Dr. Rasha Kelej on Breaking Infertility Stigma Through Multilayered Leadership

Dr. Rasha Kelej, CEO of the Merck Foundation, has written about a leadership principle she learned the hard way: the most visible problem is rarely the only problem. In a new article published as part of her virtual mentorship platform, she reflects on her work creating and directing the "More Than a Mother" movement, an initiative designed to transform how fertility care is delivered and understood across Africa and beyond. The article, titled "Leadership Beyond the Obvious: How I Worked to Transform Fertility Care and Break Infertility Stigma," traces how she came to see infertility not as a purely medical challenge but as a social, cultural, and communicative one—and how that shift in perspective changed what her organization actually did.

Kelej's understanding of the problem's true shape came from direct observation. She traveled to rural communities across Africa, watching how infertility functioned as a source of profound social devastation, particularly for women. In many places, women bore the blame for infertility regardless of its actual cause. They faced discrimination, isolation, and social rejection for a condition often entirely beyond their control. Kelej also encountered religious and cultural resistance to fertility treatment itself—barriers that no amount of medical innovation alone could overcome. These visits made clear that building clinics and training doctors, while necessary, would not be sufficient.

So the Merck Foundation's approach became deliberately layered. If there were no trained fertility specialists in a region, the foundation built medical capacity—providing more than 800 scholarships to healthcare providers from 42 countries, establishing local expertise where none had existed before. If stigma kept women and couples from seeking care, the foundation worked to shift cultural perception. If misinformation circulated through public narratives, the foundation trained journalists and media professionals to report more accurately. If religious or cultural beliefs created resistance, the foundation engaged those communities respectfully rather than around them. And when conventional health communication could not reach everyone, the foundation partnered with artists and creative communities to carry messages in forms that would resonate.

This multi-directional strategy reflects Kelej's core insight about leadership itself: lasting change does not come from solving only the problem you can see. A leader must identify the many layers surrounding the visible crisis and work on all of them simultaneously. In the case of infertility, that meant recognizing that the barrier was not just medical scarcity but also social shame, cultural resistance, misinformation, and the absence of trusted local voices willing to speak about the issue openly.

The scholarship program illustrates the scale of the capacity-building effort. Eight hundred healthcare providers trained across 42 countries represents a deliberate investment in creating permanent local expertise rather than importing solutions. In many of those countries, the foundation supported the training of the first local fertility specialists and embryologists—professionals who could serve their own communities and, crucially, who understood the cultural context in which they worked. This approach built not just medical capacity but also trust and cultural legitimacy.

Kelej's article positions this work as a case study in what she calls "leadership beyond the obvious." The obvious problem was infertility itself—a medical condition affecting millions. The obvious solution would have been to build clinics and train doctors. But the deeper work required understanding why women suffering from infertility often suffered alone, why communities resisted treatment, why misinformation persisted, and why local expertise mattered as much as foreign expertise. Addressing those layers simultaneously created what Kelej describes as a broader culture shift alongside the strengthening of access to care and healthcare capacity.

The article and the mentorship platform it belongs to suggest that Kelej sees this experience as instructive for leaders working on other entrenched problems—health disparities, gender inequality, cultural resistance to change. The principle is consistent: look beyond the immediate challenge. Understand the social, cultural, and communicative architecture surrounding it. Work on multiple layers at once. Build local capacity and local trust. Engage the communities most affected, not as recipients of solutions but as partners in defining what change actually looks like.