D- Define the gap, and the bar

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In 2018, we were trying to change how countries provide healthcare to people far from hospitals.

The evidence was overwhelming. The pilots were working.

And still — most health systems didn't really budge.

When we dug into why, the answer surprised us. It wasn't political resistance. It wasn't lack of evidence. It wasn't even competing priorities.

It was this: we hadn't made our standard something people actually wanted.

Not because it wasn't good. Because we'd built something rigorous and correct — and completely uninviting. No minister was going to stake their legacy on "catalyzing the adoption of high-impact community health systems design" (painfully true).

No country was going to race to be first to adopt something that felt like homework and sounded like gobbledygook.

The standard had no pull.

The first phase of DRIVE is Define the gap and the bar — and the job isn't just to define what's broken. It's to define something so clear, so doable, so obviously the direction things are heading — that people want to be part of it before it's official.

The best standards work like the best products. People don't adopt them because they're solving a problem. They adopt them because everyone they respect is already there — and being left behind is worse than changing.

That means your standard needs to pass three tests (thanks, Mulago):

Big enough — this could be a legacy project. A minister's signature achievement. Something worth putting your name on.
​Cheap enough — doable. Nothing kills momentum faster than a standard that feels out of reach.
​Simple enough — explainable in a sentence. Achievable within a political term. Something people can actually cross the finish line on.

If it can't pass all three, it won't travel. Not because people disagree. Because it won't feel like something worth wanting.

And then: make the bar itself irresistible.

This is where most teams blow it. They build a dashboard. Forty indicators. Seventeen sub-metrics. A methodology document no one reads.

It feels rigorous. It is uninviting.

The standard that gets adopted looks different. Three to seven core thresholds. Defensible. Pressure-tested in real contexts before it's published — so the first objection, "this doesn't apply to us," is already answered. Simple enough that an early adopter can hold it up and say: we did this. You can too.

Make it something people want to be first to claim. And watch who races to the front.

Try this:

Ask yourself honestly: is your standard something a minister would want their name on?

If you hesitate — that's your first design problem.

🌿 A standard no one wants is a standard no one adopts. Make it easy to want.