as well as their willingness and ability to employ commercialization practices,” says Coleman. n Stefan Dimitriadis, Matthew Lee, Lakshmi Ramarajan, and Julie Battilana, “Blurring the Boundaries: The Interplay of Gender and Local Communities in the Commercialization of Social Ventures,” Organization Science, 28, No. 5, 2017, pp. 819-839.

Stanford Social Innovation Review / Spring 2018

REVIEWS OF NEW AND NOTABLE TITLES

SUKRIT SILAS is the cofounder of BillionToOne, a Y Combinator-backed genetic testing startup. He has a PhD in chemical and systems biology from Stanford University and studies CRISPR adaptation to RNA.

A Revolution in Science Collaboration? REVIEW BY SUKRIT SILAS & KALI ALLISON

cience has never been a solitary enterprise. Theoretical advances are not made; they emerge from within communities of scientists, and it is often difficult to pinpoint a single event of “discovery.” Even when theories come together in the hands of particular scientists, assigning credit is an exercise rife with intrigue. Some of history’s most momentous scientific breakthroughs are no exception: Charles Darwin and Alfred Russel Wallace came up with theories of evolution concurrently; the dispute continues over whether Isaac Newton or Gottfried Wilhelm Leibniz invented calculus. Yet, it is clear that practicing science in the 21st century requires an unprecedented level of teamwork, to meet the demands for specialized skills posed by modern scientific and social problems. The Strength in Numbers is an attempt to understand—and, indeed, harness for social good—what the authors term a “revolution” characterized by “the growth in the sheer number of collaborators, but also … a greater mix in the number and disciplinary diversity of collaborators.” Part anthropology of scientific teams, part sociology of scientific collaboration, and part self-help for practicing scientists, the book may seem too ambitious and simultaneously not ambitious enough to some readers. The authors surveyed more than 600 scientists (mostly tenured professors) from 108 US universities across various disciplines about their experiences with collaborative research. They suggest an “aggregate model” for evaluating a research collaboration’s effectiveness, which they use to build multifaceted assessments of scientific teams from their survey data. The process involves assessing factors such as the ability to work through differences in prac-

THE STRENGTH IN NUMBERS: The New Science of Team Science By Barry Bozeman & Jan Youtie 248 pages, Princeton University Press, 2017

tice across fields, chemistry among team members, and the team leader’s or leaders’ management ability. On this last factor, the authors recommend that project leaders consult all collaborators at all key points in the research to ensure collective buy-in—a practice they call “Consultative Collaboration Management.” The book succeeds on several counts. The diversity of scientific disciplines that the survey encompasses is remarkable, especially given the amount of effort required to organize the subjective experiences of researchers across disciplines, each with its own norms for such things as attribution, authorship, and publication. The study’s disciplinary diversity stands in contrast with much of the previous research on scientific collaboration, which has focused on the biosciences. Also commendable is the authors’ determination to maintain a subjective tone in presenting their findings. “It is our subjects’ words that provide most of the knowledge presented here,” they write. This qualitative approach is especially welcome: Scientific academia relies excessively on easily quantified outputs such as coauthorship and citation counts as metrics of productivity. In our view, these metrics may not only be misleading but also drive the vicious

KALI ALLISON is a PhD candidate in geophysics at Stanford University. She studies the physics of earthquakes that occur on faults such as the San Andreas.

publish-or-perish cycle that lies at the heart of perverse incentives in the practice of science. It is unfortunate, then, that the authors devote much of the rest of the book to discussing authorship and suggesting remedies for teams experiencing disagreements over research credit. The preoccupation with citations and authorship somewhat undermines the book’s objective of providing a more holistic view of modern scientific collaborations that can contribute to social good. Moreover, in emphasizing the novelty of its approach, the book fails to place the authors’ findings in the context of preexisting literature. This includes decades of work in operations research and management science around concepts such as transaction costs and exchange theory, which could help illuminate team members’ potential psychological barriers to collaboration and draw more concrete lessons from the authors’ findings for researchers and leaders outside of scientific academia. Underlying the book’s sentiment is the commendable ideal that scientific research ought to be a collective endeavor for the benefit of more than just the individual scientists’ careers. “Research effectiveness is not best viewed in terms of personal gain,” they write. But they do not fully explore what, if anything, can be done at a systemic or policy level to motivate scientists to pursue broader social goals. How should we restructure the scientific establishment for a collaboration-driven future? The book treats the fault lines encountered in the course of scientific collaborations almost as givens, rather than social constructs over which we might have some control. In this context at least, the authors’ entreaties for more effective communication in scientific teams risk ringing hollow, as the Consultative Collaboration Management approach appears to treat only the symptoms of the disease rather than the cause. The reader is left wondering what could be done to address institutional barriers that may prevent collaboration in the first place—such as hiring practices based on publication metrics.

Stanford Social Innovation Review / Spring 2018

JONATHAN LEVY is a professor of history at the University of Chicago and author of the forthcoming book Ages of American Capitalism.

Lacking a concrete call to action, The Strength in Numbers feels like a missed opportunity. A range of policy changes could improve scientific practice, both for scientists and for society at large. These include providing extensive management training to graduate students early on in their academic careers, establishing permanent senior scientist positions at universities for postdoctoral scholars who prefer not to manage lab groups and bring in grants, and restructuring assessment mechanisms of scientific work to de-emphasize hollow metrics such as a scientist’s number of publications and citations. We remain convinced that the scientific community is ultimately capable of holding itself to a higher standard. This book about a revolution in 21st-century science could do with a little more revolutionary thinking. n

Organizations for All REVIEW BY JONATHAN LEVY

or the longest time, social innovation was available only to elites, who controlled governments and thereby decided which individuals could formally organize, on what terms, and toward what ends. The many benefits of formal association—of, say, chartering a corporation—not surprisingly ﬂowed to them. Only in a number of countries relatively recently, sometime during the 19th century, did the tools and benefits of formal organization become available in principle to all, on a more democratic, impersonal basis. When they did, “open access” social orders began to emerge in tandem with political democracy and greater economic dynamism. That is the sweeping thesis behind Organizations, Civil Society, and the Roots of Development, a collection of essays edited by two of the best economic historians in the academy, Naomi R. Lamoreaux and John Joseph Wallis. This book brings together

ORGANIZATIONS, CIVIL SOCIETY, AND THE ROOTS OF DEVELOPMENT Naomi R. Lamoreaux and John Joseph Wallis, editors 448 pages, University of Chicago Press, 2017

an unusually diverse cast consisting of historians, economists, political scientists, sociologists, and a political theorist. The animating spirit of the volume is an earlier effort, coauthored by Wallis, Douglass C. North, and Barry R. Weingast. Their ambitious book, Violence and Social Orders: A Conceptual Framework for Interpreting Recorded Human History, first analytically defined an open-access social order and explained why, across history, self-interested governing elites restricted access to the tools and benefits of formal organization. The introduction to this book provides a lucid entry point into the microeconomic foundations of that grand narrative. But the bulk of it focuses, in rich detail, on a historical moment of transformation: the 19th century. You can agree with North, Wallis, and Weingast’s original thesis; disagree; or—like me—fall somewhere in between, and still benefit from reading Organizations, Civil Society, and the Roots of Development. You could also not care so much about academic debates and still benefit. Many readers might be surprised to learn just how contested many of the tools that business and social entrepreneurs take for granted when starting and perpetuating organizations today once were. They also might appreciate knowing just how much

social innovation has been inextricably at stake in the great themes of modern history, including economic growth, the rise of democracy, and the evolution of civil and political rights. Many scholars will appreciate knowing all of this too, since until now historians have documented only parts. Now much more of it is available under a unified, if contestable, framework. Alexis de Tocqueville’s Democracy in America posited that the United States possessed a uniquely dynamic civil society, where “voluntary associations” abounded and flourished. But when Tocqueville traveled to America, it was not possible simply to create a corporation devoted to pursuing any end that a flesh-and-blood individual might legally pursue. Various laws forbade it. One chapter in the book, by the legal scholar Richard Brooks and the economic historian Timothy W. Guinnane, helpfully distinguishes between “the right to associate” and “the rights of associations.” The right to associate through formal, legal association in almost all states remained quite restricted. A chapter by historian Ruth H. Bloch and Lamoreaux catalogues for the first time the “legal constraints on the development of American civil society.” There were many. Courts found various reasons to revoke corporate charters. Take redundancy. Imagine if you could not charter a nonprofit because another nonprofit, with the same general purpose, already existed in your neighborhood. Furthermore, “the rights of associations” remained restricted. Many legal benefits of incorporation that we take for granted today—the ability to own and convey property, legal perpetuity, the ability to sue in courts, or limited liability—emerged only in fits and starts. Organizational purpose and means were not flexible (an issue of interest today, with the arrival of many hybrid organizations, such as benefit corporations). This was true then for both joint-stock companies and nonprofit corporations. How and why did open access emerge, and when and where? There is no single, tidy cause or explanation. The editors appeal

Stanford Social Innovation Review / Spring 2018

to the right preconditions and the contingency of “circumstances,” with which the chapters then grapple. There are nine of them, each with its own arguments and points of view regarding the general problem at hand, and I cannot give each its full due. But the first three chapters, one by the economic historian Dan Bogart on the slow death of the British East India Company monopoly; another by Weingast, a political scientist, on Adam Smith’s appreciation of early modern political coordination between monarchs and incorporated towns; and a third by political theorist Jacob T. Levy, on early modern political philosophers’ nor-

access to bank charters was not the best way to build their political coalitions. Hilt unravels the awfully tangled history that, after decades, led to general incorporation laws in manufacturing. By the American Civil War, open access was emerging as a matter of—as the followers of Andrew Jackson wou ld have put it—“equa l rights,” or as we would put it today, equal opportunity. Even then, in America the transition was slow and halting. One takeaway from Bloch and Lamoreaux’s chapter on civil society is that throughout the 19th century, states preserved access to nonprofit organizations

The power dynamics of organization still remain in play, shaping the terms of association, the quality of democracy, and the substance of our rights. mative understanding of civil society and association, together set a backdrop. Even when appreciation for both the value of civil society and the wrong of closed monopoly emerged, the assumption that states can and should control access by their subjects and citizens to the tools of organization remained strong among rulers. The final six chapters provide a number of different case studies where something like open-access social orders finally took shape, although with much difficulty. Two chapters complement each other well: economic historians Qian Lu and Wallis’ look at the politics of bank charters in early Massachusetts, and economic historian Eric Hilt’s analysis of the rise of general incorporation laws in antebellum American manufacturing. General incorporation laws were giant steps toward open access. Citizens (a restricted category in an age of, among other things, slavery) no longer needed legislative approval to charter a legal entity. Incorporation was a right. Lu and Wallis reveal a contingent political history, where members of different political parties finally realized that restricting

more tightly than for-profits. In the nonprofit sector, open access took more time. An open, expressive, and plural civil society—even the ideal of it—was a long time coming. Pivoting to France and Germany, Brooks and Guinnane find a similar situation. General incorporation laws came to these countries in the 1860s and 1870s, but states commonly staunched social and political association. They did so because rulers jealously guarded their prerogatives and feared contest from below. A chapter by sociologists Victoria Johnson and Walter W. Powell and the concluding chapter of the book have a more contemporary feel. Johnson and Powell track the evolution of civic order in 19th-century New York City by seeking to explain why an attempt to found a botanical garden in the city failed in the 1800s but succeeded in the 1890s. They point to the social quality of “poisedness,” or readiness for organizational innovation, which explains why social innovation not only succeeds, but also can “cascade.” This chapter most explicitly places the general framework of the book in the context of social entrepreneurship.

The final chapter, by political scientists Margaret Levi, Tania Melo, Weingast, and Frances Zlotnick, deals with the passage of the 1935 National Labor Relations Act in the United States (also called the Wagner Act, after its main congressional sponsor, New York Senator Robert F. Wagner). The authors suggest that this federal law—the first to legalize and formalize collective labor bargaining in the United States—ended a “violence trap,” in effect the same trap that many elite-controlled, closed social orders feared long ago. Until the Wagner Act, the most contested of all voluntary associations were by far labor unions. It is difficult to appreciate today just how much labor violence there was in late-19th- and early-20th-century America. Legally, unions and many of their activities— strikes above all—were dubious at best, until the Wagner Act passed into law. There is no space here to do justice to the authors’ novel account of the Wagner Act’s passage. But in light of the preceding chapters, it might not be correct to say that a single, clean-swipe transition—from a closed to a fully open-access social order— ever occurred. The volume invokes recent works by economists and economic historians underscoring the many prerequisites of economic growth and argues that open access deserves pride of place among them—an argument well worth more consideration. But taken as a whole, the volume more directly addresses political issues of democracy, freedom, and equality. These issues remain perennial. In other words, the power dynamics of organization and the interests of various actors, including elites, still remain in play, shaping the terms of association, the quality of democracy, and the substance, in practice, of our civil and political rights. We cannot separate these issues from whatever we might call social innovation. Thus, this unusually rich collection of historical essays left me thinking about the many ways in which the democratic struggle for open access continues and wondering what role social innovation, defined expansively, might play in that ongoing struggle today. n

Announcing the launch of a new project at Stanford University

The Project on

Democracy Internet and the

A cross-campus, cross-disciplinary international effort, the Project on Democracy and the Internet promotes collaborative research, hosts convenings, and supports publications and teaching that engages with the promise and peril that new technologies pose to democracy in the digital age.

OBJECTIVES â&#x2014;ź Developing new, authoritative knowledge about how the internet is affecting democracy. â&#x2014;ź Establishing a needed new field of study around the internet that brings together technologists and social scientists. â&#x2014;ź Convening key stakeholders to respond to the challenges the internet is posing to the basic mechanisms of democracy.

www.democracyandinternet.org pacscenter.stanford.edu This project is made possible, in part, by

Stanford Social Innovation Review / Spring 2018

I MAGES THAT INSPI RE

Year of the Woman

n January 21, 2017, the day after Donald Trump was inaugurated the 45th president of the United States, millions of women (and men) across the United States and around the world assembled

for the Women’s March. The marches and rallies were the single biggest day of protest in US history. Fast-forward one year, and again millions of people turned out for the second Women’s March, not as many as the previous year, but still in significant numbers. More important, the energy, anger, and hope that have fueled the two marches are being channeled into other activities. Time’s Up launched a new Legal Defense Fund to combat sexual harassment; the #MeToo campaign caught fire; and a record number of women have filed to run for local, state, and national political office in the fall. This past year has truly been the Year of the Woman.—ERIC NEE

PHOTOGRAPH BY CHERISS MAY, NurPhoto via Getty Images

from POSSIBILITIES to RESPONSIBILITIES

KANSAS CITY

TORONTO

BRUSSELS BERLIN

LONDON

BEIJING

NEW YORK CITY MEDELLIN STANFORD MUMBAI

BRISBANE

CAPE TOWN

WORLD TOUR

Join us at www.dataworldtour.org

Upcoming stops, Videos, Interviews, Blogs, Shared resources, Virtual conversations Digital data offer a world of possibilities for civil society to achieve greater impact. Digital resources also present a new set of responsibilities and challenges for civil society. The Digital Civil Society Lab at the Stanford Center on Philanthropy and Civil Society is exploring the implications of the digital age for global civil society. We are applying that knowledge to build a universal framework for civil society to use digital resources safely, ethically and effectively. Through the Digital Impact world tour we are learning directly from leaders of nonprofits and foundations, individual funders, and advocacy groups about how they are using digital resources in line with the unique values of civil society. At every stop, participants are contributing to the custom-built tools and resources that the Lab is developing, while sharing insights into how they are maximizing social impact in the digital age. The Digital Impact World Tour is powered by the support of Microsoft, the Mastercard Center for Inclusive Growth, and Perpetual, Ltd., and by many local partners and hosts.

PRESENTED BY

Thank you for the support of our Global Partners.