A Mighty Purpose (19 page)

After Colombia’s immunization crusade—as big campaigns were mounted in country after country—Grant’s propulsion was rapidly outpacing UNICEF’s resources. He needed a cash injection. Now he had one.

But like most big sums of money, it came with some irksome demands. In exchange for the contribution, the Italian government wanted UNICEF to “buy Italian” and hire Italian staff, among other things.

When he had confirmed the donation, Vianello-Chiodo called Grant at his hotel room in Boston. His boss didn’t answer, so he left a message. Grant called back at midnight Rome time and apologized for waking Vianello-Chiodo (he apologized for this a lot).

The fund-raising chief then told him about the pledge from the Italians and the “strings” that dangled from it.

No reply.

“Are you listening?” Vianello-Chiodo asked.

“Yes,” Grant finally said.

“So?”

Nothing. Not a word from Grant.

“You are not going to refuse a hundred million dollars?” Vianello-Chiodo asked. He made the point that the money would allow Grant to expand his revolution and would help put the world behind UNICEF.

Then, finally, came the faint “
Holy shit
.”

Why had he taken so long to answer? It may have been simple shock. His mind may have been clambering to keep up with the cavalcade of possibilities let loose by this amount of money.

Either way, Vianello-Chiodo was relieved. “I knew you were going to accept it,” he told his boss.

The donation was transformative, and it would be followed by other infusions of money. But many people were not happy about the quid pro quo. At a regional staff meeting in Abidjan, Ivory Coast, according to Vianello-Chiodo, several staff members voiced qualms about the Italian donation. “They were furious because they had to buy Italian cars,” he recalls. “And the only car that could go anywhere was a tiny Panda four-by-four, which is a rickety little affair, and so they were furious about that.”

The Italians pressed Grant hard. UNICEF’s Fouad Kronfol, then Africa section chief, recalls a tangibly uncomfortable meeting between Grant and Italian officials, including one who was pelting demands at the UNICEF chief in a “rather condescending” way, says Kronfol.

“They were being a little bit too obnoxious,” he recalls, “but Grant swallowed it all … he had a very thick skin.”

As he sat there watching the Italians talk down to his boss, Kronfol remembers thinking that if he had been in Grant’s seat, “I would have stormed out of the meeting.”

Instead, Grant listened patiently and, as each demand was hurled at him, he calmly replied that he would see what he could do.

The ebullient “master fund-raiser” wrangled money from lots of other places, too. As he relentlessly browbeat heads of developing countries to up their immunization rates, he hassled richer countries to boost their financial support for UNICEF. He would remind them that UNICEF’s revenue was all voluntarily contributed. Unlike “specialized” UN agencies such as the World Health Organization—which got regular allocations from UN dues—UNICEF was a “fund” and, as such, had to raise almost every penny it spent. Grant made it a very popular investment. During his tenure, the United States’ total annual contribution to UNICEF went from around $44 million to more than $130 million. Funds also flowed in from the private sector—Grant would take money from pretty much anyone, including oil titans Exxon and Texaco. About a quarter of UNICEF’s income came from “national committees,” nongovernmental organizations that were set up in wealthier countries to raise money and awareness for UNICEF.

Despite rising antipathy toward the United Nations and a suffocating recession, Grant ultimately presided over more than a tripling of UNICEF’s financial resources during his tenure. As its coffers grew, so did its clout. In a 1988 editorial, the
New York Times
noted that UNICEF’s positive reputation was an anomaly among
UN agencies. Applauding the US Congress for increasing its support for the Child Survival Fund and UNICEF programs, the
Times
noted that Congress had not treated the rest of the UN very well: “Congress continues to starve the U.N., the Organization of American States and a host of development agencies.” The UN children’s agency, “the little engine that could,” as Grant liked to call it, was blazing brighter than any other star in the UN firmament.

It was only fitting that Grant would use the occasion of the UN’s fortieth anniversary on October 24, 1985, to garner more attention for his cause. At Grant’s urging, UN secretary general Javier Pérez de Cuéllar invited world leaders to a conference the day following the anniversary to recommit to the once elusive goal set by the World Health Assembly in 1977: universal childhood immunization by 1990.

Speaking to UNICEF staff a few months earlier, Grant had said that the aspiration of reaching all children with immunizations by 1990 “might really take hold and become a serious goal … and not just one of these cartoonist’s goals with which we are so accustomed.”

Two reasons the goal was now a serious one: Colombia and El Salvador. Grant had shown it could work in both places. It was now a lot harder to ignore or forget the 1977 commitment. Another potent prod was the Pan American Health Organization’s announcement in May of a coordinated plan to wipe out polio in the Americas (major strides against polio had recently been made in Brazil). UNICEF had also secured the buy-in of the world’s two most populous countries—India and China. Without either of them, universal childhood immunization was a sheer impossibility.

As many as one thousand people attended a ceremony at the United Nations, and fifty-seven world leaders signed a pledge reaffirming their governments’ commitment to meet the ambitious target. One of the nongovernmental signatories was Rotary International, which used the occasion to announce that it would raise a game-changing $120 million to help eradicate polio; over the next three years, it would astonish everyone by pulling in more than twice as much (by 2015, it would contribute more than $1.3 billion). The service organization had been involved in the polio battle since 1979 and had recently teamed up with Albert Sabin, the inventor of the oral polio vaccine (and Jonas Salk’s bitter rival). Grant enthusiastically welcomed Rotary to his revolution and would later remark: “Thank God Rotary was born.”

The ceremony was standing room only, guests packed shoulder to shoulder. Some diplomats complained that the meeting had violated protocol, recalls former UNICEF staffer Allegra Morelli, who organized the gathering. One guest remarked aloud: “Who is the crazy person who organized this mess?” Standing nearby, Morelli answered that she was.

Looking out over the teeming room, Grant began his speech with a quote from Shakespeare:

He did not mention, according to his prepared remarks, that the source of the quote was Brutus, one of the murderers of Caesar in Shakespeare’s
Julius Caesar
.

But the metaphor served his purpose. He used it as a somewhat clumsy goad. “Let us indeed suppose that those of us who bet on life can succeed,” Grant said. “Let us prove to the world in these next five years that on such a full sea are we now afloat, and we shall take the current!”

In its coverage of the event, the Associated Press noted that, just the day before, UN member states could not even come to a consensus on the wording of a declaration marking the world body’s anniversary. The immunization pledge, however, “was a chorus of unanimity.”

Now, Grant had to figure out how to actually do what he said could be done. And fast. Five years was not a long time.

Some of Peter Adamson’s most enjoyable moments at the UN were “watching Jim deal with experts.”

One of those moments came in a meeting between Grant and several WHO officials. After Halfdan Mahler’s promise of support, the health agency had emerged, however begrudgingly, as a full-fledged partner in the push for universal childhood immunization (the WHO’s immunization chief, Ralph Henderson, had been a diligent proponent of vaccination—even if Mahler and others had been unenthusiastic). Its technical expertise and monitoring capacity were indeed essential. But hints of elitism and inflexibility still flickered.

Adamson watched as WHO officials told Grant that immunization rates couldn’t simply be doubled and redoubled—the infrastructure wasn’t there, the cold chains were inadequate, the electricity coverage was insufficient.

“They were making this point to Jim as though they had to teach him a few elementary things about immunization,” Adamson recalls. Grant had heard much of it before, of course.

To anchor their point, the WHO experts mentioned Pakistan as an example. Which was a mistake.

Grant immediately began reeling off immunization statistics from Pakistan—they were among the dense and growing compilation of numbers that swarmed in his head. And he could snatch any one of them when it suited.

“Well, if you look at the figure for Pakistan for DPT1,” Grant began, “you see it’s around 70 percent.” DPT1 refers to the first of three rounds of the diphtheria, pertussis, and tetanus vaccine.

He went on: “DPT2 is about 40 percent, and DPT3 is around 20 percent.”

Then the knockout line: “If you can reach 70 percent on DPT1, then there is no reason, infrastructurally, why you can’t reach it with DPT3. This is not an infrastructure or supply problem. It’s a demand and communications problem.”

The WHO officials were flustered. They did not expect the head of UNICEF to know more about immunization than they did.

Says Adamson: “Two minutes after they were patronizing him, they were left wondering what to say.”

“He’s a military dictator,” Steve Woodhouse began. “He’s not interested in kids.”

The jovial British head of UNICEF’s Syria office—who helped pull Grant out of a soak pit in Pakistan a few years earlier—had met his boss at the airport in Damascus. They sat in the gilded, wood-paneled VIP lounge, probably sipping coffee, as Woodhouse briefed Grant on his upcoming meeting with Syrian president Hafez al-Assad. With scant time between meetings and flights, the head of UNICEF did a lot of work in airport lounges.

Genial and reassuring, Woodhouse had the bearing of an affable high school guidance counselor. He tried to impress upon Grant that he didn’t think he would get very far with Syria’s repressive leader, known for his cruel tendencies.

The father of the cold-blooded Bashar al-Assad, who has terrorized Syria in recent years, Hafez al-Assad was also widely feared and perhaps even more ruthless. In 1982, he brutally put
down a Muslim Brotherhood uprising by razing much of the city of Hama. Estimates of casualties ranged up into the tens of thousands.

Woodhouse summed up his reservations for Grant: “Look, I’m not very optimistic.”

Grant looked at Woodhouse. He had listened intently, nodding and taking in everything he said.

But he did not agree. The two proceeded to the presidential palace.

Dressed in military fatigues, al-Assad greeted Jim Grant with a reserved handshake. They sat side by side in slightly angled chairs. Woodhouse and al-Assad’s aide sat behind them. Interpreters lingered nearby. Coffee was served in small cups.

With a big forehead, sharp chin, thin mustache, and a stern bearing, al-Assad did not give away much. He wore a placid “poker face,” Woodhouse recalls.

As he looked at his dour host, Grant’s face began to glow with sudden intensity. He was “almost like a madman,” says Woodhouse, with the “eyes of a Rasputin.”

Then, without any warning, he let loose a whopper.

“Mr. President,” he said, “how would you like to beat the Turks?”

There was a tinge of mischievous excitement in Grant’s voice, as though he were asking the president of Syria to help him pull off a really great prank.

Al-Assad’s poker face thawed instantly. His gaze snapped sharply onto Grant.

Woodhouse was shocked and appalled by what his boss said. But he also understood that objective number one had been achieved: Grant had commandeered the president’s attention. Now he had to keep it.

Al-Assad finally replied: “I thought you were the UNICEF executive director.”

In other words,
Isn’t that a wildly inappropriate thing for you to say?

Sounding perturbed, he added, “What do you mean, ‘Do I want to beat the Turks?’ ”

Grant first answered, “Yes, I am.” Then without missing a beat, he told al-Assad that “your former colonial master during the Ottoman Empire days” had recently immunized the majority of its children against several killer diseases.

He likely smiled—his quick, gotcha grin—then continued. Beginning his sentence, “I’m sure, Mr. President,” he egged al-Assad on and said he knew he could do even better than Turkey.

Reminding Syria’s dictator of the country’s former overlords was risky at best. Such a tart comment could have gotten Grant and Woodhouse thrown out of the country. What of the immunization campaign then?

But al-Assad did not throw them out or react at all adversely. Instead he listened. Grant began to describe what Turkey had achieved, how such a big country had mobilized its entire population against considerable obstacles.

At the time, according to WHO estimates, immunization coverage for one-year-olds in Syria was between 27 and 29 percent for polio, measles, and the third dose of DPT; for the
tuberculosis vaccine, it was higher, at 53 percent. As many as tens of thousands of young lives were lost every year, simply because most Syrian kids were not immunized.

Earlier, Woodhouse had asked Grant why he was focusing so many of UNICEF’s resources on immunization. Grant cited a lesson he had learned while working for President John F. Kennedy as deputy assistant secretary of state in the early 1960s. What Kennedy had taught him, he said, was not to hit complex problems head-on. Instead, envision the problem as a wall of bricks. “Try to identify a few bricks—if you take them out, the wall will collapse by itself,” Grant had said. “I see immunization as one of those bricks.” Immunize a country’s kids, and the wall of ill health, early death, misery, and lack of services will start to crumble.