Man of the World: The Further Endeavors of Bill Clinton (15 page)

The challenges faced by the initiative’s volunteer advisers were substantial. Few of the Harlem businesses were equipped with computers at all, let alone current technology; none were able to communicate electronically with their customers, or reach out to new ones. Most of them had no way to keep abreast of inventory, track and analyze expenses, or evaluate product sales—in other words, to run their businesses like the large chain competitors that were invading their neighborhood and driving them out of business.

With technical assistance provided by the program partners—eventually involving more than a hundred advisers with expertise in marketing, finance, computerization, and inventory management—Clinton hoped to establish a record that would attract many more community businesses, and encourage new entrepreneurs.

“Everyone,” he told Clyde Williams, “deserves an opportunity to succeed.”

On a chilly morning in January 2002, Ira Magaziner picked up the telephone in the office of his small consulting firm, known as SJS Advisors, in Quincy, Massachusetts, a suburb just south of Boston. Standing at his desk, the tall, thin, angular Magaziner realized that he hadn’t seen or spoken with Maggie Williams for at least five years, since she and then he had both left the Clinton White House. Now she was on the phone, back with Clinton, asking his advice: Would he help them to decide what the former president should do now?

Magaziner was soft-spoken, almost diffident, but his manner concealed a steely temperament. He had done very well since leaving government and he didn’t hesitate. His children were grown, he had money and time—and he still carried many of the same ambitions that had driven him as an idealistic young activist, when he and Clinton had first met at Oxford. Yes, he told Williams, his business success would allow him to take time away from his firm, and he wanted to do “something of value. . . . I want to help the Senator and the President, if I can.”

The urgency of finding a post-presidential purpose—beyond the
endless speechmaking and fundraising—was growing as Clinton faced the first anniversary of his departure from the White House. He needed something bigger than himself, bigger than his library, bigger than the small business program for his Harlem neighbors. A few months earlier, joining with his former 1996 adversary, retired Kansas senator Bob Dole, Clinton had agreed to raise another $100 million to finance college scholarships for the children of the 9/11 dead. That sounded like a huge undertaking, and would require some of his time, but he needed to do more than that, too—something more substantive than soliciting for a charitable cause, no matter how worthy. Without that, he would end up looking like a glorified pitchman.

But to focus his attention on a single issue would be difficult, as Williams knew. Both she and Doug Band, with whom she shared responsibility for booking and planning Clinton’s time, were preoccupied with trying to keep him from appearing on behalf of organizations and causes they considered distracting, unworthy, or beneath his stature, simply because someone had approached him at an event or a party. Rarely would Clinton himself say no.

Talking with Magaziner, Williams explained that they had at least narrowed the list of potential projects down to a few broad categories, based on guidelines the former president had articulated. Whatever Clinton did should be connected in some way to the Millennium Development Goals, eight key priorities set forth by the United Nations in 2000, which ranged from eradicating extreme poverty to achieving universal primary education, reducing infant mortality, and promoting gender equality. Whatever project he undertook should be located mainly or entirely outside the United States, said Williams, since any domestic enterprise might be perceived as violating the unwritten protocol for former presidents not to get in the way of their successors.

Clinton was considering a foray into education, an issue with which he had long been associated, dating back to his stint as Arkansas governor. Many developing countries still required families to pay school fees, a backward policy that harmed children and hindered progress. He was also thinking about economic development, a signature issue on which he also possessed substantive credibility. It would not be hard to advocate economic or educational reform, and to notch a victory here and there.

What preoccupied him more and more, however, were the enormous global consequences of the AIDS pandemic, sweeping lethally through the poorest countries on every continent like a postmodern plague. Curtailing the ravages of the incurable virus was also among the Millennium Development Goals, although nobody had been able to provide a persuasive plan.

Taking on AIDS as a cause would be far riskier than many other global issues. The potential for a public failure was much higher. Moreover, the Clinton administration record on HIV and AIDS remained highly controversial. While he and Al Gore had devoted far greater attention—and federal money—to fighting AIDS than previous administrations, scornful activists still said they had never done enough.

When the topic came up in interviews, Clinton’s tone sometimes turned defensive. At those moments, he would blame the xenophobic (and homophobic) Republicans in control of Congress for blocking broader action; he would contrast his legislative and budgetary activism with the utter passivity of the Reagan-Bush years; he would point out that they had tripled overseas aid funding against the pandemic; and then, he would finally agree that indeed, he still had not done enough.

Among the people who shared that mixed opinion—and whose views mattered most to Clinton—was his daughter. The previous autumn, Chelsea had enrolled at University College, Oxford, where her father read politics on a Rhodes scholarship in 1968, and where she would pursue a master’s degree in international relations. For her thesis topic, she had chosen the sensitive but acutely relevant history of global efforts against pandemic disease, specifically the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria—the massive health financing organization created by the World Health Organization, the G-8 countries, and other nations, along with private-sector funders in 2001, which would eventually raise and disburse as much as $30 billion. While she had scarcely begun working on her research, she had spoken with her father about her choice of topic, and what she might learn from looking at his role.

Whatever Chelsea might discover—and whoever ultimately might share blame for the world’s failure to act—Clinton knew that his best efforts during the final years of his presidency had been inadequate to
the crisis. He was also aware that the pandemic was raging out of control across the less developed countries in a way that most Americans did not begin to comprehend.

Since leaving the White House he had become increasingly voluble about the impending catastrophe of AIDS, addressing far-flung audiences in a tone that sought to balance the terrible reality with a measure of optimism. He had brought essentially the same message to Rev. Jesse Jackson’s PUSH convention in Chicago, to the United Nations AIDS Summit in Abuja, Nigeria, to the National AIDS Trust in London, where he gave a speech in memory of Princess Diana. More than 40 million people were infected, and more than 100 million could be infected within a few years, he said. AIDS, the equivalent of the European plagues of centuries past, threatened both developing and advanced nations far more than al Qaeda—yet much less money had been committed to ending that threat.

World leaders already knew what needed to be done, he went on, pointing to the only developing country where both prevention and treatment were available to the entire population. Without available treatment, prevention programs that relied on widespread testing were unlikely ever to work.

“They did a study in Brazil,” he told the well-heeled London audience, “and found that it was cheaper to give people the drugs than bury them when they die and pay for their last few weeks in hospital—so it would be morally wrong and economically stupid” to end the program. Within three years, the number of deaths from AIDS in Brazil had been cut in half, and the rate of hospitalization had been reduced by 80 percent. In the rest of the developing world, the number of HIV-positive patients receiving effective treatment was no more than seventy thousand; at least three million were dying every year.

“This is not rocket science,” said Clinton. “It is about money, organization, and will.”

Invariably, these speeches elicited enthusiastic responses from his listeners—and conveyed the passion he had come to feel about the AIDS crisis. Even a columnist for London’s
Sunday Telegraph
, a Tory newspaper deeply and eternally hostile to the Clintons, admitted that he couldn’t stop himself from applauding loudly when he heard the former president give a speech about AIDS in Ireland, blaming the famous “
charm, hugginess, and irresistible downhome Arkansas sincerity.” But the thrust of his column depicted Clinton as an international “con artist” spewing “rubbish” and “pigswill.”

Clinton’s ideas about confronting AIDS were unworkable and unaffordable, complained the
Telegraph
; what he urged was plainly fraudulent, in fact, just like the man himself: “Clinton isn’t looking for a cure for AIDS, but glory, creating morally approving communities wherever he goes, helped somewhat by his fee, pounds 100,000 a pop.” It was a bellowing denunciation, extreme and angry, yet it reflected the corrosive skepticism that speechifying alone was certain to provoke, eventually.

As Magaziner listened intently, Williams expressed her boss’s own dissatisfaction with talking rather than doing, even as still another major AIDS speech loomed on his calendar. He had agreed to participate in the 14th International Conference on AIDS in Barcelona, she explained, and to speak, along with Nelson Mandela, at the closing ceremony there on July 12.

Six months left ample time to write a rousing oration, but very little time to create a meaningful program of action. Clinton wanted Magaziner to determine what the foundation might be able to contribute concretely to the struggle against the pandemic, without duplicating, or complicating, the efforts of those already in the field.

Magaziner agreed to canvass the relevant players in order to determine what could and should be done. He would reach out to American organizations fighting AIDS, leading public health authorities in the United States, and several African leaders, whose views would influence Clinton’s decision about whether and how to move forward. And he would do all this at his own expense, on his own time, living off his savings, because the foundation had no money at all to pay for any of it yet.

What Magaziner learned during his travels confirmed Clinton’s most apocalyptic rhetoric about the impact of the pandemic. Conferring at the presidential palace in Dar-es-Salaam with the president of Tanzania, Benjamin Mkapa, whom he had met years before in the White House, he explained that President Clinton was considering how his foundation could advance African development—in education, the economy, health . . . and what would His Excellency advise?

A short, round, blunt man who had earned a master’s degree in international affairs from Columbia and spoke perfect English, Mkapa didn’t hesitate. “Look,” he said, “I’m happy to talk about education. But I can’t educate teachers fast enough to replace the number of teachers dying of AIDS. If I don’t solve the AIDS problem it’s going to undermine my ability to provide any education at all.”

From Dar-es-Salaam, Magaziner flew south to Maputo, capital of Mozambique, where he had an appointment with Prime Minister Pascoal Mocumbi, another old acquaintance. A medical doctor and former revolutionary leader in his country’s revolt against Portuguese colonial rule, Mocumbi was as plainspoken as Mkapa. “You know, Ira,” he said, “we’re hiring two people for every one job, because I’ve got so many people dying from AIDS now.” Nothing in his country could move forward—indeed, everything was moving backward—under the relentless stress of the pandemic.

But when Magaziner returned home and quietly tried to float a new proposal to provide AIDS treatment in the developing world, most of the public health experts and Western government officials whom he consulted told him that they would not participate under any circumstances. Among the skeptics was the dean of Harvard University’s School of Public Health, who sat in his office with Magaziner and patiently explained why he—and everyone else of any stature in the field—believed there could be no successful treatment campaign in poor countries.

It was sad, terribly sad, but true.

“AIDS treatment is not going to work in those places,” said the Harvard dean dismissively. “It’s really too hard to do, because you can’t just give people pills. You’ve got to monitor them, test them, do the outreach.” None of those countries had the resources, doctors, nurses, clinics, or equipment to complete these tasks properly.

In London, where he met with the head of the United Kingdom’s foreign aid agency, Magaziner heard the same argument, warning him against any such foolish undertaking. “We’ll continue to support prevention measures, but we’re not going to support treatment. We don’t think it can be done effectively and we’re not going to waste money on it.”

They were wrong, he thought, and despite their good intentions, they were insisting on an immoral policy that would condemn millions
to death. He felt certain they were wrong because he had seen successful AIDS treatment delivered in the poorest country in the Western Hemisphere.

On another trip that spring, Magaziner had visited Haiti, where a thin, bespectacled Boston doctor named Paul Farmer demonstrated how his organization, Partners in Health, was successfully treating AIDS patients on the impoverished island. The scale of Farmer’s project was very small, numbering only in the hundreds of patients, but its effectiveness was undeniable. Dying patients in an extremely poor district, far from any city hospital, had been saved and restored to health. Although author Tracy Kidder would soon immortalize the young doctor in a gripping bestseller—
Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World
—he was a radical voice of dissent from the public health consensus, which he frankly regarded as genocidal in result if not intent.