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Mary McClymont
The Foundation Over Time: views from past and present/ from within and without

December 4, 2007

Marymount Manhattan College

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March 3, 2009
Might and Right: The Shape of Philanthropy to Come
Filed under: Members' Blog — Treasurer @ 4:31 pm

 
PhilanTopic (the PND Blog)
http://pndblog.typepad.com/pndblog/
Might and Right: The Shape of Philanthropy to Come

Posted: 03 Mar 2009 07:29 AM PST

(Bradford Smith is president of the Foundation Center. In his last post, he wrote about the nonprofit equivalent of “too big to fail.”)

An interesting fact leapt out at me from a 224-page document I downloaded today: when taking into account the twenty-seven EU member states, European philanthropy is mightier than American philanthropy by a considerable margin. According to theFeasibility Study on a European Foundation Statute:

    Allowing for all data uncertainty and validity problems, we estimate that the European foundation sector has assets of between EUR 350 billion and EUR 1.0 trillion (!) and annual expenditures of between EUR 83 billion and EUR 150 billion. By contrast, US foundations have assets of approx. EUR 300 billion and expenditures of EUR 29 billion.

The study arose out of efforts by the European Commission, theEuropean Foundation Centre, and others to cut through the maze of foundation tax laws that impede foundations in Europe from engaging in cross-border activities. These barriers exact a cost of somewhere in the neighborhood of EUR 100 million per year that could be avoided by allowing foundations to constitute themselves as European foundations as opposed to being registered in a single country.

Many will find the report to be a tough slog, but having lived and worked in Europe for the past three years I found it fascinating. I will admit to being a big fan of the European Union — a remarkable achievement after centuries of conflict, ethnic cleansing, and two horrific world wars in the 20th century. Philanthropy in Europe is quite different than in the United States; it favors operating programs over grants, engages directly with governments and the EU while relying less on advocacy, and, as the report tells us, is simply bigger.

At the other end of spectrum lies the Dalit Foundation in India. During fiscal year 2007-08, the foundation’s grants and fellowship budget totaled only $340,000 and the average grant size was $5,300. But what the Dalit Foundation lacks in resources, it more than makes up for in courage and ambition.

Dalits, sometimes called “untouchables,” fall beneath the communities that are included in India’s four main caste groups. They comprise a population of 160 million and, despite caste bias having been outlawed in l950, suffer daily discrimination and are relegated to degrading occupations such as “manual scavenging” —- being lowered into latrines to clean them out by hand.

The Dalit Foundation grew out of the National Campaign on Dalit Human Rights and represents the philanthropic arm of a social movement. Having made significant gains on the political front, the movement recognized the need to invest resources in proving that Dalits are no different than any other Indian, when given a chance. Their small projects are emblematic of the larger struggle: arming men who say “no” to manual scavenging with new job skills, a theatre group that helps Dalits out of alcohol and drug dependency, a leadership program that equips youth with “education about perspectives that are relevant to Dalit liberation, research and intensive participation in grassroots-level activities.”

American philanthropy has provided critical support to the European Foundation Centre over the years as well as a number of European foundations, particularly in EU accession countries. But now that European philanthropy is more than its equal, how will U.S. philanthropy react? The Dalit Foundation received critical endowment support from the Ford Foundation. Yet many American foundations tend to see such efforts as “intermediaries” that add an extra layer of administrative cost in delivering grants to the poor, rather than an exercise in contributing to social justice by building viable indigenous philanthropies.

The might of the European foundations and the right of the Dalit Foundation show us the shape of philanthropy to come.

– Bradford Smith
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Two new books
Filed under: Members' Blog — Treasurer @ 11:43 am

Abe Lowenthal reports on two books to be published in March.

 On March 10, Stanford University Press will publish Lowenthal’s Global California: Rising to the Cosmopolitan Challenge, addressing how the citizens of a state with the dimensions and power of a nation are affected by international trends, and what they can do to identify and promote their own interests in a rapidly changing world. For more information or to order the book, go to Stanford University Press (sup.org) and click “Policy Books.”

 On March 30, Brookings Institution Press will publish The Obama Administration and the Americas: Agenda for Change, co-edited by Lowenthal, Theodore Piccone and Laurence Whitehead. This volume, comprised of essay by leading U.S., Latin American and European scholars and practitioners, assesses the problems and opportunities in U.S.-Latin American relations. It provides advice to the new U.S. Administration on how to improve the prospects for enhanced cooperation on shared concerns, and focuses on the hard cases likely to press themselves onto the U.S. agenda: Bolivia, Colombia, Cuba, Haiti, Mexico and Venezuela.

February 25, 2009
News about two former staff members
Filed under: Members' Blog — Treasurer @ 7:53 am Edit This

Submitted by Peter Weldon

I realize that not all of you had the pleasure of working with both Brent Ashabrenner and Reuben Frodin as I did.

 I was fortunate today to speak with both Brent and Reuben.  Both were in good spirits, sharp as ever, excited about political developments in the U.S.A. and both are well at age 86 and 97.

 Brent has arthritis and claims no longer to be a threat to David Bell on the tennis court.

 Reuben uses a walker, after his fall three years ago from which he has not fully recovered.

 Their contact details can be found in the LAFF directory and I know they would welcome hearing from you.

 Neither Brent nor Reuben is on email.�
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February 23, 2009
Science-base Policy Making in Health
Filed under: Members' Blog — Treasurer @ 11:35 am Edit This

Richard Mahoney

The 1960s and 1970s saw the introduction and rapid growth in use of several new contraceptives including intrauterine devices and pills.  The Ford Foundation had large programs run out of the regional offices and a headquarters program, the Population office, under the visionary leadership of Bud Harkavy.  The regional offices were leaders in working with developing country governments to design and launch family planning programs that delivered these technologies.  The Foundation’s Population office undertook a wide ranging set of activities including a major program – at one time, the world’s largest – to support research in reproductive biology and contraceptive development.  While this natural science program focused on basic biological research, the office also supported work by the Population Council and others to undertake product development and to work on various social science and policy issues.  This latter work included dealing with anti-family planning advocates and their sometimes inflammatory claims about the safety and efficacy of new, and old, contraceptives.  The issues that were addressed in those days concerning contraceptives are echoed today in the field of vaccines and immunization.  Family planning and immunization are two fields that have attracted zealous opposition and the way in which this opposition has been addressed illustrates the value of science-based policy making.

 Science has come a long way in the last 200 years. Medical investigators have learned to do studies that assess whether vaccines really do what we hope they do. The carefulness with which these studies are carried out is illustrated by the fact that the cost of developing a new vaccine is now roughly $1 billion, of which the cost of conducting clinical trials to demonstrate safety and efficacy is a very large part.  In the last few years, new vaccines have been developed against cervical cancer and against pneumonia and diarrhea in infants.  The global use of these vaccines will save annually the lives of many hundreds of thousands of women and of over 1 million children who might die from pneumonia or diarrhea.

 

 Studies are constantly underway to assess the safety of vaccines. Because vaccines are given to otherwise healthy individuals (as with contraceptive), the safety standards they must meet are naturally higher than for drugs for treating serious illnesses.  Sick individuals are willing to suffer side effects to obtain the benefits of the medicines. But parents do not and should not accept vaccines that do not achieve the highest level of safety possible.  Thus, the US Centers for Disease Control and Prevention, the National Institutes of Health, and pharmaceutical companies spend billions of dollars each year supporting studies to evaluate the safety of vaccines. Vaccines are considered by experts in public health to be perhaps the most cost-effective intervention available to combat disease.

 

 There are problems with vaccines but not the problems we might expect.  Ironically, one of the problems for vaccines is that they prevent people from getting sick. Why is this a problem? It is a problem because, if a person doesn’t get sick, you don’t see that the person didn’t get sick - it’s a non-event. This has become a major problem in United States and elsewhere. Many diseases that were very common in human history have virtually disappeared. These include polio, measles, mumps, diphtheria, tetanus, pertussis (whooping cough), and meningitis. One of the difficulties of modern medicine is that young doctors in training do not see patients who suffer from these diseases, and these young doctors are not able to sufficiently address the needs of such patients in the rare cases they are encountered. Perhaps the greatest public health achievement in history was the eradication of smallpox through vaccination. We don’t see headlines in newspapers hailing the number of children who did not die this year as a result of smallpox. That is simply not news.

 Another reason why the success of vaccines is a problem is that parents get used to the idea that their children do not and probably will not ever get these diseases. They take the absence of these diseases as a fact of life. Headlines in newspapers that report on claims of vaccine adverse events may have greater impact on parents than the fact that their children are not getting sick from the diseases. Such claims with respect to vaccines against pertussis and measles led to a dramatic drop in vaccination against these diseases in Europe some years ago. The claims were eventually not confirmed, but in the meantime many children died or suffered severe avoidable illnesses. The claim that hepatitis B vaccine causes autism in children has also had a substantial negative effect on the uptake of this very important vaccine and numerous studies including one published just in 2008 have failed to confirm any association between hepatitis B vaccine and autism.

 

 Another claim about vaccines is that a mercury-containing preservative – thimerosal - used in multi-dose vials might adversely affect the health of children. No scientific evidence has been reported demonstrating an association between vaccinations and illness caused by mercury. However, when anti-vaccination advocates raised concerns, the companies concluded that the cost of protecting themselves from potential liability suits was greater than the cost they would incur by removing mercury from vaccines. Also, public health officials at CDC were exposed to intense pressure that led to decision making that was probably not wise.  One step for the manufacturers was very simple.  They stopped putting vaccines in multi-dose vials. A preservative had to be put in multi-dose vials because health personnel would often vaccinate a number of individuals using the vaccine from a single vial over several days, thus the need for a preservative.  However, there is a high cost now being borne by the American public for this removal of mercury from vaccines based on unsubstantiated claims. Vaccines in single dose vials are much more expensive than vaccines in multi-dose vials.  Fortunately, the World Health Organization and governments of developing countries have largely continued to use multi-dose vials with thimerosal.

 Other anti-vaccine proponents point out that vaccines are not 100% effective or 100% safe and thus try to discourage their use.  No medicine or vaccine is 100% effective or 100% safe. To advise individuals not to be vaccinated because a vaccine is not perfectly effective or safe is to assume to one’s self a power that boggles the mind – the power of life and death.  Getting the flu, especially if you are over 60, can be a very serious, life threatening event.

 Skepticism about science and medicine is healthy.  There should not be an unquestioningly acceptance of recommendations to use vaccines and other drugs. However, there is an obligation upon anti-vaccine and family planning groups to understand the harm they may do, as well as the good they think they may achieve.  Opposition to contraception, sometimes put forward with unsubstantiated claims of adverse effects, did much to impede women’s access to methods that could give them greater control of their fertility.   In recent years, opposition to the use of condoms in HIV prevention programs has done much harm. It is well documented that restrictions on access to contraceptives are effective in increasing the incidence of abortion.  Impediments to vaccine access leads directly to otherwise avoidable mortality and morbidity.  Policy making based on the best available science is the best policy making. The Foundation deserves great credit for the work it did in family planning to ensure a sound scientific basis for policy making.

 

Rich Mahoney has had a long career in international public health and vaccines.  He served in the Foundation’s Population office from 1970 through 1979 under Bud Harkavy.  He left the Foundation to help found, with Gordon Perkin and with Foundation seed support, the organization PIACT (Program for the Introduction and Adaptation of Contraceptive Technology) which eventually became PATH, (which may show that he and Gordon got a little better at coining names).  PATH is currently the world’s largest non-governmental organization undertaking research in health technology.  Mahoney was also a founding member of the International Task Force on Hepatitis B Immunization, which played a major role in the global introduction of hepatitis B vaccines. He is now with the Pediatric Dengue Vaccine Initiative at the International Vaccine Institute in Seoul, Korea, an international organization established by treaty with more than 40 countries as signatories. He also served as Senior Advisor in Health to The Rockefeller Foundation from 2001 - 2006.  Rich has a home in Sedona, AZ.�