by Adam Fifield
Jim Grant invited around a hundred people—UNICEF staff members and outside experts—to a three-day retreat here. One goal was to stir dialogue about UNICEF’s priorities and its strengths and weaknesses in a setting outside of the UN, but that was really secondary. What he really wanted to talk about was how to change the world for children everywhere. The people in this room, he believed, held the power to help him do just that. But first, they would need to be jolted and then convinced. They would need to see the big picture. No one knew what to expect from the new boss, and what they were about to hear would kindle inspiration in some and sow dread in others.
Though radiantly earnest, Grant was also awkward. He spoke in a halting, stilted way. His midsentence pauses were sometimes so pronounced that you might think he had forgotten what he was going to say. “His timing and rhythm were not good,” says Grant’s communications adviser Peter Adamson, who attended the Sterling Forest meeting and recalls what Grant told the audience.
He walked to the podium and welcomed everyone. Then he started to lay out his vision. What he planned for UNICEF, he said, was a “quantum leap.” The organization needed to “shift gears.” “We’ve been going along nicely in second … I want us to shift into third, and then fourth.”
As he spoke, Grant projected an almost missionary ardor, like a preacher whipping up a revival crowd. But many in this crowd did not react accordingly. Worried glances ricocheted around the room, and smiles morphed into winces.
“I’m not interested in incremental increase,” Grant went on. UNICEF’s impact on the world must increase tenfold, a hundredfold even. “How do we do this?” he asked. “We’re a handful of people with a pocketful of coins,” he added, noting that UNICEF’s budget was a few hundred million dollars. “We can’t change the world with that.”
So, he asked, how can we? His emphatic answer: “A major shift in thinking.”
It sounded to some like Grant intended not to wipe the slate clean, but to discard it entirely. A few younger staffers were excited by his bold proclamations—what is this guy going to come up with?—but many others were uneasy.
After Grant’s speech, some people clustered in a corridor, shaking their heads, rolling their eyes, and whispering to each other, recalls Adamson. Some were “carrying on—‘What the hell is happening,’ ” he says. “Including me, I was wondering what the hell was happening.”
UNICEF veteran David Haxton muttered to a colleague, “Holy shit. What does he think we do every day?”
Gravelly-voiced, with a keen intellect and acid wit, Haxton was an American who served as UNICEF’s regional director for South Asia and would later openly challenge Grant on several occasions. That evening, after a drink at the hotel bar, he asked Grant to go for a walk with him. Like other UNICEF old-timers, he was frustrated that the new boss did not seem to appreciate everything the agency was already doing. The two sat outside in the hotel garden.
“Jim, I have to say,” Haxton told him, “you need three or four people in that room to be your legionnaires and your lance people to get this thing moving.” But what he had done, Haxton added, was “piss off the people who should be working with you.” Haxton then invited his new boss to India, so he could get a better feel for what UNICEF was already doing.
Grant was receptive, though Haxton doesn’t recall his exact response. Sometimes, the new executive director simply wouldn’t respond to an adverse comment; sometimes he would just look at you wordlessly, maybe cock his head.
The next morning, when Grant went out for his morning jog, a bevy of UNICEF people joined him. Some were runners, some not. Some had brought sneakers, some had not. They ran in whatever shoes they had. If the boss went jogging, you went jogging, too.
Over the next few weeks, Grant’s Sterling Forest speech unleashed a torrent of speculation. Decades of progress could be undermined, a carefully crafted reputation indelibly sullied, and future operations jeopardized. Many felt his big talk was rash and certain to backfire—and that when it did, the scar left behind would be a nasty blemish, the kind that can’t be covered up or scrubbed away. Didn’t he know that UNICEF had already won the Nobel Peace Prize? That it had helped spare millions of children from tuberculosis and the misery of yaws? That it had valiantly delivered lifesaving aid during the Nigerian civil war in the late 1960s? And didn’t he see what was now at stake? That the organization’s ability to raise money and provide basic services—to function on a fundamental level—could be compromised?
The meeting was “quite shaking—almost a shattering experience for some,” says Racelis, then a junior staff member.
Word rapidly traveled in conference rooms, the cafeteria, and after-hours bars: Jim Grant is crazy.
Chapter 2
THE QUANTUM LEAP
In the summer and fall of 1981, the scuttlebutt flitting around the corridors of UNICEF, alighting on one tongue after another, was grim: A year and a half after taking the job, just as he was starting to establish himself, Jim Grant was in trouble. He was so out of touch, his ambitions so fanciful, his thinking so divorced from UNICEF’s programs, that the board had decided to get rid of him before he could do real damage. The new boss would be fired—that was the rumor, anyway.
It started with Grant’s first “big idea,” his plan for making his quantum leap. One way to take UNICEF to the next level, he had decided, was to hire a group of experts to foster a “marketplace of ideas,” to cook up a robust medley of game-changing strategies that would enable the organization to far exceed its existing capacity. The message heard by some existing staff members was: You are subpar, insufficient, unremarkable. We need superior individuals, intellectual pioneers, and we have to go outside the organization to find them. Some sarcastically described Grant’s proposal as “giving UNICEF a brain.”
The children’s organization had long been known as the “doer” agency of the UN. An oft-told joke that has circulated for years among the disparate constellation of organizations under the world body’s umbrella goes like this: The World Health Organization knows everything, but does nothing. UNICEF knows nothing, but does everything. The United Nations Development Program (UNDP) knows nothing and does nothing.
Apparently, Grant felt UNICEF should do everything and know everything.
The board did not agree.
At a May 1981 meeting, in addition to proposing the creation of a team of experts, he also asked the board to approve a dramatic staff expansion—a total of 384 new positions (some were temporary slots he wanted to make permanent). This request coincided with the dawn of the conservative Reagan era, an emerging global recession, and austerity measures throughout the UN system. Many members were taken aback. Who did this guy think he was, suggesting such a big increase when everyone else was counting pennies?
The UNICEF board was composed of thirty members (soon to be expanded to forty-one) who represented a mix of developing and industrialized countries; Grant would eventually garner far more sympathy from the developing country delegations. At the May meeting, he was roundly admonished. Your ideas could take UNICEF away from its core functions, isolate it from other agencies, and make it too top-heavy, they told him. Your income estimates are too ambitious, as are your budgetary requests. The Swedish delegate said that Grant’s “far-reaching policies” could change the “policies and structures of UNICEF.” The discussion eventually became so heated that a special, closed-door session was called.
To show the quixotic executive director that it meant business, the board referred his ambitious, unwieldy proposal to the UN budget committee for review. This was a bitter pill, particularly for someone who had once served on the governing body.
Go back to the drawing board, Grant was told. Start over.
“It was a slap in the face,” says Fouad Kronfol, a Lebanese man who then ran UNICEF’s Vietnam office and was the organization’s longest-serving employee at the time. Staff were shocked, he adds, and their doubts about Grant mushroomed. “People were saying, ‘What
do we have here? This is someone who does not have the confidence of the board.’ We had never in our history had any serious issues with the board.”
This rancorous atmosphere was Richard Jolly’s introduction to UNICEF. Grant had recruited the gracious, erudite British economist to serve as his deputy executive director for programs and had invited him to a later board meeting in October 1981, so he could get a feel for what the job was all about. During breaks in the proceedings, Jolly chatted with board members in the corridor. Several told him Jim Grant might have to step down. “I was amazed,” he says.
Grant’s stepmother, a voluble Frenchwoman named Denise, wrote him on May 19—after the first board session—presumably to cheer him up. She reminded him that his own father—a widely revered public health doctor, whom Jim idolized and who had died in 1962—had also faced ridicule and resistance. She wrote that after reading a copy of Jim’s response to the board, “my heart sank”; she equated the tone of Jim’s statement to “that of a rebuttal to the prosecutor’s indictment.” She continued: “If you are any good, and you are very good, you will be pilloried for the rest of your life. To my question to your father if it had bothered him to be attacked and criticized all his life, he answered: ‘No, because, in the long run, I always proved right.’ So will you.”
In this instance, Grant had proven woefully wrong. He had misjudged where UNICEF’s primary strength lay. It was not at headquarters. It was not in its intellectual fecundity. It was in the field. It was in the programs, people, and on-the-ground presence in more than 110 countries. And it was in the good name that had been scrupulously forged over the years in nearly every corner of the world.
Says Jolly: “Jim came in wanting to change gears, wanting to give new objectives to UNICEF, and not showing enough understanding, let alone respect, for UNICEF’s existing structure … So there was a need for change there.”
And Grant did change. But he still needed a strategy—a springboard from which to make his quantum leap.
The man who would provide it had first met Grant in June 1979 at the Narita International Airport in Tokyo. Frank, fervent, and impelled by a potent mix of optimism and indignation over the preventable deaths of children, Dr. Jon Rohde was an American pediatrician and graduate of Harvard Medical School. He had helped set up clinics for refugees fleeing war in East Pakistan (now Bangladesh) in 1971 and later ran a clinical practice at a rural hospital in Haiti. A sailing enthusiast who grew up in Rhode Island, he savored adventure and a physical challenge. There was a blunt toughness to Jon Rohde and an overall air of no-nonsense pragmatism. Though a formidable intellectual who was then amassing several scholarly works to his name, the young doctor was, and still is, impatient with ponderous academics. “There are too damn many experts in the world,” he says now.
One of Rohde’s most trying experiences as a doctor happened not in an impoverished village or a refugee camp but at Children’s Hospital in Boston, where he did his residency. He was caring for a twelve-year-old girl named Debbie who had a congenital heart disease. She had a rough home life—Rohde didn’t know the details—and had come to view him as a father figure. One night she had started vomiting blood. Rohde rushed to her side. She threw her arms around his neck, hugged him tight, and told him, “I know you’ll save me.” Then she said, “I love you.” She died in his arms, as he feverishly tried to resuscitate her. He kept trying to bring her back for what seemed like hours, tears flowing down his face, until hospital staff finally pulled him off. They told him she was gone. “I failed Debbie,” he says, his eyes growing moist at the memory. But there were many other children he did not fail, many who were alive because of Jon Rohde.
In June 1979, he was working in Indonesia for the Rockefeller Foundation. Grant was then serving on the Rockefeller Foundation’s board; both men had been invited on a trip to China sponsored by the foundation. The day before the flight from Tokyo, Rohde and his wife, Candy, had put their five- and seven-year-old daughters on a plane by themselves for the first time (they had all gone to Tokyo together). The girls were now flying back to the United States to stay with relatives. The parents got little sleep that night, “chewing our fingernails,” as Rohde recalls. The next day, after they knew the girls had arrived safely, they checked in for the flight to China. Milling around the waiting area was a group of people on the same flight. A gregarious middle-aged man with a kind, lined face walked up and introduced himself. He was with his wife. When he said his name, recognition flared in Rohde’s mind: Oh, the son of John Grant.
A major pioneer in global health—known to some as “the father of primary health care”—John Black Grant was born in China to medical missionaries who had come from Canada. He became the first head of the Department of Hygiene and Public Health at Peking Union Medical College (where his son James was born in 1922). He believed that health care should be made available to all for a negligible cost and created a program by which health workers were recruited from their own communities—this would later become the basis of China’s barefoot doctor initiative in the 1960s. Like Rohde, John Grant had long worked for the Rockefeller Foundation.
“I saw myself as the heir to John Grant of the Rockefeller Foundation,” Rohde says, adding that he had never met the great health guru.
But now, here he was in the Tokyo airport, face-to-face with John Grant’s son. Grant and his wife, Ethel, were convivial, and the two couples fell into a companionable rhythm over the next month as they traveled through China. Grant, who had lived in Beijing until age fifteen and spoke fluent Mandarin, served as a de facto interpreter and tour guide.
During a boat trip on the Yangtze River, Grant and Rohde stood together, taking in the imposing rock gorge walls that towered over them, and discussed Grant’s nascent plans for UNICEF. “Jim was looking for ideas,” Rohde says. “He was looking around for what was possible.” Pulsing in both men’s minds at that moment was a simple phrase that was then echoing in the zeitgeist: “health for all.” Less than a year earlier, UNICEF and the World Health Organization had sponsored a seminal international conference on health in Alma Ata (now Almaty), Kazakhstan, that was attended by government representatives from around the world. The conference had set a daring new goal: “health for all by the year 2000.” The laudable aim—to provide every citizen with comprehensive, quality, locally sensitized, and affordable health care within the next two decades—had excited many in international health. But it had flummoxed others. Whether startlingly utopian or boldly idealistic, there did not seem to be much of a plan to make it a reality.
As the broad Yangtze slid beneath them, Rohde shared his two cents with Grant: instead of trying to solve all the health and social problems of the developing world, focus on a few specific things. At some point, as they spoke, they drifted by an astonishing sight that ultimately reinforced Rohde’s point. It was an old mining town on the riverbank, almost completely coated in black soot.
“Can you even imagine comprehensive health care in this community?” Rohde asked. “Where would you start?”
This small moment on the Yangtze would reverberate with great force over the next few years.
If Jim Grant was depressed or shaken after his drubbing by the board, he did not show it—not to staff, anyway. He projected a visceral enthusiasm; so much so that you’d think he was riding the high of a great victory. His optimism was obdurate, as if Teflon-coated. At a staff meeting shortly after the board showdown, Grant framed the setback not as an inconvenience but as an opportunity. We have six months, he jauntily told those in attendance, to reorient ourselves and refocus our priorities.
“He exuded positivity in that meeting,” recalls Alan Court, a Briton who worked in the Indonesia office but was visiting New York at the time. “I remember other people saying, ‘Oh my God, he’s gone out of his head. He doesn’t understand this board. Things aren’t done that way.’ ”
Grant didn’t let on there were any problems. He also did not have the luxury of wallowing or pausing
to take stock. Drought and civil conflict had spawned new emergencies in several African countries, and Grant began to ramp up assistance. The Cambodia crisis continued, though by the spring of 1981 the worst was definitely over—“that patient is off the critical list,” he had told donors in December. The Cambodia operation, despite the taint of Cold War rivalry and the Khmer Rouge quandary, would be lauded as one of the greatest international aid efforts in history. In spring 1981, it looked as though UNICEF would be able to extricate itself from Cambodia by the end of the year.
The same diplomatic dexterity he had used in Cambodia came in handy as UNICEF was drawn into a controversy involving infant formula. Grant was a vociferous advocate of breast-feeding and would routinely tell anyone who would listen that it could save a million babies’ lives each year. He would explain that breast milk boosts young immune systems and wards off deadly diseases—this was especially critical for babies without decent nutrition or basic medical care. The advertising of infant formula in developing countries was therefore a matter of life and death. Babies in impoverished communities who drank formula were at a double disadvantage: they were denied the protection of breast milk and they were also ingesting powder that was often mixed with contaminated water (which was, in many cases, the only water available). This, in turn, could lead to fatal bouts of diarrhea.
After a major global campaign was launched against the makers of infant formula, including Nestlé, the World Health Assembly (the governing body of the World Health Organization) passed a measure in late May 1981 banning the advertising of formula to hospitals and health clinics. It was up to individual countries to implement the code on the marketing of infant formula, as it was called. The Reagan administration was dead set against the code, siding with the formula companies; the United States had, in fact, been the lone dissenting vote. UNICEF had backed the code, but Grant was cognizant of the need to appease the American government, UNICEF’s biggest donor.
