Centers and Margins

Lessons From Sierra Leone’s Debt Swap Journey In this final episode of our four-part series on Sierra Leone’s debt swap journey, I step back from the technical process and focus on what this reform taught me—about leadership, alignment, patience, and the realities of systems change. If you’re new here, Centers & Margins is a podcast where we explore global health, public sector reform, and wha...

Big reforms don’t live or die with ministers alone. They depend on the machinery beneath them. In Episodes 1 and 2, I traced the early journey of debt-for-health swaps in Sierra Leone: from first hearing about the tool, to testing its relevance, to earning political attention from the Minister of Health and the Ministry of Finance. In Episode 3, the story shifts. A new Minister of Finance steps in...

In Episode 1 of Centers & Margins, I explored why debt swaps caught my attention as a possible tool for expanding Sierra Leone’s fiscal space for health. But moving from an idea to something real required testing the waters with those who mattered most. In this episode, I share how we took those early steps: learning from the Global Fund’s experience across 12 countries, engaging the Minister...

Welcome to Centers and Margins,  A podcast where we systematically unpack policy discussions from the engine room of reform. From global financing tools to the gritty realities of local politics, we explore what it really takes to move ideas from concept to implementation.  Episode One introduces the origin story of debt2health swap in Sierra Leone, the concerns about the viability of the instrume...

Welcome to Centers and Margins,  A podcast where we systematically unpack policy discussions from the engine room of reform. From global financing tools to the gritty realities of local politics, we explore what it really takes to move ideas from concept to implementation. Each episode draws lessons from working at the intersection of policy, politics, and systems change where human capital ambiti...