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In this three-part conversation series, Co-editor David Lockington speaks with highly influential individuals about their journey to the top, with advice for the next generation of leaders. Part One: David speaks with Peter Holland, CEO of the IAPB.
Peter Holland.
Peter, thank you so much for making yourself available for this series of interviews. Could you tell us your position?
Thanks David, I’m the Chief Executive of the International Agency for the Prevention of Blindness (IAPB), the overarching alliance for the global eyecare sector. I’ve been in this role for six years.
What was your background before that?
I started life as a health service manager developing primary care services in South London. I did that for about 10–11 years and then changed career completely, became a diplomat and joined the Foreign Office. I had postings to India and work led onto tackling counter narcotics in Afghanistan. I was Director of International Policy on Intellectual Properties and had a range of jobs in the Foreign Office before I stepped away about 10 years ago and went to the Royal National Institute of Blind People (RNIB).
I had a couple of years at RNIB where I was head of strategy. I then went and ran a social purpose business that essentially did public engagement, research and evaluation around social outcomes, before finally arriving at IAPB.
Wow. Who knew narcotics in Afghanistan would lead to helping people see better?
Exactly. Even though there are billion people who need access to eyecare – that feels more doable than stopping the drugs trade from Afghanistan, I’m afraid.
That’s a fascinating background, and one that’s shaped you into who you are today. I suppose the obvious next question is: What skills do you bring to the CEO role based on your background?
When I started my career in international policy work, I described the role as almost public health diplomacy. What we’re trying to do is engage the international community in making eye health a priority. We’re trying to push eye health up the agenda, and so it’s a lot of engaging with countries and governments and through international institutions.
What attracted me to the role was it combined two areas of what I loved the most – I’ve brought to the role both an understanding of healthcare systems, but also an understanding about how global diplomacy works, and that’s been very helpful in terms of navigating and trying to get eye health on the agenda.
It was a values-based business, but at the same time it needed to make a profit, so balancing both of those business imperatives with the social purpose mission was an incredible learning experience.
That’s a valid point. There’s an attitude out there that the public sector is like an enormous oil tanker, which you cannot turn around. I think people get disillusioned because they feel they have no power. So, in your experience, how can the public sector flex their muscles to get things done?
Firstly, that impression of the public sector is based in reality – that is, that can be the experience, and at the same time I’ve worked in organisations which had really inspirational people in them. Frankly, what we did in South London was transform primary care over a 10-year period. That was the work of a whole range of people – so within public sector organisations there are incredibly energetic, inspiring people who are really committed to the public sector ethos and really want to deliver.
Equally, I have to confess I spent a couple of years in our tax office while I was in the Foreign Office and that was, shall we say, less inspirational, and that perhaps more reflected the basis of your question – it was much more bureaucratic and much slower.
The first thing I would say is that the public sector is seen as a monolith and it really isn’t – it’s made up of lots of organisations and those organisations can vary. The people in [the Foreign Office] are fantastic, but it leveraged the UK’s influence globally when I was there, and obviously more recently, there have been more significant challenges with things like Brexit. But certainly, when I was there the UK could influence a whole range of areas and take the lead and it brought that authority to it.
If I contrast [to the IAPB] – we’re a membership organisation, so we work for our members and it’s important that our members drive our agenda. As long as we can ensure that we’re aligning our agenda, we do have enormous freedom to then set the direction and go off and do things. That’s agility – we’re much more able to be agile and respond and engage at different points.
The flip side is we’re outside the tent. We’re not inside the tent. We’re not a government. We’re trying to persuade governments to change and ultimately, it’s governments that have the power and the authority to do things. So, we can be creative – we’re definitely able to do that much more – but you trade that off. We’re not the ones who have the power.
That’s fascinating because I did want to ask you, as a CEO, do you see yourself as a figurehead, or even as a cheerleader? Do you have autonomy and power or are you answerable to your equivalent of stakeholders, like you’re just a puppet who has to stand up and say what they want?
I see myself as a leader; I recognise I have a position in the sector. I’ve learned that I probably need to be a bit careful about what I actually say because what I say suddenly comes with an authority. I think it’s just me saying this, but actually it’s not just me; I represent the sector.
I think this is true of leadership wherever you are. If you run a big private sector business and you’re the CEO, you’re still going to have to negotiate with your board and with your teams and everybody else about what you do. You can’t just say charge and assume everybody is going to follow you. And frankly, it’s quite exciting to have that position, to set the agenda, but the only way that agenda is actually going to happen is if you persuade many others do it.
How would you advise us through your experience of how best to bring people along with you?
I think people have lots of different styles and I don’t think there is a singular style. The best leaders I’ve worked with have effectively been themselves; they bring their own personality.
I like engaging and talking to people. I enjoy that bit. I want to set directions so I enjoy thinking strategically about what I’m trying to achieve and why. Being able to repeatedly explain why you’re doing something I think is really important.
One of the things I have got better at, and I know I wasn’t good at it, is making decisions. When I started, I drove people mad because I’d make a decision and then two days later change my mind. I probably still do that if you talk to my team – they probably complain about that a lot – but I think I am better at recognising that in fact, at times, it’s better to make a decision even if it’s not the best decision. That’s one thing I have learned as a leader. You will be making decisions much more than you anticipate.
Did you know you were ready to be a CEO?
I was a CEO in my previous job, but fundamentally it is about confidence and recognising what your role is. It’s about understanding the impact you have on other people. It’s entirely reasonable to be anxious about making decisions because sometimes they can have significant implications.
One of the things I’ve learned is that you don’t necessarily want to display that anxiety all the time because then people lose confidence and worry themselves about it. It’s about confidence and understanding that it’s probably better to make the decision than continue to agonise – it becomes easier to do it.
So often the best decisions are based on evidence, and I believe that you’ve had a recent research report published.
When I joined IAPB, eye health wasn’t high on the global agenda and it was a bit siloed away. We were very good at talking to one another, but we were really struggling to get ourselves heard by policy and decision makers. And you know, if you’re talking at the UN or even within the World Health Organization, inevitably there are lots of other priorities that are out there. So, you’re really battling to get on the agenda.
One of the things we began to talk about is the relationship and the impact that eye health and eyecare has on the sustainable development goals (SDGs) – essentially making the case that eye health isn’t just a health issue – it’s an issue that cuts across a whole range of other areas as well. Eye health impacts on work, it impacts on education, it impacts on daily life. Essentially that allowed us to go back into those forums.
There are 17,000,000 children who go to school with uncorrected refractive error – so they haven’t had their eyes screened and don’t have the glasses that they need. We know that children who are in that position learn about half as much as children whose vision is OK or have glasses. It’s an immediate and direct impact on their educational attainment and what they can achieve. It then means that they are much less likely to earn as much as their peers who have access to eyecare. The research and the evidence that we published shows that, if you have access to eyecare, you earn 78% more over a lifetime. In the UK that figure is 95% – an even bigger difference than it is globally.
You know, it’s not just an individual tragedy, it’s a huge injustice because this is something that can be straightforward to sort out. It’s about eye screening. It’s about access to glasses. These are not difficult things to do.
It’s a very convincing, but sobering argument, isn’t it? You have not only identified the problem, but you’ve also highlighted the solution, but part of that solution is public awareness, so although I’m sure you have a media strategy person, what would be your best media strategies to get your message out there?
Talking to you, of course!
Yes, well I am hugely influential in my own house!
Exactly! It’s all about clear communication. One line of attack is the advocacy strategy that we’re doing and it’s evidence like this that has got us to the table. This genuinely is shocking when you talk to ambassadors, it really is, and it really helps us have the discussion.
How do you get access to these individuals?
We have a group at the UN called the UN Friends of Vision, which is a group of 60 countries represented at ambassador level and we have a number of leaders within that group.
My problem with this is everyone you’ve mentioned will be exceptionally busy, so how do you distil your message in your elevator pitch to these guys and girls to say, “This needs to be top of your agenda”?
The first thing is around building relationships. This doesn’t happen overnight, but I can describe what we did: we set up the UN Friends of Vision group and in the second meeting, we had a discussion about this kind of question. I made a short presentation, setting out the data, and we had about 20–25 of them in the room. There were quite a few and what it triggered was personal.
Pretty much everybody there had a sight issue themselves or had a close relative or friend who had a sight issue. The most powerful thing for our issue is that it affects absolutely everybody. But you don’t think about it, because we take so much for granted. At the beginning when we were trying to build the relationships, I would just ask everybody to take their glasses off for 10 seconds and say, “Can you now do your job?” And you know, instantly everybody goes, “Oh gosh, of course.”
So, coming back to your question about the media strategy. One of the things we’ve done over the past few years is build a global campaign to raise awareness to do exactly this. Our campaign is called ‘Love Your Eyes’ and we co-ordinate World Sight Day for the sector as a whole, and it’s all about this.
We have heart-shaped glasses which we get people to put on and we’ve had lots of celebrities doing it. We do sight screenings in Parliament. I was at the UN a couple of weeks ago and we did a sight screening and it was astonishing – we had over 500 people queuing up to get their eyes tested, over half of them we had to give glasses to. Extraordinary. So, I think one of the answers to your question is: “make it personal.” That’s what we’re trying to do: get it right in front of people, literally in front of people’s eyes.
And you’re absolutely right. They’re dealing with Ukraine, the Middle East, climate change. These are huge problems, but one of the things we found is they like our issue because actually it’s something they don’t really disagree about. There’s no debate, and it’s also something where they can do something. It’s unlike some of these other problems which are so complex; this is something you can do something about.
I think you’re right – personalising the issue – really gives people a real incentive to engage. I suppose it would be remiss of me not to ask then: While this has all been very positive and exciting, have you ever had difficulties engaging with the media?
In this role. I would say no, to be honest. I haven’t experienced that here at all. The challenge is getting ourselves out of the sector press and into the mainstream press, and really getting onto the table. But even then, it’s interesting – once you begin to put the facts on the table, there are stories there.
I’m sure there must be a good journalist somewhere, but that’s not the impression you get.
Yes, though in my other roles I have certainly witnessed that and seen it. When dealing with narcotics in Afghanistan, there’s an incentive to come up with bad stories. Although to be perfectly honest, it was such a challenge anyway, they weren’t terribly difficult to find. I think I’ve probably experienced what I would describe as bad faith journalism once in my career, early on.
What do you find most difficult about being a CEO?
A number of things. There are obvious things like having to give bad news and difficult messages. That’s unavoidable. I don’t know any leader colleagues who ever find that comfortable. And I think if you did, you would have to begin to question whether you should still be doing it.
Another challenge I alluded to earlier is that there are times when you can feel uncertain or you’re having a bad day, or there are things going on which are nothing to do with work. You want to switch off or not engage, but you’re on display and you’re on show. I remember some advice that was given to me by a boss who was a CEO some years ago, when I was working in the Intellectual Property Office. They said, “You’ve got to remember the moment you walk through the door, everybody is looking at you.” And even if you don’t really think that, it’s kind of true. One of the things is remembering that it’s the impact you have not just in terms of the technical things you do, but the way you do it and the way you talk to people. It’s a big one.
I think that’s valuable advice and really helpful. In light of that, what advice would you give a younger version of yourself?
I think it would have been about confidence. It’s easy advice to give, but actually to sort of say, you know, “It’s fine.”
I think there’s a tension, particularly in medics who are often high achievers but very task driven. For example, I want to swim in the deep end, but I don’t want to drown. How do you get that balance? And how do you relax? How do you switch off?
How do I relax? Well, I guess the football, though I realised I often don’t relax at all when I’m watching football. It’s often quite the opposite. I also run.
Are you a part-time runner or a serious runner?
I was running marathons up until Covid-19, but very, very, slowly. If there’s one thing I would say I do to relax, it would be running.
What do you think about when you run? Is it simply decompression? Do you listen to podcasts or are you thinking of the next policy strategy and it gets it out of your system?
Much more the former than the latter. I find that it’s a disaster if I start thinking about work. I wouldn’t say it’s a meditation, but the best thing about running is my brain switches off.
It’s a good lesson in pacing yourself, isn’t it? Well, Peter, thank you so much for your contributions. We really appreciate those great learning points from your leadership perspective.
Declaration of competing interests: Consultant grants, advisory boards, lectures for Alcon, Bausch & Lomb, MST, Santen, Scope, Théa Pharmaceuticals.