The week began with rumors swirling about whether Dr. Paul Farmer, the visionary founder of Partners in Health and a Harvard Medical School professor, was still a contender to head the US Agency for International Development.
The week ended with the same lack of clarity, and even more frustration.
Several blogs in Washington this week have quoted unidentified sources as saying Farmer is no longer being considered. Those include The Cable at Foreign Policy, whose author Laura Rozen is very well plugged in at the State Department.
Farmer himself isn't talking. Andrew Marx, spokesman at Partners in Health in Boston, says Farmer is adamant that he won't comment. Farmer is currently in Rwanda, assisting the Rwandan Health Ministry to revamp its entire system for providing rural health care in a more coordinated, patient-focused manner. That program received an $8 million grant last week from the Doris Duke Charitable Foundation, just the latest endorsement of the critical need to reshape the way healthcare is delivered in developing countries.
Both the State Department and White House decline any formal comment on staff negotiations. Without citing sources, some of these blogs suggest the White House ruled out Farmer during its arduous vetting process. Secretary of State Hillary Clinton complained publicly a couple of weeks back about the frustratingly slow and detailed vetting process, suggesting it was what had had kept the USAID post vacant since the start of the Obama Administration in January.
The delay and the official silence only serve to feed the speculation frenzy, with blogs seeming to quote other blogs about Farmer's withdrawal until it seems that it must be true, but without any on-the-record confirmation. No staffer I could reach on Capitol Hill knew anything first-hand. So at this point, there's no clarity whether Farmer is still in the running, or, if he did pull out, whether it was because he became fed up with the bureaucratic infighting that was already engulfing him, or whether something had arisen in the vetting that made the Obama Administration decide it wouldn't be worth the resulting Senate confirmation battle. Or some other reason.
Of course, they must have known from the outset that Farmer has been critical for years of the US government's handling of development issues. Anyone who has read Tracy Kidder's "Mountains Beyond Mountains" gets that instantly. Presumably, the very reason someone wanted Farmer in the first place is because he is provocative, he thinks big and he's not afraid to take on vested interests.
Maybe the smartest thing he could have done was just what he did -- go to Rwanda and provide some real service to people in need while this Washington echo chamber drones on.
Laurie Garrett, the Pulitzer-Prize winning author on global health care and Council on Foreign Relations health and development analyst, captured the frustration this way to me via email:
"Nearly nine months into the Obama Administration we have absolutely no solid indication either that the White House intends to name a director for USAID, or that the agency will be given the sort of budget and political clout that health and development advocates insist are essential to making U.S. foreign assistance work. It's shocking. The merry-go-round we've been on regarding Paul Farmer's "appointment" has been disheartening."
About this blog
About James F. SmithJim Smith came home to his native Boston in 2002 to become the Boston Globe's foreign editor after spending 22 years abroad. He was previously based in Buenos Aires and Mexico City for the LA Times, and in Johannesburg, Tokyo and The Hague for the AP. In 2007 he became the Globe's national political editor, coordinating presidential campaign coverage. He is a Yale graduate, and has an MBA. He is married to Maxine Hart and has two sons, Matthew and Daniel.
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