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Disease-fighting group gets off to rocky start
Chief's pay package, comment on funding needs are criticized
By John Donnelly, Globe Staff, 7/1/2002
WASHINGTON - Richard G.A. Feachem, about to become the first director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, is already under fire from activists who want him to quit for saying the fund has ''plenty'' of money to start.
At a critical time in the fight against the three killer infectious diseases, and on the eve of the 14th International AIDS Conference in Barcelona, Feachem is set to begin building an organization almost from scratch while fending off the activists.
Feachem, who was named director by the fund's board in April, has yet to sign a contract. Over the last two months he has negotiated a package deal worth an estimated $200,000 tax free per year, among the highest for a public health official.
Several senior officials at the United Nations, which is overseeing the terms of the contract, were dismayed by the high figure, saying it would send the wrong message, but others said the fund needs to pay what is necessary to recruit the best possible leader.
Feachem said he may sign the deal as early as today.
He also must deal with new criticism of the fund from US Treasury Secretary Paul O'Neill, who told a House panel last week that he was impressed by Feachem but troubled by the board's early decisions.
In particular, he said the first grants had no accounting to track the numbers of people helped, and there seemed to be no discernible logic in how the board spent the money.
''The reason, I think, is this,'' said O'Neill, who last month traveled with Irish rock star Bono on a tour around Africa. ''Do you know how many people there are at the Global Fund doing this work, including secretaries and administrative assistants? You might think they have a big bureaucracy. They've got 10 people.''
With 40 million people infected with HIV and AIDS; with new infections expected to skyrocket soon in India, China, Russia, Asia as a whole, and sub-Saharan Africa again; and with 58 percent of people newly infected under the age of 25; global health specialists warn that the pandemic is just in its early stages. If major new interventions are not begun soon, specialists predict that the disease may not peak until after the year 2050.
The fund, which was founded with such promise last year as a new, independent force to fight the diseases, desperately needs new momentum. Most tellingly, donations have dried up since last fall, staying at the $2 billion mark. UN Secretary General Kofi Annan said that in five years global spending on AIDS alone needed to be up to $10 billion annually.
''Barcelona is going to be key for the fund's success,'' said Phillippa Lawson, a board member who represents people infected with HIV/AIDS, of the conference that begins next Sunday. ''It will be Richard's debut before 10,000 people - activists, health ministers, scientists. It is where we really need the Global Fund concept to take hold.''
Activists such as Northeastern University law professor Brook K. Baker and Gorik Ooms, head of Medicins Sans Frontieres in Tanzania, last week called on Feachem to quit unless he distanced himself from his earlier comments, which first appeared in the Memphis Commercial Appeal.
''The question from me is whether he is beating the bush for money as he should be doing in what is a grotesquely underfunded fund, or is he making `nice nice' with politicians in the hope that they will become more forthcoming in the future,'' Baker said. ''The fund needs a drum major who is marching at the head of the pack and demanding the money.''
Feachem, a former senior World Bank official and currently the founding director of the Institute for Global Health at the University of California, San Francisco, responded to Brook and Ooms in an e-mail that said the fund needed much more money and also needed to be held accountable.
In an interview, he said he understood both the activists' frustration to move more quickly and the donors' demand that they had a right to know whether their money was well spent.
''If we want to be able to support all the high-quality proposals in the near future, the fund must receive a lot more money,'' he said. ''On the other side of the coin, the Global Fund must rapidly demonstrate that it is an effective instrument to get the money to the front line and that the investment delivers the goods.''
But Feachem also believes that the fund needs to take some chances. Speaking on Capitol Hill last month, he said, ''We will take risks. We will fail. We will make mistakes. We will learn, and we will move ahead.''
E. Anne Peterson, assistant administrator for the Bureau of Global Health at the US Agency for International Development, said one way to reduce the amount of time needed to study a program's success was not to wait for outcomes - but to watch how the program is implemented and who is served.
''I don't think anyone wants to wait two or three years down the line to get outcomes,'' she said.
For now, Feachem first needs to wrap up his salary negotiations. He said he expected to receive paperwork today; a WHO official said the fund also is expected to finalize the contract today.
Feachem wouldn't release specific terms of his deal, but said that he will assume the rank of UN undersecretary general and he will receive partial assistance in housing.
Two UN officials said Feachem would receive in the neighborhood of $200,000 annually tax free, roughly equivalent to his current salary. When Feachem asked fund officials for the board to match his pay at the University of California, WHO officials asked for documentation proving his current earnings, a typical request when the amount is above the range for a specific rank.
''Richard Feachem is a good negotiator,'' said Helene Gayle, a board member and senior health official at the Gates Foundation. ''This has been one of those hiccups when you start a new organization.''
Feachem's salary would make him among the highest-paid public health workers in the world. WHO Director General Gro Harlem Brundtland receives a package worth more than $200,000 tax free. Peter Piot, head of UNAIDS, in contrast, earns $130,000 tax free.
John Donnelly can be reached at donnelly@globe.com
This story ran on page A6 of the Boston Globe on 7/1/2002.
? Copyright 2002 Globe Newspaper Company.
Disease-fighting group gets off to rocky start
Chief's pay package, comment on funding needs are criticized
By John Donnelly, Globe Staff, 7/1/2002
WASHINGTON - Richard G.A. Feachem, about to become the first director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, is already under fire from activists who want him to quit for saying the fund has ''plenty'' of money to start.
At a critical time in the fight against the three killer infectious diseases, and on the eve of the 14th International AIDS Conference in Barcelona, Feachem is set to begin building an organization almost from scratch while fending off the activists.
Feachem, who was named director by the fund's board in April, has yet to sign a contract. Over the last two months he has negotiated a package deal worth an estimated $200,000 tax free per year, among the highest for a public health official.
Several senior officials at the United Nations, which is overseeing the terms of the contract, were dismayed by the high figure, saying it would send the wrong message, but others said the fund needs to pay what is necessary to recruit the best possible leader.
Feachem said he may sign the deal as early as today.
He also must deal with new criticism of the fund from US Treasury Secretary Paul O'Neill, who told a House panel last week that he was impressed by Feachem but troubled by the board's early decisions.
In particular, he said the first grants had no accounting to track the numbers of people helped, and there seemed to be no discernible logic in how the board spent the money.
''The reason, I think, is this,'' said O'Neill, who last month traveled with Irish rock star Bono on a tour around Africa. ''Do you know how many people there are at the Global Fund doing this work, including secretaries and administrative assistants? You might think they have a big bureaucracy. They've got 10 people.''
With 40 million people infected with HIV and AIDS; with new infections expected to skyrocket soon in India, China, Russia, Asia as a whole, and sub-Saharan Africa again; and with 58 percent of people newly infected under the age of 25; global health specialists warn that the pandemic is just in its early stages. If major new interventions are not begun soon, specialists predict that the disease may not peak until after the year 2050.
The fund, which was founded with such promise last year as a new, independent force to fight the diseases, desperately needs new momentum. Most tellingly, donations have dried up since last fall, staying at the $2 billion mark. UN Secretary General Kofi Annan said that in five years global spending on AIDS alone needed to be up to $10 billion annually.
''Barcelona is going to be key for the fund's success,'' said Phillippa Lawson, a board member who represents people infected with HIV/AIDS, of the conference that begins next Sunday. ''It will be Richard's debut before 10,000 people - activists, health ministers, scientists. It is where we really need the Global Fund concept to take hold.''
Activists such as Northeastern University law professor Brook K. Baker and Gorik Ooms, head of Medicins Sans Frontieres in Tanzania, last week called on Feachem to quit unless he distanced himself from his earlier comments, which first appeared in the Memphis Commercial Appeal.
''The question from me is whether he is beating the bush for money as he should be doing in what is a grotesquely underfunded fund, or is he making `nice nice' with politicians in the hope that they will become more forthcoming in the future,'' Baker said. ''The fund needs a drum major who is marching at the head of the pack and demanding the money.''
Feachem, a former senior World Bank official and currently the founding director of the Institute for Global Health at the University of California, San Francisco, responded to Brook and Ooms in an e-mail that said the fund needed much more money and also needed to be held accountable.
In an interview, he said he understood both the activists' frustration to move more quickly and the donors' demand that they had a right to know whether their money was well spent.
''If we want to be able to support all the high-quality proposals in the near future, the fund must receive a lot more money,'' he said. ''On the other side of the coin, the Global Fund must rapidly demonstrate that it is an effective instrument to get the money to the front line and that the investment delivers the goods.''
But Feachem also believes that the fund needs to take some chances. Speaking on Capitol Hill last month, he said, ''We will take risks. We will fail. We will make mistakes. We will learn, and we will move ahead.''
E. Anne Peterson, assistant administrator for the Bureau of Global Health at the US Agency for International Development, said one way to reduce the amount of time needed to study a program's success was not to wait for outcomes - but to watch how the program is implemented and who is served.
''I don't think anyone wants to wait two or three years down the line to get outcomes,'' she said.
For now, Feachem first needs to wrap up his salary negotiations. He said he expected to receive paperwork today; a WHO official said the fund also is expected to finalize the contract today.
Feachem wouldn't release specific terms of his deal, but said that he will assume the rank of UN undersecretary general and he will receive partial assistance in housing.
Two UN officials said Feachem would receive in the neighborhood of $200,000 annually tax free, roughly equivalent to his current salary. When Feachem asked fund officials for the board to match his pay at the University of California, WHO officials asked for documentation proving his current earnings, a typical request when the amount is above the range for a specific rank.
''Richard Feachem is a good negotiator,'' said Helene Gayle, a board member and senior health official at the Gates Foundation. ''This has been one of those hiccups when you start a new organization.''
Feachem's salary would make him among the highest-paid public health workers in the world. WHO Director General Gro Harlem Brundtland receives a package worth more than $200,000 tax free. Peter Piot, head of UNAIDS, in contrast, earns $130,000 tax free.
John Donnelly can be reached at donnelly@globe.com
This story ran on page A6 of the Boston Globe on 7/1/2002.
? Copyright 2002 Globe Newspaper Company.
