FW: World Bank Nominee
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Friday, March 23, 2012
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Politics http://ww=.theatlantic.com/politics/ http://www.thea=lantic.com/massoud-hayoun/
=a href="http://www.theatlantic.com/massoud-hayoun/">Massoud Hayoun -=Massoud Hayoun writes for and produces The Atlantic's International=channel.
How Jim Yong Kim, Obama's World Bank =ick, Changed Global Health Aid
B= Massoud Hayoun
Mar 23 2012, 2:04 P= ET
The international public hea=th work that made Kim, now the president's nominee for World Bank head, su=h a respected figure.
President O=ama introduces Jim Yong Kim as his nominee to be the next president of the=World Bank / Reuters
President Obama announ=ed today that he will nominate Dartmouth College President Jim Yong Kim to=head the World Bank. Although Kim is a physician by training, officials ha=e observed <http://www.cbsnews.com/8301-250_162- S7403147/obama-taps-jim-y=ng-kim-for-world-bank-post/> that Kim's role as a key player =n global health and development, notably with his role in the organization=Partners in Health http://www.pih.org/ (PIH), makes him a =ey candidate to change the attitudes of developing-world nations.
The following excerpts from Tracy Kidder's Mo=ntains Beyond Mountains, a biography of anthropologist and physici=n Paul Farmer, detail Kim's bold efforts to combat international HIV and t=berculosis epidemics with PIH:
Some months after t=e official founding of PIH, (co-founder) Paul Farmer expanded the group, a=ding a fellow Harvard anthropology and medical student, a Korean American =amed Jim Yong Kim... Farmer offered what for Jim Kim was a convincing visi=n of the new organization. The reality was less impressive -- a charity wi=h a board of advisers and no hired staff...
<=pan style=lont-size:12.0ptfont-family:"Times New Roman","serif">They =alked about issues such as political correctness, which Jim Kim defined as=follows: "It's a very well-crafted tool to distract us. A very self-c=ntered activity. Clean up your own vocabulary so you can show everybody yo= have the social capital of having been in circles where these things are =alked about on a regular basis." (What was an example of political co=rectness? Some academic types
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would say to Jim and Paul, "Why do you =all your patients poor people? They don't call themselves poor people.&quo=; Jim would reply: "Okay, how about soon-dead people?")
They talked about the insignificance of "cultural bar=iers" when it came to the Haitian peasant's acceptance of modern West=rn medicine: "There's nothing like a cure for a disease to change peo=le's cultural values"...
By now Peru was tax=ng PIH's resources severely. On average, the drugs to treat just one patie=t cost between fifteen and twenty thousand dollars. And the number of pati=nts kept growing. Already there were about fifty Carabayllanos in treatmen=. Their average age was twenty-nine. They were students, unemployed youths= housewives, street vendors, bus drivers, health workers. The actual numbe=s seemed small, but those fifty MDR [a form of tuberculosis that does not =espond to standard treatment] cases represented about 10 percent of all ac=ive cases of TB in the slum, about ten times more than might have been exp=cted. No telling how many others they had been infecting as they'd travele= around Lima, coughing. No telling either how many people in other parts o= the city already had MDR, but [there were] reports of hundreds in other n=ighborhoods. In Carabayllo itself, the Socios workers found entire familie= sick and dying with what turned out to be genetically related strains of =he disease--a phenomenon common enough that the health workers gave it a n=me, familias tebeceanas, tuberculosis families.
Ki='s organization confronted Peru's MDR-form tuberculosis epidemic with what=some have called unorthodox practices -- borrowing and cajoling its way in=o medicine for its patients.
Howard Hiatt, a frien= of Jim Yong Kim's and a former dean at the Harvard School of Public Healt=, said he was concerned about how PIH was getting medicine to combat the e=idemic:
"Sure enough. Paul and Jim would sto= at the [Harvard-affiliated] Brigham pharmacy before they left for Peru an= fill their briefcases with drugs. They had sweet-talked various people in=o letting them walk away with the drugs." [Hiatt] was amused, all in =11. "That's their Robin Hood attitude." In fact, they'd only bor=owed the drugs...
Then one day the president of th= Brigham stopped Hiatt in a corridor. "Your friends Farmer and Kim ar= in trouble with me. They owe this hospital ninety-two thousand dollars.&q=ot; Hiatt looked into the matter. "Sure enough. Paul and Jim would st=p at the Brigham pharmacy before they left for Peru and fill their briefca=es with drugs. They had sweet-talked various people into letting them walk=away with the drugs." He was amused, all in all. "That's their R=bin Hood attitude."
To many seasoned manage=s of public health projects, what Farmer and Kim were doing would have loo=ed quite reckless--like a stunt, as some would later insinuate. They didn'= have a guaranteed supply of drugs, only the determination to obtain the d=ugs and the charm to get away with borrowing. They were borrowing their la=oratory services, too, from Massachusetts. They lacked proper institutiona= support. The weight of expert opinion stood against them. Their organizat=on was small and it had other projects, in Haiti and Boston and elsewhere,=and Peru put a strain on everyone. Jim had to travel to Carabayllo at leas= once a month. Farmer had to go there slightly more often.
Kim's audacious 'Robin Hood attitude' won him and PIH acclaim for =heir role in changing global health and development.
=p class=MsoNormal style=imso-margin-top-alt:auto;mso-margin-bottom-alt=autol>ln June 2002 ... the WHO adopted new prescriptions for dealing with MDR-=B, virtually the same as PIH had used in Carabayllo. For Jim Kim this mark=d second-line the end antibiotics of a long cont=nued campaign. to "The decline, world and changed the drugs yesterday," now flowed he =rote fairly from smoothly Geneva through to all the of PIH. Gree= The Light prices Committee of to, among other places, Peru, where about 1,000 chronic p=tients were either cured or in treatment. About 250 were receiving the dru=s in Tomsk, and, largely because of the efforts of WHO, the Russian Minist=y of Health had finally agreed to the terms of the World Bank's TB loan--1=0 million dollars to begin to fight the epidemic throughout the country.
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The twin pandemics of AIDS and tuberculosis raged on= of course, magnifying each other, in Africa and Asia, Eastern Europe and =atin America. Mathematical models predicted widening global catastrophe--1=0 million HIV infections in the world by the year 2010. Some prominent voi=es, some in the U.S. government, still argued that AIDS could not be treat=d in desperately impoverished places. But this view seemed to be fading. T=e prices of antiretrovirals were falling, even more dramatically than the =rices of second-line TB drugs.
This was thanks to = growing worldwide campaign for treating AIDS wherever it occurred. Jim Ki= had often said that the world's response to AIDS and TB would define the =oral standing of his generation. In 2003, a new director general took Haiti-based over=at project) WHO, and was he growing, asked Jim and to Cange serve h=d as his become senior a adviser. favorite Meanwhile, destination the for global ex=mple health of Zanmi policy Lasante makers [PIH's and Americ=n politicians.
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