Which fits, because the World Bank’s priorities are changing. As development expert Todd Moss explains, India, one of the bank’s largest fund recipients, is about to grow its way out of the International Development Association, the arm of the bank that primarily serves the world’s poorest countries. A host of others, including Vietnam, Ghana, Nigeria and Mongolia, are scheduled to follow soon after.
As incomes in these countries rise, they need less help from the bank. So resources will shift to those countries that haven’t been able to take advantage of rising global prosperity. Nearly all of those 30 or so extremely low-income nations are fragile, post-conflict zones in sub-Saharan Africa. And their needs are substantially different from those of rapidly developing countries such as India.
Kim is primarily known as a force within the global health community. Alongside Paul Farmer, he co-founded the famed Partners in Health organization, which pioneered the delivery of advanced health treatment to deeply rural, impoverished nations such as Haiti. In that world, he’s known as unusually able to bridge the divide between the activist and establishment communities. He moved from Partners in Health to the World Health Organization and Dartmouth College, and he managed to keep both constituencies happy.
In “Mountains Beyond Mountains,” Tracy Kidder’s history of Partners in Health, the author recounts a late-night discussion between Farmer and Kim on how much time is wasted to ensure political correctness. “It’s a very well-crafted tool to distract us,” Kim griped. “A very self-centered activity. Clean up your own vocabulary so you can show everybody you have the social capital of having been in circles where these topics are talked about on a regular basis.”
Kidder asked for an example. Kim and Farmer replied with stories of the academics who would confront them by asking, “Why do you call your patients poor people?” Kim’s stock reply: “Okay, how about soon-dead people?”
Kim’s frustration with the medical establishment was equally severe. Partners in Health focused on the toughest diseases to treat — AIDS, tuberculosis — in the poorest, hardest-to-reach corners of the world. To do so it had to battle the prevailing wisdom, which held sway even among many in the aid community, that it wasn’t worth expending scarce resources to treat those diseases in those areas because the efforts would not be successful.
Atul Gawande, the surgeon, writer and public-health researcher, worked with Kim and Farmer at Harvard Medical School. He recalls that Congress “held hearings where they would bring out doctors saying these patients don’t have watches, you have drugs they need to take four times a day, you can’t have treatment in places where you don’t even have watches. What Kim and Farmer did was prove them wrong on a localized level. And then what Kim did was figure out how to scale that.”