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Authors: Adam Fifield

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Grant looked disappointed. “I got the sense he was not totally happy that this wasn’t everybody jumping up and down and saying, ‘Oh, you’ve discovered sliced cheese!’ ” says
Mayrides. “He was so convinced that this was going to happen and that we were going to do it.”

But GOBI was not an easy sell. As Grant took the idea to his staff and tried to win their approval and stoke their excitement, the reaction was often muted. Some made fun of the term—“Isn’t that a desert in Mongolia?” was an oft-repeated joke. Though he now backed the concept, Peter Adamson never liked the name. “I felt it was giving people a stick to beat us with,” he says. The acronym grew even more unwieldy when Grant agreed to add three components to the program: food supplementation, female education, and family planning. “GOBI” sprouted an awkward offshoot, becoming “GOBI-FFF.” A longtime veteran reportedly once made the wry suggestion that the “FFF” really stood for “Fuck, Fuck, Fuck.”

Many also shared the reservation that had originally made Adamson uneasy—that GOBI clashed with the idea of bottom-up development and primary health care, the very sort of philosophy espoused by Jim Grant’s father and that had shaped UNICEF’s current “basic services” approach. But, as Adamson eventually recognized, this was really a false dichotomy—promoting the widespread use of simple, cost-effective measures to save children’s lives and supporting community-based, bottom-up, grassroots heath care were not mutually exclusive. Even so, this belief continued to stubbornly tarnish GOBI.

But it was more than a philosophical disagreement. The premise of GOBI also seemed so
naive
, so laughably simplistic. And it seemed to ignore the most basic on-the-ground realities:
the infrastructure necessary to carry out such a campaign did not exist in most countries. What about the lack of roads? How could you develop a cold chain—the system of refrigeration for keeping vaccines cool—without basic electricity? Where would the money come from? How would you get everybody in these countries on board? And the stated scope of the program was astonishing—how could you possibly do something like this on a global scale with UNICEF’s relatively meager resources? Nothing like it had ever been attempted. The risk of complete, unqualified failure loomed like a flashing neon billboard. And if GOBI did fail, if it sunk into the slippery sands that had consumed many of international development’s grand ambitions, UNICEF’s reputation would go down with it. And what about all of UNICEF’s other existing programs—water, sanitation, education, child protection—what would happen to them?

The unanswered questions were crippling. And Grant was not doing a good enough job of answering them.

“At one point, nearly everyone was against him,” says Adamson.

The details, the pesky hows and wheres and what-ifs—Grant would deal with those later. First, he had to summon momentum. If he could not do that among his own staff, he could do it elsewhere. He would go outside UNICEF. He would go to the media. He would go to political leaders. He would set in motion an inexorable public relations juggernaut that would flatten doubts as it steadily gained size and speed. That was the plan, anyway.

As he hastily tried to carry it out, the day-to-day exigencies of his job—including a major emergency in Lebanon and
an important donor-pledging conference—chipped away at his time and attention.

The child survival revolution was officially launched on December 16, 1982, with the release of the 1982–83
State of the World’s Children
report. The lead-up to the event was a frenzied whir of last-minute, late-night scurrying—something everyone would soon learn to expect as a matter of course during the Grant era. According to an account in UNICEF’s internal staff newsletter, the final report barely made it into Grant’s hands before he unveiled it to reporters at a press conference in Paris. The day before the launch, as changes were still being made in New York, facsimile service to Paris broke down. Copies of the report would have to be delivered via courier, but the courier would need it by 3:00 p.m. As final graphic elements were composed and texts checked and French translations completed, 3:00 p.m. came and went. A harried call was made to Air France—maybe copies could be put on the last flight to Paris that night and still make it to the press conference on time the next morning. After a two-hour delay, an Air France official finally responded and arranged for a passenger, a young woman, Ms. Duchange, to take the package with her on the 7:00 p.m. flight. It was now well after five, changes were still being made, and UNICEF would have to somehow get the material from midtown Manhattan to John F. Kennedy International Airport in Queens. “Not even a Grand Prix driver could reach Kennedy airport through rush hour traffic in time,” noted the author of the staff newsletter account, Tony Hewett. The only option was the 6:00 p.m. Pan Am helicopter at the Sixty-third
Street heliport. It was a long shot—getting to the helicopter and then to the plane—but an editorial consultant named Salim Lone volunteered to try. At 5:43 p.m., he finally got the parcel and ran out the door.

The package arrived in Paris just as the press conference was getting under way, and copies were promptly given to reporters. Grant then made a blunt, bold proclamation: the daily number of preventable child deaths around the world could be cut in half by the year 2000. Twenty thousand children’s lives could be saved every single day—if governments around the world committed to using a few simple, inexpensive techniques, and if communities were organized and paraprofessional health workers trained to put them to use. Summing up the report’s central theme, he insisted that these basic measures offered “new hope in dark times”—a reasonable, affordable way to reverse a grim backslide in children’s health triggered by the global recession. At scale, it would cost about $6 billion a year, which, Grant would frequently note, was a hundred times less than what the world spent on weapons each year.

The announcement and stated goal were intentionally audacious—Grant’s aim was to snag people’s attention, make them do a double take. Cut child deaths in
half
? How the hell is he going to do that? Grant would show them how.

“At the start of one of the bleakest holiday seasons in a generation, this is one of the most powerfully hopeful news stories of a decade,” he told the reporters, according to a United Press International account. His words often came out in quick staccato bursts, punctuated by swollen pauses, especially when he spoke publicly.
When concluding an emphatic point, he would clamp down hard on his final syllable, his mouth snapping shut like a trap. After describing the four tools in the GOBI arsenal, as reported by United Press International, Grant hoisted a wineglass filled with oral rehydration solution—as he would do at many future press events—and gleefully gulped it down.

Everything needed to make this happen, he went on, was already in hand. Just as important as vaccines and oral rehydration salts and recent medical advances, Grant claimed, was a technological item that had become ubiquitous in recent years: the radio. Even in the poorest, most remote places—even where there were no health centers or wells or schools—you could find radios. Combined with rising literacy rates, they enabled communities to connect with one another and created a critical conduit for lifesaving information. The burgeoning capacity to communicate in even the most isolated pockets of the world made great gains in child health possible.

The main obstacles, he would repeatedly explain, were a lack of awareness and commitment and resistance from the medical establishment. Opposition had also already sprouted out of ugly Malthusian reasoning—saving kids’ lives in Africa and Asia could exacerbate population growth. These fears, Grant insisted, were unfounded—the more you can assure parents their children will live, the fewer children they will have. (He probably did not say that such fears, which essentially justified the death of African and Asian children, were also patently racist.) When making such points, he emanated a visceral elation
and a certainty that all of these impediments could be overcome, knocked aside like balsa wood bowling pins.

He enticed the reporters, but he also chastened them. “Forty thousand small children in developing countries die every day,” he said, according to the Associated Press. Likely hammering each syllable, he repeated: “Ev-a-ree day!” And then added: “And it goes unreported in the press.”

The jibe worked. For a few weeks, the mass, preventable deaths of poor children were widely reported. Grant’s “revolution” drew considerable coverage, landing in the pages of the
New York Times, Newsweek
, the Associated Press, the
Washington Post
, and a slew of other publications and outlets. UNICEF was not used to such intense media attention.

This was owed not just to Grant but also to Peter Adamson. Unlike most dry, dense, acronym-laden UN documents,
The State of the World’s Children
pulsed with emotional fervor. Adamson’s crisp, kinetic prose took the reader by the collar and would not release its grip. At the core was a searing moral question: How can a child be allowed to die of malnutrition or preventable infection when the means to save him readily exist? Adamson described such a tragedy in chilling detail:

No statistic can express what it is to see even one child die in such a way, to see a mother sitting hour after anxious hour, leaning her child’s body against her own; to see the child’s head turn on limbs which are unnaturally still, stiller than in sleep, to want to stop even that small movement because it is obvious that there is so little energy left inside the child’s life; to see the
living pink at the roof of the child’s mouth in shocking contrast to the already dead-looking greyness of the skin, the colours of its life and death; to see the uncomprehending panic in eyes which are still the clear and lucid eyes of a child; and then to know, in one endless moment, that life has gone
.

Adamson had witnessed this child’s death himself in Upper Volta (now Burkina Faso). He was in a remote village, with a small group of people, none of them doctors. A woman nonetheless brought her limp baby to them, hoping someone could do something. The infant boy, maybe eight months old, was probably malnourished and badly dehydrated. “We didn’t have anybody who could do anything for this child,” Adamson says. “The child was almost dead.”

For this child, it had been too late. But for hundreds of millions of others, it was not. Echoing Jon Rohde’s paper, which had sparked all of this, Adamson wrote that making children’s survival and health a worldwide priority required even more than technological know-how and community organization—it required political commitment. To pry the world free of its inertia, the wielders of power had to be mobilized.

And so Grant, a veteran government operative and former Kennedy administration official, wooed another class of people, even more important than journalists: heads of state. Grant quickly secured endorsements from prime ministers Indira Gandhi of India, Olof Palme of Sweden, and Pierre Mauroy of France. The day of the report’s release, he snared a meeting with British prime minister Margaret Thatcher in London (where he had
presided over a second press conference). She pronounced the findings “very exciting.” Grant proudly later told people that after he had shown the Iron Lady one of his props, a growth chart in Haitian Creole, she had been so impressed with it she had asked to keep it. Soon, he would win the blessing of Pope John Paul II; Grant painstakingly cultivated the Vatican’s support over the next several years. He even managed to coax a morsel of endorsement out of US president Ronald Reagan, despite Reagan’s open antagonism toward the United Nations. “Literally hundreds of millions of young lives would be healthier,” Reagan said in a statement, urging Americans to back the new UNICEF program.

Those within UNICEF who thought Grant naive or bombastic or profoundly irritating could not help but be dazzled by his marketing and political acumen. No previous executive director had so easily toured the corridors of power or so readily hobnobbed with presidents and prime ministers. Like him or not, he had propelled UNICEF’s profile to a new level of notoriety.

Grant’s whiplash-inducing marketing blitz signaled a monumental shift in UNICEF’s approach: the role of advocacy and communications became central to everything the agency did. After all, this “handful of people with a pocketful of coins” had more than just money and manpower at its disposal—it had influence. It could pressure other entities to spend their money for children. It could prod governments forward. And it could shame those that lagged behind. It could be a potent catalyst, a peerless PR machine. But if Jim Grant had begun to bolster UNICEF, it bolstered him, too. It was his pulpit—from perhaps no other perch could his voice carry so soundly and so far.

For a while, that voice still came to a thudding halt in the halls of UNICEF itself. The enthusiasm wafting from the press and prime ministers’ offices had still not done much to thaw the cynicism at his own agency. Grant’s senior health adviser, Stephen Joseph, recalled sitting with a group of high-ranking old-timers one night during a staff retreat at Mohonk Mountain House in New Paltz, New York. At the time, he says, senior leadership at UNICEF comprised “a white men’s club.” Headquarters was an insular place dominated by a small group that had held power for a long time. They did not appreciate Grant’s upheaval. That night they were playing poker—and trashtalking the executive director. Joseph, an incisive, principled American pediatrician who would go on to become New York City’s health commissioner, just sat back and listened to the contempt clatter out amongst the cards:

What a ridiculous idea—a child survival revolution!

What kind of political bullshit is that?

We know what we’re doing! We’re plugging down wells! We’re doing emergency feeding programs! We’re handing out midwifery kits!

In other words, we’re practical, clear-headed veterans, and this guy is a dangerous dreamer.

Says Joseph: “It was a dislike of the person, because he was disparaging of what they had accomplished” (or so they perceived). The old-timers also “disliked his methods.”

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