CIA's despicable Pakistan vaccination ploy

Via Conflict Health, The Guardian reports that the "CIA organised fake vaccination drive to get Osama bin Laden's family DNA":

In March health workers administered the vaccine in a poor neighborhood on the edge of Abbottabad called Nawa Sher. The hepatitis B vaccine is usually given in three doses, the second a month after the first. But in April, instead of administering the second dose in Nawa Sher, the doctor returned to Abbottabad and moved the nurses on to Bilal Town, the suburb where Bin Laden lived.

Christopher Albon of Conflict Health writes:

If true, the CIA’s actions are irresponsible and utterly reprehensible. The quote above implies that the patients never received their second or third doses of the hepatitis B vaccine. And even if they did, there is absolutely no guarantee that the vaccines were real. The simple fact is that the health of the children of Abbottabad has been put at risk through a deceptive medical operations by the Central Intelligence Agency. Furthermore, the operation undermines future vaccination campaigns and Pakistani health workers by fueling conspiracy theories about their true purpose.

Albon notes that the Guardian's source is Pakistan's ISI... but this McClatchy story seems to confirm it via US sources:

The doctor's role was to help American officials know with certainty that bin Laden was in the compound, according to security officials and residents here, all of whom spoke only on the condition of anonymity because they feared government retribution. U.S. officials in Washington confirmed the general outlines of the effort. They asked not to be identified because of the sensitivity of the topic.

The sensitivity of the topic? No kidding. This is absolutely terrible, and not just because the kids originally involved might not have gotten the second round of vaccine (which is bad) or because it will make the work of legitimate public health officials in Pakistan even harder (which is very bad). Vaccines are amazing innovations that save millions of lives, and they are so widely respected that combatants have gone to extraordinary lengths to allow vaccination campaigns to proceed in the midst of war. For instance, UNICEF has brokered ceasefires in Afghanistan and Pakistan for polio vaccine campaigns which are essential since those are two of the four countries where polio transmission has never been interrupted.

I hope I'm not overreacting, but I'm afraid this news may be bad for the kids of Pakistan, Afghanistan, and the rest of the world. Assuming the early reports are confirmed, this plot should be condemned by everyone. If US officials who support global vaccination efforts are going to control the damage as much as possible -- though it's likely much of it has already been done -- then there need to be some very public repercussions for whoever authorized this or had any foreknowledge. What tragic stupidity: a few branches of the US government are spending millions and millions to promote vaccines, while another branch is doing this. The CIA is out of control. Sadly, I'm not optimistic that there will be any accountability, and I'm fuming that my own country breached this critical, neutral tool of peace and health. How incredibly short-sighted.

Update: In addition to the Guardian story, Conflict Health, and McClatchy stories linked above, this NYTimes article offers further confirmation and the CNN piece has some additional details. Tom Paulson at Humanosphere, Mark Leon Goldberg of UN Dispatch, Charles Kenny of CGD, and Seth Mnookin all offer commentary.

Advice not to trust

Yesterday morning I came across the gentleman pictured below in New York's Union Square. I've been meaning to take more pictures of "things you only see in NYC" -- a category which generally consists of extremes of pets and fashion -- but I think this deserves its own post:

He was either selling or trying to give away copies of a book titled Uropathy: The Most Powerful Holistic Therapy by one Martin Lara. Since the review of Uropathy on Amazon.com is from the Village Voice, I assume that the evangelist was either Lara or one of his disciples. The review:

Vitamin Pee! Urine is a natural remedy, so raise a glass! That's what alternative therapist Martin Lara wants everyone to do. In his Uropathy: The Most Powerful Holistic Therapy, pee's the ultimate cure-all. Gagging aside, it's not so unconventional: former Indian prime minister Morarji Desai guzzled ounces each morning, observing an ancient Hindu practice. Lara learned about it 11 years ago, when the self-taught therapist he's never studied traditional medicine became disenchanted with science's inability to cure his ailments. Since then he's lectured to thousands. Not any pee will do it must be your own, which Lara says is a nontoxic biofeedback stimulator that boosts immunity by activating the lymphatic system, thus restoring the body to an internally balanced state of health. Dosages range from a few drops of Lara's "Ultimate Universal Remedy" an elixir of water, urine, and white rum to several ounces for serious conditions like cancer, dysentery, or Alzheimer's. Of course, not everyone is ready for this leap of faith. On his Web site Lara argues against obsessing over taste and smell: "Urine is a sample of what is flowing through your veins and repulsive urine should be a motivation to improve the internal conditions, rather than an excuse for not using Uropathy." -- The Village Voice

He was quite earnest. I didn't engage him in conversation because two other passersby were already talking to him. A girl was explaining that urine is what your kidneys decide your body doesn't need. But she wasn't just explaining it, she was disgusted, and angry. His response was similar to a major defense of homeopathic medicine, that the "toxin makes the remedy" (or something like that). The girl got exasperated and left with her friend, and you could hear her ranting as she walked away. I chose not to continue the conversation because I was on my way to meet friends, but in hindsight I wish I had stayed because there are some questions I don't have the answers to:

• How often does he talk publicly about this? What does he do for a living? Ie, is this it, or does he have a boring day job and this is his true passion?
• Does he feel that drinking urine has cured whatever health problems that he originally sought help for? (I would guess so.)
• Why does he think drinking urine has not been more widely adopted?
• Does he think that his approach (especially the t-shirt and public 'evangelism') is the most effective way to spread his message? I would guess he enjoys the attention on some level, but also promotes his beliefs through other, more effective channels.
• What are the typical reactions he gets? How many people stay and talk with him at length, and of those how many eventually adopt his therapy?
• I'd like to talk a bit about Western medicine. Not necessarily the biomedical interventions we favor, but the scientific process by which we (ideally) establish that a practice is beneficial. Does he think urine therapy could be tested by a randomized controlled trial? If not, why not?
• If the passerby had stuck around: why did she choose to argue with him? Did she really think that a guy wearing a bright yellow "Drink Urine" t-shirt in Union Square was likely to change his mind? And for the man himself: how common is her argumentative reaction?

I think a natural first reaction to something this out of the ordinary is laughter or mockery, or the assumption that he's clinically insane. On further thought, what he believes -- in factual support and argumentative method, if not in substance -- isn't that different from much of alternative medicine, and his methods have been widely adopted by many mainstream religions and social movements as well as less-respected 'fringe' beliefs. If those are both true, why isn't his belief more widely adopted? Is it just too taboo?

I think I could have learned valuable things about the mixture of reason and emotion and belief that guide human choices if I had stayed and asked some of these questions. I don't think I'll change his mind, but I plan to look for him if I'm ever strolling through Union Square on a weekend again.

(Note: evidently "urine therapy" is a thing. The Wikipedia page starts with "In alternative medicine..." -- never a good sign.)

Something powerful, ctd

Yesterday I posted about HU Queer Press, an online magazine published by an anonymous group of LGBTQ students at my alma mater, Harding Unviversity. Since then the issue has gotten a lot of press, including Jezebel, The New Yorker blog, KARK, and others. I got a call earlier today from a gay Harding student who is upset by HUQP's approach to the issue and says that some of what they say is factually incorrect. I said that if he wanted to write a response, I'd publish it for him and keep him anonymous as well. I'll reserve my reactions for the comment space, and would love to hear other views as well. Here's what he said:

I am a gay student currently attending Harding University who wants to voice my own experiences and give voice to the experiences of other gay students at HU.  While the accounts presented in “The State of The Gay” e-zine are compelling, sad, frustrating, and even downright infuriating, they are not representative of the current environment on campus.

Harding University does not have a rule against “being gay.”  I am open about my sexuality all over campus—to students, faculty, staff, and members of the administration.  The fact that I am a gay man is common knowledge, not just at Harding University, but also at my church (a Church of Christ). Never once have I been threatened with expulsion or forced reparative therapy.  If anyone was threatened with disciplinary action unless they received counseling, it was not for simply identifying themselves as gay.   When a rule is broken, action is taken, but there is no rule against “being gay.”  This hasn’t always been the case, and Harding isn’t a perfect place. Is there bigotry there?  Yes, and we must deal with that.  We should not blast them, however, for things that simply aren’t true.

Additionally, there is a growing impression that Integrity Ministries at Harding is a place where people are forced to go and be “fixed.”  This is simply not true.  Everyone who is a part of Integrity Ministries is there of their own free will and choice.  The names of the persons attending meetings and/or utilizing resources are not even known by anyone in the administration, faculty, or staff. Students approach the ministry, the ministry does not approach (or impose upon) students, and their identity is kept highly confidential.

If the ethic driving the current debate is freedom of choice, then we must extend that freedom to those whose faith and personal relationship with God have led them to CHOOSE to address their sexuality in the way they see fit. The reason my friends and I remain anonymous in this debate is not because we fear oppression from Harding University—but the exact opposite.  Those who are driving this debate are not allowing us our own freedom, and not creating a “safe place” for us to be honest about who we are and who we want to be.  These people who demand a safe place for themselves are guilty of denying the same thing to us.  At Harding University, we have found many, many, many people who are loving, accepting, nurturing, and inclusive.  Simply put:  HUQueerPress does not represent the majority of gay students at Harding University, and everyone at the University (administration included) is not the grotesque stereotype that HUQueerPress is trying to make them out to be.

--Joe Gay

Something powerful

I've tried to keep this blog professionally relevant, focusing on global health and development. But I want to share something a little different, and this is the best way I know how--hope you'll forgive the tangent. I went to college at Harding University, a conservative, private Christian University in my hometown of Searcy, Arkansas. Harding is strict -- you can get kicked out for dancing,* having sex, being gay, or drinking alcohol. The 5,000+ undergraduates are required to live on campus at first, with guys' dorms and girls' dorms and a nightly curfew where your RA's check to see if you're in your room. Daily chapel is required and everyone must take a Bible class each semester. It's like Footloose but with more Jesus and a lot less Kevin Bacon.

Except that earlier today, a bunch of gay and lesbian students at Harding spoke out:

We are here to share with you our struggle. We are here to be a voice for the voiceless who are quietly dying inside the walls of our campus. We want you to know us. We are your friends, co-workers, students, family members, fellow worshipers, professors, athletes, and scholars.[...] We are queer. We are gay, lesbian, bisexual and transgender. While the rest of you fall in love with the opposite sex, we share our lives and beds with those of our own gender.

All is not well for us at Harding. Our voices are muted, our stories go unheard, and we are forced into hiding. We are threatened with re-orientation therapy, social isolation, and expulsion. We are told stories and lies that we are disgusting sinners who are damned to hell, that we are broken individuals and child abusers....We have felt the pain of the deep, dark closet, and we are here to announce that we will not stand for it any longer.

That's the opening statement from HU Queer Press, a group of anonymous LGBTQ students, who are publishing a webzine about being gay at Harding. You can find the first issue, "State of the Gay at Harding University" at their website:

It's powerful stuff, ranging from the sweet to the visceral. The stories mix courage with self-hatred, love of friends and allies at Harding with hatred for its oppressive atmosphere and teachings. You really should read the whole thing, but here are a few of my favorite parts:

First is this sweet piece from "Dovey" writing about "How I Realized I Like Girls (And Why I'm Surprised I Didn't Realize Sooner.)":

When I was13, I, like most every girl my age, had a best friend (we'll call her Elle.) We spent almost all of our free time together, wrote several-page-long notes to each other that we passed when we met in the school halls, wrote stories about what our lives would be like when we grew up. We loved all the same movies, all the same books, and some of the same music....

I began to realize, though, that every time Elle had a boyfriend (and she had a LOT of them) I got immensely jealous. Even if he was someone who had always been a good mutual friend, I would begin to resent him. It wasn't just that Elle was spending less time with me, or that I felt left out. I wanted to hold her hand like they did. I wanted her to look at me the way she looked at them. I wanted to kiss her goodbye when we all left at the end of the school day.

Then "C" writes about coming out:

Most of the people I first told just kind of smiled and said "I figured." And of course they still loved me. Soon I had this great group of people encouraging me. I got enough confidence to finally tell my parents. They too already had some idea that this might be coming, but there was no smile on their face when they said so. "We were afraid of this." "I'm very disappointed."

"Z" chronicles his history:

[Age 13] Jeff kissed me... One day Jeff took me in the woods and said that he liked me, like he liked Kathleen. He leaned in and kissed me. I felt more alive in that moment than I had ever felt before. The next day in school, Jeff told the entire locker room that I tried to kiss him and that I was a Fag. I knew what it meant now. I sat alone in the lunchroom for the rest of middle school. I never had one friend from school. I turned to church....

[Age 17] Brad pulled me in the back of the room. He kissed me. I kissed him back. He unbuttoned my shirt and I pulled his off. He took off my belt and got down on his knees. He took me in his mouth and I came. I punched him in the face. I called him a Faggot and kicked him in his ribs. What had I done? God please save me. Take this away from me and I'll be a slave to you. I'll never do this again. I want you to take me under your wings and rescue me? Rescue me from whom? ME.

"K" criticizes the "Toxic Teachings" at Harding by highlighting the following course notes for a currently offered class. These were written by a Harding professor:

Certain signs of pre-homosexuality: 1) repeatedly stated desire to be other sex or act like other sex, 2) strong preference for cross dressing or pretending to dress like other gender, 3) strong and persistent desire for opposite roles.

Single Mothers: Cub Scouts and male Sunday school class is not enough to help a boy reach a clear gender identity: the boy must have one salient (good and strong) man who takes a special interest in him - one male chooses him. Men: find those fatherless boys and invite them to go fishing. Play catch with him - especially the quiet boy in the background... the one in the background - he is the one we have to go after.

Seriously? Who's recruiting who?

"K" also shares notes from a journal entry after a therapy session at Harding:

I need to make this decision. Will I go through with this or not. If so I need to truly count the cost and realize that this will cost me. If yes, that I for sure want to pursue my life as a Godly person with Him above all else:

I would have to see myself as heterosexual.

Every time I am attracted or want to look at another guy I would have to say "No. I am a heterosexual and I do not have these desires. They are not natural." I would completely have to capture my thoughts, deny them, and never intend to pursue or continue these thoughts.

There's a lot, lot more. Some amazing introspection, some self-loathing. A little coming out, a lot of the closet, some falling in love. They write a how-to for reading the Bible as gay-neutral, if not gay-friendly. They write about getting called fags.

And they write about the problems they have with "Integrity Ministries," the fairly new support group for students who "struggle with same-sex attraction." In some ways, Harding, or at least the people who are associated with it, have come a long way. The creation of Integrity Ministries a couple years ago suggest that the administration at Harding has realized it has a "gay problem" that isn't going away with denial and condemnation alone, the previous approach. I know that some of my friends saw the inception of Integrity Ministries as a step forward. But taking a tiny step forward from a wallowing pit of homophobia still leaves Harding far short of where it should be.

I really admire the authors for doing this, in part because even writing anonymously, they still face big risks. If someone rats them out they could all get kicked out, and they could lose many friends. And just because they're gay doesn't mean they can easily leave Harding. Some students can only afford college with their parents' support, and some parents will only send their kids to Christian colleges. I guess others stay at Harding because they love the institution despite its flaws and want to go to a Christian school because of their deep faith, and they hope to change it from the inside out. If it were easy and they had no other ties, they'd transfer elsewhere and start a new life with people who love them regardless of their sexuality. But it isn't that easy.

I sympathize with them because I have mixed feelings about Harding as well. My dad teaches there and I grew up around the school. I went to Harding of my own free will because I wanted to be a missionary. I deconverted during my third year there. The process was a gradual one. The more I studied theology and the Bible and war and history and science (some through courses at Harding but also much on my own) the more my views shifted towards progressive theologies. I maintained an unhappy equilibrium as a liberal Christian with a belief in a vaguely Einsteinian God for somewhat less than a year. In hindsight the shift from fundamentalist belief to liberal belief was driven by an intellectual desire to believe something that was compatible with science and history and critical thought, but the choice to go from liberal theology to discarding my faith in faith altogether was more about choosing my allegiances. In the South, and especially at Harding, the association between that particular Christian tradition and reactionary filth was just too strong for me. At some point I couldn't stomach being associated with all that was anti-science, anti-feminist, and yes, anti-gay. If it wasn't clear before you read the HU Queer Press, one reason people get turned off by Christians like many at Harding is that their beliefs and actions cause a world of pain to those they label as sinful.

I have a lot of good memories, and I still love many people associated with Harding -- family, professors and mentors, and classmates. I doubt Harding will change much, or fast. They still don't let women speak in chapel or lead prayers, and you get kicked out for having straight sex too. My hope is more for the students who go to Harding and then move on, that they will emerge more compassionate and less homophobic than they might otherwise have been. Maybe we'll get a step closer to that if everyone at Harding reads this webzine (probably on their laptops at Midnight Oil since I'm sure they'll block www.huqueerpress.com on campus!).

One last thing: Early on, like many other straight male dorm student at Harding I called everyone a fag -- man, don't be such a fag! I used to be part of that putrid homophobic culture, and for that -- to anyone who reads this who I knew at Harding -- I'm sorry. It was as if by joking about it we could make "the gays" all just disappear." But they can't. They're there and they're not going away no matter how hard you pray, and now they're finding a way to speak out. Awesome. Read it and share it with your friends.

----------------------------------------------------------------------

One note: I was not involved in the production or hosting of HU Queer Press, and I don't know who they are. I just received an anonymous email a few days ago asking me to help with getting the word out since I have a blog.  In fact I think it's more powerful not knowing because they could be anyone I knew at Harding.

*Update 1: a commenter points out that they've never heard of anyone getting kicked out for dancing, and I think that's right. My apologies for the imprecision -- I should have said that dancing is against the rules.

Update 2: I'm tracking who all has written about the zine. If you notice a blog I haven't listed please mention it in the comments. So far: Hemant Mehta, Political Cartel, Ian Thomas, NWA Equality, Don Gaines, Talk About Equality, Arkansas Times' Arkansas Blog, Coleman Yoakum, Change.org petition, Nelson Shake, 

Why World Vision should change, but won't

Note: I've edited the original title of this post to tone it down a bit. World Vision has recently come under fire for their plan to send 100,000 NFL t-shirts printed with the losing Super Bowl team to the developing world. This gifts-in-kind strategy was criticized by many bloggers -- good summaries are at More Altitude and Good Intentions are Not Enough. Saundra S. of Good Intentions also explained why she thinks there hasn't been as much reaction as you might expect in the aid blogosphere:

So why does Jason, who did not know any better, get a barrage of criticism. Yet World Vision, with decades of experience, does not? Is it because aid workers think that the World Vision gifts-in-kind is a better program? No, that’s not what I’m hearing behind the scenes. Is it because World Vision handled their initial response to the criticism better? That’s probably a small part of it, I think Jason’s original vlog stirred up people’s ire. But it’s only a small part of the silence. Is it because we are all sick to death of talking about the problems with donated goods? That’s likely a small part of it too. I, for one, am so tired of this issue that I’d love to never have to write about it again.

But in the end, the biggest reason for the silence is aid industry pressure. I’ve heard from a few aid workers that they can’t write - and some can’t even tweet – about the topic because they either work for World Vision or they work for another nonprofit that partners with World Vision. Even people that don’t work for a nonprofit are feeling pressure. One independent blogger told of receiving emails from friends that work at World Vision imploring them not to blog about the issue.

While I was one of the critical commentators on the original World Vision blog post about the NFL shirt strategy, I haven't written about it yet here, and I feel compelled by Saundra S.'s post to do so. [Disclosure: I've never worked for World Vision even in my consulting work and -- since I'm writing this -- probably never will, so my knowledge of the situation is gleaned solely from the recent controversy.]

And now World Vision has posted a long response to reader criticisms, albeit without actually linking to any of those criticisms -- bad netiquette if you ask me. Saundra S. responds to the World Vision post with this:

Easy claims to make, but can you back them up with documentation? Especially since other non-profits of similar size and mission - Oxfam, Save the Children, American Red Cross, Plan USA - claim very little as gifts-in-kind on their financial statements. So how is it that World Vision needs even more than the quarter of a billion dollars worth of gifts-in-kind each year to run their programs? To be believed, you will need to back up your claims with documentation including: needs assessments, a market analysis of what is available in the local markets and the impact on the market of donated goods (staff requests do not equal a market analysis), an independent evaluation of both the NFL donations (after 15 years you should have done at least one evaluation) and an independent evaluation of your entire gifts-in-kind portfolio. You should also share the math behind how World Vision determined that the NFL shirts had a Fair Market Value - on the date of donation - of approximately $20 each. And this doesn't even begin to hit on the issues with World Vision's marketing campaigns around GIK. Why keep perpetuating the Whites in Shining Armor image.

So to summarize Saundra S.'s remaining questions:

1. Can WV actually show that they rigorously assess the needs of the communities they work in for gift-in-kind (GIK)? especially beyond just "our staff requested them"?

2. Why does WV use a much larger share of GIK than other similarly sized nonprofits.

3. Has WV tried to really evaluate the results of this program? (If not, that's ridiculous after 15 years.)

4. How did WV calculate the 'fair market value' for these shirts? (This one has an impact on how honestly WV is marketing itself and its efficiency.)

Other commenters at the WV response (rgailey33 and "Bill Westerly") raise further questions:

5. Does WV know / care where the shirts come from and how their production impacts people?

6. Rather than apparently depending on big partners like the NFL to help spread the word about WV is doing and, yes, drive more potential donors to WV's website (not in itself a bad thing) shouldn't they be doing more to help partners like the NFL -- and the public they can reach -- realize that t-shirts aren't  a solution to global poverty? After all, wouldn't it be much more productive to include the NFL in a discussion of how to reform the global clothing and merchandise industries to be less exploitative?

7. WV must have spent a lot of money shipping these things... isn't there something better they could do with all that money? And expanding on that:

Opportunity cost, opportunity cost, opportunity cost. The primary reason I'm critical of  World Vision is that there are so many things they could be doing instead!

For a second, let's assume that GIK doesn't have any negative or positive effects -- let's pretend it has absolutely no impact whatsoever. (In fact, this may be a decently good approximation of reality.) Even then, WV would have to account for how much they spent on the programs. How much did WV spend in staff time, administrative costs like facilities, and field research by their local partners coordinating donations with NFL and other corporate groups? On receiving, sorting, shipping, paying import taxes, and distributing their gifts-in-kind? If they've distributed 375,000 shirts over the last few years, and done all of the background research they describe as being necessary to be sensitive to local needs... I'm sure it's  an awful lot of money, surely in the millions.

Amy at World Vision is right that their response will likely dispel some criticism, but not all. But that's not because we critics are a particularly cantankerous bunch -- we just think they could be doing better. Her response shows that, at least in one sense, they are a lot better than Jason of the 1 Million Shirts fiasco, if they're spreading the shirts out and doing local research on needs -- but those things are more about minimizing potential harm than they are maximizing impact. In short, World Vision's defense seems to be "hey, what we're doing isn't that bad" when really they should be saying "you know what? there are lots of things we could be doing instead of this that would be much greater impact." So in another way World Vision is much worse than Jason, because they have enough experts on these things to know what they're doing and that this sort of program has very little likelihood of pulling anyone out of poverty, they know there are better things they could be doing with the same money, and they still do it.

To get to why I think that's the case, let's go back to WV's response to the GIK controversy. From Amy:

At the same time, I’ll also let you know that, among our staff, there is a great deal of agreement with some of the criticisms that have been posted here and elsewhere in the blogosphere.  In my conversations, I’ve heard overwhelming agreement that product distribution done poorly and in isolation from other development work is, in fact, bad aid.  To be sure, no one at World Vision believes that a tee shirt, in and of itself, is going to improve living conditions and opportunities in developing communities. In addition, World Vision doesn’t claim that GIK work alone is sustainable.  In fact, no aid tactic, in and of itself, is sustainable.  But if used as a tool in good development work, GIK can facilitate good, sustainable development.

There are obviously a lot of well-intentioned and smart people at World Vision, and from this it sounds like there are differences of opinion as to the value of GIK aid. One charitable way of looking at the situation is to assume that employees at WV who doubt the program's impact justify its use as a marketing tool --  but if that's the case they should classify it as a marketing expense, not a programmatic one. But I imagine the doubts run deeper, but it's pretty hard for someone at any but the most senior of levels to greatly change things from inside the organization, because it's simply too ingrained in how WV works. Clusters of jobs at WV are probably devoted to tasks related to this part of their work: managing corporate partnerships, coordinating the logistics of the donations, and coordinating their distribution.

One small hope is that this controversy is giving cover to some of those internal critics, as the bad publicity associated with it may negate the positive marketing value they normally get from GIK programs. Maybe a public shaming is just what is needed?

[I really hope I get to respond to this post in 6 months or a year and say that I was wrong, that World Vision has eliminated the NFL program and greatly reduced their share of GIK programs... but I'm not holding my breathe.]

Gates and Media Funding

You may or may not have heard of this controversy: the Gates Foundation -- a huge funding source in global health -- has been paying various media sources to ramp up their coverage of global health and development issues. It seems to me that various voices in global health have tended to respond to this as you might expect them to, based on their more general reactions to the Gates Foundation. If you like most of Gates does, you probably see this as a boon, since global health and development (especially if you exclude disaster/aid stories) aren't the hottest issues in the media landscape. If you're skeptical of the typical Gates Foundation solutions (technological fixes, for example) then you might think this is more problematic.

I started off writing some lengthy thoughts on this, and realized Tom Paulson at Humanosphere has already said some of what I want to say. So I'll quote from him a bit, and then finish with a few more of my own thoughts. First, here is an interview Paulson did with Kate James, head of communications at the Gates Foundation. An excerpt:

Q Why does the Gates Foundation fund media?

Kate James: It’s driven by our recognition of the changing media landscape. We’ve seen this big drop-off in the amount of coverage of global health and development issues. Even before that, there was a problem with a lack of quality, in-depth reporting on many of these issues so we don’t see this as being internally driven by any agenda on our part. We’re responding to a need.

Q Isn’t there a risk that by paying media to do these stories the Gates Foundation’s agenda will be favored, drowning out the dissenting voices and critics of your agenda?

KJ: When we establish these partnerships, everyone is very clear that there is total editorial independence. How these organizations choose to cover issues is completely up to them.

The most recent wave of controversy seems to stem from Gates funding going to an ABC documentary on global health that featured clips of Bill and Melinda Gates, among other things. Paulson writes about that as well. Reacting to a segment on Guatemala, Paulson writes:

For example, many would argue that part of the reason for Guatemala’s problem with malnutrition and poverty stems from a long history of inequitable international trade policies and American political interference (as well as corporate influence) in Central America.

The Gates Foundation steers clear of such hot-button political issues and we’ll see if ABC News does as well. Another example of a potential “blind spot” is the Seattle philanthropy’s tendency to favor technological solutions — such as vaccines or fortified foods — as opposed to messier issues involving governance, industry and economics.

A few additional thoughts:

Would this fly in another industry? Can you imagine a Citibank-financed investigative series on the financial industry? That's probably a bad example for several reasons, including the Citibank-Gates comparison and the fact that the financial industry is not underreported. I'm having a hard time thinking of a comparable example: an industry that doesn't get much news coverage, where a big actor funded the media -- if you can think of an example, please let me know.

Obviously this induces a bias in the coverage. To say otherwise is pretty much indefensible to me. Think of it this way: if Noam Chomsky had a multi-billion dollar foundation that gave grants to the media to increase news coverage of international development, but did not have specific editorial control, would that not still bias the resulting coverage? Would an organization a) get those grants if it were not already likely to do the cover the subject with at last a gentle, overall bias towards Chomsky's point of view, or b) continue to get grants for new projects if they widely ridiculed Chomsky's approach? It doesn't have to be Chomsky -- take your pick of someone with clearly identifiable positions on international issues, and you get the same picture. Do the communications staffers at the Gates Foundation need to personally review the story lines for this sort of bias to creep in? Of course not.

Which matters more: the bias or the increased coverage? For now I lean towards increased coverage, but this is up for debate. It's really important that the funding be disclosed (as I understand it has been). It would also be nice if there was enough public demand for coverage of international development that the media covered it in all its complexity and difficulty and nuance without needing support from a foundation, but that's not the world we live in for now. And maybe the funded coverage will ultimately result in more discussion of the structural and systemic roots of international inequality, rather than just "quick fixes."

[Other thoughts on Gates and media funding by Paul Fortner, the Chronicle of Philanthropy, and (older) LA Times.]

Afraid

Here are two semi-related articles: one by William Easterly about how aid to Ethiopia is propping up an oppressive regime, and another by Rory Carroll on the pernicious but well-intentioned effects of aid tourism in Haiti. Basically, it's really hard to do things right, because international aid and development are not simple. Good intentions are not enough. You can mess up by funneling all your money through a central regime, or by having an uncoordinated, paternalistic mess.

A couple confessions. First, I'm a former "aid tourist." In high school and college I went on short-term trips to Mexico, Guyana, and Zambia (and slightly different experiences elsewhere). My church youth group went to Torreon, Mexico and helped build a church (problematize that). In Guyana and Zambia I was part of medical groups that ostensibly aimed to improve the health of the local people; in hindsight neither project could have possibly had any lasting effects on health, and likely fostered dependency.

Second, I'm an aspiring public health / development professional, and I'm afraid. I don't want to be the short-term, uncoordinated, reinventing-the-wheel, well-intention aid vacationer -- and I think given my education (and the experience I hope to continually gain) I'm more likely to avoid at least some of those shortcomings. But I'm scared that my work might prop up nasty regimes, or satiate a bloated aid industry that justifies its projects to sustain itself, or give me the false impression of doing good while actually doing harm.

I think the first step to doing better is being afraid of these things, but I'm still learning where to go from here.