If she had been told when she was in medical school that one day she would become president & CEO of CARE, USA, a leading humanitarian organization fighting global poverty, Helene Gayle may have discounted the prediction. As it turns out, her career path led her directly to CARE’s door. Her last job—as director of the HIV, TB and Reproductive Health Division at the Bill & Melinda Gates Foundation—was a precursor to her current role, as was the 20 years she spent at the Centers for Disease Control and Prevention (CDC), most of that time devoted to the treatment and prevention of HIV/AIDS.

But before she gained access to Bill Gates and collected more passport stamps than most heads of state, Gayle spent her residency in pediatrics at an inner-city hospital in Washington, D.C. There, she spent a significant amount of time in the emergency room (ER) treating uninsured children with non-emergency issues because their families couldn’t afford regular health care. As she treated the children, she thought about how to address the underlying issues causing these kids to end up in the ER. After her residency, Gayle entered a training program in epidemiology at the CDC.

Her inspiration to forego a “normal” medical doctor trajectory was due in part to a speech she attended while a psychology student at Barnard College in New York City. A talk by Dr. D.A. Henderson, one of the men who directed the World Health Organization’s global smallpox eradication project, “solidified something in me,” says Gayle, who spoke to a group of Goizueta Business School students as part of the school’s Leadership Speakers Series. (Gayle was also the keynote speaker at the Executive Women of Goizueta’s Empowering Women Conference in October 2008).

Henderson’s speech not only exposed Gayle to the story of the eradication of small pox, but it helped set the course of her life—something Gayle, the first African-American and the first woman to run CARE, may have had on her mind as she addressed the students. It wasn’t just that small pox, a disease that claimed millions of lives in the 20^th Century alone, had been vanquished. What stuck with Gayle was how a group of people joined together to make, she said, “a huge contribution to human kind.” A belief in the power of joining forces to change people’s lives is still with her.

Gayle has seen firsthand what many policy makers have not—death and disease caused by HIV/AIDS and drug-resistant tuberculosis, as well as death and disease due to lack of access to clean water. (According to a United Nations Development Report, approximately 3800 children die every day from diseases commonly associated with lack of access to clean drinking water, inadequate sanitation and poor hygiene). Gayle has come to understand global health as a development issue, a foreign policy issue and an economic issue.

While improved health may boost an entire community’s economic viability, studies show that it is by improving the health and well being of women that greatest benefits are reached. “If [women] aren’t in good health, there’s less chance to work and take care of the family and they’ll slip further into poverty,” Gayle says. “Catastrophic illness is often what puts people into financial straights. There’s a real link between poor health and poverty.”

Women and children suffer disproportionately from poverty (70 percent of the world’s poorest people are women). CARE works to make women self-sufficient in an effort to create long-term social change. According to the CARE website, “Women are at the heart of CARE’s community-based efforts to improve basic education, prevent the spread of HIV, increase access to clean water and sanitation, expand economic opportunity and protect natural resources.” One of the ways it accomplishes this is by supporting moneymaking activities. Microfinance is a “large effort” for CARE, says Gayle, and the organization initiates community savings-and-loan programs and technical training that will assist inhabitants in running their small businesses.

Women, when equipped with the proper resources, have the power to assist whole families and entire communities escape poverty. “Investing in them is the best way of bringing long term change in a community,” says Gayle. Give women opportunities for economic growth, she explains, and they’ll use their resources to invest in their children’s health and education—most often in that order. This is at the heart of CARE’s current approach.

Originally formed more than 60 years ago to assist the rebuilding efforts in Europe after WWII (the organization’s infamous “CARE packages” were part of that effort), CARE now has a staff of 13,000, a $650 million budget and a presence in 66 countries (the organization’s poverty-fighting projects supported more than 65 million people in 2007). The organization facilitates change by strengthening peoples’ capacity for self-help, providing economic opportunity, delivering emergency aid to survivors of war and natural disasters, influencing policy decisions and addressing discrimination. Gayle points out that what CARE does is not charity. “We think of it as capacity building,” she says.

Although progress has been made in terms of “joining forces” (public, private and non-government organizations, or NGOs) there is still a need, notes Gayle, for a more comprehensive and systematic approach to foreign assistance. More often than not, assistance money is earmarked for specific projects or concerns, such as HIV. If a community is in dire need of a good water system, it can’t spend any or part of assistance money designated for other things to build one. Gayle would like to see individual countries asked to play a bigger role in decision-making so that the assistance given to them is more appropriate. Says Gayle, “There’s a lot more potential to extend what we do in ways that are more useful.”

While anecdotes about CARE’s work make people feel good about the organization and about donating to it, organizations like CARE recognize the need to quantify the positive effects of their efforts. While it may be difficult to measure things such as “empowerment,” deconstruction of what it takes to empower someone does lead to measurable effects and CARE can show contributors the return on investment of their financial contributions.

Raising capital in an economy like this does pose difficulty. Approximately 50 percent of CARE’s budget is covered by funds from the U.S. government. Grants from the Bill & Melinda Gates Foundation provide a substantial amount of funding as well. The rest, about 20 percent of contributions, come from individual and corporate donors and that is where CARE predicts a slowdown. To combat a decrease in funds, the organization is preparing contingency budgets at 97, 95 and 90 percent of its original plan and reminds the public that in tough times, the world’s poor don’t have the option of tightening their belts.

The middle child of five children, Gayle grew up in Buffalo, NY. Her father was a small businessman and her mother was a social worker. On Sundays, her father sometimes took the family to visit elderly people who were sick and/or unable to leave their houses.

“Both parents gave a real example of doing whatever you could to try and make people’s lives better,” Gayle told Newsweek Magazine in October 2008. In the same article, Gayle said she was intrigued by the opportunity to lead CARE because it was an opportunity to “pull together the different strands of my life…. This was full circle back to what brought me into medicine to begin with—wanting to address social inequity,” said Gayle. “I feel very fortunate to be here. You reach a point in life where you know you may have more years behind you than ahead of you. I want to know that I’m using each day in ways that are meaningful to me.”