James Orbinski, pragmatist with a heart for humanitarian medicine
Globe & Mail, October 5, 2010
By Nick Rockel
The Transformational Canadians program celebrates 25 living citizens who have made a difference by immeasurably improving the lives of others. Readers were invited to nominate Canadians who fit this description. Over several weeks, a panel of six judges will select 25 Transformational Canadians from among the nominees.
James Orbinski, physician, humanitarian, scientist and author, has been selected as one of 25 Transformational Canadians.
James Orbinski chose to study medicine because he wanted to help people in need and explore the unknown. But for the U.K.-born son of hard-working immigrants to Canada, an epiphany awaited. As a medical student at McMaster University in the late 1980s, Dr. Orbinski spent a year in Rwanda researching children’s HIV. Overwhelmed by the vast scale of suffering there, he returned from the Central African nation forever changed.
“I went as a researcher, I went as a scientist, and I came back as a man who was focused almost entirely on humanitarian medicine,” recalls the soft-spoken Toronto resident.
Dr. Orbinski, 50, is now a research scientist at St. Michael’s Hospital in downtown Toronto. But he’s also pursued a global humanitarian career in which his achievements are as profound as they are impressive. Dr. Orbinski has never been afraid to lead by example. Throughout the 1990s, he worked for aid organization Médecins sans frontières (Doctors Without Borders) in several troubled countries, including Rwanda and Somalia.
As MSF’s head of mission in Rwanda during the 1994 genocide – an experience recounted in his 2008 bestseller An Imperfect Offering: Humanitarian Action for the 21st Century – he learned a powerful lesson about leading others.
“Genocide really is the final limit where there is no possibility of humanitarian action,” says Dr. Orbinski, who received the Meritorious Service Cross for his efforts in Rwanda. “Part of effective leadership is knowing the limits when they’re there.”
Having co-founded the Canadian chapter of MSF in 1990, Dr. Orbinski served as international president from 1998 to 2001. His first task was to stop what he regarded as MSF’s drift away from its core values. Dr. Orbinski also reasserted the agency’s independence by increasing the share of private-donor support to 80 per cent from 50 per cent of its budget. Third, he boosted capacity in epidemiology, policy analysis and other evidence-based approaches to humanitarian work.
In 1999, Dr. Orbinski accepted the Nobel Peace Prize on behalf of MSF. The father of three says that leading such a sprawling operation – MSF now has 27,000 medical professionals in some 60 countries – means being only nominally in charge. “If you can steer the boat in a certain direction – which is not always easy – that is a marker of success in an organization of that kind.”
An associate professor of medicine and political science at the University of Toronto, Dr. Orbinski has proved adept at forging alliances. He chaired the working group behind the seven-year-old Drugs for Neglected Diseases Initiative (DNDi), a partnership between MSF and medical research organizations in several countries including Brazil, France and India.
Thanks also to relationships with pharmaceutical companies such as Sanofi Aventis, DNDi has yielded two anti-malarial drugs and a treatment for African sleeping sickness. The project has 17 other drugs and compounds in development.
With similar pragmatism, Dr. Orbinski and his colleague James Fraser enlisted global health experts for the launch of Toronto-based Dignitas International in 2003. Dignitas provides HIV/AIDS prevention, treatment and support in Malawi, where this year it will expand its services to reach three million people.
Dr. Orbinski was also a key player in launching MSF’s Access to Essential Medicines campaign. One example of its success: The annual cost of treating an HIV patient with anti-retrovirals has fallen from about $13,000 (U.S.) for patented drugs to $80 (U.S.) for generic versions. “The face of global health has fundamentally changed very much as a consequence of the initiatives and catalytic effects, if you will, of that campaign,” Dr. Orbinski says.
For the 2009 Order of Canada recipient, leadership means being open to new ways of thinking. “There’s no point in preaching to the converted,” he says. “If I can bring a different perspective – and if I can also learn a different perspective – then one can see the pragmatic possibilities.”