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Authors: Adam Fifield

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But eventually, the UNICEF chief gave in and pledged his cooperation. He had no choice.

The results, based on a survey of seven hundred and fifty staff members (and interviews with three hundred and fifty)
were shared with Grant and others as early as October and formally released in December. While lauding UNICEF for its considerable achievements, the three-hundred-page report noted a “value system that staff renounce” and “personnel processes that have lost credibility.” It cited complaints about global goals, concerns about accountability, and a perceived lack of transparency in financial management. It also concluded that the organization “does not have substantial experience” with important issues central to its mission, including child abuse and exploitation. Also pointing out “unusual hostilities” between the board and UNICEF leadership, Booz Allen called for major reforms.

Several Grant loyalists dismiss the Booz Allen report as a vindictive move by some board members to rein in a man they could never really control or understand—one whose unrivaled triumphs had stirred pungent feelings of jealousy and resentment. The study amounted to a betrayal, says Gourisankar Ghosh, whom Grant had recruited from the government of India to run UNICEF’s water programs. “It was very unfair to him … I felt very, very sad the way he was treated toward the end.”

Others see value in some of Booz Allen’s recommendations, which included appointing a special “associate executive director” to handle day-to-day management issues that Grant clearly eschewed. Some of the problems cited in the report were valid criticisms, and they certainly needed to be addressed. Grant had pushed staff members past their limits, ignored unpleasant realities, blatantly favored some field
operatives, hired and promoted people according to his own close-to-the-vest set of criteria, and upset an established system of career advancement. All of that was true. But Booz Allen did not seem to appreciate the context in which much of this had happened or the momentous change that had accompanied it. The firm did not seem to get who Jim Grant was or what he and UNICEF had done.

The tensions cited by the consulting company stemmed, in part, from friction between Grant and wealthy donor countries represented on the board, especially European ones. Some felt the UNICEF chief cared too much about child survival to the detriment of other issues and that he did not listen enough to UNICEF’s principal funders. Grant’s primary support on the board—and the reason he had been able to weather all the criticism for so long—came from the developing countries. They had always been in his corner, because he had always been in theirs. He had grown up in a developing country, after all, and his sympathies were far more attuned to the plight of the poor than most “first world” UN officials. The child survival revolution had focused on children in the poorest countries (where the most were dying) and directed a current of resources to their governments. Grant and Richard Jolly had openly challenged the World Bank and IMF for structural adjustment policies that unduly punished developing countries. Grant also repeatedly championed debt relief for strapped governments of poorer nations. And he often pointed out that, in terms of according priority to children, some developing countries had done a better job than their
richer peers; immunization rates in some cities in the developing world, he would joyfully note, were higher than in New York City and Washington, DC. As the well-being of children improved during the 1980s in some of the world’s poorest pockets, the situation of children in Grant’s own country, the United States, deteriorated—this sad truth, he would say, was “my greatest disappointment.”

“Jim became a hero to the developing countries,” says Joe Judd, an American who worked for UNICEF in Bangladesh, China, Indonesia, and the Philippines. In return, he adds, they “were not going to let Jim sink.”

But at the very end, he was sinking a little bit anyway. Over the course of fifteen years, he had defied every doubter in the most extraordinary way. He had tapped the potential of the UN as no one else ever had. He had unlocked a whole new realm of possibility in health and international development. He had shown that poor children did not have to die in mass numbers. He had mobilized the entire world to take better care of its young citizens. Now, after all that, his tenure was ending on a stubbornly sour note.

As Grant’s condition worsened, a small circle of friends, family, and staff kept gently pushing a harsh, unvarnished piece of advice: quit. For his sake, and for UNICEF’s, it would be best, they told him, for him to step down now.

But he wouldn’t. If he resigned, he was done—invisible,
insignificant, denuded of power. He was going to keep moving until he dropped.

Though he mentioned it to almost no one, Grant had been struggling for some time with the prospect of a post–Jim Grant UNICEF and a post-UNICEF Jim Grant. At some point within his last six months, likely before he became gravely ill, he had asked his senior adviser Jim Sherry to meet him at the Cosmos Club in Washington, DC, to discuss his future and his options. Charming, raspy-voiced, and politically astute (he was the former chief of staff for Congressman Sandy Levin), Sherry was an American doctor who had become part of Grant’s inner circle.

He met Grant in the evening at the genteel private social club housed in a Beaux Arts mansion near Dupont Circle. Grant had been a member of both the Cosmos Club and Metropolitan Club for decades. The stately, stuffy bastions of male power in Washington had stirred controversy in the 1960s for denying membership to women and minorities. Though this had changed by 1994, they were still exclusive and reeked of elitism. As unfussy as he was, Grant still seemed to relish some trappings of prestige. But the main reason he belonged to the clubs, according to his son Bill, was that “they were the right places to meet the right people.”

As Sherry listened, Grant talked about Halfdan Mahler, the legendary former WHO director general who had been both his adversary and his collaborator. Grant was fixated on what happened to him after he left WHO in 1988.

“It was as if he disappeared from the scene,” Grant told Sherry.

They talked for a long time, but Sherry knew that Grant had another appointment—a very important one. He was supposed to see his eldest son John’s family, including his grandsons. They lived nearby. And he was late.

“Jim, you gotta get going,” Sherry said.

“Okay, okay, okay,” Grant said. He seemed distracted.

At some point, Grant’s son John called him (likely on a Cosmos Club phone) and asked him where he was.

“Okay, yeah, I’ll get out of here right away,” Grant said. “I’m a little delayed.”

But Grant wanted to keep talking to Sherry. Sherry reluctantly agreed. He says now: “When he had an issue, he didn’t let it go.”

Jim Grant loved his family deeply. His sons Bill and Jamie say he was an excellent, caring, attentive father, husband, and grandfather (John Grant died of a stroke in 2000 at the age of forty-eight). But as several staff members have suggested, the children of the world came first—before anyone or anything else. The mission of child survival had progressively possessed Jim Grant, pervaded his soul—now perhaps more than ever.

He had not always been like this. His now near mythic persona had evolved, and he had evolved with it. “He wasn’t ‘Jim Grant’ when he started at UNICEF,” Sherry notes. “He was ‘Jim Grant’ when he left UNICEF.”

And, as his days dwindled, his mission only grew more urgent.

On November 11, 1994, he gave what would be his last speech. Several people advised him not to appear, to skip this one. He was in “terrible shape,” says Mary Cahill. “It looked like he could expire at any moment.”

His jaundice was full-blown. His voice was light and wheezy and breathless. He was haggard and bony and short of breath. His discomfort was total. Sitting down for long periods tortured him—at least the speech would give him a chance to stand up and move around.

He spoke at the Third Committee of the Forty-ninth General Assembly of the United Nations. Though nominally about “child rights,” this address covered a host of issues—his final laundry list of asks for the governments of the world. He plugged the Convention on the Rights of the Child and mid-decade goals. He urged the UN member states to keep children where he had put them—at the “very center of development strategy.” He argued for a ban on land mines, a crackdown on child labor and child trafficking, greater protection for children trapped by war, and the humanizing of economic sanctions to make them less harmful to children.

As though anticipating that the unprecedented concern for children shown in recent years might evaporate as soon as he stepped away from the podium for the last time, he made a bald plea: “A child has only one chance to develop, and the protection of that one chance therefore demands the kind of commitment that will not be superseded by other priorities. There will always be something more immediate; there will never be anything more important.”

Shortly after this speech—Mary Cahill thinks it was later that same afternoon—he left UNICEF House for the last time. Word zipped through the corridors that this might be the final chance to see the “Mad American,” and a throng of people massed in the lobby and spilled onto the narrow Manhattan street outside. Traffic stopped. Grant carefully made his way through the lobby and past the UNICEF card and gift shop. The crowd parted, allowing him a path of about six feet. He did not rush, but he was determined to make it out. People reached out to try to touch him, shake his hand, and he greeted them. He stopped to hug them and to thank them. “He was saying goodbye with his eyes,” says Judd. “Those eyes could communicate so much.”

Staff members were crying and cheering and applauding for him as he walked by. Many could not believe the man who had made UNICEF what it was, who in some cases had made them who they were, who had galvanized the entire world, was now slowly shuffling off the stage. A palpable feeling of dread spread from the lobby through the crowd on Forty-fourth Street. How could UNICEF possibly go on without him?

“Everyone was really shell-shocked,” recalls Judd. “It was an incredible spontaneous outpouring … He went out like the true showman he was.”

A few days later, he slipped into a coma and was hospitalized again. Dr. Brennan performed another procedure, this one purely palliative. It was far too late to stop the cancer—that tumor had taken over most of his liver by now. But the surgeon
was able to allow his bile to drain better and alleviate the jaundice and the bloating.

Cole Dodge remembers visiting him in his hospital room. Dodge, then the regional director for eastern and southern Africa, was in New York at Grant’s request. Before he left Nairobi, he had bumped into the film director and UNICEF ambassador Richard Attenborough, who had given him four tickets for the New York premiere of his new film, a remake of
Miracle on 34th Street
(Attenborough was starring in it). The premiere was at Radio City Music Hall on November 15, the day of Grant’s surgery.

When Grant found out Dodge had the tickets, he insisted that Dodge round up Ellan and Jon Rohde and take them to the premiere with him. “I don’t want anybody around this hospital room,” Grant instructed. “You just do it.”

Dodge did as he was instructed.

A knotty question grew more cumbersome with each passing day: Who would succeed Grant after he died? Another question was tied to it: Would Jim Grant have a say in the matter?

He knew whom he wanted as his successor: his friend Dr. Bill Foege. A figurative and literal giant at six feet seven, Foege approached NBA altitude. His influence was even bigger. A former director of the US Centers for Disease Control, he had played a pivotal role in the eradication of smallpox in the 1970s. He was well known and well liked by virtually everyone
in the universe of global health. As the chair of the Atlanta-based Child Survival Taskforce—a consensus-building group formed in the wake of the launching of GOBI—Foege had deftly sewn together cooperation from many disparate actors (including WHO, the United Nations Development Program, the World Bank, and the Rockefeller Foundation). Deliberate and unflappable, he had been able to soothe egos Grant had trodden upon.

Foege understood and wholeheartedly supported Grant’s child survival revolution and was trusted by many at UNICEF. And more importantly, he shared Grant’s zeal. To ensure that zeal—or some variety of it anyway—continued, there was simply no better choice than Bill Foege. Rohde and many others agreed.

The UN secretary general appoints the executive director of UNICEF, but there is always a secretive, behind-the-scenes tussle that sways the decision. The Europeans would undoubtedly front a candidate or two. Pressure was also building to appoint a woman to lead UNICEF. There was no guarantee that Grant’s wish would be honored.

But Jon Rohde believed that, given Grant’s near epic stature, there was no one who could say no to him—as long as he was still alive. Grant would have a much better chance of getting Foege installed, Rohde felt, if he stepped down now and made a forceful case for the transition.

Rohde wrote his friend a letter urging him to do just that. “I felt I owed it to him,” the blunt pediatrician says. “He didn’t have long.”

No one can ignore you, Rohde wrote. No one will deny you your wish, your pick for the next executive director, as long as you are still breathing. But you have to resign in enough time to make it happen.

Grant disregarded the letter.

“He did not come to grips with his own mortality very well,” says Rohde. He describes Grant’s attitude: “I’ve got too much to do to die.”

His denial edged into delusion. Instead of focusing on his successor and other important matters, Grant was concerned about getting his carpet cleaned. He wanted to get his apartment ready so he could entertain guests once he was better. He bought tickets for him and Ellan for a cruise along the Alaskan Inside Passage that he would never be able to use. Even when it was clear his cancer was inoperable and that his days were preciously finite, part of him never accepted it. He somehow believed he was going to resume his life and his mission. He was determined to “bulldoze reality,” says Cahill.

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