Trust the Work, Trust Yourself

Summary

Smart Women, Smart Power: "Trust the Work, Trust Yourself"

Host: Dr. Kathleen McInnes
Guest: Gargi Ghosh, Director of Global Policy and Advocacy, Gates Foundation
Release Date: April 30, 2025

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Episode Overview

This episode of Smart Women, Smart Power explores the groundbreaking global impact of the Gates Foundation through the personal and professional journey of Gargi Ghosh, who leads its Global Policy and Advocacy division. Host Dr. Kathleen McInnes and Ghosh discuss the intersection of economics, politics, and humanitarian work—reflecting on career-defining moments, global health challenges, and the power of trusting oneself to drive change. The conversation highlights both technical milestones and deeply personal motivations, offering insights into the evolving role and influence of women in global affairs.

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Key Discussion Points & Insights

Gargi Ghosh’s Origin Story and Motivation

[01:17 – 05:58]

• Ghosh describes her upbringing as a child of Indian immigrants in Canada, frequently returning to India and experiencing starkly different realities firsthand.
• The idea of the "birth lottery"—the circumstances of one's birth shaping opportunity—became central to her perspective.
• Family stories of loss to preventable diseases in India, like tetanus and smallpox, fueled her commitment to addressing health inequity:
  • “My story intertwines with hers [her mother] ... Another sibling of hers was born in a preterm birth and didn't survive that. Now, having worked in global health, I have the language to talk about that differently. But it was really a story of undernutrition, access to healthcare, having the resources to support family through difficult times.” (Gargi Ghosh, [03:59])

Pivoting to International Development and the UN Experience

[05:58 – 11:31]

• After feeling that economics alone didn’t explain global outcomes, Ghosh pursued further studies in politics, realizing the importance of policy in development.
• She recounts working as an unpaid intern in Kofi Annan’s office at the UN in the late 1990s, describing Annan as “peak influential” and quietly powerful ([08:46]).
• Her defining early task at the UN: researching global threats, specifically pandemics (her coin-flip assignment) and terrorism—prescient topics at the time:
  • “He asked the two interns in his office to work on two things ... keeping him up at night ... one was terrorism and the other one was pandemics ... I got pandemics, he got terrorism ... that was a really determining coin for both of us.” (Gargi Ghosh, [09:08])

Lessons from COVID-19: Progress and Shortfalls in Global Health

[10:24 – 12:09]

• During COVID-19, Ghosh often reflected on what had improved since her UN internship (disease surveillance, rapid vaccine development) and what had not (global governance, stockpiling).
• Explains enduring tension between national interests and the necessity of pre-built cooperative systems:
  • “You don't build those cooperation systems in the moment of crisis. You've got to have them set in advance ... that's where I wish we had made more progress.” (Gargi Ghosh, [11:41])

Joining and Impact at the Gates Foundation

[12:39 – 20:28]

• Ghosh describes joining (and betting on) the then-unknown Gates Foundation, motivated by the opportunity to try new approaches, risk-taking, and integrating science into development.
• Explains the risk and intuition involved in making such career leaps, sharing her method of “refining your gut” with walks or runs.
• Discusses the Foundation’s hallmark achievement: spreading ambition and optimism in global health:
  • “A mentor ... said ... the singular achievement was to bring a sense of optimism and ambition to the field. I can't imagine a bigger compliment ... than being seen to have done that.” (Ghosh, [17:42])
• Outlines transformative projects, including GAVI (vaccine access) and efforts to make country financing central rather than donor-dependent.

The Human Impact of Global Health Work

[20:28 – 22:22]

• Celebrates concrete progress in global health (halving child death rates, increased vaccine access) and wishes more people understood the tangible differences these achievements mean for families:
  • “For me now, even as a data nerd ... sitting with other mothers who are able to send their kids to school because they’re not sick ... it's just ... so motivating.” (Ghosh, [20:51])

Gender and Leadership: Head and Heart

[22:22 – 24:21]

• Ghosh candidly admits it took time to appreciate how her gender positively influenced her approach to leadership:
  • “Most of your career was spent proving that being a woman wasn't a liability ... it’s ... a beautiful thing of ... the past decade ... that we can talk about how much ... it's an asset ... I carry the head and heart in everything I do.” (Ghosh, [22:55])
• Emphasizes value in connecting quantitative rigor with empathy and human impact.

Defining Power and Courage

[24:21 – 25:13]

• Ghosh redefines power not as hierarchy or budget size, but as the “ability to do brave things” and enable others to take risks or challenge the status quo:
  • “It means the ability to do brave things... Now it’s the ability to take a risk, or allow other people to take a risk. It’s the ability to call out my own organization when we're not living up to our own standards or to bet on a new approach.” (Ghosh, [24:34])

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Notable Quotes & Moments

• On the "birth lottery":
  “Where you are born shouldn't matter to the opportunities you have in life.” (Ghosh, [01:37])
• On applying "head and heart":
  “It was a gateway for me to bridge the head and heart parts of my career and interests.” (Ghosh, [13:30])
• On personal method for decision-making:
  “My personal approach is to go for a long run or go for a long walk and sort of refine your gut.” (Ghosh, [15:54])
• On empowering ambition:
  “The singular achievement was to bring a sense of optimism and ambition to the field.” (Ghosh citing a mentor, [17:42])
• On power and bravery:
  “It means the ability to do brave things ... to take a risk, or allow other people to take a risk ... to call out my own organization when we're not living up to our own standards or to bet on a new approach.” (Ghosh, [24:34])

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Timestamps for Important Segments

• 01:20 — Ghosh’s upbringing and the “birth lottery”
• 03:59 — Family health stories and their impact
• 06:56 — Studying economics vs. politics, joining the UN
• 09:08 — The coin flip: pandemics vs. terrorism
• 10:24 — Pandemic preparedness: Past vs. COVID-19
• 12:39 — Transitioning to global development and Gates Foundation
• 15:54 — Learning to trust your instincts
• 17:42 — Defining achievement: optimism and ambition in global health
• 20:51 — The real, lived impact of development work
• 22:55 — Gender, leadership, and authenticity
• 24:34 — Redefining power: courage and risk-taking

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Tone and Takeaway

Candid, thoughtful, and quietly inspiring, this episode offers a nuanced look at what it means to lead with both expertise and empathy in global health advocacy. Gargi Ghosh’s story is a testament to trusting your instincts, valuing both the analytical and human sides of problem-solving, and using power to enable meaningful, often risky change rather than mere authority. For women—and everyone—in global negotiations, her journey underscores: trust the work, trust yourself, and be brave enough to elevate ambition.

Transcript

[Dr. Kathleen McInnes]

This is Smart Women, Smart Power, a podcast that features conversations with some of the world's most powerful women. We feature thought leaders at all career levels where we explore, among other things, the many contributions that women make to the fields of international business, national security, foreign policy, and international development. Does having women in positions of power influence the outcomes of decisions in these fields? Why or why not? Join me, Dr. Kathleen McInnes, Director of the Smart Women's Smart Power Initiative at the center for Strategic and International Studies. For these incredible conversations.

The Gates foundation has become synonymous with leading global change on some of the world's hardest issues, like advancing global health to expanding economic opportunity for the world's most vulnerable. To discuss this worldwide impact, we are joined today by Gargi Ghosh, who leads the Global policy and Advocacy division of the gates foundation. I'm Dr. Kathleen mcinnis, and this is.

Smart Room and Smart Power.

Well, welcome to the podcast, Gargi. Thank you so much for schlepping downtown in the pollen and the. I mean, it's a beautiful day out there.

[Gargi Ghosh]

It is gorgeous, and I'm happy to be here.

[Dr. Kathleen McInnes]

I was gonna say it's not going through the snow or anything. It's just. Yeah, it's gorgeous. But, man, that pollen. To kick us off today, I'd love to start with your origin story. How did you get into the world of international development?

[Gargi Ghosh]

Well, thanks for having me. It's great to be here. I didn't set out to be in the world of international development, so I think this is really a back to my roots story more than anything else. My parents were immigrants. They moved from India to Canada in the 60s. My mom is from Darjeeling up in the Himalayas. My father's from Calcutta. And when they got to Canada, they, like many immigrant parents, raised kids who were part of two cultures. And so we had, you know, deep, deep connections and community in Canada. But it was really important to them to take us back to India. We did every couple years. And so I grew up sort of what at the Gates foundation we now talk about as the birth lottery, where. Where you are born shouldn't matter to the opportunities you have in life. I didn't know that phrase, of course, growing up, but I saw really viscerally what communities in Calcutta in rural India were, what that would have meant for my life. And I think it just became an ingrained part of who I. I am, that people want the same opportunities for their children, but. But that didn't process for me as a career. It just was a personal story. So it took a while for me to get through economics, graduate school, policy, graduate school. I thought I would end up, you know, working in international macro. I knew I loved economics as a field, but it wasn't until I had spent some time sort of in the corporate world that I thought, no, actually I really want to do something that brings me back to my roots, that helps people. And for me, that was going to be international development and just applying economics to development.

[Dr. Kathleen McInnes]

Well, to go back to that, the four, those formative moments, is there something that you can. A memory you recall that you saw when you were a child, that juxtaposition between those two worlds? Is there some. Is that moment. Is there a moment that sort of stands out to you as you think back about your upbringing?

[Gargi Ghosh]

You know, my mom was the only surviving child in her family of four or five kids. And so my story intertwines with hers in a sense of, you know, understanding. Again, the language is retrospective. We didn't have it at the time, but from her stories, it sounds like I had an aunt who died of tetanus. Another sibling of hers was born in a preterm birth and didn't survive that. Now, having worked in global Health, I have the language to talk about that differently. But it was really a story of undernutrition, access to health care, having the. The resources to support family through difficult times. And then later in our life, you know, I have an uncle who was one of the later cases of smallpox. He survived and he still talks about that experience. It. It just about bankrupt his family supporting him through that. So I don't know that it was a single moment so much as the narrative through what could have been, what would be. But the reality is that what I'm talking about is 1950s, 60s India. And so probably the most important part of that is that that shouldn't be anyone's story. 40, 50 years on, 70 years on, and yet you travel to parts of India, still parts of Asia, parts of Africa, and you see that many of the scientific advances that we take for granted are still out of reach for families. So that, that really motivates me at a deeply personal level.

[Dr. Kathleen McInnes]

Wow. Because that story is so sadly, still pervasive in so many places. And so going back to. So you are in university and then you move into the previs and you realize you want to sort of apply your upbringing and your education to this particular problem set. And along the way you ended up working for Kofi Annan, who was then the UN Secretary General. So how did that. How did that experience. So going from this very personal, grassroots sort of experience of global health dynamics to all of a sudden being working within the world's major institution for global governance, how did that happen? How did that happen?

[Gargi Ghosh]

I finished my graduate studies in economics and really felt that that didn't explain what I saw happening in the world, that economic theory should have led to different results for kids around the world. And so I did a second graduate degree in politics because I thought that must be what's messing with economic theory in terms of outcomes that happen. So I have these. I have these degrees.

[Dr. Kathleen McInnes]

Do you have a great question? Was it true? Was it the politics that messes with the economics that's led to the sort of divergence between theory and reality?

[Gargi Ghosh]

Between theory and reality, yes.

[Dr. Kathleen McInnes]

Of course.

[Gargi Ghosh]

Now we also know people aren't the rational actors that economics wants them to be. So there's all kinds of dynamics that make it more interesting. But for me, it was a way to round out the story because in, in development you see so many market failures where the market alone hasn't responded to the needs of the poorest. And so you have to get public policy involved, you have to get entrepreneurship anyway. So for me, that helped explain the world a little more. And I ended up, through a series of great introductions and connections as an unpaid intern in Kofi and Han's office. I did. I had student loans to pay. I did not have the budget to do that, but a very good friend let me sleep on a couch on the Lower east side, let me do this. And it was incredible. This was, with the benefit of hindsight, this was probably the UN at one of its apex moments of respect, of influence. And a lot of that had to do with Kofi Annan. This is the late 90s.

[Dr. Kathleen McInnes]

And.

[Gargi Ghosh]

So he, as an individual was also sort of peak influential at that time.

[Dr. Kathleen McInnes]

Yeah.

[Gargi Ghosh]

And you'll probably remember he did that in the most mild mannered of ways.

[Dr. Kathleen McInnes]

Right.

[Gargi Ghosh]

He had this quiet voice that made everybody just want to lean in and hear what he had to say.

[Dr. Kathleen McInnes]

But.

[Gargi Ghosh]

But he asked the two interns in his office to work on two things that weren't sort of on his urgent list, but that were keeping him up at night in terms of threats to the global system. One was terrorism and the other one was pandemics. I know a lot of foresight in that. Right. Because this was before we had understood that those were imminent threat.

[Dr. Kathleen McInnes]

Yeah.

[Gargi Ghosh]

And so, you know, my fellow intern and I were generalists. We flipped a coin to see who should take which issue. I got pandemics, he got terrorism. He went on actually to work at the International Criminal Court. So that was really determining coin for both of us.

[Dr. Kathleen McInnes]

That's amazing.

[Gargi Ghosh]

And I took pandemics, and for me, it was at that time, it was what would become the HIV AIDS pandemic that we were really focused on, but it was also kind of assessing the infrastructure that the world had to deal with pandemics. And did we have surveillance? Did we have governance? And of course, the answer to all of that at the time was not sufficient. But for me, it was just one of those moments that defines the next phase of your career.

[Dr. Kathleen McInnes]

What having just all of us gone through the COVID pandemic were the moments during COVID where you were like, reflecting on that. That moment in Kofi Annan's office, thinking about what existed, what didn't, and what we should have been doing to prepare.

[Gargi Ghosh]

For that so many times, even now. I mean, some things had gotten way better. Disease surveillance. We had the ability to track disease outbreak that then, of course, became an epidemic and a pandemic, but we didn't have that ability even a few decades ago. And then other things where we weren't as ready and still aren't as ready, like global governance mechanisms. I think we're way better today on the ability to rapidly develop treatments or vaccines. So that we've made a lot of progress on, you know, global procurement and stockpiling. We probably haven't made enough progress.

[Dr. Kathleen McInnes]

Right.

[Gargi Ghosh]

So it's a mixed bag.

[Dr. Kathleen McInnes]

As a national security practitioner by trade, the, the, the work we need to do on stockpiling, that's one of the things that keeps me up at night.

[Gargi Ghosh]

I think there is the tension between national interest, which will always, always be a real thing in a global threat, and the need to build cooperation systems. And of course, you don't build those cooperation systems in the moment of crisis. You've got to have them set in advance. And I think that's where I wish we had made more progress in the intervening years.

[Dr. Kathleen McInnes]

So thinking about that moment in the, in the United nations and then moving forward into your career, were there, Were there specific moments, Was there a specific moment that cemented this, this, like the work that you're doing, the Gates foundation, that this is where you want it to be, that this is the, this is your life's calling?

[Gargi Ghosh]

You know, I, I left the private sector and actually went to a think tank. And for me, that was a conscious decision to go back into development. The way I did that was by reconnecting with Some of the academics, policymakers that I had admired met in the course of my early career. And I ended up at the center for Global Development because I saw that Larry Summers, Nancy Birdsall were starting this serious economics shop focused on development, because I'm sure you have a version of this in national security. But there's a snobbery in the economics profession where, you know, we don't know.

[Dr. Kathleen McInnes]

Anything about snobbery in my world. No.

[Gargi Ghosh]

But some of the sort of humanitarian global health. At that time, it wasn't obvious that a. That a serious economist would think about those issues. So it was such an exciting moment for me to see that those serious economists were applying their brains and their time to issues of poverty and inequality and development and global health. So that was a gateway for me to bridge the head and heart parts of my career and interests. And so from there, I actually worked on a Gates grant at cgd. That's how we got snowgates.

[Dr. Kathleen McInnes]

Okay, okay.

[Gargi Ghosh]

And it's hard to say this now, but at that time, it was a wild card. Nobody had heard of this foundation that was getting started on the west coast at that time. I remember my friends and families sort of scratching their heads why I would sit in D.C. with all of these established institutions and choose to work for a startup unproven. So in retro. I mean, today it has the brand and the cachet and hopefully a track record that makes it an attractive place for all kinds of people, partners. But at that time, it was really just getting started. And for me, the draw was actually not the brand. It was the chance to approach development from a different vantage point, from not the established institutions working on the Washington Consensus, doing the same thing for another decade. But actually, let's try something different. Let's work with the private sector. Let's bring science into the conversation. So at that time, the proposition for me was the fact that it was unproven and willing to take some risks.

[Dr. Kathleen McInnes]

Was because I think this has been a recurring theme in a couple of our conversations at Smart Women, Smart Power. How did you learn to trust your gut on that? Especially when there's so many people saying, yeah, really, really, do you want to do this? Any pro tips or any idea or reflections on how you trusted yourself?

[Gargi Ghosh]

Oh, my gosh, I'm so glad that's a repeat theme, because even today I have to remind myself to trust my gut versus collect as much analysis. You know, at some point, there isn't a right answer. You have to make a judgment call. So I'm sure I did the same thing. At the time, I'm sure I collected lots of opinions. And then my personal approach is to go for a long run or go for a long walk and sort of refined your gut. But actually at that time, it was the bringing together of so many threads in my life. Being able to work on an economics question, development, poverty, but in a very grounded way. It was going to be a global health anchored organization. Despite the Kofi Annan experience, I wasn't a global health specialist. And yet it was one of the most tangible, it still is one of the most tangible ways to make progress on development. You help a family get, get healthy and they can then get education, stay in their jobs, get on the pathway.

[Dr. Kathleen McInnes]

To.

[Gargi Ghosh]

Income growth and prosperity. It was a way to think about head and heart. As I said, I'm from the West Coast. It was a way to kind of build an anchor on the West Coast. So it just, it was sort of obvious. It just took me a minute to get through all the noise and the risk to, to jump in.

[Dr. Kathleen McInnes]

What would you say has been your most impactful moment or the moment you reflect on and you're most proud of in your work at the Gates Foundation?

[Gargi Ghosh]

You know, I have a mentor who said a decade or so ago that in her view of all the things Gates had done in global health development, the singular achievement was to bring a sense of optimism and ambition to the field. Wow. I know. Isn't that amazing?

[Dr. Kathleen McInnes]

Wow.

[Gargi Ghosh]

I can't imagine a bigger compliment for the Gates foundation than being seen to have done that. And it's also the way I think about the most important moments in my time at Gates are those moments when we have, you know, perhaps been on a trajectory and then been able to do something that created a step change. Right. So looking back, there are moments like the creation of GAVI that we were one part of, but, you know, immunization, until that time, even global health people will tell you immunization in the early 2000s was like the stepchild of global health. You just sort of trudging along. I know you're just sort of trudging along with the same vaccines you've had for ages, the same level of coverage, and just the idea that this would be a global priority to make sure every kid had access to vaccines, so we weren't losing children to preventable causes. So my part is the wonky part of figuring out how to get GAVI financed, how to bring in a bond financing mechanism to take that to yet another scale. But the impact is the elevation of ambition Same thing a decade later. I was one of the people who helped Gates start thinking about country financing and domestic resources that health would need to be a priority domestically, not just aid funded. Of course, with today's aid environment, I wish we'd started a decade earlier because we know domestic resources will be critical. But just that connection between Gates's product ambitions, programmatic ambitions and country development I think is going to be another. I hope it's an ERA area that we look back on as another step change in the sustainability of this ambition that can't ultimately be driven by donors.

[Dr. Kathleen McInnes]

What do you wish the world knew better about global health and global health crises? If you're going to talk to my mom or anybody, what do you wish people had a better sense of as they engage with, as they think about or as they're exposed to questions about global health?

[Gargi Ghosh]

You know, I think if you asked me that, I don't know, I was going to say X years ago, but maybe even some days tomorrow I would be tempted to give you a policy answer. And oh, the great scientific pipeline. All the progress we've made. We've cut child deaths in half. That's something the world should be proud of. I wish more people knew how much progress we have made, how much progress every dollar of foreign assistance of hours of time that scientists have made. I wish people knew that. But actually, I think the most important thing is knowing how much of a difference it makes to families around the world. For me now, even as a data nerd, I spend my life with the facts of that progress that pennies a dose, but it's actually sitting with other mothers who are able to send their kids to school because they're not sick, because they're sleeping under a bed net and not suffering from malarial fevers all the time. It's just no matter how wonky your brain is, sitting with a sister or a mother or a just really motivate is so motivating. And I wish more people got to experience that. Yeah.

[Dr. Kathleen McInnes]

Do you think your gender as a woman has had an impact on how you've approached your career? Some of the decisions you take, the way you lead, if so, why? Or if not, why not?

[Gargi Ghosh]

Yes, for sure. But I think it's taken me a while to get comfortable with it 100%.

[Dr. Kathleen McInnes]

Like for me, like I like woman doesn't completely get. But now I'm like oh, actually. But anyway, filling in the blanks.

[Gargi Ghosh]

But if you came up in a certain field, national security economics, and are of a certain age, most of your career was spent proving that being a woman wasn't a liability, that you could still be trusted with data and to make objective decisions. And so it's really so true.

[Dr. Kathleen McInnes]

It's really.

[Gargi Ghosh]

A beautiful thing of, I would say the past decade or so that we can talk about how much and it's an asset to come. So how do I think it's affected me? I I mean, no question I carry the head and heart in everything I do, whether that's thinking about HR decisions in my, in my division or why we should prioritize certain aspects of our portfolio. I also just, I, I, I think a motivated staff matters. I think being connected to the human impact of makes us better at the quantitative choices, the investment choices we have to make. I don't mind incorporating that into the way we think about the world. In fact, I think it makes me.

[Dr. Kathleen McInnes]

A stronger leader and to close us out. I'd love your thoughts on what does power mean to you.

Today?

[Gargi Ghosh]

It means the ability to do brave things.

[Dr. Kathleen McInnes]

Wow.

[Gargi Ghosh]

I think for most of my career I would have said power is the number of people who report to me or the size of the budget I sign off on. But but now it's the ability to take a risk or allow other people to take a risk. It's the ability to call out my own organization when we're not living up to our own standards or to bet on a new approach. There's no question it's taking risks.

[Dr. Kathleen McInnes]

Gargi, thank you so much for your time today. Thank you for reminding us that we need to be elevating our ambitions and to be brave. That's so easy to forget, but in these moments of strange, turbulent times, being big and being brave is so important. Thank you for this conversation.

[Gargi Ghosh]

Thank you.

[Dr. Kathleen McInnes]

Subscribe to the Smart Women Smart Power Podcast on Apple Podcasts, Spotify, or wherever you listen to great content. Be sure to follow us on Twitter martwomen or you can follow me on Twitter jmcinnis1. Thanks for listening and join us next time.