Atlanta, Georgia February 4th, 1968, Dr. Martin Luther King delivered his final sermon with a clear and lasting message: serve, don’t lead. In particular his reflections centered on the concept of “the drum major instinct,” our collective need as individuals to feel validated by our achievements. To lead and inspire not for the greater good but rather as a personal motivation or cultivation of a sense of self worth. Leadership in this sense can be dangerous. This is quite a paradox as Martin Luther King himself is considered to be amongst one of the most profound leaders of our time. As Paul Farmer points out, it was ironically this very desire to strive to reach the top, to be a powerful voice and champion of civil rights, which brought Dr. King to the forefront of this cause. However, upon listening to King’s words from that very day, it’s clear that he is advocating for something more powerful than leadership, something more meaningful. Service. This culture of service is what Dr. King envisioned when he spoke of true greatness, this compassion and goodness which could change the very world in which we live. As King would go on to say, above all else, it was his desire to “feed the hungry,” and “ love and serve humanity,” which he sought to be remembered for. His service was his legacy.
Amongst his many drivers, Dr. King recognized the lack of access to healthcare as an urgent challenge to overcome. As he believed, “of all the forms of inequality…injustice in health care is the most shocking and inhumane.” In this sense, taking the “drum major instinct,” into consideration could prove to be quite interesting and valuable when evaluating the state of leadership in global health efforts. As such in the discussion which follows, Dr. King’s words are utilized to provide a framework through which to understand, evaluate and interpret leadership practices. In addition this piece seeks to highlight the work of those health advocates who have not been written about as traditional leaders. These are the men and women that perhaps Dr. King would agree have to some degree “harnessed” the “drum major instinct,” they lead not for the glory or the name, but rather because they desired change, justice and dignity.
Take dark horse and activist Ron Woodroof for instance, his work in relation to accessing treatments for AIDS patients has only in recent times been labeled heroic and gained acclaim, and that too on the heels of the film The Dallas Buyers Club. However, what is apparent in his story and in his life and work, is that he wasn’t doing any of it for the applause or prestige. He was doing it to keep himself and his friends alive.
With the outbreak of the HIV/AIDS epidemic in the United States, several competing philosophies and agendas came to light. It’s in this climate which Woodroof encountered injustice and marginalization for himself and those who had contracted the disease. He fought back, developing a “buyers club,” providing experimental treatments (unapproved by the government) and medical resources to anyone and everyone who could afford to pay a fee of $400* a month. Though some may say Mr. Woodroof was looking to make a profit, his years of advocacy and tireless work to raise awareness of the injustice at the hands of restrictive drug policies suggest otherwise. In particular the FDA restricted access to several experimental drugs and was slow to approve new treatments. That being said it is also important to note that at the time (mid-eighties) HIV/AIDS treatments were under researched and underfunded.
It is in response to these sorts of limitations which buyers clubs such as the one led by Mr. Woodroof came into existence. Though this sort of buying and importing of unapproved, barely legal treatments, was considered to be fraudulent, it’s important to take a critical look at the landscape of care being provided to many of these ailing individuals and communities. As Mary Franklin, long-time receptionist at the Dallas buyers club noted, “I know it made them feel more powerful about their disease…that they had a fighting chance, which is something the government was not offering.”
In this sense although, Mr. Woodruff’s role was a controversial one, his actions whether classified as service or heroic leadership certainly fulfilled an immediate and desperate need. After all those impacted communities were simply trying to access the care and dignity which they deserved. He took steps when there was a need for a dedicated and compassionate response, for the most part keeping arrogance aside from his main mission of providing affordable and accessible treatment.
In essence, leadership is complex. As the third volume of the Global Health Governance Journal states “the rhetoric which presents leadership as a solution to global health ills… is not necessarily an unproblematic good” (2013). It is this sort of critical approach to dissecting leadership efforts which I think Dr. King would appreciate. However, as I consider my own professional aspirations in global health and my desire to make a change, I continue to circle back to the following paradox: How can one lead without putting oneself at the forefront of a cause? Therefore, I believe leadership, in its’ most honest representation, must consist of finding this balance between heroism and service. In the meantime I will look to the message of the “drum major instinct,” to keep myself accountable. With the right attitude and intent we are all capable of greatness and we can all be change makers.
*The cost at the time for the approved treatment Zidovudine, or AZT, was around $8,000 per year (New York Times, 1989)