Dykki Settle joined Medic as Interim CEO in May 2024. Here, he shares defining moments from his 30 years of experience in digital technology and data systems, and the crossroads of connection that led him to Medic.
I remember one of the first times that I watched technology bring the wind of change.
It was in the early 1990s, before the internet had pervaded the public and instead was more of an academic research network.
I was working with the Sun Microsystems SunSITE group at UNC-CH and in my boss’s office next over from where I was sitting, sat the very first web server this side of the Atlantic. It still houses what may be the oldest web-page in existence.
One day I came in to find an email announcing the first browser that could download images and rich text (fonts), together on the page for the very first time.
They loaded very slowly, a line at a time, but there they were: the images and rich text in the first graphical webpage.
It was a profound, tangible moment. You knew everything that was going to come after was going to be different.
Turning technology outwards
One of the projects I worked on was converting the first book to web format, which led me to join Ventana Communications as their Chief Technology Officer, right out of college.
We set up the first book sales – long before Amazon came along. People would get our software, buy our books, and this was the way that many began to join the internet.
But we were only having an impact on a small group of people. I realized that this transformation of the digital economy risked exacerbating the global inequities in the world rather than alleviating them.
I wanted to turn my work outwards to make sure that all of humanity could participate.
Looking at Maslow’s hierarchy of needs, I saw that health was the first place to start.
That’s how I came to be the Director of Systems and Technology at IntraHealth, the global reproductive health agency. There I helped create and support iHRIS, the free, open-source digital health software now used by over 30 countries to better plan, manage, and support their health workforce – much like Medic does for community health workers today.
The greater (global digital) good
In that work, I saw the powerful synergies between international development and open-source approaches: for local ownership, local capacity, and local adaptability. I began to campaign for open source in global health.
As I saw it, international development did not yet have a good mechanism for supporting the kind of adaptation and growth countries needed to implement global goods.
I wanted to find a platform advocating to better align and coordinate investment, as well as defragment and find better sustainability models for the digital health global goods space. In my search, the health equity nonprofit PATH invited me to lead its digital health team. Together, with USAID, the Bill and Melinda Gates Foundation, and a number of other pioneering donors, we co-created Digital Square, the leading flagship initiative supporting digital health global goods.
Digital Square has successfully moved over $30 million out into global goods. It mobilizes important conversations to move us forward as a global ecosystem, recognizing the many different components that go into advancing universal health coverage.
But we were not seeing digital transformation take hold to support countries in a way that was meeting their needs. It was all still very fragmented, and it became increasingly clear that digital transformation is a sociopolitical problem disguised as a technical problem. We were working with technocrats who did not have the mandate to convene all of the stakeholders needed to effect true health system-wide transformation.
Health in the digital age
So we went to where that mandate was, to where political leaders discussed digitalization: the World Health Assembly…the World Health Summit…UNGA…G20…G7.
Together with Fondation Botnar and other colleagues, I supported the establishment of the Transform Health Coalition to speak to these leaders in their language. We shifted from talking about tech, to talking about transformation; from talking about digital health, to talking about health in the digital age.
We built digital health resolutions, advocacy talking points and agendas for political leaders. And we began, for the first time, to see the political and technical classes align on, and advance, this work.
Arriving at Medic
My work with PATH, and Medic’s path, has been a long, parallel and intersecting journey. There have been many commonalities in our commitment to health workers and we’ve had many touchpoints and opportunities for collaboration along the way.
I have been celebrating Medic as a champion of health workers and open-source technology since the early days of the organization. So when I was asked to join their Board of Directors in 2022, I was honored.
I’m excited that the Board has now appointed me as Interim CEO. I am committed to serving Medic, its people, and our exceptional mission to the best of my ability every day. We will keep challenging ourselves to create greater health and wellbeing by closing gaps and resolving some of the greatest inequities in the world.