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Trailblazers with Garry: a conversation with John-Arne Røttingen
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"Trailblazers with Garry" is a new series from Global Health Matters, where host Dr Garry Aslanyan sits down with trailblazers — thinkers, leaders, and influencers shaping the future of global health — for short face-to-face conversations, available in both audio and video formats. It’s a chance to get to know the people behind the work and hear their perspectives on the current global health landscape.
Step inside the Wellcome Trust in London with our next trailblazer, the newly appointed CEO John-Arne Røttingen — former head of CEPI and Norway’s Ambassador for Global Health — traces his leadership journey and vision for the foundation. He explains why bolder citizen-scientist partnerships are crucial to navigating the global-health funding crunch ahead.
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Welcome to Trailblazers with Gary, a serious but Global Health Matters podcast. I'm your host, Gary Aslan. In this series, I sit down with Trailblazers in Global Health for short face-to-face conversations, which you can listen to in audio or watch the video. It's a chance to get to know the person behind the work, hear their stories, and gain their perspectives on current global health landscape. Join me as we explore the people, places, and ideas driving global health forward. Let's get started. For this episode, I had the pleasure of visiting John Arne Rottingen and Wilcome. Welcome is the Global Charitable Foundation in London, United Kingdom. John Arne stepped into the role of the Chief Executive Officer of Wilcome in 2024. Through his career, he has held numerous prominent leadership roles in health and research, including serving as Norway's Ambassador for Global Health and as Chief Executive Officer of the Coalition for Epidemic Preparedness Innovation, otherwise known as FE. In our conversation, John Arne reflects on his leadership journey at Welcome, the vital importance of fostering collaborations between citizens and scientists, and shares his insight on the current funding crisis facing global health. Hi there. So I'm here at the Building of Welcome, and I've just met CEO, Dr. John Arnie Rottingen, and we're gonna have a quick chat. So it's really great that you were able to watch us on video because if you're listening to this on audio, this is a new uh podcast style we're using of video conversation. So, John Arnie, uh welcome your second trailblazer in our series of trailblazers.
SPEAKER_00Yeah, thank you. Thanks for the opportunity to have this conversation.
SPEAKER_01Great. So maybe we can start, and uh, we met a really uh long time ago, and I know you're from Norway and uh worked in global health. What's uh in your upbringing in Norway that really uh made you interested in global health in in this area?
SPEAKER_00Yeah, I guess it's coincidence is probably the most uh correct way of describing it. Uh, but of course, there there's some drivers, and um for me it's the science drive, it's the justice drive, and it's also the drive to see results of what I do. Um, and uh, in one way, global health is a great combination. I was I was quite a geek as a child, and the or as a youth, uh interested in computer science, did a lot of programming, um, did well in school, uh, had inspiring teachers, in particular, one my chemistry teacher did a sort of add-on biotechnology course that was a voluntary, and that sort of introduced me to the proxy of the potentials of uh biomedical science, uh, which was really inspiring. Um I at the at the same time I I guess my upbringing the Norway is a sort of quite a flat society, equality is important. Uh I was also quite active not in party politics but sort of politically engaged. Um wanting justice, wanting equity and and uh and equal opportunities in society. And then my family is really from a small, small community in the in the on the west coast of Norway. Uh my grandfather, I remember he was a farmer and actually my my parents were the first with higher higher education in in the family. Um but he he wanted me to do something practical. He wanted me to do something he could something, yeah. Yeah, but study, but study something that could actually achieve results. Uh-huh. And in some way he was uh disappointed when I decided to do not do surgery, which was practical and actually see the results, and and more do the public health and the theoretical parts of medicine.
SPEAKER_01Interesting, because now that you're saying there you were from the west coast of Norway, I remember going on um fjords cruise along the coast, and you would see houses every I don't know, five to ten kilometers. And the first thing I thought about was how do they organize a health system here? And how does that work? It's so dispersed, right? So maybe public health is just as important in that kind of uh setting.
SPEAKER_00Yeah, and and in some way also uh community health. And actually, my my grandmother, my great-grandmother, and my great-great-grandmother were all midwives in this uh community uh and and needed to assist on deliveries uh locally before it was sort of usual to actually do deliveries in in the main hospital that were at that time probably three hours drive away from the community. So um yeah, in some way the rural part of Norway is similar to many contexts we see around the world today. Uh and and then how do you how do you make sure that people have access to professional support or even educated lay support for for health? Um and if you look at the numbers, it's I actually did that sometime, so probably my great-great-grandmother. Then the maternal mortality, child mortality at that time in Norway was very high and and not similar to some of the challenging context we see in Africa today. Um, so it it demonstrates that countries have gone through a phase of development. Uh we just need to make sure that all countries can actually go through this improvement and improvement in child survival and improvement in maternal mortality. Oh, great. Thanks for sharing that.
SPEAKER_01You had many really leadership roles in your career in Norway and also Global Health Ambassador for Norway. And what is leadership for you in terms of values and how you perceive that role? And of course, now being CEO of Wilcome, um, what are your sort of approaches to leadership?
SPEAKER_00Yeah, I think you need to really be really committed to the mission of the organization. You really need to emotionally connect and and want to deliver because that's I think it's inspiring for your colleagues. Uh a leader has a special role. I I guess I'm by nature seeing leaders at on equal terms with with the rest of colleagues in an organization. That's that's another value I I have uh very much sort of believe in, but at the same time, leaders they play roles and and that role as championing the mission of the organization, championing the values of the organization. Uh at welcome, we we want to be both thoughtful and uh brave. Um so uh and and so balancing those different values uh for instance um is important. But to me, the most important is really this commitment to the mission and actually being able to communicate and inspire that in your organization, but also wider in in society.
SPEAKER_01Right. So if the leader embodies the mission, then that kind of trickles down to the organization through that leadership.
SPEAKER_00Yeah, through and through inspiration and through setting examples, I guess. Absolutely. Right, right.
SPEAKER_01In your first year or year and a half, you've been in this position. Uh, you visited a lot of um partners in countries in Africa, in Malawi, in Kenya, I heard also in Vietnam and Thailand, uh, where you have uh work. Uh, why were these visits important? And also what did you learn in the countries uh where things are going there?
SPEAKER_00Yes, so Wellcome is a global foundation, so we have a global uh mandate, and and we want to support science to improve health for everyone across the world and really make sure that we can deliver benefit to humankind. That's uh already written in the will of Henry Wellcome when he established the foundation now almost 90 years ago. Um, my my thinking was that when I started here, I will be sort of swamped into really focus on the organization, and and of course, um, we are situated here in London. Uh, it means that it's easier access to the community, stakeholders, research groups here in the UK. So I decided to spend a lot of my first couple of months actually due to travel to our major partners uh in both Africa and Asia, uh South Asia, Southeast Asia. Um, and and that was really inspiring. I must say I hadn't understood the size of these centers and programs that we fund around thousand staff in in several of the locations. Uh really nice. I came to Malawi the Malawi Liverpool and Welcome partnership there. Um it's uh it's it's fantastic what they do alongside the the hospital uh and uh the University for Health Sciences in Blantyre. Henry Mam Mandumba has been sort of going through that program. He he came in, he's now the leader. He came in um as uh as a student uh and have gone all the grades. I've been professor here in Liverpool for some time and then come back and now leading the centre. Just inspiring what they they do in that society. Um another example uh Africa Health Research Institute that has sites both in Durban and in Somkele, a bit further up north in Kwausulu-Natal, and and combining very advanced lab sciences with population health and really serving the full community up in Somkele. Emily Wong, for instance, one of the researchers there, doing very interesting work, advanced work on multi-omics, uh, understanding immunology, pathogenesis of uh of TB, and in particular in in a population, as you know, with with high HIV rates, that's that's um it's it's a partly a different form of TB but also more prevalent. And and understanding, for instance, now that we uh we see there is probably quite more um actively transmitting TB that is asymptomatic, so in a way silent TB, which is has a big impact for transmission. Right. Um and and you may know we are partnering with Gates Foundation and GSK. Gates Foundation and Welcome funds uh a large now phase three trial on uh tuberculosis, the M72 vaccine. South Africa is the country where we recruit uh most uh patients now for the vaccine trial. Um and TB is still the most deadly infectious disease in the world, a problem that we have not really been able to handle. Still very, as you know, very long treatment regimes necessary to treat, uh increasing uh multi-drug resistance, yeah, compliance challenges. So that's why we we're really hopeful on potential of actually the first TB vaccine approved in 100 years, if if the trial is successful. We will know in 2028, so still some years to go. So that's that's the challenge when doing large large clinical trials like that. So those are just a couple of examples, but equally inspiring in Kilifi, where we collaborate with uh Kemri and and we support uh the Cemri program and in Vietnam and and in in Thailand that are more networks of uh research centers across many uh Asian countries. Right, right.
SPEAKER_01And what about the countries themselves? Do you feel? Um how how do you assess sort of capacities in other parts of the research ecosystem in countries, their plans and all of that? What were your observations about that, where where things are going in countries?
SPEAKER_00Yeah, so I if I I think if you look at the numbers, Africa, if if you use that as an example, uh, because uh it's still the continent that is probably lagging the most behind on many economic indicators, but if you look at research capacities, research capabilities, number of research papers coming from Africa with African uh lead authors, uh it's really increasing, and this is across fields. Uh and life science and health is uh is leading among them. So it's a really positive development. Um we I think what we the the centers that we support there are are centers that were originally established as partnerships between UK-based researchers that really devoted their lives to research uh infectious diseases in particular and and and challenges in in low-income country settings. Established these centers and programs in collaboration with local uh researchers and institutions, but gradually evolved into, as I mentioned, more locally led research institutions. I think the next step that Welcome should really consider is how we how we engage the broader research ecosystem in in those countries, uh, how we make sure that we engage in a good way with governments. Uh I I would want to see governments in Africa taking up more of a research investment responsibility because that is a necessary part of a pathway to economic development and prosperity and and improving health. Right, right. And we could probably do more, and that's definitely an ambition I would have in the in the coming period. So that that speaks to to welcome being a foundation. We and as I said, as I often say, is that foundations are are not the main sector in society in any way. We we we need to complement what governments do, I mean we need to complement what private sector uh can do. Um so so we are first and foremost catalytic and and hopefully can initiate things that can then be taken on by the larger sectors, that uh public sector or or private sector.
SPEAKER_01Great. Interesting observations. Uh thanks for that. So I think I read somewhere that you said, and I'm gonna read what you said, hopefully that I got that right. Science is not enough to change the world. Uh it must be um allied with collaboration action across society. Maybe you can um elaborate a bit more on that statement, and I think particularly this time where science is being discussed differently or where we're facing some additional kind of views on science, etc. Can you add more why this approach that you uh mentioned is important in terms of how science really is aligned with societal goals?
SPEAKER_00Yeah, no, um first uh and of course I've I've been very engaged in what you can call knowledge translation or sort of trying to foster that science-based knowledge, uh, new technologies derived from science can be implemented and used, either if it's changes in policies, if it changes in clinical practice, if it's um commodities, technologies that needs to be regulated and onto the market. I I I'd be probably focusing more on that sort of latter part of the scientific ecosystem, if you see what I mean. Right, right. Um and and I believe um we we definitely understand that science is not enough. And that's why it's so beautiful for me and so inspiring that Welcome is um our research funding organisation that has a broader mandate and we have made a decision to not only be a research funder, we we do invest in research, yes, and and of course most of our charitable investments go to research, um, but we also invest in policy work and influencing work that can contribute to making sure that uh that we both have evidence-informed policy and practice, but also that technologies are taken up in in um in in at and at scale. For instance, in the global global system of health, I I think we we are so dependent on making sure that policy is uh is sort of future-looking and uh and aware. And then the third um sort of way we work is is really about citizen engagement, uh societal engagement, and and I think that is even more important than ever. Uh, we see challenges related to trust in science and in science-based solutions. Uh for some reason, vaccines and vaccinations have become a sort of a poster child of this mistrust, and we see that in many countries and contexts. Uh, we saw it during the pandemic as well. Other public health measures during the pandemic also became quite contested, and I see that as a as a signal that we need to just double down on on trust in science. And then, yes, to build on that and to build trust in science, we we need to engage with citizens and and actually also tackle problems and issues that are important to people. So that's why we it's not only sort of a broad communication strategy on engaging citizens with science, but it's actually how do we want our grantees to do their research when they work on applied research? How do they engage with local results? Yeah, exactly. Um, and that has been important for Welcome for a long time, and and we are definitely continuing that. Making sure that um research questions are addressing problems and issues that also the local communities see, and making sure that the research community is also representative of uh communities. Uh, and that speaks to the the need for diversity and and inclusion also in in uh in research. Um and I see those as as tools to really derive delivering on our mission on on improving health for everyone.
SPEAKER_01Yeah, great. So we have a lot of work to do, obviously. Absolutely as a global health research community. Uh but global health recently is really experiencing a little bit of um a crisis in terms of uh funding, in terms of um a lot of uh cuts um uh from government sources as well. Um I also like probably yourself have uh seen people uh calling for maybe it's a uh opportunity for us to think about how we do things differently and how we reassess. What in your view uh and your experience in global health that you think worked well and we should uh continue and do it, and what we should change as we kind of face this new uh reality in the last um few months, things have changed, so we will be uh global health will change, and what would you keep and what would you change from that?
SPEAKER_00Yeah, those are big and and really key questions, and and we are we are in a difficult time. Uh I can come back to some of that, but I I I think I first wanted to say that we um global health as a system has delivered uh it's very strong results really uh when it comes to population health. If we look at um at as we discussed earlier, maternal mortality, uh child survival, uh life expectancy, reductions in incidence in in the three big infectious diseases HIV, TB, and malaria, um and much of that was driven by very Very dedicated investments and institutional mechanisms and funds and so forth on the MDGs, the Millennium Development Goals. It demonstrates that science has delivered because a lot of this is science-based solutions, and we can improve global health and global population health. At the same time, I think actually the pandemic, I would say that the pandemic was maybe the first clear indication that the system is not fully delivering what is needed. But at the same time, we also saw the big differences in access to vaccines and the continent that probably spoke up the most was the African continent, which is very understanding. They had established more of a public health institutional mechanism, partly coming out of the Ebola outbreak, and understanding that public health and infectious disease and health security is a continental sort of challenge and priority. But I'm starting with the pandemic because I think that already indicated a system where there is uneven capabilities and distrust in some way. So that was maybe the first. And then we saw after the pandemic that the world has many other crises. Of course, the climate crisis was a high priority for many countries and including what you can call donor countries. And then we unfortunately had the wars in Ukraine and in Israel-Palestine, which both needed resources and attention. So health was already sort of prioritized less from a political point of view coming out of the pandemic. And then with Ukraine, the security situation in Europe, with a new administration in the US, indicating clearly that they will focus more on the US needs and America first is the slogan. But actually they they want to, I guess, respond to the electorate that elected the new administration and Trump as the president so they will focus more domestically. This has an impact on the security situation. It means that European countries are now committed to increasing spending in defence. So they will, and some countries explicitly, like the UK, have said that they will move funds from the official development aid envelope to the defence budgets. Other countries in Europe indicating that they will need to cut in development aid assistance. And then the very abrupt changes now we are around 100 days, I guess, into the Trump administration. The abrupt changes they have done on the USAID, PEPFAR of course has meant that being the biggest global health funder, we have a dire situation with I would say most likely a 30-40% cut in external finance for health in the coming couple of years. So these three changes call for self-reliance, more independence in the developing countries and in particular from Africa. So what should we maintain? What should we improve? I think we need to first and foremost see that it's governments that are responsible for the health of their population. So the centrality of democratically elected governments being accountable for health and health care, and meaning that in the poorest countries when they are supported externally, we need to more be more respectful of actually governments being in control, leading national health plans, having one plan and not 30-40 different plans that we see in some African country contexts, and making sure that the external system for development assistance for health can support those plans and support governments more coherently and and and then build up more of a broader primary health care based. I talked about my family being midwives and in communities.
SPEAKER_01So we have some good indications of where we should go. We just need to act on that and really uh bring it to life and and implement as all of us as a global health community, really.
SPEAKER_00Yeah, I believe so. And and we need we probably need to be more devolved, we probably need to build more capacity regionally and locally. For us as an institution that supports science, we we are strong believers of uh also um building research capacity and doing the research necessary to address the the health problems of developing countries, in developing countries, by developing countries. Um we need to double down on that.
SPEAKER_01Okay, well, great. Uh thanks for this conversation, Gianarni, and um thanks uh for joining our uh listeners again. Uh John Arlene Rothingen is the CEO of Welcome, and uh we just had a great conversation. Um so see you next time. Thank you guys. Thank you for joining me for this episode of Trailblazers with Gary, brought to you by the Global Health Matters podcast. The audio and video versions of this episode are available wherever you get your podcast. Be sure to visit the Global Health Matters webpage for more information about my guests in this series.
