Medical philanthropy has a long history in the United States—from the founding of our first charity hospital in 1735 (by a common businessman acting in a remote frontier town that had only been in existence for 18 years) to the development of therapies that have saved hundreds of millions of lives. Charitable giving has been crucial in catalyzing many of the most far-reaching advances in medicine, such as penicillin, insulin, hookworm control, the polio vaccine, kidney transplants and dialysis, and much of today's success against cancer. Philanthropists established most of America's best medical schools and research institutes. They have endowed professorships, created labs, and built clinics. Philanthropy has been vital in carrying improved health measures out into communities—from the Rockefeller Foundation's heroic campaign against yellow fever right up to today's Gates Foundation battles against malaria, leprosy, polio, and other neglected diseases. With the last generation's explosion of private-industry research and government spending on health care, private philanthropy now comprises only a small portion of funding for medical research and public health, yet because it tends to be flexible, risk-tolerant, fast-moving, and offered without the onerous red tape of government grants, philanthropic funding is especially prized by medical researchers today and continues to have a powerful impact on the field, as you will learn in the pages following.
— Section research provided by Karl Zinsmeister, Cindy Tan, and Thomas Meyer
The Chicago-area Duchossois family had previously donated $37 million to the medical school of the University of Chicago. But in 2017 they made an especially interesting gift of $100 million, aimed not just at treating disease, but at understanding how the body fends off invaders and keeps itself well. Specifically, they funded work to deepen understanding of human “microbiomes”—the large collection of healthy bacteria and other microorganisms that exist inside all of our bodies, which we have recently learned are crucial to balancing our nutrition and body weight, immunizing us against environmental threats, and influencing how effectively we metabolize the drugs we take to cure problems.
Chicago sciences dean Conrad Gilliam called the Duchossois family’s decision to focus on the microbiome “prescient.” He noted it now “appears that the microbiome affects nearly every organ and possibly every disease. So…we liked the family’s idea that rather than try to go after each disease, let’s focus on how the microbiome can be manipulated to maintain a person’s health.”
Another innovative twist to the family’s gift is that they have connected it to business spinoffs to make it self-sustaining. Their new program will link with the university’s center for entrepreneurship to bring scientific discoveries to the health-care market in partnership with businesses. All money made in this way will be reinvested into the institute’s work. The $100 million of philanthropy will last ten years, by which time revenue from the commercial spinoffs is intended to support future investigations.
After Sanford Diller put together one of the most successful companies developing apartments in northern California, he and his wife Helen Diller became energetic philanthropists. They were long-time supporters of the medical faculties at the University of California, San Francisco (whose facilities include the hospital where she was born). From 2003 until Helen’s death in 2015 the couple made gifts totaling more than $150 million to build up the university’s cancer center on a new campus. Then in 2017 their foundation offered a $500 million grant to support UCSF’s medical education and research. That tied for the second largest gift ever to a university, exceeded only by Gordon Moore’s $600 million donation to the California Institute of Technology in 2001. Campus officials said they particularly appreciated the relatively unrestricted nature of the offering, which will allow them to apportion funds efficiently to emerging priorities.
Jeff Bezos, the founder of Amazon and now the second richest man on earth, is just getting started on philanthropy. Most of his giving comes through the foundation run by his parents, which he has endowed with Amazon stock. The Fred Hutchinson Cancer Research Center in Seattle has been their favorite recipient thus far, through gifts totaling about $65 million. Immunotherapy, bone-marrow transplantation, and study of cancers sparked by exposure to germs have been particular focuses of the Bezos cancer gifts.
Training accidents, sports injuries, and battlefield blasts put military servicemembers at risk for concussions and brain injuries. Most of these heal with standard medical treatment and time, but some are persistent and disruptive. Getting treatment for these can be difficult and frustrating.
When Home Depot co-founder Bernie Marcus found that out, he went to work. He was on a 2007 visit to Shepherd Hospital, a top destination for neurological care, when he met a young brain-injured servicemember who had recently regained his ability to walk after military doctors wrote him off as paralyzed for life. In talking to the young man and then learning about the relatively high prevalence of concussions and brain injuries in the military today, he decided to launch a private clinic to provide attention to difficult cases. With his $2 million grant to Shepherd Hospital, the SHARE Program was born, offering specialized care that is time-consuming and expensive, but doesn't cost a dime for those injured in service.
After registering successes, Marcus offered to work closely and collaboratively with the Department of Veterans Affairs and Department of Defense, but was quickly frustrated by the bureaucracy and territorial posturing of the government agencies. So he pushed the SHARE program forward on its own, intensively treating around 40 patients per year. But Marcus knew the potential and the need were far greater.
In 2014, he hired a young Army officer to help him expand his philanthropy for veterans, and particularly to launch a wider effort in concussion treatment. They recruited a leading expert who had founded the Fisher-family-funded National Intrepid Center of Excellence and considered what private-sector care for brain-injured veterans might look like. They zeroed in on diagnosing underlying causes of different symptoms, recruiting doctors from a wide range of specialties, developing detailed treatment plans that involve family members, and ensuring that veterans transition home with ongoing care.
With this plan and a $38 million grant from Bernie Marcus, the University of Colorado Anschutz Medical Campus became the first site for the Marcus Institute for Brain Health. Marcus will next develop other sites around the country to build a network of care. By early 2017, he had already committed over $70 million to veterans' causes, making him one of the most generous donors to this population.
When he was five years old and seriously ill, Robert Kern received charitable medical treatment at the Mayo Clinic—under a program for helping the children of religious workers like his father, a Baptist pastor. The child recovered, grew to be an engineer and inventor, and built his company making portable generators into a billion-dollar enterprise. Then he paid back the Mayo Clinic’s kindness. More generally, he began to apply his engineering instincts to upgrade medical education and care.
Robert and Patricia Kern donated $20 million to Mayo in 2011 to establish the Center for the Science of Health Care Delivery. It uses scientific assessments to improve the effectiveness, safety, and value of patient treatments, and then shares proven models with other doctors and hospitals around the country. The Kerns followed up with an additional grant of $67 million in 2013. This brought their total giving to the Mayo Clinic to $100 million (they have also supported neuroscience there).
Then in 2017 the Kerns made their latest gift aimed at re-engineering medical care for improved outcomes. They donated $38 million to the Medical College of Wisconsin to establish an institute that will coordinate a group of top medical schools as they explore new approaches for improving doctor training. For instance, the Medical College of Wisconsin (to which the Kerns had previously given $10 million) recently established new satellite campuses to school physicians who want to practice in rural areas and smaller cities that currently lack doctors, or go into specialties like primary care and psychiatry where there are occupational shortages. These refinements will benefit lots of Americans—including needy five-year-olds.
Steve Cohen had made billions of dollars as a hedge-fund manager when his son, Robert, decided to enlist in the Marine Corps. There was no draft or financial necessity for him to join, but he felt a calling to serve the nation in a time of war. After deploying to Afghanistan, Robert reported to his father that some of his friends and colleagues struggled with mental-health adjustments when they returned home.
The elder Cohen got involved. First, he co-chaired the Robin Hood Foundation's $13 million fundraising for veterans in New York City. Then he put up $7 million to underwrite a free mental-health clinic in the city for vets and their families, and separately funded $17 million in PTSD research (see nearby 2013 entry). He had hoped to find an existing nonprofit he could fund to provide mental-health care across the country, but none quite fit the bill. So he launched his own.
In 2016, Cohen committed $325 million to help veterans, members of the National Guard and Reserves, and their families address mental-health needs. It was the single largest commitment of philanthropic support to Americans with military service. The lion’s share went to establishing the Cohen Veterans Network—a collection of roughly two dozen mental-health clinics around the country specially staffed and resourced to care for 25,000 patients annually. At least $30 million will be directed to Cohen Veterans Bioscience, a research organization dedicated to accelerating the development of diagnostics and treatments for traumatic stress and brain injuries.
Within a year, Cohen's network had opened its first four locations. The clinics offer same-day enrollment and first appointments within a week—radically faster service than what’s offered by the V.A. They also provide services like transportation and childcare to make sure that patients face minimal barriers to treatment. And unlike the V.A., the Cohen clinics provide care to family members, and all veterans regardless of discharge status.
The clinics quickly found that most of the mental-health challenges that current and former servicemembers seek help for are not battle-related at all, but the same issues that affect the rest of us—like depression, guilt, family strife, anxiety. In addition to providing high-quality evidence-based treatment to patients, the Cohen clinics train new practitioners, and gather data that can be used to improve practices across all sites. And all of this comes at no cost to the veteran.
From his Facebook proceeds, Sean Parker donated $250 million in 2016 to found an unusual cancer institute. It will focus tightly on using the body’s own immune system to fight tumors. Until very recently, notes Parker, immunology was “the red-headed stepchild of the oncology world. There was a dedicated band of scientists who were convinced that the immune system played an important role in cancer, but they were essentially refugees from the cancer establishment.” Now they’ll have a chance to pursue their theories.
Even more than the huge pile of money Parker put up, or the bleeding-edge science he is supporting, it is likely to be the business-like philanthropic method he applied that separates his efforts from others. Parker insisted that all scientists receiving his money must coordinate their work in order to avoid duplication, and speed practical progress from research lab to treatment clinics. Neither bureaucracy nor prima donna personalities will be allowed to encumber transfer of information among the 40 labs in six institutions (ranging from UCLA to Penn to the M.D. Anderson Cancer Center). The cooperative network Parker set up will propose research agendas, collect and share data on results, establish the necessary clinical trials, and handle all licensing of useful technologies and ideas so companies can bring them to market quickly. The network is also establishing direct partnerships with 30 private companies with valuable expertise, and with several patient-advocacy groups.
In explaining his effort to chop down intellectual barriers, Parker says that philanthropy is not “giving away money so much as trying to solve a set of not-easily-addressable problems.” He told the Financial Times that if you “form a scientific advisory board composed of the luminaries in the field—who are all at that point the establishment—and then you let those people determine how your resources are going to be allocated, you’re going to end up doing essentially more of the same thing that everyone else is doing.” Smart philanthropy often looks instead for roads not taken and new tacks by fresh thinkers. There are topics and approaches, summarizes Parker, that are “either too far ahead, or they’re unpopular for some reason, or the establishment isn’t yet interested, where private philanthropists can step in and have a huge impact.”
Parker says the slow “incrementalism” that has “taken hold of” academic science in many places is a symptom of the tendency of government agencies to fund only sure things. Most government research grants “aren’t really that interesting” because they are channeled to “the things that are already so obvious, experiments where the outcome is already so predictable.” The many top researchers who have decided to participate in Parker’s venture apparently agree. They say its flexible mechanisms and funding will allow them to pursue riskier, harder, longer-term, more radical ideas than government grants would allow.
The Parker Institute for Cancer Immunotherapy is but one of many recent mold-breaking creations by philanthropists frustrated with the conventional and risk-averse research that flows from much public funding. Paul Allen’s three innovative research institutes (see 2003 entry in this section, plus separate 2014 and 2016 entries), Bill Bowes’s special faculty funds (2016 item nearby), the genome center created by Russell Carson and James Simons (also nearby under 2016), Bill Gates’s innovative malaria vaccine consortium (2011 entry), Larry Ellison’s attempt to promote discipline-mixing in medicine (1997 entry), and the self-contained Janelia Farm campus set up by the Howard Hughes Medical Institute (see 1953 Medical entry) are similar efforts to avoid stifling effects that are often connected to conventional government-funded medical research. Other donors like Peter Thiel, Mark Zuckerberg (2016 entry on Prosperity list), and Sergey Brin are likewise promoting fresh ways of organizing research, and depending as much on their management insights as on their money to create medical-science breakthroughs.
In one of his last gifts, biotech investor and philanthropist Bill Bowes made a 2016 gift to the University of California, San Francisco to establish special support for medical research that is unconventional or outside of standard health-science boundaries. The program offers biomedical investigators $250,000 per year for five years so they can test new ideas, including ones with a high probability of failure, without endangering their lab support. Young and pioneering faculty will particularly benefit. The gift brought Bowes’s total giving to the university to $100 million. His previous donations also tended to encourage experimentation. Bowes “has a history of funding cutting-edge research…at a time when federal funding tends to reward more established scientific approaches,” commented the San Francisco Examiner shortly before his death in 2016.
Retired oil executive James Mulva and his wife Miriam took aim in 2016 at “widespread and difficult diseases that impact so many people and families.” They donated $50 million to create a neurology clinic at the University of Texas medical school in Austin, and $25 million for prostate and melanoma treatment at another UT facility, the M.D. Anderson Cancer Center. The Mulvas had previously donated $75 million to engineering and business programs and ROTC training at UT-Austin.
Thanks to donor support, the Cleveland Clinic’s institute for eye and vision problems went from a hole in the ground to one of the top programs in the country in only about 15 years. That kind of meteoric rise is unusual in the medical world. But success can also cause problems. Board member Jeffrey Cole (who ran one of the world’s largest companies selling eyeglasses) discovered that the vision clinic had reached the capacity of its building, and thus could no longer accept more patients, or expand into additional areas of research. So he provided $31 million to fund a new building that will provide needed space. As the plans for the building began in 2017, the eye institute had a staff of 100 physicians and researchers who carried out more than a quarter-million patient visits and 13,000 annual surgeries.
In 2011, financiers Russell Carson and James Simons jointly launched the New York Genome Center. This new consortium encourages hospitals, research groups, universities, and medical schools in the region to work together to advance biological research and improve treatment of patients via genomic medicine. Founding members include Weill Cornell University, Columbia University, Memorial Sloan Kettering Cancer Center, Rockefeller University, New York-Presbyterian Hospital, and others. Both men served on the group’s board to guide it during its early years. And five years later they put up big gifts to build a nest egg for the nonprofit. They announced that if the center raised $100 million over the next three years, Simons would put up $80 million and Carson $20 million to double the pot. The consortium now oversees an extensive research agenda, including investigations of specific diseases like glioblastoma and rheumatoid arthritis, plus work at a dozen separate specialized labs scattered around the New York metro area.
On the same day in August that he and three other Johns Hopkins University researchers published in Science their breakthrough explanation of sources of ALS (also known as Lou Gehrig’s Disease), Jonathan Ling did a Q&A session on Reddit. He said he wanted to set the record straight on whether the ALS Ice Bucket Challenge actually accomplished anything. The fundraising craze sponsored by the ALS Association raised $115 million for disease research in just six weeks in 2014 when it went viral on the Internet. It continued to raise tens of millions more in repeat donations that followed, and the ALS Association tripled its annual budget for research.
Ling recounted “reading a lot of stories about people complaining that the Ice Bucket Challenge was a waste and that scientists weren’t using the money to do research, etc. I assure you that this is absolutely false.” The surge of research money from the ALS Association allowed his Johns Hopkins team to conduct high-risk, high-reward experiments that were crucial to their discovery, he reported.
Researchers hope this new understanding could translate into lifesaving therapies. And thanks to more than $200 million of Ice Bucket cash, the expensive clinical trials needed to test applications were already paid for in advance. This unusual arrangement will speed results.
Meanwhile, a different academic team centered at the University of Massachusetts Medical School made a separate breakthrough on ALS. By carrying out the largest-ever study of families of ALS patients, they discovered that a gene variation is one of the top causes of the disease. This important finding was “really made possible by the ALS Ice Bucket Challenge donations” that funded the special investigation, according to principle scientist John Landers.
At any given time, about 30,000 people suffer from ALS—which kills most of its victims within a couple years of diagnosis. There is currently just one drug for treating the disease, and it quickly loses its effectiveness, extending a patient’s life only three to six months.
Investors Louis Simpson and Kimberly Querrey are interested in the new medical specialty of regenerative medicine—which is developing ways to repair, replace, or regrow body tissues that are not functioning. Once a science-fiction dream, medical scientists are now discovering they can grow organs, skin, and other body parts to help victims of disease, accident, war, or genetic breakdown.
Between 2012 and 2014, the couple donated $25 million to establish an institute at Northwestern University that applies nanotechnology—the manipulation of matter at the molecular level—to regenerative medicine. One year later they added another $92 million to their gift to broaden their support for regenerative medicine. The gift allowed the university to break ground on a new biomedical research tower that will be completed in 2018. In addition to advancing fundamental understanding of how the body builds and repairs tissue, the Querrey/Simpson gift aims to speed development of drugs, fresh procedures, and clinical trials that will allow doctors at Northwestern to bring patients new solutions to cancer, burns, trauma, and degenerative diseases.
Cornell University is one of the strongest engineering schools in the country, but until 2015 did not offer an undergraduate degree in biomedical engineering. This despite the growing importance of that field, the fact that 60 percent of engineering students express interest in biological applications of engineering, and the existence of other Cornell entities that need expertise at the intersection of biology and engineering—the renowned vet school, the medical school, and Cornell Tech in New York City.
The Meinig family, who had previously given $25 million to Cornell to support research in the life sciences, filled that gap in 2015 when they doubled down on their previous bet with a $50 million gift. This donation spun Cornell’s existing biomedical engineering department into an independent school of biomedical engineering. It allowed the launch of the undergraduate major in the fall of 2015. And it put into motion a wide array of new research and teaching in four areas: tissue engineering, biomechanics, biomaterials and drugs, and instruments and imaging.
On the east side of mid-Manhattan, close enough to each other to be the three bases in a game of stickball, stand a trio of formidable medical facilities: the New York-Presbyterian Weill Cornell hospital campus, Rockefeller University, and Memorial Sloan Kettering Cancer Center.
On the very same day in 2015, the latter two of those neighbors announced that they had received major philanthropic infusions. Rockefeller University received $100 million from Henry and Marie-Josée Kravis to create a new medical laboratory that will host research by top academics. Since its founding by John Rockefeller in 1901, Rockefeller University has been our nation’s foremost biomedical research institution, but the labs being replaced with Kravis assistance date back to the 1950s. That’s an eon in scientific time, so the new setup is crucial to keeping the university strong.
Simultaneously, Memorial Sloan Kettering was promised $150 million by David Koch for an outpatient center that will treat cancer victims. This gift will produce a giant people’s clinic serving 1,300 patients daily, housed in a new 23-story skyscraper. Cancer is an age-related disease, and with New York City’s population over 65 rising fast toward an estimated 1.4 million by 2030, there will be many new patients needing radiation, chemotherapy, surgery, and related help.
The third of those neighbors was simultaneously in the midst of its own $2 billion donation campaign. Pledges to NY Presbyterian/Weill Cornell began with a $100 million gift from David Koch. (As of 2016, Koch had donated $517 million to battling cancer—about half of his total giving.) Then Steven and Alexandra Cohen offered $75 million to create within the Koch center a new hospital for women and newborns. (Children’s hospitals are a favorite cause of the Cohens, who gave $50 million for one in Washington Heights in 2005, and $50 million for another in New Hyde Park in 2010.)
These contributions came just as an earlier medical angel in New York City passed from the scene. Between 1987 and his death in 2016, Herbert Irving, co-founder of the Sysco food-service company, donated more than $300 million to build up hospital care in the city.
Allergies are both a common nuisance—with an estimated 60 million sufferers in the U.S.—and sometimes a mortal threat. The manifestations of allergic reaction include asthma, drug allergies, bee sting reactions, eczema, and food allergies. For unknown reasons, our rate of allergic problems is rising.
Sean Parker, who became wealthy at Facebook and is now an active philanthropist, understands this plague, having himself been hospitalized 14 times in the last four years for allergic trauma. Hoping to contribute to better understanding and cures for allergies, he offered $24 million in 2014 to establish a center for allergy research at Stanford University. Clinical trials began in 2015.
Nearly 5,000 residents were killed when an epidemic of the dread disease Ebola swept west African countries in 2014. Philanthropists were among the quickest to understand the importance of nipping the epidemic before it spread.
Paul Allen, a major donor since retiring after co-founding Microsoft, had been watching Ebola for years. Back in 2009 he funded a project at Kansas State University to adapt an Ebola vaccine for use with wild apes. Perhaps a third of African gorillas and chimpanzees have been killed by the Ebola virus since the 1990s, and these infections give the virus easier pathways to humans. So it is perhaps not surprising that Allen led philanthropic responses to the 2014 outbreak of the disease, saying “I am committed to doing my part in tackling this crisis…to prevent it from becoming a global epidemic.”
Allen offered $100 million of his own money to a mix of immediate and longer-term efforts to tamp down the virus. He helped convince other donors to contribute as well, including $50 million from the Gates Foundation, $25 million from Mark Zuckerberg, and other large and speedy gifts. The emergency operations director of the U.S. Centers for Disease Control later attributed the successful control of the 2014 Ebola outbreak in West Africa “to the huge contribution made by Paul Allen.” The almost instant speed with which Allen’s foundation delivered the money made it possible to dispatch 500 emergency health responders and all of their equipment to Liberia and two other countries where the disease was ravaging thousands.
Gerald Chan worked on a master’s degree and then a doctorate at the School of Public Health at Harvard in the 1970s. After that he pursued medical research for a period. Eventually he entered the family business of real-estate development and founded his own investment fund.
Grateful for his education, and alarmed by growing international threats like Ebola, in 2014 Chan and his brother gave Harvard the largest single gift in its history—$350 million—to bolster the endowment of the university’s public-health school. The money will be used for things like increased financial aid for the 1,000 students who are enrolled in the school at any given time, forgiving loans for graduates willing to work in underserved areas, improved faculty recruitment, and funding for early-research projects. “While medical doctors give health benefits to individual patients, public health is a field that helps to give benefit to the whole population,” Chan told the Boston Globe in announcing the family gift.
Chan’s gift was just the latest and largest in a string of donations that have energized this field. Michael Bloomberg provided tens of millions of dollars to build up the school of public health at Johns Hopkins University (the world's largest). Then in 2016 he gave the school an additional $300 million. In 2014, Michael Milken donated $40 million to the school of public health at George Washington University. In 2007 the Rollins family doubled the size of the public-health facility at Emory University with a $50 million grant, and the Gillings family made a similar $50 million investment in the school at the University of North Carolina at Chapel Hill. And Columbia’s public-health program was strengthened by one of the first large philanthropic infusions to this field, a $33 million gift in 1998 by Joseph Mailman.
Marie-Josée Kravis has served on the overseers’ board at the Memorial Sloan Kettering Cancer Center for decades, and she heads the board of its research arm, the Sloan Kettering Institute. Her husband, financier Henry Kravis, was also interested enough in the Center to ask officials whether its long experience in the field could be combined with new advances in gene sequencing. The Kravises eventually offered $100 million to create a new center for molecular oncology at the New York City facility. Within a week of the public announcement, six new-generation gene-sequencing machines were being installed at the hospital. These will be used not only to analyze the tumors of 10,000 active patients each year, but also to explore the characteristics of “archived” tumors from more than a million patients who have been treated at MSK since 1980. The genetic qualities of each preserved tumor will then be compared with the archived records of that patient’s care and his or her final treatment outcome. This cross-referencing of deep biological and clinical records could uncover important patterns previously undetected by physicians, and lead to new directions in treatment.
In the last decade or so, Johns Hopkins University has jumped to the top of the charts when it comes to cancer research and treatment, and this has been particularly powered by philanthropy. The university’s state-of-the-art program for investigating cancer and teaching students is centered in the Bunting Blaustein Building, launched by twin $10 million gifts from each of those families. Another $20 million gift created the connected David Koch Research Building in 2006.
Inside those structures labor teams led by Bert Vogelstein and Kenneth Kinzler, two cancer investigators with more citations in scientific papers over a recent ten-year period (50,000+) than any other researchers in the world. Their work was supercharged in 2006 by a $20 million open-ended gift from the foundation of Daniel Ludwig (see 1971 entry), which they used to create the first genomic maps of cancer. Of the 75 cancers which had been genetically sequenced as of 2014, fully 68 were mapped at Hopkins. Hopkins also became a leader in developing cancer screening tests, cancer vaccines, and therapies like bone-marrow transplants. In 2014, the Ludwig trustees made an additional $90 million grant to Johns Hopkins.
Like many other lab directors (see Eric Lander’s remarks in 2012 entry on the Broad Institute, Charles Marmar’s observations in his 2013 entry, and Leroy Hood’s comments in entries below dated 2000, 1986, and 1982), the co-directors of the Ludwig Center at Hopkins have remarked on the outsized importance of philanthropic gifts in allowing laboratory breakthroughs that traditional research grants won’t back. “The Ludwig bequests have revolutionized what we’ve been able to do,” says Bert Vogelstein. “We’ve pursued some of the most important questions in cancer—not necessarily the most fundable questions.”
When asked by a reporter, “Your discoveries have outpaced much larger laboratories. What is the key to this success?,” Kenneth Kinzler answered: “Part of the reason we have been so successful and beaten huge groups is because of our Ludwig funding. It allows us to do what’s important. Our focus is not decided by committee. We could do the most groundbreaking research without having to worry about where the next level of funding would come from.... We try to develop research projects that are not in the mainstream now.”
Kinzler adds that, “Our current research programs focus on diagnostics for the early detection and prevention of cancers thanks, in large part, to Ludwig support. Compared with treatment research, early detection and prevention research is underfunded, but it can potentially make more of an impact on reducing cancer deaths. It takes a long time and a sustained effort to see the results of cancer prevention and early detection studies. Ludwig funding will enable us to carry this and many other research projects forward.”
The tradition of timely and intelligent cancer philanthropy at Johns Hopkins has continued in recent years. Around 2013, the university realized that with its treatment of cancer patients expected to increase 35 percent or more over the next decade, it needed a new building where therapies could be offered to the ailing. The foundation of Albert “Skip” Viragh solved that in one fell swoop by providing $65 million in 2014 to cover nearly all of the construction costs for a new center. A Marylander who started a mutual fund and grew it into a $9 billion entity, Viragh died of pancreatic cancer himself. His foundation previously established a center for research and care of that disease with a $20 million gift to Hopkins.
The Viragh building relieves pressure on a prior cancer-treatment center that opened in 1999 thanks to a $20 million pledge from the Harry and Jeanette Weinberg Foundation. The Weinberg and Viragh structures are complemented by a facility located across the street that offers subsidized housing for patients and their families while they are in therapy. It was funded by the Hackerman family (who also endowed a lab and oncology chair at the cancer facility).
Umbrella funding over all of Hopkins’s cancer work came from businessman Sidney Kimmel, who gave $150 million in 2001. He donated an additional $50 million in 2016, matched by $50 million from Michael Bloomberg, and another $25 million from other donors, so that Johns Hopkins could dive deeply into immunotherapy—one of the most promising new techniques for battling cancer. The university was at risk of losing its leading researchers unless it created a new venture to let them move fast and deeply into the emerging field, which it quickly did by relying on philanthropy—the keystone on which Johns Hopkins has built its rise to the heights of cancer work.
One of the commonest injuries of the Iraq and Afghanistan wars, also a domestic concern thanks to auto and sports accidents, is brain injury. The resulting depression, irritability, and stress disorders can be almost impossible to document and measure, and thus hard to treat. A $17 million donation to New York University by financier Steven Cohen and his wife, Alexandra, aims to find out if brain injuries and mental health conditions can be assessed more concretely.
In a five-year study of 1,500 military veterans, NYU psychiatrist Charles Marmar and his lab will see if they can establish characteristic biomarkers of mental disruption. Hormone levels, blood chemistry, brain images, genetic clues, even voice patterns, will be assessed to see if any of these reliably signal disability or illness after a concussion. Just as certain blood proteins and brain shrinkages are now known to indicate Alzheimer's, the hope is that physical indicators can be established for syndromes like PTSD. That should improve diagnosis and treatment. “We want to elevate mental health to standard physical health,” says Marmar.
Marmar told the audience at a 2014 Philanthropy Roundtable gathering that the speed, flexibility, and non-bureaucratic nature of private donations were crucial to getting his project off the ground. “I’ve been a National Institutes of Health researcher for decades, and to get an NIH grant from the government you essentially have to already have solved the problem in question.” His business-experienced donors, however, were comfortable in undertaking highly speculative investigations, recognizing that huge benefits could result if the experiment succeeds.
In addition to $800 million of medical donations to his native region of South Dakota, businessman Denny Sanford has been an important angel for medical research in San Diego—a national center for that work, and a second home for Sanford. He began by providing $70 million, in two chunks, to what is now known as the Sanford Burnham Prebys Medical Discovery Institute. His gifts sparked a subsequent $275 million donation offered anonymously, and then a $100 million gift from philanthropist Conrad Prebys.
Sanford Burnham Prebys has become one of a half-dozen bio-med powerhouses in San Diego, nearly all of them cooperating in a research alliance that Sanford established with a $30 million gift. The Consortium for Regenerative Medicine aims to accelerate practical therapies in its field by developing new drugs and treatment plans for patients. Sanford provided another complementary nudge in 2013 when he offered $100 million to consortium member University of California, San Diego to launch a stem-cell clinic in the region. Sanford has now provided $200 million to the hotbed of San Diego charities working to transform the promise of regenerative medicine into a practical, lifesaving reality.
Back in 2008, South Dakota businessman Denny Sanford gave $80 million to bolster the Consortium for Regenerative Medicine in San Diego. In 2013, Sanford donated an additional $100 million to establish the allied Sanford Stem Cell Clinical Center at the University of California, San Diego. Building on the same hope for new therapies that motivated the regenerative medicine consortium, the new center aims to help transform promise into reality by accelerating the development of new stem-cell-derived drugs and treatment plans for patients. The particular focus will be clinical trials which attempt to translate research into everyday medical practice. With this gift, Sanford passed the $1 billion mark in lifetime donations, with most of his funding going to health-related causes.
In 2008, Penny and Phil Knight (co-founder of Oregon-based Nike Sportswear) donated $100 million to the Oregon Health and Science University to create the Knight Cancer Institute. The university’s prior cancer institute had grown to prominence and then hired one of the top cancer researchers in the world, Brian Druker, as its director in 2007. Druker launched the world’s first drug to target a genetic weakness in a particular cancer when he developed Gleevec, which smothers myeloid leukemia by targeting an enzyme that triggers the disease. Gleevec has saved tens of thousands of lives since it burst onto the scene in 2001 and is credited with inspiring a whole train of similar potentially revolutionary drugs that zero in on specific cancer genes, thereby shutting down tumors without harming healthy surrounding tissue.
Armed with the $100 million Knight donation, Druker and his colleagues went on a hiring spree shortly after his arrival, attracting some of the brightest minds in the field to OHSU. 1n 2009, Druker received one of the Lasker Awards established by philanthropy to encourage top medical investigators (see 1945 entry).
Then in late 2013, the Knights announced they would donate an additional $500 million to OHSU if the university could raise the same sum from other donors within two years. (In between these two anti-cancer gifts, Penny and Phil Knight had donated $125 million to support cardiovascular medicine and research at OHSU.) If the university could meet its side of the challenge, its president concluded the day after the Knight’s announcement, their cancer program would leap “from excellence to true preeminence.” Thanks to many additional gifts, including one of $100 million given by Gertrude Boyle—the chairwoman of Columbia Sportswear, whose sister was a pioneering biologist and a cancer victim—the university announced in 2015 that it had collected sufficient donations to match the Knight pledge..
Back in 2002, entertainment executive David Geffen donated $200 million without restriction to the medical school of UCLA, the single largest gift ever to a school of medicine. In 2012 he made an even more interesting donation to the school—a $100 million endowment to allow one fifth of each incoming class of medical students at UCLA thereafter to attend free of charge.
Geffen stipulated that the scholarships would be awarded by merit, allowing UCLA to attract some of the very best medical candidates in the country. And he included in the pool of students he would support those on a combined M.D./Ph.D. track—a path from which many medical-research breakthroughs emerge, though it is generally much less lucrative for the individual. The average newly minted doctor today leaves med school with a debt burden of about $200,000, which constrains subspecializations, regions of practice, and other career decisions.
One out of every two American men, and one out of three women, will be diagnosed with cancer in his or her lifetime. In 2012, the Broad Institute (see 2003 entry) announced one of its typically ambitious efforts to get at the root of this plague. They would build a public archive listing the genetic aspects and chemical susceptibilities of 947 different types of human cancer. Called the Cancer Cell Line Encyclopedia, this compendium of uncommon data on sadly common afflictions will help scientists understand cancer, predict its course, and design therapies and drugs. The encyclopedia is a philanthropy/industry collaboration involving the Broad Institute, the Dana-Farber Cancer Institute, and research elements of the drug company Novartis.
The M. D. Anderson Cancer Center lies at the heart of the remarkable Texas Medical Center, which has become by far the world’s largest complex for healing the sick. The TMC, which CEO Richard Wainerdi describes as “probably the biggest confluence of philanthropy in the world,” currently has more than 41 million square feet of office space. Every year the complex hosts 7.1 million patients, 350,000 surgeries, and 28,000 births. The first coronary bypass surgery in the U.S., the first heart transplant, and many other important medical innovations took place within the TMC. A wide range of top-flight hospitals and other medical facilities are now located in the center, which grew up around M. D. Anderson after it admitted its first patients in 1944.
The depth and power of Houston medical philanthropy can be seen in the capital campaign M. D. Anderson launched in 2006, with a goal of raising $1 billion in six years. The campaign was halted two years early when it passed the $1.2 billion mark. At that point more than 630,000 individuals had made gifts and a staggering 127 donors had given at least $1 million. In 2012, M. D. Anderson’s regular annual philanthropic support totaled more than $190 million. In 2013, the center announced a $50 million gift from Texas philanthropist Lyda Hill toward a new $3 billion “Moon Shots Program” that aims to make fundamental research progress against killer cancers.
M. D. Anderson has applied this deep support to make itself a world leader. The hospital will serve its millionth patient within the decade. And in the U.S. News & World Report rankings it has been named the top cancer center in the U.S. for ten of the last 12 years. Other hospitals and treatment facilities within the Texas Medical Center have likewise benefited from private philanthropists—who made more than half a billion dollars of gifts to the wider complex in 2013 alone.
Malaria remains one of the most intractable diseases in the developing world, killing one million people a year and damaging the economic productivity of many more. Large resources have already been poured into combating the disease, yet a McKinsey study has noted that $11 billion more would be needed to end malaria deaths in the 30 worst-affected African countries. One promising alternative funded with support from the Bill & Melinda Gates Foundation is a vaccine. In 2011, the first-ever malaria vaccine was announced. It is still in trial stages, but so far seems to prevent severe symptoms in half of the individuals who receive it, while offering extra protection to infants and toddlers. While efficacy rates need to be improved before the vaccine is put into wide use, the initial findings have begun discussions about the long-dreamed-of possibility of widespread immunization in endemic countries.
In 2013, the Gates Foundation entered into an innovative pact with a consortium of investors and drug makers that will invest in bringing to market new therapies like a malaria vaccine, as well as drugs and technologies combating diseases like tuberculosis and HIV that also weigh heavily on poor countries. Gates’s role will be to offset potential losses in the so-called Global Health Investment Fund. By eliminating some of the downside risk in the expensive business of developing new medicines, the foundation intends to stimulate more aggressive private investment.
The Gates Foundation also continues to spend heavily on other types of anti-malaria research and on treatment and practical measures to eliminate the disease. For instance, it announced in 2016 that it would put up $200 million per year over the following five years to support a new British blitz to eliminate malaria deaths.
Tooth decay is the most common chronic childhood disease, with recent research suggesting it can lead to a wide variety of other health problems. Even though tooth decay is a preventable disease, many children face barriers that make it hard for them to obtain basic dental care. In particular, residents of isolated and rural communities, like Indian reservations, can be underserved. It’s estimated that millions of Americans live in areas with a shortage of dentists and that the U.S. could use an additional 9,000 dental-care providers.
In response, the W. K. Kellogg Foundation established a new dental therapy program for children in 2010, starting in five states. The program promotes prevention and builds understanding of the importance of dental health. It funds mobile dental vans to reach rural and underserved areas, plus dental education, training for “dental therapists” who can substitute for dentists in underserved areas, and educational grants for underrepresented minorities to attend dental school. The Kellogg Foundation has drawn lessons from philanthropy-assisted community programs used to bring good dental care to remote parts of Alaska (funded by the Rasmuson and then Robert Wood Johnson Foundations—see 2006 entry on Local Achievements list) and is now a leader in addressing this widespread but highly avoidable problem.
The founder of a firm that makes many of the plates and screws used to repair broken bones, sold to Johnson & Johnson for $20 billion, gave $125 million in 2009 to establish an institute for “biologically inspired engineering” at Harvard, the largest single gift ever received by the university. In 2013, Swiss-born Hansjoerg Wyss gave another $125 million for the same purpose to the school where he earned his MBA in 1965. Thanks to these gifts the Wyss Institute now employs 350 full-time researchers working on programs such as Human Organs-on-Chips—microchips lined with human cells that are poised to revolutionize drug development and environmental testing by replacing animal studies; a Biospleen that cleans blood of many toxins and pathogens by mimicking the body’s natural immune system; a new surface coating called SLIPS that prevents blood coagulation in dialysis devices and tubing; and many other practical products. Aiming to bridge the divide that separates academic labs from products and drugs with immediate practical value, the Wyss Institute is involved in a spectrum of activity stretching from basic scientific research to industrial fabrication to business development. Wyss also has supported medical research at Clemson University, the University of Washington, the University of Mississippi, the University of Maryland, the University of South Alabama, and Children’s Hospital of Philadelphia.
Research has shown that one third of Medicare patients who leave a hospital will be readmitted within 90 days, and that a large portion of these rehospitalizations are unnecessary, due to things like patients not taking their medications properly. The costs of these elderly patients churning in and out of hospitals are high: unhappy patients, burdens on family members, and tens of billions of dollars in public health-care expenses. Studies in 2008 and 2006 estimated that patients unnecessarily returning to hospital within just the first 30 days cost a total of $49 billion.
To combat this, health-care providers at the University of Pennsylvania developed what they called the Transitional Care Model, which used nurses to train patients and caregivers in how to manage their medications and therapies and avoid future health issues, and then make sure in home visits that the instructions are being followed. This was not a program for long-term care, but strictly an effort to bridge between the hospital experience and the first months back at home. When the effort proved very successful, a program was launched to demonstrate the cost-effectiveness of this approach to insurers and health-care operators. This was done with financial support from five philanthropies: the Commonwealth Fund, the Jacob & Valeria Langeloth Foundation, the John Hartford Foundation, the Gordon and Betty Moore Foundation, and the California HealthCare Foundation.
Careful academic studies showed powerful results: improved health, greater patient and caregiver satisfaction, and a whopping 30 to 50 percent reduction in rehospitalizations, heading off unnecessary costs of nearly $5,000 per patient. When the program costs of $456 to $1,019 per patient are factored in, net savings came to approximately $4,000 per elderly participant. With this evidence in hand, health insurers began voluntarily integrating transitional care models into their coverage plans starting in 2009.
The Robert Wood Johnson Foundation, America’s third-largest private grantmaker, with a strong focus on health issues, announced a half-billion-dollar commitment in 2007 to research how fast-rising childhood obesity could be slowed through improved diet and exercise. As their campaign wound down, child obesity wasn’t rising fast any more; in fact it had begun to decline among younger children—from 14 percent of all two- to five-year-olds in 2004 to 8 percent in 2012. Buoyed by that progress, the foundation announced an additional $500 million commitment in 2015, bringing its total spending to a billion dollars. The next phase of the effort will emphasize educating parents on the advantages of a healthy diet, with a particular emphasis on poor and minority families, where obesity is commonest. More exercise, improved nutritional content in school lunches, calorie reduction in snacks and drinks, and similar efforts will be supported by foundation grants.
The business triumphs of Denny Sanford allowed him to retire to Florida at age 45—but he was soon itchy and returned to the upper Midwest where he had spent his entire previous life. After further commercial successes, he started giving away money.
Having lost both of his parents to illness a few years after he was born, his philanthropic passion was medicine. He turned his attention to the Sioux Valley Hospitals and Health System, beginning with a $16 million gift for a children’s hospital designed like a fairy castle. With his $400 million donation in 2007 (the largest single gift ever made to a U.S. health-care organization), the nonprofit was renamed Sanford Health. Sanford Health now includes nearly three dozen hospitals and more than 140 clinics, centered on South and North Dakota but spread across eight states, making it one of the largest rural, not-for-profit health systems in the nation. After the latest in Denny Sanford’s string of gifts to the health system—a $125 million donation made in 2014 that launched new efforts to tailor patient care using genetic information—his total contributions to Sanford Health exceeded $800 million.
In Fargo, Sanford Health is in the midst of one of the largest construction projects in the history of the Dakotas. The result will be a top-shelf medical facility filled with the best technology and some of the brightest medical experts in the country. It will bring a new level of care to the region, including a major trauma center, enhanced pediatric services, a heart center, an expanded cancer center, and new services in areas such as eating disorders and rehabilitation.
Sanford has also made massive medical-research donations in the San Diego area. (See 2013 entry.) A signatory of the Gates-Buffett Giving Pledge, Sanford says he aims to “die broke.” That day comes a little closer with each subsequent gift, with Sanford’s lifetime philanthropic giving having roared past the $1 billion mark in 2013.
Industrialist David Koch is one of the most active medical philanthropists in American history. He currently sits on about a dozen hospital boards. He has provided $30 million for cancer research at Memorial Sloan Kettering and $150 million for its new cancer outpatient center (see 2015 entry), $20 million for a cancer center at Johns Hopkins, $25 million to M. D. Anderson Cancer Center, $15 million to New York-Presbyterian, and $25 million to the Hospital for Special Surgery in New York. He also supports Rockefeller University, Cold Spring Harbor Laboratory, and the Whitehead Institute. From 1998 to 2015, he donated about $600 million to support medical research and treatment.
His 2007 $100 million donation to the Massachusetts Institute of Technology created the David Koch Institute for Integrative Cancer Research—which aspires to energize the battle against cancer by drawing more engineers into the biological sciences. (Koch comes from a family of engineers.) The new facility opened in 2011, and its 650 investigators are working on projects like the one that uses nanoparticles to deliver chemical toxins directly and solely to a tumor instead of flooding the entire body with toxins as conventional chemotherapy does. The radical new therapy is now being tested, successfully, on patients suffering from advanced cancers.
When a hospital focused on children opened in San Diego in 1954, the city received it as a godsend as it suffered through another polio epidemic. The facility initially treated just 12 patients, and the hospital was gradually built up by a long string of donations. The biggest leap forward came in 2006, when hometown real-estate investor Ernest Rady donated $60 million, in addition to offering leadership on the hospital board. This soon turned the San Diego children’s hospital into the largest such facility in California.
In 2014 Rady and his wife, Evelyn, presented an additional $120 million. This created an institute at the hospital that will apply genomics and other emerging medical knowledge to the treatment of its child patients, cementing its position as a prominent research and teaching institution as well as a saver of young lives.
Financier Cornelius Vander Starr was an active but quiet philanthropist. His Starr Foundation, established in 1955, also maintains a low profile, though it has given away nearly $3 billion during its operating years, more than half of that in New York City. The group has a particular emphasis on fostering collaboration among successful civic institutions operating in the areas of medicine, education, public policy, and culture.
This longstanding strategy resulted in a burst of important medical grantmaking in 2005 to 2006. First a medical-research collaboration called the Tri-Institutional Stem Cell Initiative was announced—a $50 million grant to encourage the world-leading biomedical researchers at Rockefeller University, the cancer experts at Memorial Sloan Kettering, and the faculty at Cornell’s Weill Medical College to cooperate in stem-cell work. (This initiative was renewed with an additional $50 million gift to the same three institutions in 2012.)
The second collaboration, launched in 2006, donated $100 million to the same three adjoining New York research organizations, plus two others, to create the Starr Cancer Consortium. (This new effort was likewise renewed in 2012, with an additional $55 million donation.) A third large Starr Foundation gift announced in 2006 sent $50 million to Rockefeller University to create a Fund for Collaborative Science. The Starr gift was paired with a $100 million pledge from David Rockefeller, $25 million given by investor Russell Carson, $15 million from financier Henry Kravis, a $25 million anonymous gift, and others.
Starr Foundation donations of more than $300 million have thus sped discoveries in basic biomedicine, and reinforced valuable cross-fertilization among the critical mass of research talent in the New York metro area.
Sportswriter Rick Reilly first learned about malaria’s toll in Africa from a BBC documentary. He was struck by the film’s rhetorical question: “Did you know that every day 3,000 children in Africa die of malaria, needlessly?” Reilly was even more impressed by the ready availability and low cost of one easy solution: $10 bed nets treated with insecticide. Reilly dedicated his May 5, 2006 Sports Illustrated column not to sports, but to malaria. He exhorted his readers to donate ten lifesaving dollars to an anti-malaria charity.
To his great surprise, the campaign collected over $1 million in its first month. Soon, celebrities and public figures lent their support to the campaign. Major League Soccer and the National Basketball Association became sponsors. The United Methodist Church and the Lutheran Church pledged to raise up to $100 million each. Corporate sponsors like Orkin Pest Control and Makita Tools joined in. The initiative soared primarily on a multitude of small donations from more than 70,000 individuals, averaging $60 each. Because Ted Turner’s $1 billion donation covering all of the administrative costs of the United Nations Foundation (which managed the Nothing But Nets funds), 100 percent of the giving went to mosquito nets (whose price dropped to $3 per net as production soared over the next several years).
While governments and international organizations have strived to eradicate malaria for years, Reilly’s campaign raised public-awareness cheaply and at unprecedented speed. Nothing But Nets made possible the distribution of more than 10 million mosquito nets to vulnerable residents of Africa. The effort primed the pump for the nearly simultaneous establishment of groups like Malaria No More, a charity that helped take the crusade to a larger scale. Founded in 2006 by financier, Wesray Capital principal, and philanthropist Raymond Chambers, it and many other allies made anti-malaria efforts an international phenomenon. As of 2017, well over a billion bednets have been delivered to Africa, along with millions of treatments and diagnostics. Annual malaria deaths dropped by half, saving about 400,000 lives every year.
Early in the new millennium, Montana was one of the top ten states in methamphetamine usage. Fully 53 percent of kids in foster care were there because of meth, 50 percent of adults in prison had committed meth-related crimes, and the drug was costing the state tens of millions every year—not to mention human lives.
When Montana resident Tom Siebel learned of this, he wanted to do something about it. Siebel was a software developer who had made billions creating programs to manage customer relations. He began investing his own money to create the Montana Meth Project, which in 2005 launched the first of its memorable ad campaigns. The ads, ranging from billboards to television, show the effects of meth on the human body, relationships, and more—in graphic detail. The idea was to show teens (the target age group was 12-17) what they were getting into. The campaigns were based on extensive research about what kinds of communication and advertising had an effect on teenagers, and they were aired in such quantity that the project became the single largest advertiser in the state.
From 2005 to 2010, meth usage in Montana declined 63 percent according to the Montana Office of Public Instruction, a result of the public education done by the Meth Project, increased law enforcement, and state rehab programs. These results impressed Montana’s neighbors enough that by 2012 there were spinoff programs, also aided by Siebel, in several other states. The Montana Meth Project has won more than 50 awards and was named the third most effective philanthropy in the world by Barron’s.
Since 2000, the Thomas and Stacey Siebel Foundation has granted $230 million to various charitable causes, including more than $30 million to the Meth Project.
Charles Feeney has nothing named for him at the University of California, San Francisco School of Medicine, but he built much of the facility. His $100 million check written in 2015 to support faculty, students, and building projects brought his total giving to the medical school, which started in 2004, to $394 million. That is not Feeney’s record in education giving—he has donated about a billion dollars in total to Cornell University—but it is the most any individual has donated to any campus of the University of California.
And Feeney’s support has allowed the UCSF medical program to bloom. The school is now ranked as one of the finest in the country, and in 2014 led the list of U.S. medical schools winning biomedical research awards from the National Institutes of Health. UCSF’s allied nursing, dentistry, and pharmacy schools were also top ranked that year in NIH grants.
Marc Benioff, founder of Salesforce.com, is another generous supporter of UCSF, having channeled $200 million to the children’s hospitals affiliated with the university.
Philanthropists Eli and Edythe Broad put up $100 million in 2003 to start a new type of biomedical research center: One that seeks to revolutionize clinical medicine by building deep understanding of the human genome. They later followed up with donations of an additional $600 million, for a total gift of $700 million.
The Broad Institute is an independent nonprofit run as a collaboration among the Massachusetts Institute of Technology, Harvard University, and the Whitehead Institute. It quickly became one of the top biomedical research facilities in the world. The Broad Institute seeks to describe all the molecular components of life, to understand the molecular basis of disease, and to share this information widely.
Of the launch money from the Broads, $400 million was put into an endowment. That philanthropic kernel throws off $20 million of investment income every year. The institute is able to direct those funds into whatever it wants, with no strings attached.
“Our unrestricted funds are gold, they’re magic,” states director Eric Lander. “We’re able to say when we have a good idea, ‘Let’s start investing in it now,’ rather than writing a grant and start working on it two years from now after it wends its way through the NIH system.”
FasterCures, founded in 2003 with funding from the Sumner Redstone Charitable Foundation, Milken Family Foundation, and other donors, is a nonprofit that chips away at practical obstacles that slow medical progress. Its goal is to accelerate the movement of ideas from lab experiment to patient treatment, and its methods aim to link health researchers more closely with philanthropists, policymakers, and business investors. The organization’s annual Partnering for Cures event has become an influential gathering of leaders from medical research, industry, foundations, and policy organizations. In 2007, FasterCures joined with the Robert Wood Johnson Foundation and the Bill & Melinda Gates Foundation to create a Philanthropy Advisory Service that guides donors to smart medical investments. In addition to counseling many private givers the group has influenced decisionmaking at the National Institutes of Health.
One result of FasterCures has been to heighten interest in so-called “orphan diseases” which affect too few victims to attract major interest from either pharmaceutical companies or government agencies. FasterCures and the Philanthropy Advisory Service both offer extensive support for disease-specific philanthropy—from compiling “disease landscape reports” that summarize the latest research efforts, to offering “investment opportunity landscapes” which identify key investigators and paths to treatment for a specific disease.
FasterCures benefited from some of the lessons learned by Michael Milken while funding his Prostate Cancer Foundation (see 1993 entry). A 2004 Fortune magazine cover story entitled “The Man Who Changed Medicine” summarized his approach:
The Milken model, in a nutshell, is to stimulate research by drastically cutting the wait time for grant money, to flood the field with fast cash, to fund therapy-driven ideas rather than basic science, to hold researchers he funds accountable for results, and to demand collaboration across disciplines and among institutions, private industry, and academia.
“Of all the programs we’ve supported over the last generation,” Milken concludes, “the biggest payoff…has come from the awards to young investigators.” His organization funded Lawrence Einhorn, who went on to develop a highly successful chemotherapy regimen for testicular cancer, and Charles Myers, subsequently chief of the clinical pharmacology branch of the National Cancer Institute. They supported Dennis Slamon, who discovered Herceptin, a major advance in the treatment of one type of breast cancer, and Owen Witte, whose subsequent work provided the basis for development of the cancer-inhibiting drug Gleevec. Milken backed Bert Vogelstein, who went on to conduct pathbreaking investigation on the p53 gene, whose mutant form is believed to be involved in more than half of human cancers..
One of the most effective ways to stem disease is early detection. Access to diagnostic tests remains a significant challenge for developing countries, in part because of the high cost of delivery and transport to remote areas. To address this problem the Foundation for Innovative New Diagnostics was launched in 2003 to develop urgently needed diagnostic tests for tropical diseases. The goal is to provide highly affordable point-of-care tests that will help control the spread of disease in endemic countries. This new organization and its work were made possible almost entirely by grants from the Bill & Melinda Gates Foundation, which considers fighting infectious disease in developing countries its first health priority.
In recent years, brain research has been a rising interest among philanthropists. For instance, Microsoft co-founder Paul Allen donated $200 million in 2003 to establish a Seattle-based nonprofit aimed at accelerating understanding of the human brain and its diseases. Among other projects, the Allen Institute for Brain Science produced interactive atlases of the mouse brain and the human brain, which have become staple tools for scientists worldwide.
In 2012, Allen pledged an additional $300 million to the institute, allowing it to increase its staff to 350 employees and to undertake deeper studies in three areas: how the brain processes information; what the basic structures of brain function are; and what goes wrong in brain cells to create neurological disorders. Freed of the need to repeatedly apply for federal grants, and working in teams more like an Internet firm or corporate lab, Institute researchers have made rapid progress in their chosen fields. When the federal government launched a $100 million human-brain initiative in 2013, Allen Institute researchers provided shape to the plan.
In 2017, Paul Allen funded a new center focused specifically on understanding how the human brain developed so fast and so far over the last 50,000 years. This new effort, based at Boston Children’s Hospital, was launched with a $10 million grant, expandable to $30 million as it yields fruit. Identifying genes crucial to our brain evolution will be a particular goal.
Other donors have also made important contributions to neurological research. Patrick and Lore McGovern made one of the largest philanthropic gifts to a university when they donated $350 million to MIT in 2000 for creation of the McGovern Institute for Brain Research. Inventor Fred Kavli funded brain institutes at Columbia, Yale, Johns Hopkins, Rockefeller University, and the University of California. In 2013, property developer Mortimer Zuckerman donated $200 million to Columbia University to endow a new neuroscience institute whose “mission is both greater understanding of the human condition and the discovery of new cures for human suffering.” The innovative Center for Brain Health of the University of Texas at Dallas has been built up with broad philanthropic support since its founding in 1999.
In 2015 the O’Donnell Foundation pledged $36 million to start a new Brain Institute at the University of Texas Southwestern Medical Center. The same year, venture capitalist Mark Stevens donated $50 million to create a brain center at USC, and Atlantic Philanthropies gave $177 million to establish a dementia-research project run jointly by Trinity College in Ireland and U.C. San Francisco. In 2016, new neuroscience institutes were established at U.C. San Francisco with a $185 gift from Sanford Weill, and at Caltech with a $115 million pledge from a Singaporean couple. Both will mix experts from medicine, biology, engineering, chemistry, computer science, and other fields to understand brain functions outside of typical academic boundaries.
The Brain & Behavior Research Foundation is another philanthropically funded organization that has dramatically advanced neurology and psychiatry. In 1987, the group began offering grants and prizes to young researchers in the brain sciences. By directing more than $300 million to 3,300 scientists, the organization has become not only the world’s leading private funder of mental-health research, but an important spur to innovation in the field—particularly by encouraging promising young investigators with its research grants, and recognizing neurological breakthroughs with its five lifetime-achievement prizes.
Electronic health records that are consistent, interchangeable, and accessible by consumers and health professionals from anywhere will be essential to many future advances in health care, including medicine that is personalized to the patient, better quality control, and reduction of duplication and waste that inflates prices. It’s estimated that electronic health records could save more than $100 billion in unnecessary medical costs.
Back in 2002, when universal electronic records were just starting to be discussed seriously, the Markle Foundation put up $2 million to launch Connecting for Health. The foundation acted as a neutral convener on this contentious topic, bringing together computer experts, medical professionals, insurers, government, and other interested parties—rejecting no one who wanted to participate. When the effort began to show promise, the Robert Wood Johnson Foundation became a partner and put additional millions into supporting regular exchanges of information among participants.
In 2003, Health and Human Services Secretary Tommy Thompson announced, with thanks to the Markle Foundation, that the standards produced out of the Connecting for Health meetings would be adopted by the federal government as it moved toward personal electronic health records. Duke University’s philanthropy center concluded that the Markle Foundation’s inclusive approach made it irreplaceable in this success. “The value added by Markle’s participation has been widely recognized. As a private foundation, Markle was able to fill a key niche: that of the convener. No other entity, public or private, would have been able to conduct the discussions that led to the Connecting for Health standards.”
The attacks of September 11, 2001 prompted an unprecedented outpouring of American giving. The American Red Cross organized one of the nation’s largest charity drives after 9/11, called the Liberty Fund. Americans donated more than $752 million to this fund to provide medical care and aid to survivors of the attacks and their families. Counting donations to other organizations, a total of more than $2.8 billion was offered to charitable causes after 9/11.
Researchers believe this historic outpouring set new standards for disaster relief and set the table for other massive surges of emergency giving by Americans in the years since—including $1.9 billion to the victims of 2004’s Pacific tsunami, $1.5 billion in relief to Haiti after its 2010 earthquake, and a record $5.3 billion charitable outpouring in the immediate aftermath of Hurricane Katrina.
Systems biology is a new approach that studies complex interactions among networks of cells, tissues, and organisms, with the view that many aspects of biology and medicine cannot be understood except as interlinked phenomena. This often requires complicated measuring of simultaneous factors and then integration of the data using mathematical models. Another name often applied to this emerging discipline is quantitative biology. The deluge of data now being generated by automated gene sequencing, advanced imaging, and other technologies has overwhelmed the ability of biologists to make sense of it—so mathematicians, physicists, and statisticians are migrating into the field to help them draw useful inferences and models of complex life processes.
When government and commercial support for this new and highly speculative field proved impossible to come by in the early days, the seminal Institute for Systems Biology was established in 2000 as a nonprofit research organization supported by philanthropic funds. Individual donors like Bay Area financier Bill Bowes, whose William K. Bowes Jr. Foundation contributed $6 million, collectively offered $30 million to start the institute.
As it established scientific breakthroughs, this philanthropically launched organization (and its wider discipline) also began to attract hundreds of millions of dollars of venture capital. By 2012, ISB had spun off 17 separate for-profit companies. That same year, the Institute for Systems Biology was ranked as the fourth most successful scientific-research institute in the world (assessed by the impact of their published papers), and today there are 70 or 80 copycat institutes located across different parts of the globe.
“That’s the kind of thing that a front-end investment by philanthropy can lead to,” comments ISB founder Leroy Hood. “What I’ve always loved about philanthropy is it’s money that has a potential to be flexible. It’s money that can catalyze new ideas. It’s money that lets you push the frontiers, follow the leading edge. Hard to do that at the National Institutes of Health. Today, if you haven’t completed two thirds of your research, you’re probably not going to get a NIH grant because everything is so competitive and so conservative. So a philanthropist who is willing to say ‘Yes, I’ll step in and help you find something new’ is a jewel.”
Hedge-fund founder James Simons has stepped up as a donor in just this way. In 2005 he funded the Simons Center for Systems Biology at Princeton. Three years later his foundation put additional millions of dollars into quantitative work at Rockefeller University, one of the foremost biological research institutions in the country. He also planted seeds that year at Cold Spring Harbor Laboratory, a birthplace of molecular biology. Those seeds entered full bloom in 2014 when James and Marilyn Simons donated $50 million to expand and institutionalize the Simons Center for Quantitative Biology at Cold Spring Harbor Lab.
In the 1980s, researchers uncovered the genetic cause of cystic fibrosis. But by the late 1990s only incremental improvements in treatment were in place, despite decades of investments in researchers by the Cystic Fibrosis Foundation. Most sufferers of the disease continued to pass away by their 30s.
So in 1999, the foundation decided to shift gears. Instead of just funding academic researchers, it would put money directly into pharmaceutical companies, seeking to speed useful drugs and also to interest the industry in making its own larger investments in lifesaving treatment. The Cystic Fibrosis Foundation eventually poured $450 million into investments in a variety of small and large drug companies, an example of what is sometimes called “venture philanthropy.”
These bets paid off in a big way. In 2012, a breakthrough drug developed with CFF funding was approved by the FDA. It treats underlying causes of the disease rather than symptoms. In 2015 an even more broadly effective drug was approved; it offers significant relief to half of all sufferers. These compounds may double the life expectancy of some patients.
In addition to catalyzing these clinical breakthroughs, the foundation recouped its investments. It sold its rights to future royalties from the drugs for $3.3 billion. These proceeds will allow the Cystic Fibrosis Foundation to maintain and expand existing patient support services while directing additional money into a “supercharged” scientific search for a long-term CF cure for all patients.
Bill Gates has described how his perspective changed when he read a 1996 New York Times story about how hundreds of thousands of children in the developing world die every year from dehydration after they become infected with something called rotavirus. “That can’t be right,” Gates thought. “I read the news all the time. I read about plane crashes and freak accidents. Where is the news about these half-million kids dying?” At that time, Gates was “exclusively focused” on running his company, and the Bill & Melinda Gates Foundation was just getting launched. Very soon, though, the “number-one global health priority” of the organization was delivering vaccines to poor children throughout the world. And by 1998, Gates had retired from Microsoft to pour himself into his philanthropy full-time.
Then in 1999 Bill and Melinda Gates hosted a dinner at their home for experts and asked how momentum could be regained in vaccinating children overseas. By the end of the year the Gates Foundation had put $750 million on the table to launch a new Global Alliance for Vaccines and Immunization, now known as GAVI. The foundation subsequently made additional huge grants to expand the vaccine alliance, bringing the total Gates commitment to this cause to $2.5 billion.
With this burst of energy and funding, around three quarters of a billion children have been immunized against basic diseases since 2000, averting perhaps as many as 10 million deaths over a 15-year period. Working through the alliance and on its own, the Gates Foundation has been the prime driver in creating new vaccines—like ones for rotavirus, approved for widespread use in 2009, and pneumonia. In 2015 Gates announced a $50 million grant to Stanford University to set up a center to study how the immune system can be harnessed to develop future vaccines. The foundation has also greatly expanded access in poor countries to underutilized existing vaccines like those against hepatitis B, influenza type B, measles, and the five diseases blocked by the so-called pentavalent vaccine.
Former Stanford University professor of computer science James Clark established a clutch of successful business ventures: Silicon Graphics, Netscape, Healtheon, and myCFO. Feeling indebted to Stanford as the site where he incubated many of his ideas, he approached the university in 1996 and inquired about what he might give the university to express his gratitude. Thus was born the James H. Clark Center for Biomedical Engineering and Sciences, created with a $150 million contribution from the entrepreneur—then the single largest gift to Stanford since its founding, and the largest personal gift in higher education. The facility served as a bridge between Stanford’s engineering departments and its medical school. The gift allowed the hiring of about 15 new faculty, the construction of a biomedical-engineering center and the purchase of extensive equipment to fill its labs, plus graduate student fellowships. Atlantic Philanthropies, the foundation created by businessman Charles Feeney, also contributed major funding to the center.
Both of Jon Huntsman’s parents died of cancer. In 1992, he was diagnosed with the disease himself—the first of his four separate personal battles with the killer. His stints in the hospital convinced him that better treatments, better research, and better institutional experiences for cancer patients were all sorely needed.
After inventing, at the company he founded, the clamshell container that cradled McDonald’s Big Mac, Huntsman added many other commercial successes, so he had the resources to act on his dream. He brokered a deal with a big pharmaceutical company to split the $250 million cost of building a state-of-the-art cancer treatment and research center in Salt Lake City, to fill a void in the Rocky Mountain region. Then the company backed out at the last minute. Huntsman and his family decided to foot the entire bill.
A patient care center opened in 1999, followed by the new hospital in 2004. Today, the Huntsman Cancer Institute serves 60,000 patients every year and performs 3,000 surgeries. The treatment facilities are renowned for their peaceful beauty, comfort, family-friendliness, and attention to patient services. The institution now ranks in the 99th percentile in patient satisfaction. The six states of the Intermountain West region finally have the comprehensive cancer-treatment center they previously lacked.
In addition, the HCI conducts groundbreaking research on genetic cancer patterns that could change the way the disease is approached across the globe. One reason Huntsman placed his cancer institute in Utah is because the Mormon church has compiled meticulous genealogical records that can be cross-indexed with patient records to uncover patterns illuminating the genetic aspects of cancer. HCI now manages a database of 16 million people that links health records to genealogies—the largest such resource in the world. “It’s an incredibly rich source of information that supports research on genetics, epidemiology, and public health,” says Mary Beckerle, director of the Huntsman Cancer Institute.
Already, HCI researchers are credited with identifying more cancer-causing genes than any lab in the world, including the genes responsible for inherited breast, ovarian, and colon cancers, as well as melanoma and malignant paraganglioma. In late 2013 Huntsman announced he would make an additional $100 million donation to the institute, bringing his total giving to that organization to $450 million. Huntsman’s lifetime charitable giving stood at $1.6 billion at the end of 2013, making him just one of 19 people in the world to have donated at least a billion dollars (there are about 1,200 living billionaires).
Huntington’s disease is a genetic disorder that destroys portions of the brain involved in movement, thinking, and emotions, progressing over decades with ultimately fatal results. It strikes perhaps 30,000 persons in the U.S., and if one of your parents had it, you have a 50-50 chance of developing the disorder yourself. For years it was one of those afflictions that attracted relatively little research funding or attention outside of the families plagued by it. That changed in the mid-1990s, when a single donor began to pour large resources into a broad campaign against the disease.
Andrew Shechtel entered Johns Hopkins University at the precocious age of 16 and left three years later with degrees in math and political economy, then spent time at Harvard Business School and Wall Street before entering an investment firm focused on abstruse quantitative financial trades. He became a multibillionaire, and continues in the field, while also giving away several billion dollars.
His favorite cause is battling Huntington’s Disease, to which he has donated at least $732 million directly since 2000, plus more indirectly via grants to allied organizations. In recent years, his annual spending of more than $100 million for an HD cure has exceeded the total efforts in this area of the massive National Institutes of Health (which devoted $55 million to Huntington’s in 2013). With the charitable trust established by Shechtel containing $5 billion as of 2013, a good deal more spending can be expected.
The donor’s gifts are primarily channeled through his CHDI Foundation, whose mission is to “bridge the translational gap that often exists between academic and industrial research” and “develop drugs that will slow the progression of Huntington’s disease and provide meaningful clinical benefit to patients as quickly as possible.” The organization’s description of itself is businesslike: “Essentially, CDHI is a science-management organization…. Our science directors and project managers work closely with a network of more than 600 researchers…in the pursuit of novel therapies, providing strategic scientific direction and management. [Our] overall strategy is to de-risk therapeutic approaches [so] pharmaceutical company partners will view them as a good investment…. Our bottom line is ensuring the shortest possible time to getting effective therapeutics to HD patients.”
Part of this involves encouraging scientists to take up work on Huntington’s, by providing background knowledge, chemicals and supplies, animal models, and working protocols that can speed research. The nonprofit also has created its own large registry and observational study of families experiencing Huntington’s disease. And it collaborates with a network of other advocacy organizations to support patients, family members, and clinicians.
In the 1990s, Oracle software founder Larry Ellison developed a friendship with Nobel-winning molecular biologist Joshua Lederberg of Rockefeller University. This led in 1997 to establishment of the Ellison Medical Foundation, with Lederberg as lead scientific adviser. For 15 years, the foundation supported basic biomedical research focused on understanding how organisms age, and how age-related diseases and debilities might be prevented. During that decade and a half, the foundation distributed $430 million of money donated by Ellison to 600 prominent or rising researchers. This financial surge advanced both the discipline of aging and the techniques of molecular biology (advanced versions of which are often required in age-related research).
In 2016, Ellison started a different medical-research organization, with a different approach. He donated $200 million to the University of Southern California to build a new interdisciplinary medical center focused particularly on cancer, but marshaling a wider than normal range of scientists and engineers to prevent, detect, and treat the disease. “The new institute will invite mathematicians, physicists, and other scientists to collaborate with cancer researchers from the traditional disciplines of medicine and biology. We believe the interdisciplinary approach will yield up new insights currently hidden in existing patient data,” explained Ellison.
Jim Stowers founded Twentieth Century Mutual Funds at his kitchen table in 1958. A low-cost investment vehicle for small investors, the company began with initial capital of $107,000. By the time its creator died in 2014, the firm (renamed American Century Investments) was managing $141 billion in assets. In 1994, Stowers and his wife, Virginia, gave away 95 percent of their fortune. Both being cancer survivors, and Jim having grown up as the son and grandson of doctors, they donated $2 billion to endow a new top-flight medical-research facility in their hometown of Kansas City, Missouri. Experts pressed for the money to go to an existing organization, or at least one created in a major East- or West-Coast city, but the Stowers were determined to build something in their own region. The 550-employee institute focuses on basic science research, and has sparked growth of biological sciences of various sorts in Kansas and Missouri.
In 1994, retired physician Jack McConnell, best-known as the developer of Tylenol while a researcher at Johnson & Johnson, had the idea of recruiting other retired doctors and nurses to serve, at no charge, the medical needs of poor people living in the area of Hilton Head, South Carolina. Soon, there followed a national organization dedicated to helping local volunteers start similar free clinics all across the U.S. Volunteers In Medicine, based in a small office in Burlington, Vermont and operating on a modest $250,000 annual budget, has provided the model and management guidance for 96 free clinics (and counting), in a riot of locations: Red Bank, New Jersey; Dunlap, Tennessee; Monroe, Michigan; Springfield, Oregon; inner-city Baltimore; Farmville, Virginia; Indio, California.
Much of the care is targeted toward those with chronic conditions—diabetes, hypertension, cardiovascular and gastro-intestinal problems—with the aim of preventing these long-term afflictions from debilitating their victims. Many clinics also provide vaccinations (especially for children) and dental services, which are not covered by public programs like Medicaid, but which have been increasingly shown to have consequential medical effects. Patients include a broad cross-section of immigrants and low-income persons who despite qualifying for Medicaid have difficulty actually getting access to medical care.
Without a central management structure or government funding, these valuable clinics have emerged via strong community support. The staff in Burlington have no mandate or goals for opening new clinics, and they don’t own or operate any. They simply aid local “champions” who ask for their expert assistance. Before any local “champion” is allowed to use the VIM name in launching a clinic, he or she must first put together a committee that “represents various constituencies in the community—people of influence, including within the medical community,“ as VIM director Amy Hamlin puts it.
The free labor of 11,000 medical professionals and associated volunteers drives these facilities, while donors cover building rents, lab charges, support staff, and medication costs. The end product is a half-million annual patient visits, worth tens of millions of dollars to the beneficiaries—all produced (as of 2011) at a modest per-visit philanthropic outlay of $316, including all medication and lab work.
Business financier Michael Milken, a longtime anti-cancer donor, detected inefficient patterns in medical research similar to those he had worked against during his career in high finance. He discovered it tended to be established “safe” researchers who garnered grants even though many of these individuals were well beyond their years of peak creativity. Meanwhile, brilliant young unknowns with bold if risky ideas had great difficulty getting funding to test their theories. Milken also observed that grant paperwork absorbed large amounts of time for scientists who would be much better employed in their lab than at a desk filling out forms. He noticed that during basic research too little attention was paid to whether a new regimen had the potential to lead to better diagnostics or treatment. In all these areas, private donors were able to be much nimbler than federal grant agencies, and he made getting around such obstacles one priority of the Prostate Cancer Foundation he founded in 1993.
The PCF quickly became a leader on prostate cancer, having raised $500 million for medical research in less than two decades, which it used to fund more than 1,600 projects in 15 countries. One of PCF’s first grants was to Judah Folkman, whose work on starving the blood supply to tumors had effects on many branches of cancer research. Early funding from the foundation also led to new treatments and drugs—including Zometa (for treating prostate cancer and other solid tumors), Provenge (an immunotherapy), and Jevtana (an enhanced chemotherapy). PCF-funded researchers made big strides in identifying various types of prostate cancer and creating treatments, and are now driving dozens of new drugs and therapies through clinical testing. Since the founding of the Prostate Cancer Foundation, the number of prostate deaths has fallen from 40,000 per year to below 30,000, despite a growing and aging population.
Michael Milken’s medical giving now exceeds a billion dollars. The philanthropy model he pioneered, grafting business principles onto donating, is popularly called venture philanthropy. Its success in speeding the pace of innovation in research and treatment—and also in expanding public awareness of prostate cancer—has fed similar efforts from other funders and nonprofits—like the Susan Komen efforts against breast cancer, the Livestrong Foundation (testicular cancer), the Michael J. Fox Foundation (Parkinson’s), and the Melanoma Alliance.
One of the first major philanthropic projects of Bill Gates, launched long before he shifted his gaze steadily to philanthropy, came back in 1992. The University of Washington Medical School was trying to create the first-ever cross-disciplinary department of biology. Gates made the new department possible by putting up $12 million of his own money. He told the organizers, “I just want you to understand I am giving $12 million, but I’m in my acquisition phase, I’m not in my philanthropic phase, so don’t expect any more.” That offering was sufficient to launch what became not only a highly successful department but a blooming new discipline of molecular biotechnology.
Among other work, the team at Washington invented an inkjet device for creating DNA arrays that allowed tens of thousands of genes to be read at once. This instrument was soon commercialized and made available to other scientists, and transformed genomics, biology, and medicine. Given estimates by the Battelle Foundation that automated DNA sequencing and the human-genome project may have created in excess of $800 billion of value, this comparatively modest investment yielded potent returns. And philanthropy played a crucial role.
In the early 1990s, an employee in an Atlanta Home Depot outlet had been missing work, then showing up sleepless and unkempt. Company co-founder Bernie Marcus took her aside and asked what was wrong. “Her child had this strange—well, I guess we called it a disability at first,” say Marcus. “Nobody knew what it was. The child was not communicating. He would scream in pain and nobody knew why. Doctors didn’t have the patience to work with him…. That’s when I first saw how autism destroys families.”
Marcus got involved. He learned that one out of every 88 kids has autism, versus one out of every 25,000 who have cancer, and yet cancer funding for children outstripped autism funding by a factor of 200 to one. Finding that “nobody was really doing a good job with this,” Marcus decided to start an autism center himself. After much cajoling he arranged an affiliation with Emory University, and the operation opened with two psychologists working out of a pair of double-wide trailers. In addition to providing heavy financial subsidies every year, Marcus worked energetically to make “autism” a household word. He came up with the idea for Autism Speaks, and provided $25 million to launch the national advocacy organization, which has since raised more than $180 million for research, and expanded insurance coverage to behavioral treatments of autism.
By 2011, the Marcus Autism Center was treating 5,676 children annually. That same year, the center was able to hire away from Yale one of the foremost clinician-researchers in the field, Ami Klin. That spurred Marcus to make an additional $25 million gift (with $15 million more coming from the Joseph Whitehead Foundation) to support a major advance at the center. Dr. Klin and his team have developed eye-tracking technology that allows babies with autism to be identified in their first year, before symptoms develop. With treatment beginning early, instead of around age five when autism is generally recognized today, a child’s development can be much improved. The new technique will undergo clinical trials at the center to gain FDA approval for use nationwide, with the aim of instituting universal childhood screening. Meanwhile, the Marcus Center is gearing up to treat more children as they are diagnosed, pledging to eliminate its current waiting list of 1,700 families.
The $90 million Bernie Marcus has invested has transformed autism from heartbreaking mystery to treatable condition. It has also made Atlanta and the Marcus Autism Center the leading organization for treatment and study in the world. In 2014, the city hosted more than 3,000 scientists from three dozen countries for the International Meeting for Autism Research.
Once this target had been painted on autism as an affliction that can be ameliorated, other donors became involved. The foundation of hedge-fund operator James Simons created a major Autism Research Initiative in 2003. It currently has an annual budget of about $60 million, with which it supports 175 investigators. In the last half-dozen years, Simons’s center has granted more than $260 million to leading researchers.
After noticing that the mental and physical health of many of his patients was deeply entwined with their spiritual state of mind, a Duke-trained M.D. named David Larson founded the National Institute for Healthcare Research in 1991 to systematically study how religious views and practice affect health. Throughout the next decade until Larson’s sudden death in 2002, the John Templeton Foundation invested nearly $10 million in research and publication grants to allow NIHR to explore this uncharted territory.
In addition, the Templeton Foundation provided Duke University with a $9.8 million eight-year grant which created the Center for Spirituality, Theology, and Health at the Duke University Medical Center in 1998. The mission of CSTH was to “conduct research on the relationships between religion, spirituality, and health, to train others to do so, to interpret the research…and design future research.” The center recruited a team of faculty from medicine, psychiatry, nursing, sociology, and other fields, and commenced an ambitious schedule of investigation and publishing. By 2012, the center had produced more than 200 peer-reviewed scientific articles on “relationships between religious involvement and a host of psychological and physical health outcomes.” By that same time, ten other centers on health and spirituality had also taken root in the U.S., at places like the George Washington University Medical Center, Massachusetts General Hospital, and the Texas Medical Center, and four more had been founded in Canada and Europe.
Both medical education and medical practice have been affected by this new knowledge. As late as 2000, for instance, 92 percent of professional psychiatrists reported that while they encounter significant religious and spiritual issues in their practices, two thirds of them had had no serious training or research background in religious or spiritual issues. The number of medical schools offering courses on patient religious life could be counted on one hand when Templeton entered this field in the early ’90s. By 2010, however, three quarters of U.S. medical schools had brought spirituality into their curricula, spurred not only by clearly demonstrated correlations between religious life and health but also by Templeton awards for medical schools and residency programs that innovated in this area. There is also now a David Larson Fellowship in Health and Spirituality, which is awarded to post-doctoral scholars annually by the Library of Congress.
“The amount of studies done since the year 2000” on spirituality and health “probably exceeds all the research in the 150 years prior to 2000,” says Harold Koenig, associate professor of medicine and director of the Duke center. Christina Puchalski, director of George Washington University’s Institute for Spirituality and Health, observes that including faith factors in medical treatment is part of a larger shift in medicine away from just thinking about disease, and taking account of wellness and “the inner life of the patient.”
In 1985 the Aaron Diamond Foundation was founded in New York City to honor the eponymous real-estate developer, who passed away suddenly of a heart attack in 1983, by his wife Irene. When Irene and Aaron decided to give most of their assets to their foundation, they committed to blasting its funds out intensively within about a decade of either’s death, with the aim of making fast progress against targeted ills. When the funding of the foundation was all settled, one of the first places that Irene Diamond’s gaze settled was the alarming new AIDS epidemic that was just beginning to ravage her hometown of New York City.
HIV had been identified as the cause of AIDS in 1983, and early hopes for a vaccine, treatment, or cure for the disease faded quickly. The Diamond Foundation and other New York City funders felt that “an effort was necessary to bring the city closer to its level of responsibility as the epicenter of the AIDS epidemic in the United States.” So plans were laid for the Aaron Diamond AIDS Research Center, which opened in 1991 and immediately dove into high-level research under the direction of David Ho, a prominent microbiologist Irene Diamond selected to be director. By the time the foundation closed down at the end of 1996, it had invested $220 million and become the largest private supporter of AIDS research in the U.S.
The Diamond Center’s scientific accomplishments are legion. ADARC did some of the most important basic research at the molecular level on what made the AIDS virus so tenacious. The center identified a gene mutation that confers immunity to HIV. Diamond clinicians championed anti-retroviral “cocktails” that by combining medications were able to suppress HIV infection to undetectable levels. Combination therapy is expensive, though, and HIV’s ability to evade and adapt to immune defenses meant that a constant flow of improved and augmented cocktails was necessary, so ADARC researchers helped propel more than two dozen different drugs through the development pipeline. As a result, the death rate from HIV in America is now one fifth of what it was 20 years ago.
The center also did important work on prevention. Its major project in China, for instance, demonstrated that the rate of transmission of HIV from mothers to infants could be reduced from over 30 percent to less than 1 percent. Diamond researchers also pursued various HIV vaccination strategies right through the stage of clinical trials, including some work funded by the Gates Foundation using very innovative techniques.
Though never numbering more than about 75 researchers, its no-strings philanthropic funding gave the Diamond Center a nimbleness, speed, and tolerance for risk that allowed it to repeatedly precede and outperform government labs. By the time the Diamond funds were spent down, the center had developed a broad base of support. It remains the largest private AIDS research organization in the world, with a clinical relationship with Rockefeller University. In 1996, the year the Diamond Foundation closed, Time magazine selected ADARC’s director as its Man of the Year, in recognition of the center research that saved millions of lives.
Each year more than 480,000 Americans die of tobacco use—the nation’s largest cause of preventable death, accounting for about one out of every five U.S. deaths according to the Centers for Disease Control. About two thirds of smokers say they want to quit, but only about 5 percent succeed in a given year. In 1990, the new president of the Robert Wood Johnson Foundation, Steven Schroeder, aimed his organization squarely at reducing “the harmful effects, and the irresponsible use, of tobacco, alcohol, and drugs.” As part of this, the foundation spent $700 million on a range of anti-tobacco programs during the next two decades. Programs were aimed especially at reducing youth smoking, publicizing the bad health effects of smoking and of secondhand smoke, and helping addicted smokers quit. (See 1991 entry on Public Policy list for other aspects of the campaign.)
In 1990, New York City real-estate developer Zachary Fisher learned about a servicewoman who had recently received medical treatment at a military hospital. Her husband, unable to afford a hotel, spent the duration of her hospitalization sleeping in his car. Fisher was shocked to learn that the military made no provision for the families of hospitalized servicemembers and veterans—and decided to do something about it.
With an initial donation of $20 million to establish the Fisher House Foundation, Zachary and his wife Elizabeth began building “comfort homes” within walking distance of Veterans Affairs and military medical centers. These complexes were designed to provide free housing for families of military personnel and veterans who were hospitalized. At the time of Zachary’s death in 2000, the Fisher House Foundation had built 26 houses at busy medical facilities, and there were 65 houses in operation by 2015.
As of 2015, the Fisher House Foundation has provided 6 million days of free lodging to the families of hospitalized servicemembers and veterans. In addition to saving those individuals a serious expense, the opportunity to commune with other families in similar stressful situations has proven invaluable for many beneficiaries.
With this enormously popular innovation under their belt, the Fisher family expanded their military-medical philanthropy. Between 2000 and 2012, their Intrepid Fallen Heroes Fund provided $120 million in support to wounded service members and their families, first through direct payments to the families of soldiers lost in war and later through the construction of new medical research and rehabilitation facilities for wounded military personnel. The Center for the Intrepid in San Antonio is focused on treatment of soldiers with amputations, burns, or loss of limb use. The National Intrepid Center of Excellence in Bethesda, Maryland, is focused on the care of brain injuries and psychological health and connects to satellite centers to bring advanced brain-injury care to other parts of the country.
Ted Stanley was a pioneer in mental-health philanthropy. Back in the late-1980s the billionaire retailer founded the Stanley Medical Research Institute, which quickly became the biggest private backer in the U.S. of investigations into bipolar disorder and schizophrenia—diseases the director described as “massively underresearched” by government health agencies. Stanley ended up funding between a quarter and half of all research on those two maladies, to the tune of hundreds of millions of dollars in total.
Among other scientific contributions, this organization collected several hundred brains from persons suffering from various mental illnesses, which became the source for hundreds of thousands of tissue samples shipped to researchers making requests from all around the world. The Stanley Institute also supported scores of drug trials, seeking effective treatments via off-label uses of older medicines.
More recently, Stanley gave massive gifts for mental-illness research at the Broad Institute of MIT and Harvard. His initial $100 million grant established a separate Center for Psychiatric Research. In 2014 he announced a huge $650 million gift to the Broad Institute, bringing his total giving to that group to $825 million. These funds continued the work he launched there on uncovering the genetic roots of various psychiatric disorders.
And just days after Ted Stanley died in early 2016, the Broad Institute announced, in the words of director Eric Lander, "amazingly consequential" findings flowing directly from the research Stanley funded. By taking 100 genetic locations linked to schizophrenia by a 2014 Broad study and matching them with 29,000 patients showing symptoms of the disease, Broad researchers concluded that most schizophrenia is linked to one genetic variant that causes normal “pruning” of brain synapses to run out of control. This breakthrough could eventually lead to much better diagnosis and treatment of the 2-3 million schizophrenic Americans—whose suffering is often severe—while also reducing the economic penalty of tens of billions of dollars that the disease imposes on society.
Only one infectious disease has ever been eradicated: smallpox (gone as of 1980). Soon though, a second affliction will disappear, likely around 2018, when the Guinea worm becomes extinct. This will happen thanks largely to three philanthropic interventions: the leadership of the Carter Center, a nonprofit formed by former president Jimmy Carter and Emory University; the money of the Gates Foundation, which has donated more than $100 million to the effort while inspiring matching funds from many other givers; and the donated hours of hundreds of thousands of volunteers.
A parasite transmitted by eggs borne in drinking water, the worm is an affliction that has sickened millions in Asia and Africa for millennia (its signs can be found in ancient mummies). While rarely fatal, a Guinea worm can cause intense pain as it travels through the body. It usually migrates eventually to the feet or legs, where the worm chews its way through tissue and skin to exit the body, causing blistering pain that prevents victims from walking, secondary infections, and other miseries.
There is no known curative medicine or vaccine for Guinea worm. What is eliminating this horrific affliction today is not medicine or complex technology, but aggressive canvassing by volunteers. They give out simple hand-held filtering straws, teach villagers to use them whenever drinking water so as to avoid infection, add larvicide to central water sources, and scout the countryside for disease outbreaks.
When the current campaign against Guinea worm began in 1986, there were 3.5 million new cases of the disease every year, spread across 21 countries. In all of 2014, there were only 126 reported infections, in just four countries. In total, the Guinea worm eradication effort will have cost about $375 million.
Harvey Picker had played an important role in commercializing X-rays and other forms of electronic imaging and became a significant donor with the money he made in the process. Making health care more humane became one particular interest. He wanted to encourage physicians and other professionals to treat patients as persons, not “imbeciles or inventory,” and he would not be content with small changes. In 1986 he established the Picker Institute, devoted to seeing medical treatment “through the patient’s eyes.” The institute is credited with coining the phrase “patient-centered care,” and promoting structural changes which would encourage it.
One Picker project to improve the quality of health care by more directly involving patients offered a grant to Beth Israel Hospital in Boston so they could conduct a survey of patients’ perception of their treatment, in conjunction with the Louis Harris polling firm. The survey uncovered a lack of trust among patients, and inadequate communication which led to incorrect pain management and confusion among patients about their treatment regimens. Picker initiatives brought systematic surveying to other hospitals as well, hosted conferences on the prevalence of patient dissatisfaction, and instigated efforts to make medical care less impersonal and more patient-driven. The Picker patient-satisfaction surveys subsequently became a standard measure of patient care worldwide, and are credited with substantially improving the delivery of medical services.
In the early 1980s, longtime Caltech biology professor Leroy Hood had conceptualized an instrument that would automate the slow, labor-intensive process of sequencing DNA. The tedious hand process, which required scientists to repeat multiple steps using hazardous radioactive elements, made it impossible to read any more than a tiny portion of any genetic string. Hood’s new procedure substituted safe fluorescent dyes for the radioactive chemicals and used lasers and computers rather than human eyes to read the DNA patterns. Yet when he applied to the federal National Institutes of Health for grants to help his team create the planned machine, Hood reports that his grant proposals “got some of the worst scores the NIH had ever given. People said it was impossible, or they said ‘Why do this? Grad students can do it more easily.’”
To get around this roadblock, Hood turned to what he called “a really interesting consortium of philanthropy and business.” The philanthropy came from legendary donor Sol Price. The originator of the warehouse superstore concept that eventually produced Costco and Sam’s Club, and an early creator of Real Estate Investment Trusts, Price poured himself into numerous charities after making his fortune in southern California.
“When the NIH funding didn’t work out for the automated sequencer, I went to Sol, and he ended up giving me $200,000 a year for two or three years,” says Hood, who describes Price as “really smart and flexible, and excited by innovation and new ideas…. He was a hard-nosed, critical guy who asked tough questions. But when he was done, he was satisfied, and he more or less gave me a blank check to spend as I felt needed. And that was enormously valuable.” With the philanthropic money, Hood launched his work on the automated sequencer, and then went to the Monsanto Company and used Price’s donation to leverage from the firm another $200,000-per-year for-profit investment.
By June 1986, Hood had his machine on the market. With continual improvements it was soon capable of sequencing 150 million DNA base pairs on a fully automated basis. Without this breakthrough, the sequencing of the human genome would not have been feasible. “The combination of philanthropy and industry really led to the conceptual and early-stage development of the automated sequencer. Had it not been for those things, progress would have been delayed for an unknown period of time… . It was a critical catalytic moment, and philanthropy was there to push it forward.”
By the time Lucille Markey died in 1982, at age 85, she had seen a lot of death, sickness, and suffering, so she left her fortune (derived from her father-in-law’s founding of the Calumet Baking Powder Company) to medical research. To get the biggest possible bang for her buck, Markey stipulated that her trust should push all of its money out the door over just a 15-year period. As a result of this concentrated burst, and some very sage leadership by those she put in charge, the Markey Trust became one of the most important forces in U.S. medical research from the mid-1980s through the time when it closed its doors for good in 1997, distributing more than $500 million in 200 grants.
An important part of the success of Markey’s philanthropy was the flexibility it offered to investigators. Funding from NIH or NSF can rarely be used for preliminary investigations or risky science. Nor can it be used to recruit new scientists or graduate students or to build or equip a lab. Forget about shifting money from one year to another or one project to another, under a government grant, no matter how salutary the effects. And don’t try to dramatically change research directions to follow new leads with government funding. The Markey grants, however, explicitly allowed these sorts of things in order to encourage innovation by recipients, and maximum efficiency. The trustees and experts who gave the Trust its marching orders in a series of intense meetings in 1984 emphasized several targets: support for young investigators with promise; trusting outstanding researchers with wide discretionary powers in using funds; supporting fields with the biggest upside; funding fields that are important but not popular; being willing to pay for the infrastructure (buildings, equipment, and people) necessary for great research, not just the end research.
In addition to being flexible, Markey was patient. One of the distinctive contributions of medical philanthropy has been to support top young researchers through the “valley of death” that extends from the end of their training until they are able to establish their reputations and begin winning grants from government science agencies. The Markey Scholars Awards are now considered exemplars for nurturing young talent in this way. The awards offered each recipient funding for five to seven years, plus money to establish his or her own lab. The 113 Markey awardees turned out to be extraordinarily successful and productive. Dr. Eric Lander is an example; during his fellowship he refined new concepts of gene mapping in the lab Markey supported, and today he heads the largest genome center in the world—the Broad Institute of MIT and Harvard.
The trust’s savvy extended right to its shutdown. It produced a handbook on how to effectively spend a foundation right down to closure. And it paid the National Academy of Sciences to conduct a major assessment of its programs (published several years after the trust’s shutdown) focused on two questions: Were its funds well spent? What can others learn from Markey’s experience, both in terms of improving biomedical research and refining philanthropic practice? Academy investigators published five separate reports, and gave the trust brilliant grades for its influence on biomedical progress.
In the late 1970s, researchers at the California Institute of Technology were ramping up new investigations in human biology, talking about establishing a specialized cancer center, and doing all of this in an interdisciplinary, technology-heavy way. The university’s scientists and administrators convinced John Braun to give a building that soon became an important center for new kinds of scientific collaboration. One researcher called it “a beautiful example of philanthropy encouraging innovation and creating new opportunities that didn’t exist before.” Funded by a large gift from the Carl F. Braun Trust (a philanthropy growing out of one of the world’s leading engineering and construction companies), plus four other foundations, two companies, and four major individual donors, Braun Laboratories mixed researchers from the Caltech biology and chemistry faculties with some very advanced equipment and labs. The end result was to jump-start scientific work in recombinant DNA, monoclonal antibodies, and other early innovations in biotechnology. “We’re talking about investigations of the fundamental structure and mechanisms of life itself,” stated Caltech president Marvin Goldberger at the building’s dedication.
Asked by Philanthropy magazine why the laboratory was so important, biologist Leroy Hood explained that “Federal funding has almost always focused on specific kinds of projects. It isn’t focused on creating infrastructure—and it’s the infrastructure that’s so essential to making the house that really good people can work in. That was the point at Caltech with the Braun building. Suddenly we had 200,000 square feet into which we could bring all sorts of new people and things. And without that enabler we couldn’t have made that jump. You don’t get federal grants and contracts in general to build new buildings and create new visions and do those kinds of things. It’s philanthropy that fuels these new opportunities and opens up innovation in exciting ways…. I think at really excellent places like MIT or Caltech or Harvard, new innovation almost always comes from philanthropy.”
For whatever reason, philanthropic activity in alcohol and drug treatment gets relatively little attention or public visibility. At the grassroots level, the most effective force for sobriety in the U.S. is Alcoholics Anonymous, the classic voluntary organization of the sort that has long kept American civil society healthy. But AA is powered by voluntarism and mutual collaboration, not by donated money.
There have, however, been some notable philanthropic successes in battling substance abuse. The philanthropy-supported Salvation Army does cost-effective, hands-on, faith-based work with difficult populations, persevering through the high relapse rates that afflict all treatment regimens and ultimately achieving success with many individuals. The nonprofit Hazelden Foundation, which started a twelve-step program for alcoholics in 1949, now operates a half-dozen campuses; in 2012, its 7,431 donors provided Hazelden with more than $10 million in gifts. The Betty Ford Center, founded in 1982 by the former First Lady with philanthropist Leonard Firestone, has served 90,000 patients as a high-visibility nonprofit supported by its own foundation, which raises several million dollars every year in donations. In 2013, Hazelden and the Ford Center announced a merger to create the largest nonprofit addiction-treatment organization in the U.S.
Another treatment center launched in 1982 by a political family is Marworth, donated by former Pennsylvania governor and U.S. ambassador to the United Nations William Scranton and his wife, Mary. Recognizing the dearth of residential substance-abuse treatment options in their area, they offered their magnificent family estate (located near the Pennsylvania city that bears their surname) to Geisinger Health Systems to become one of the country’s leading alcohol and drug detoxification facilities. A nonprofit that grew out of philanthropist Abigail Geisinger’s 1915 donation of a hospital (inspired by the Mayo Clinic), the Geisinger system is now one of the largest rural health-care networks in America, treating 2.6 million people in 44 Pennsylvania counties.
Since its establishment, Marworth has treated more than 40,000 patients—with a special focus on helping doctors and health-care workers as well as law-enforcement officials who are suffering from addiction. All services are rendered in the original stone mansion, “where the breathtaking exterior matches the interior—with colonial furnishings, paintings of the Revolutionary War, and leather and crochet-topped sturdy sofas and chairs,” in the words of one rehab review. For years, William and Mary Scranton (he died in 2013) maintained a modest home at the foot of their erstwhile estate, from which they would periodically check in on the people being helped by their gift.
Philanthropists Mel and Betty Sembler founded Straight Inc., which treated 10,000 adolescents from 1976 to 1993 in a strict but effective program. They now support the policy, research, and advocacy work of the Drug Free America Foundation. Perhaps the most prominent advocacy group on this topic is the Partnership for a Drug Free America, which has long enjoyed major funding from the Robert Wood Johnson Foundation. And major donor Tom Siebel has put more than $30 million of his money into a highly focused and successful public campaign against methamphetamine use (see separate 2005 entry).
The number of elderly Americans is in the midst of doubling in less than one generation—to a total of more than 70 million. And they are heavy consumers of medical care. Though persons older than 65 account for only 13 percent of the population, they account for four out of every ten surgeries today and 44 percent of all visits to primary physicians. More than 40 percent of the elderly are currently taking five or more medications, and seniors with multiple chronic illnesses make an average of 37 annual visits to 14 different physicians, who write them 50 separate prescriptions.
With these stark realities in mind, starting in 1982 the John A. Hartford Foundation established a tight and disciplined focus on building the emerging field of geriatric medicine. A product of the A&P grocery fortune, the Hartford Foundation had been the largest funder of biomedical research in America during the mid-twentieth century decades prior to the growth of the National Institutes of Health. During this period the foundation underwrote many major medical innovations (see 1954 entry). The organization has proved equally savvy and influential in its latest focus on the health of the aged.
In the early ’80s, Hartford set up many programs to build expertise in the new field of geriatrics, and offered multiple grants to recruit physicians into it. Among other efforts, money was provided to 13 medical schools to help them recruit and train faculty. The foundation then made 16 separate grants to pioneer the field of geriatric pharmacology, improving the safety and efficiency of drug-dispensing to the aged. Next, it funded efforts to develop geriatric subspecialties in fields like surgery, internal medicine, and primary care. To attract top researchers to medical problems associated with aging, the foundation devoted $39 million to establishing the now-prestigious Paul Beeson Awards.
Eventually, 28 Centers of Excellence were established with Hartford money at academic medical centers, deepening the quality of geriatric training. Major effort was also devoted to developing the profession of geriatric nursing. Soon after, a similar push funded the rise of geriatric social work, primarily by identifying leading scholars and funding them in faculty positions. Finally, Hartford was a strong leader in efforts to help frail elderly remain in their homes rather than being institutionalized.
From 1982 to 2012, the Hartford Foundation awarded 560 grants worth $451 million solely to improve health-care provision for the elderly—funding that experts say was unusually seminal. The foundation magnified its influence by allying itself with several other savvy donors working on geriatric care, including the Atlantic Philanthropies, the Robert Wood Johnson Foundation, the Donald W. Reynolds Foundation, and others.
The result? “With program after program, they changed the health-care system and improved health-care outcomes for older adults,” states the director of the Johns Hopkins Geriatric Education Center, John Burton. The former dean of the University of Pennsylvania School of Nursing, Claire Fagin, makes a similar observation: “The contribution of the Hartford Foundation in putting geriatrics and gerontology on the map has been monumental. It is emblematic of what foundations should be doing in the sense of changing the field.”
In 1977 Susan Komen was diagnosed with breast cancer and her sister Nancy promised her she would help change the odds on that frightening disease, so more women would know how to discover it, fight it, and avoid its death sentence. Susan died in 1980 at age 36 and in 1982 Nancy Brinker founded the Susan G. Komen Breast Cancer Foundation, launching a global movement against breast cancer in the process. The foundation created successful public-awareness campaigns that increased early detection (including regularization of mammograms for women over 40) and sharply raised research budgets. From its first event in Dallas with 800 female runners, Komen’s signature “Races for the Cure” now mobilize more than a million participants each year, and have invested $2.6 billion (as of 2015) in the foundation’s education and research efforts. Since 1980, the five-year survival rate for women diagnosed with early-stage breast cancer has increased from 74 percent to 98 percent, and total breast-cancer mortality in the U.S. is down by more than a third.
Starting with one terminally ill child in Arizona in 1980, a group of volunteers gradually grew the Make-A-Wish Foundation into a charity that helps thousands of children age 3 to 17 who have been certified by their doctor as facing a life-threatening illness to enjoy some experience they have dreamed of. The nonprofit is powered by many generous donors and over 32,000 volunteers—organized in 61 U.S. chapters, and now also 45 foreign countries. From 1980 to 2014 they gave the group the capacity to arrange 334,000 life experiences
Research has shown that unmarried, poor, and teenage mothers are much more prone to problems of infant mortality, neglect and abuse, fetal-alcohol and drug damage, accidental injury, household poisonings, impaired mental development due to understimulation, attachment disorders, and other maladies that wreak costly, often permanent damage on children. In 1979, the Robert Wood Johnson Foundation launched efforts to head off these sorts of problems before they take root. It supported a demonstration project in Elmira, New York, that used registered nurses to bring preventive health services right into the homes of young, low-income pregnant women and first-time mothers.
Careful follow-up studies conducted in Elmira and then Memphis, Tennessee, and Denver showed that the home visits resulted in better health and development for both children and mothers, and less subsequent abuse, crime, and school failure. For instance, child abuse and neglect injuries were reduced 20-50 percent. Subsequent births by the mothers during their teens or early twenties were reduced 10-20 percent.
Called the Nurse-Family Partnership, the Elmira program became the model for a national program of home visits. The organization was set up as a 501(c)(3) charity, and research, manuals, training, and documentation needed to duplicate the program with a high level of quality were funded not only by Robert Wood Johnson but also by donors like the Edna McConnell Clark, Gates, Kellogg, and Kresge foundations. As the Nurse-Family Partnership gradually spread across the country it regularly updated its services—for instance with efforts aimed at discouraging partner abuse. Sponsored by nonprofits, private organizations, or local agencies of government, it is now offered in 432 counties in 40 states. An estimated 860 registered nurses are active as home visitors and more than 22,000 mothers are counseled in any given year.
In 1978, Don and Deyon Stephens were serving in Europe with the evangelical missions group Youth With A Mission. Since a time when he had helped clean up after a deadly Caribbean hurricane, Don had dreamed of a hospital ship that could bring high-quality, sanitary medicine to poor port cities. When he learned that a retired Italian cruise ship was being sold for scrap value, he approached YWAM donors for financial support, recruited 175 volunteers, and borrowed a million dollars from a Swiss bank to take possession.
By 1981 they had rehabbed the ship into seaworthiness, and hundreds of volunteers had been recruited to man her hospital bay and cruising operations. Evangelical Christian donors supplied both the funds and the bodies. Mr. and Mrs. Stephens and their four children lived on the ship for the next ten years, organizing the crew of 400 dedicated volunteers as the ship visited a series of poor countries to offer complex surgeries, dental care, vision repair, and other medical assistance.
In 2003 Mercy Ships was spun off from YWAM as a separate charity. Today it operates a 367-bed hospital ship where 1,778 life-changing surgeries were carried out and 728 African health-care professionals were given technical training in 2014. The ship also provided 12,597 free dental treatments and 6,259 vision consultations.
All positions from surgeon to deckhand are filled by volunteers, some serving for as little as two weeks, some for many years. Every volunteer is required to pay all of his or her own expenses, so that all cash donations go directly into medical care. Shipboard volunteers are also important as blood donors.
From 1978 to 2014, Mercy Ships provided free medical aid to 2.5 million poor patients in 57 nations, and trained more than 40,000 local medical professionals to improve their expertise. The organization was sustained by $82 million of personal contributions and in-kind gifts from medical suppliers in 2014. A second ship that will have 458 working beds is on order and scheduled to go into service in 2018.
Uncas Whitaker had an unusual combination of expertises: He was both an engineer and a lawyer. Each came in handy as he expanded electronics parts maker AMP from a small New Jersey workshop to a company with 45,000 employees in 50 countries, and annual sales of nearly $6 billion. And he knew how to focus on one product (terminal connectors in the case of AMP) and become the best in the world at it.
Both of those traits showed up powerfully in the philanthropy he established at his death in 1975. He and his wife ultimately devoted more than $700 million to one cause: developing biomedical engineering as a legitimate and thriving field. To maximize their impact on this embryonic specialty, the trustees of the Whitaker Foundation decided to spend not just the interest on their bequest but the entire principal as well, sunsetting the foundation in 2006. By propelling the entirety of its funds out the door in three decades, and doggedly following a tight and savvy strategy, the Whitaker Foundation essentially invented biomedical engineering as a freestanding and highly productive discipline.
In the 1960s and ’70s, there was very little engineering in medical research. The National Institutes of Health was focused on biology and regularly rejected proposals that involved lots of engineering, which it viewed as the domain of the National Science Foundation. Meanwhile, the NSF believed that engineering proposals with a heavy medical component should be brought to NIH. Most universities opposed moves toward a blending of the disciplines. So biomedical engineering languished until Uncas Whitaker filled the gap. A great believer in the ability of engineers to solve serious problems, he began with personal gifts to Harvard and Massachusetts Institute of Technology, which enabled Harvard medical students to simultaneously earn a medical engineering degree at MIT.
The Whitaker Foundation made its first research grant in 1976, to an M.D. who had invented a device to wean patients off heart-lung machines. The foundation went on to support a wide range of research at the crossroads of engineering and medicine. In addition to supporting direct research, the foundation set up programs to draw talented young investigators into the field. It offered universities funds to hire faculty. It paid for the development of curricula. It established internships at 33 universities that placed students in real-life work at companies. It paid for the construction of new classrooms, labs, and 13 entire buildings. It spawned several professional societies.
Together, these efforts institutionalized the field of biomedical engineering—it became the fastest-growing engineering specialty. Artificial hearts, lab-grown organs and skin, commonplace joint replacement, cochlear implants, laser surgery, new drug-delivery methods, image-guided surgery, and hundreds of other breakthroughs now dominate hospital suites.
Whitaker funding directly launched the careers of 1,500 biomedical engineers who invented more than 200 significant products or devices, started more than 100 companies, and accumulated 278 patents and 125 intellectual-property licenses. The foundation instigated the creation of many dozens of academic departments. In the early 1990s there were 22; now there are 80. “From a fledgling field to a mature discipline that has gained the recognition and respect of all,” observed University of California professor of bioengineering and medicine Shu Chien, “the extent and rapidity of the development of a field by the effort of a single foundation is unprecedented.”
When Fred Hill’s three-year-old was fighting leukemia, he and his family passed hours and days sleeping in chairs and living off vending-machine food as they kept vigil with her in the hospital. Feeling there had to be a better way, he rallied friends to create a residential house where families of sick children could stay nearby while their loved ones were in treatment. Hill was a player on the Philadelphia Eagles football team, so he got lots of publicity for his efforts. This helped him connect with the regional manager of McDonald’s Restaurants—which became a major funder. Thus was the concept of the Ronald McDonald House born.
Forty years after the creation of that first facility in Philadelphia there were 353 separate Houses and Ronald McDonald Family Rooms right within 196 hospitals, giving families places to sleep, eat, regroup, and meet other parents in similar situations. These are located at nearly all U.S. children’s hospitals, and in 62 countries around the world. The families of 6 million children use them every year. Most houses charge visitors nothing, the maximum is $25 per day, and no family is turned away if they lack funds.
The charity running the houses is an independent and regionally decentralized 501(c)(3). It continues to be supported by the McDonald’s Corporation to the tune of seven-figure annual donations, along with dozens of other corporate donors and small individual supporters. The group has also harnessed more than 300,000 volunteers.
Historically, hospices were institutions run by religious charities to offer short-term care to terminally ill patients too poor to afford alternatives. They began to be adapted to modern circumstances in the late-1940s, when British physician Ciceley Saunders, working in the suburbs of London, sought to bring more compassionate care to the dying, with a particular emphasis on relieving suffering. Saunders inspired a grassroots movement in the United States starting in the 1960s. A lecture Saunders delivered at Yale University inspired Florence Wald, dean of the school of nursing, to leave Yale and work at Saunders’s hospice, St. Christopher’s. Upon returning to the United States, Wald asked American foundations to support a feasibility study on opening a U.S. hospice.
An early grant from the Commonwealth Fund, then support from the van Ameringen and Ittleson Foundations, allowed Wald to establish the first such organization, in Branford, Connecticut, in 1974. It offered end-of-life care to 100 patients, in their homes and in its 44-bed facility. Abiding by the philosophy that patients need to be treated emotionally, spiritually, and physically, the hospice focused on providing comfort and dignity. It subsequently became a training facility for other hospices and paved the way for other such organizations to set up operations across the country.
The hospice movement was cemented nationally when the Robert Wood Johnson Foundation poured more than $170 million into efforts to improve end-of-life care. With 337 grants made between 1996 and 2006, the foundation sought to educate health-care professionals, improve institutions, and engage the public, all toward the end of better serving the dying. “Few foundations can say they built a field of medicine, but RWJF…built a very important field of medicine that hadn’t existed before,” summarized one expert observer. Today, there are an estimated 3,200 hospices providing palliative care across the United States.
In the early- to mid-1970s, much of the U.S. had no well-developed system for stabilizing victims of accidents, fires, crashes, crimes, and other traumas while rushing them to hospitals appropriately equipped to save them during critical early minutes. A panel of the National Academy of Sciences called accidental trauma “the neglected disease of modern society.” The Robert Wood Johnson Foundation set sights on changing that with a $15 million initiative launched in 1973 called the Emergency Medical Services Program.
When it opened in December 1971, the $1.2 billion of assets at the Robert Wood Johnson Foundation (endowed by the man who turned his father’s family business of Johnson & Johnson into a corporate behemoth) made it the second largest philanthropy in America. This allowed the foundation to undertake large and innovative projects. Its actions to catalyze a forward leap in our emergency medical services were one of its earliest initiatives, and also one of the most successful.
The foundation aimed to develop and standardize emergency services and spread them across the United States. At that point, emergency-room medicine was just beginning to develop as a specialty, EMS training was scanty to non-existent, and most ambulances were little more than hauling vehicles with sirens. RWJF sought to elevate the level of medical treatment offered by first responders, within transports headed to hospitals, and in emergency rooms themselves during the crucial early moments after a trauma arrives.
Participating hospitals developed sophisticated communications systems that linked them to newly trained paramedics in ambulances. Ambulances themselves were redesigned and fitted with essential medical equipment so that patients could be evaluated and given acute treatment before arriving at the hospital. And protocols were put into place at emergency rooms so that teams could pounce on victims with the right targeted care as soon as they arrived. When the Emergency Medical Services Program launched, there were only 12 reasonably organized paramedic units in the U.S. The foundation chose 44 grant recipients in 32 states, working with organizations ranging from fire departments to medical schools. Just four years later, at least 50 percent of the American population was within ten minutes of a paramedic unit. The RWJF efforts spurred parallel expansions funded by the U.S. Department of Health, Education, and Welfare, and together these enhancements saved many thousands of lives, eventually resulting in the 911 emergency-response system.
To research methods of preventing, treating, or curing diseases like retinitis pigmentosa and macular degeneration—afflictions that impair or end vision for more than 10 million Americans—venture-capitalist Gordon Gund co-founded the nonprofit now known as the Foundation Fighting Blindness. The group has supported thousands of research studies by leading scientists, including clinical trials of very advanced technologies like bionic retinas and gene therapies. “The foundation, existing as an independent private entity, is able to very quickly fund young investigators and fund new and exciting projects,” comments Dr. Donald Zack of the Wilmer Eye Institute at Johns Hopkins Medical School. As a result, it has “played a major role in getting a number of important projects off the ground which would not have happened without FFB support.”
Since its creation, the foundation has raised more than $700 million to battle retinal diseases—a quarter of that donated by Gund himself (along with his relatives and businesses). In 2014, Gund announced he would match any donation to the foundation made over the next two years. He said his goal was to raise $100 million for the organization, and the campaign closed in 2016 with $112 million in donations, half of that contributed by Gund.
Daniel Ludwig grew up on the shores of Lake Michigan near Ludwig’s Pier, built by his grandfather in a little port, from which four of his uncles captained vessels plying the Great Lakes. So when his natural entrepreneurial instincts began to show themselves it’s not surprising they took a nautical form. As a 9-year-old he paid $75 (which he’d earned selling popcorn and shining shoes) to buy a small sunken boat which he promptly salvaged and rented out. Bitten by the bug of commercial imagination, he left school after eighth grade and went to work. At age 19 he bought an old paddle steamer with $5,000 of borrowed money, and slowly built a shipping fleet around it. After World War II he started building tankers in Japan, using cheap local labor and a new technique he’d overseen which welded rather than riveted the ships together. Creating a series of ever-larger vessels, he pioneered the supertanker, and built his shipping firm into one of the largest in the world.
Ludwig branched out into mining, real estate, and other projects, and by 1976 he was one of only two billionaires in the U.S. Despite his wealth, he remained frugal: flying economy class, famously wearing the same plastic raincoat around Manhattan for years, walking to work, and owning only a 16-year-old Buick as a car when he died at age 95 in 1992.
Ludwig gave away nearly all of his money—and to a single entity, the Ludwig Institute for Cancer Research. Neither the donor nor any of his family members had ever been afflicted by cancer, yet he recognized the disease as a scourge of many innocent victims. Beginning slowly with endowed professorships and other support, the Institute delivered major gifts in 2006 to medical research arms at six institutions: Johns Hopkins, MIT, Harvard, Memorial Sloan Kettering Cancer Center, Stanford, and the University of Chicago.
In 2014, the Ludwig Institute for Cancer Research made its final big donation—offering $540 million to those same six academic cancer centers to endow different aspects of fundamental cancer research at each. (Prevention and early detection at Hopkins, metastasis at MIT, and so forth.) This brought Ludwig’s total contributions to anti-cancer studies to a fighting total of $2.5 billion.
The increase of American population plus general affluence following World War II caused an acute shortage of doctors, especially in rural communities, and an escalation of medical costs. The University of Colorado responded by starting a program to train registered nurses into mid-level responsibilities as nurse practitioners. This pioneering effort was made possible by a $253,998 grant from the Commonwealth Fund.
By making nurse practitioners responsible for things like routine examinations, administering immunizations, and conducting basic tests, doctors were freed up for more complicated procedures and diagnoses. A particular specialty of nurse practitioners trained to work in schools emerged after an additional grant from the Commonwealth Fund. In 1976, funding from the Robert Wood Johnson Foundation helped standardize and improve the training of nurse practitioners, and the next year the foundation funded fellowships at nursing schools to expand the profession.
At about the same time as the Colorado experiment, faculty at the Duke University Department of Medicine were pushing for a new class of medical professional who could operate in the gap between nurses and doctors. Eventually a program was created that enrolled former military medics and gave them an intense two-year immersion in biological sciences and clinical medicine. This abbreviated version of medical school allowed the resulting “physician assistants” to perform many of the routine duties of a doctor, under direction of a supervising physician. Philanthropic grants from the Josiah Macy Jr. Foundation, the Carnegie Corporation, the Rockefeller Foundation, and the Commonwealth Fund supported this new initiative.
With additional funding from Commonwealth and Robert Wood Johnson, the Duke innovation was spread to other medical schools in the late ’60s to mid ’70s. Physician assistant programs were structured as B.S. degrees until the mid-1980s. Then a master of health sciences degree for P.A.s was established.
Physician assistants and nurse practitioners are now board-certified in nearly all states, and their numbers have roughly doubled over the last decade—to more than 91,000 P.A.s and 250,000 N.P.s as of 2014. These two new classes of care-provider have fundamentally changed the practice and economics of medicine. And strong philanthropic support was crucial in overcoming extensive resistance from the nursing establishment and initial reluctance in government to fund the new professions.
Located in Memphis, Tennessee, St. Jude Children’s Hospital is internationally famous for its tight focus on treating and finding cures for catastrophic diseases of childhood—cancer especially. Nearly 8,000 young patients from all around the world are treated at the facility every year and no family ever pays St. Jude for anything.
From its beginning, St. Jude has conducted important research on childhood cancers that it shares with the profession. In a typical year, its staff will publish up to 800 articles in academic journals. Nobel Prize winner Peter Doherty conducts research on immunology at the hospital. It was the first institution to develop a cure for sickle-cell disease, via bone-marrow transplant. Protocols developed at St. Jude have helped push national survival rates for childhood cancers from less than 20 percent when the facility opened to 80 percent today.
The hospital is now America’s second-largest health-care charity and fifteenth largest charity overall. Fully 75 percent of the $1.8 million per day that it costs to run the hospital comes from donations (typical hospitals derive 8-10 percent of their revenues from charitable giving); the rest comes from health-insurance reimbursements and research grants.
St. Jude was conceived by actor Danny Thomas as he prayed at a Catholic Church in Detroit while struggling in his young career. When he became a popular star he followed through, forming the fundraising arm that now raises more than $800 million every year for the hospital. The average gift is about $30.
In 1940, an estimated $45 million was spent on biomedical research in the U.S., only $3 million of it from the federal government. World War II accelerated government health research, but as late as 1947 the entire budget for the National Institutes of Health was still only $8 million. Thus, the major force in funding biomedical research in the U.S., especially on the cutting edge, was private philanthropy. The most active foundation in this area was the John A. Hartford Foundation.
Brothers John and George Hartford created the behemoth A&P grocery chain, which became the largest retailer in the world. A&P was the first merchant to reach $1 billion in annual sales, which it hit in 1929. That very same year, John established the foundation that bears his name. After the brothers died in the 1950s, their combined contributions of A&P stock made the Hartford Foundation the fourth largest philanthropy in the country. Its trustees met and decided to focus their giving tightly on biomedical research, making the organization the largest supporter of clinical science in the U.S.
Between 1954 and 1979, the Hartford Foundation provided hospitals and medical centers with $175 million of research grants, equipment, and fellowships for scientists, catalyzing many of the era’s important advances in medicine. During its peak spending years of 1962 to 1972, the foundation funded more biomedical research than all other major foundations combined. The products of this investment included kidney dialysis, successful kidney transplantation (and then leaps in other types of organ transplants), major improvements in understanding of immunology, development of the artificial heart, cryogenic surgery, many advances in cancer research, the groundwork for microneurosurgery, and more.
In 1954, Hartford gave Boston’s Brigham Hospital a $300,000 grant that directly supported some of the world’s first successful kidney transplants. These operations created worldwide attention and led to another $200,000 of Hartford support over the next few years. The foundation simultaneously underwrote pioneering work on organ transplantation by other researchers. Crucial investigations in immunology, aiming to avoid rejection of transplanted tissues, were also funded. In addition, the Hartford Foundation underwrote creation of professional organizations like the International Congress of Nephrology, the American Society of Nephrology, and the Transplantation Society.
Making the kidney-dialysis machine practical and affordable was another product of concentrated Hartford Foundation funding. The “artificial kidney” that existed in the beginning of the 1950s was huge, expensive, and destructive of patient blood vessels. In 1961, Hartford provided $250,000 to develop more efficient dialysis machines for use in the first outpatient clinic, in Seattle. A second center was subsequently created in Spokane, Washington. On January 8, 1962, the world’s first out-of-hospital dialysis center treated its inaugural patient.
Other renal experts in Cleveland and Boston were simultaneously supported with six- and seven-figure grants from Hartford. The result? For the first time, the one-out-of-every-100,000 Americans whose kidneys had failed gained the prospect of escaping their death sentence..
In 1953, the eccentric billionaire Howard Hughes created a medical institute devoted to basic research, then gave it entire ownership of his Hughes Aircraft Company. The institute was intended to be a “steady operating organization with its own laboratories and not a general program of giving money away”—what the IRS has deemed a “medical-research organization” rather than a foundation. Business and legal battles prevented the institute from reaping much profit from the aeronautic company in its first few decades, but in 1985 General Motors bought Hughes Aircraft for $5.2 billion, and suddenly the Institute became the largest medical philanthropy in the country.
The Howard Hughes Medical Institute is focused on cell biology, genetics, immunology, neuroscience, and structural biology. It has long selected and employed Hughes Investigators who are left posted in labs across the country so they can benefit from wide cross-fertilization of ideas. In 2014 this investigator program supported about 350 scientists, along with their research teams, as they conducted experiments at more than 70 different universities, hospitals, or research centers. HHMI also runs a large program to support promising scientists at early stages of their career (a time when government grants are rarely forthcoming), as well as a program to support outstanding scientists working outside the U.S. (who again do not qualify for federal support).
Having become a driving force in U.S. biomedical research, the Howard Hughes Medical Institute launched a major new initiative in 2006 when it built a $300 million research campus of its own, called the Janelia Farm, on nearly 700 acres outside of Washington, D.C. There it employs over 400 people who do high-risk, long-term research in large interdisciplinary teams—with the idea that certain kinds of problems may be more easily solved by this more corporate style of investigation than by the traditional dispersed individual-researcher model that Hughes has long supported (and will continue to fund).
HHMI’s endowment stands at $17 billion, and in its latest year it employed 2,883 individuals and spent nearly a billion dollars. Having provided more than $7 billion in direct support to scientists just since 2004, the organization is the largest private funder of academic medical research in the world.
And there is evidence that this philanthropy’s flexible private grants have been much more effective than government counterparts. A study by the National Bureau of Economic Research, for instance, found that “investigators of the Howard Hughes Medical Institute, which tolerates early failure, rewards long-term success, and gives its appointees great freedom to experiment…. produce high-impact papers at a much higher rate than a control group of similarly accomplished NIH-funded scientists.”
As early as the 1920s, some notable philanthropists were strong backers of measures to reduce births among poor individuals. John Rockefeller Senior, Junior, and the Third were all strong supporters of the eugenics movement, as was George Eastman. But funding by elite philanthropists for population control, particularly abroad where growth was fastest, really ramped up starting in 1952.
At that time, John Rockefeller III created the Population Council, an influential information and lobbying group whose first administrator, appointed by Rockefeller, was Frederick Osborn, founder of the American Eugenics Society and trustee of the eugenics-promoting Pioneer Fund. Almost immediately after, the Ford Foundation made its first grant for population control, and by the late 1950s Ford was dispensing million-dollar grants to this cause. Throughout the Population Council’s first 23 years, Ford provided $94 million. JDRIII had launched the Population Council with $100,000 from his personal fortune after his grandfather’s foundation had rebuffed repeated entreaties to fund birth control for poor and overseas populations. But by 1963 the Rockefeller Foundation got into the game itself in a big way.
With America’s two biggest foundations having paved the way, the government followed next into population control. In 1959, President Eisenhower had said he “could not imagine anything more emphatically a subject that is not a proper political or governmental activity.” But after Dean Rusk (who ran the Rockefeller Foundation from 1952 to 1960) became President Lyndon Johnson’s Secretary of State, John Rockefeller III pressed him to make birth control a federal cause. Johnson soon delivered the first characterization, in a speech to the nation, of population growth as a problem, and by 1965 there was an Office of Population within the U.S. Agency for International Development. In seven years its budget exploded from $10 million per year to $123 million.
Even as government support for population control mushroomed, select elite philanthropists continued to pour money into the crusade. The list of individual donors and foundations who devoted large funding to the cause includes not just Rockefeller, Ford, Eastman, and Osborn, but also Milbank, Mellon, MacArthur, Packard, Hewlett, Turner, Buffett, and Gates. They put their money into everything from the U.N. Fund for Population Activities, to research and distribution of new contraceptives, to establishment of activist organizations and academic centers at universities like Michigan, North Carolina, Johns Hopkins, Harvard, Princeton, and the University of Pennsylvania. Even after eugenics was completely discredited, and the “population bomb” had fizzled as an issue, America’s large private donors were still putting on the order of $150 million per year into population-control grants in the early years of the new millennium.
Polio is one of the most wounding viruses in history, and reached pandemic proportions in the early twentieth century. In America at that time it killed more people every year than any other communicable disease. Thousands of others were left living on iron lungs or hobbling about in leg braces.
For years, the Rockefeller Institute for Medical Research had funded basic investigations into the virological underpinnings of the malady, including hosting the work of Albert Sabin from 1935 onward. Millions of people all over the country donated money to the March of Dimes—formally known as the National Foundation for Infantile Paralysis—to wage battle against the disease. The foundation’s annual
budget soared from $3 million in 1940 to more than $50 million in 1953. That year, the foundation provided 25 times more funding for polio than the NIH. Its money went to science fellowships in virology, to direct research, to public information efforts, and to support for stricken families. Among many other things, the foundation funded the lab where the polio virus was first grown in non-neural tissue.
Eventually, this combination of rich-man’s endowment with mass philanthropy—along with the timely action of a small private foundation—put a dagger in polio’s heart. In 1948, Dr. Jonas Salk won a $35,000 grant from the Sarah Scaife Foundation that allowed him to equip a modern virus laboratory at the University of Pittsburgh to investigate the disease. He also received support from the March of Dimes and its millions of small donors, as did the parallel vaccine work of Albert Sabin. Two years later Scaife added to its initial risk capital with a follow-up grant to Salk.
In 1952, a particularly nasty polio epidemic broke out—more than 60,000 cases were registered in the U.S., and 3,000 people died. That same year, Salk announced a medical breakthrough. He had bravely immunized himself and his family with an experimental vaccine that worked. The Salk vaccine, the world’s first polio blocker, was soon deemed safe, thanks to field trials paid for by the March of Dimes, and went into production for use around the world in 1955. March funds were also responsible for distribution of free vaccine to many thousands of children.
Today, polio has nearly been eradicated across the globe. It remains endemic only in Nigeria, Pakistan, and Afghanistan. And other philanthropies have taken up the cudgel to drive the disease to a final extinction. In 1985, when there were still close to 400,000 international cases of polio every year, the Rotary International Foundation pledged $120 million to battle the affliction overseas, ultimately donating a billion dollars to the fight. In 2011, the Gates Foundation made complete eradication of polio one of its top priorities. India—which just a few years prior to benefitting from a Gates-led mobilization was described as the “most tenacious reservoir” of the paralyzing virus, with half the world’s cases—recently celebrated its first year ever without a single case. The worldwide total was down to less than 250 cases in 2012, with the noose tightening.
Meanwhile, the March of Dimes, having effectively put itself out of work by beating polio, completely shifted its focus to premature birth and the prevention of birth defects.
Surgeries to alleviate congenital heart diseases began to advance rapidly in the 1940s and 1950s. Many of the techniques for detecting and diagnosing heart problems, however—life histories, physical examination, fluoroscopy, radiography, electrocardiography—remained comparatively underdeveloped or risky. This was holding back the revolution in cardiac care.
With funding from the Commonwealth Fund, Columbia University medical professor André Cournand and several colleagues pioneered various refinements in cardiac catheterization. This allowed oxygen levels and blood pressure to be safely tested right within the heart chambers, dramatically improving accurate diagnoses. These techniques were detailed in a 1949 book by Cournand and two others, which was in turn published by the Commonwealth Fund.
This work eventually yielded a 1956 Nobel Prize in medicine for the physicians supported by the fund. And the resulting clinical procedures turned cardiac catheterization into a routine diagnostic procedure. That allowed and supported tremendous advances in cardiac surgery—which over a 30-year period reduced U.S. deaths from heart disease by more than 50 percent.
Most of the funding for Sexual Behavior in the Human Male, the controversial book on sexual practice published by insect biologist Alfred Kinsey in 1948, was funded by the Rockefeller Foundation. Kinsey received the first grant of $1,600 in 1941. By 1947 he was receiving $40,000 annually from the foundation, a large portion of their commitments in behavioral medicine.
Alan Gregg, who ran two important divisions of the Rockefeller Foundation, was a particularly enthusiastic supporter of Kinsey and wrote an introduction to his first book. Kinsey’s claims, which were expanded by the 1953 publication of Sexual Behavior in the Human Female, radically transformed popular views of sex and laid the groundwork for the sexual revolution that followed.
Kinsey’s research has since been substantially discredited. His interview samples heavily overrepresented prisoners, prostitutes, homosexuals, graduate students, and other subgroups that result in skewed estimates of many aspects of sexual activity. He included pedophiles in his group and published tables documenting extensive adult sexual contact with children, which he falsified as coming from many sources. He secretly encouraged and recorded, in the attic of his own home, sexual interaction within his staff and between his staff and his family.
Kinsey’s 1948 book became a popular seller, generating large royalties that dwarfed the Rockefeller Foundation’s major grants. This would normally have led to a discontinuation of philanthropic support. In response to pleas from Kinsey, however, the foundation continued to fund him until 1954.
In 1942, pioneering advertising executive Albert Lasker and his wife, Mary, established a foundation to champion medical research. Their first major project (and the primary work of their foundation, still) was establishment of a prize to recognize and encourage leading biological research scientists. The Lasker Prize is perhaps the second most prestigious award a medical investigator can earn. Fully 83 Lasker laureates have gone on to win the Nobel Prize in medicine, including 31 in the past two decades. More recently, the foundation has established other prizes to recognize important achievements in clinical research, professional influence, and public service in medicine.
General Motors vice president Charles Kettering is most famously known for his automotive inventions, such as the first electrical starter motor and leaded gasoline, and the 185 patents he held. Less understood are his contributions to medicine and science. An extraordinarily broad tinkerer, Kettering also developed several medical innovations, such as an incubator for premature infants, treatments for venereal disease, and magnetic diagnostic devices.
In addition, Kettering was a visionary philanthropist who devoted his wealth to funding projects that could be as productive as his contraptions. In 1945, he and Alfred Sloan, another General Motors vice president, established the Sloan Kettering Institute, the first private biomedical research center of its sort in the world. The center was built next to Memorial Hospital, an institution with its own long and impressive philanthropic history. Founded in 1884 as a specialized cancer hospital by a group that included Mr. and Mrs. John Astor, the hospital was moved in 1936 to its current location, on land donated by John Rockefeller Jr.
From its founding, the Sloan Kettering Institute aimed to harness the latest technology and research techniques to battle cancer. Matching the spirit of its founders, it held fast to the principle that advances in research always rest on “the creative genius of individual scientists.” In 1980, the institute and the hospital were combined into a single entity and today the Memorial Sloan Kettering Cancer Center is one of the nation’s leading biomedical research institutions and treatment facilities, treating more than 400 different subtypes of cancer with specialized regimens and advancing the state of the art via more than 120 research labs. In 2012, the first graduates matriculated from the center’s new Ph.D. program in cancer biology.
In 1944, three scientists working at the Rockefeller Institute for Medical Research proved that it was the threadlike fibers of DNA, present in all cells, that were the chemical basis of heredity. This discovery was compared to the findings of Gregor Mendel and Charles Darwin in its scientific impact. It launched a new era in genetics.
This discovery was expanded and deepened by additional Rockefeller-funded work. Progress in X-ray imaging, for instance, and in understanding the nucleotides in DNA, was propelled by Rockefeller grants. New tools and understandings like these laid the groundwork for the 1953 discovery by James Watson and Francis Crick of the double helical structure of DNA (which won them the 1962 Nobel Prize in medicine). Indeed, the very Cambridge lab where Watson and Crick conducted their experiments owed its advanced state to the Rockefeller Foundation, according to researchers who worked there. Rockefeller grants funded many of the lab’s assistants. They also made possible the purchase of X-ray diffraction equipment that was central to the mapping of DNA.
Decoding DNA was of course the keystone to understanding how cells are controlled and how they multiply and mutate. That kicked off the subsequent revolution in genetics, whose potential for changing medicine has yet to unfold in its most dramatic forms.
Cervical cancer was the deadliest form of cancer for women until physician George Papanicolau developed a highly effective method to detect the disease even before any symptoms were present. Papanicolau arrived at the Cornell Medical College from Greece in 1913. During the 1930s he found that vaginal smears, when placed under a microscope, could show the presence of cancerous cells. The medical establishment, though, dismissed the idea that cancer could be detected in individual cells. Papanicolau later wrote that “I found myself totally deprived of funds for continuation of my research…. At a moment when every hope had almost vanished, the Commonwealth Fund…stepped in.”
Though it realized the grant was “highly speculative,” Commonwealth offered him a research grant of $1,800 in 1941. Using smears from a broad sample of patients, Papanicolau quickly found that his method did indeed identify cellular abnormalities, even before the cells became fully cancerous. The discovery was momentous, amounting to a method of cancer detection even earlier than biopsy, and less difficult, intrusive, and expensive.
In 1943, the Commonwealth Fund itself published Papanicolau’s findings in a groundbreaking study, Diagnosis of Uterine Cancer by the Vaginal Smear. The “Pap” test, named for its originator, continues to be the most effective and affordable way to detect cervical cancer today. It heads off thousands of deaths every year.
British scientist Alexander Fleming first uncovered the ability of mold to stem bacteria growth in 1928, but his finding drew little attention. It was Australian scientist Howard Florey and a team at Oxford University who revealed the therapeutic potential of mold-derived penicillin to squash bacterial infections and finally developed techniques for producing penicillin antibiotics. Florey’s scientific training had been partly financed by the Rockefeller Foundation when it awarded him a Rockefeller Traveling Fellowship in 1925, which allowed him to work for a year in the lab of University of Pennsylvania pharmacologist Alfred Richards. Afterward, Florey finished his Ph.D. at Cambridge University.
Additional Rockefeller Foundation funding supported Florey’s post-doctoral research at Oxford, from 1936 onward. Throughout a period of years, Rockefeller gave him about a half-million dollars in contemporary value, for research support, equipment, and supplies. With this crucial philanthropic help, Florey assembled a large team of a couple dozen investigators and technicians. By early 1940, they had zeroed in on penicillin as their special focus, first finding the compound to be both safe and effective in curbing bacteria in mice, then conducting their first human trials in early 1941.
It quickly became clear that penicillin had the potential to be one of the most important medical discoveries in history. For the first time, there existed a safe compound capable of killing the living bodily infections that gave deadly force to sepsis, pneumonia, diphtheria, meningitis, rheumatic fever, syphilis, scarlet fever, endocarditis, gonorrhea, and many other afflictions. The problem quickly became how to manufacture usable quantities of the miracle drug, which required laborious culturing and concentration.
In 1941, the Rockefeller Foundation brought Florey to the United States to make the case for a rapid mobilization to speed penicillin production. He convinced U.S. scientists of the import of his discovery, and with help from Alfred Richards, his Rockefeller Traveling Fellowship colleague, he enlisted assistance in fermenting and freeze-drying mass quantities of penicillin. Large-scale production soon began and by 1943 the new antibiotic was being used to treat wounded soldiers in North Africa. By the end of World War II, the drug had been produced widely enough to protect nearly all Allied troops. Penicillin and its successor antibiotics revolutionized medicine and saved literally hundreds of millions of lives. Florey and two other scientists were awarded the 1945 Nobel Prize in medicine.
The March of Dimes is one of the most popular and successful charity campaigns in American history. Founded in 1938 by polio victim Franklin Roosevelt as the National Foundation for Infantile Paralysis, the foundation existed to provide care for the afflicted and find a polio vaccine. Dubbed the March of Dimes by entertainer Eddie Cantor, the organization spurred Americans to give in a way that forever changed popular culture. Collection cans for the March of Dimes sat on diner countertops, at movie theaters, and in local schools.
In 1948, Jonas Salk’s polio vaccine, substantially supported by the foundation (see 1952 entry), heralded one of the greatest public-health discoveries in American history. By that time, the campaign had raised $67 million, the equivalent of $536 million today. It was the largest amount of money raised by any health charity, or almost any other kind of nonprofit.
Having played a major role in eliminating the mass killer and crippler polio, the March of Dimes shifted its focus to birth defects and disorders associated with premature birth. It continues to be one of the largest charity fundraisers in the United States.
Yellow fever, one of the most feared diseases in America, ravaged port towns and nearby communities throughout the eighteenth and nineteenth centuries. In addition to the human toll, international trade was often badly disrupted by its quarantines. While no medical consensus existed on the origins of yellow fever, many believed the disease originated in the tropics and was carried by ships involved in the slave trade in the West Indies or by transports returning soldiers from the Spanish-American War.
At one point President Grover Cleveland established a special commission to investigate possible causes and treatments of the disease; on both counts, no effective knowledge existed. Some scientists then believed that the disease was bacterial and that they had created the first “vaccines” against the malady. The commission declared them mistaken, that bacteria did not appear to be the cause but that the disease was transmitted by mosquitoes.
Meanwhile tens of thousands of Americans were dying in the early decades of the twentieth century. After the Panama Canal opened in 1912, exposing additional communities to the affliction, the Rockefeller Foundation launched an all-out three-decade campaign to eradicate the disease. In 1918, it sent a team to Ecuador to study potential causative agents. An initial claim that a vaccine had been discovered by Rockefeller researchers was disproven in 1926. At that same time, the Rockefeller Foundation set up another research station in Nigeria. Scientists working amidst the tension of its dangerous environment learned how to use rhesus monkeys to test infection and immunity to the disease. But three of the lead researchers working for the foundation died in the process.
A little later, the Rockefeller Institute set up a lab in New York to continue its yellow-fever research using animals. Director Simon Flexner proceeded hesitantly, given the loss of life already experienced in the institute’s work. Strict isolation policies were used to reduce the danger. Even still, many of the lab staff contracted the disease over the next two years, and a 1931 report from the institute noted that 32 cases of the disease acquired in eight labs had recently resulted in five deaths.
In 1931, Rockefeller Institute researcher Dr. Bruce Wilson volunteered to be injected with a new vaccine developed in mice. Held under strict isolation and supervision, he did not become ill and developed immunity. The vaccine required serum from already-immune humans, which meant it could not be produced in volume, but at least there was finally a means of protecting lab staff.
In 1937, foundation scientists finally announced a successful mass-producible vaccine. Between 1940 and 1947, the Rockefeller Foundation distributed more than 28 million doses of the vaccine. Lead researcher Max Theiler was awarded the Nobel Prize in medicine in 1951 for this work. The Rockefeller vaccine continues to be the most effective and affordable prevention strategy for yellow fever.
Until almost 1930, health insurance to cover the risk of expensive hospitalization or doctor care did not exist in the United States. Families rolled the dice, and if a member became badly sick they could be saddled with frightening bills. North Carolina philanthropist George Hill, whose family had founded the first hospital in Durham, North Carolina, set out to solve this problem with Wilburt Davison, the founding dean of Duke University School of Medicine.
While he was in England as a Rhodes Scholar, Davison had observed voluntary, community-based prepayment plans that allowed individuals to pay moderate monthly fees in return for a promise of coverage if ever they needed hospitalization. Davison and Hill set out to establish such a plan in their home region, forming the Durham Hospital Care Association. It was forced to close, however, after the October 1929 stock-market crash.
Though the project folded, the idea spread. The very same month that the Durham association closed, Baylor University Medical School in Texas began a similar initiative that succeeded. Participants (Dallas schoolteachers were among the first to sign up) could prepay, at fifty cents per month, for 21 days of treatment at Baylor Hospital. In 1931, a citywide prepayment plan was created in Minneapolis-St. Paul, and then another in Newark, New Jersey.
Inspired by Baylor’s great success, Davison and Hill retried their idea and opened another Hospital Care Association. Hill provided the money to get the nonprofit corporation operating. The Watts and Duke hospitals in Durham provided additional funding. And shortly after, the Duke Endowment made a $25,000 grant to establish a competing but similar voluntary prepayment plan, called the Hospital Saving Association. Eventually, the two entities merged into Blue Cross Blue Shield of North Carolina.
In 1940, less than 10 percent of the U.S. population had health insurance coverage. That grew to nearly 70 percent by 1955. Today, Blue Cross Blue Shield companies cover nearly one out of every three Americans, in every zip code in every state and Federal Territory. There are 37 independent, community-based, locally operated Blue Cross Blue Shield companies in the national federation.
Before 1933, no standard reference existed in American medicine for describing and diagnosing illnesses. The New York Academy of Medicine convened the first conference on the nomenclature of disease in 1928 and the participating medical societies and institutions met year after year to try to hammer out a common terminology for medical practice. When they ran out of funds to support their effort they turned to the Harkness family’s Commonwealth Fund, which became a major patron of the initiative.
Indeed, Commonwealth was the publisher of A Standard Classified Nomenclature of Disease when it was finally released in 1933. This reference offered the first industry standard, which not only aided clinical practice but also made compiling accurate health statistics possible for the first time. The Commonwealth Fund’s nomenclature succeeded where others had failed to be accepted because it abides by a simple and logical classification scheme that helps physicians describe diseases uniformly, leading to more accurate diagnoses, and, in turn, more appropriate treatments. Within a few years of its arrival, nearly all major hospitals and medical schools in the United States and Canada were using the Commonwealth guide.
In 1928, the Rockefeller Foundation established a natural sciences division headed by University of Wisconsin mathematics professor Warren Weaver. Weaver encouraged collaboration among biologists, chemists, mathematicians, and medical researchers, and eventually coined the term molecular biology to describe the emerging experimental field that he made a priority for Rockefeller funding from 1933 onward.
The foundation supported individual investigators as well as universities, almost singlehandedly rooting this new field of science, and incubating some of the greatest discoveries of twentieth-century science. In the words of Duke University researchers, Rockefeller’s funding under Warren Weaver “would come to have a profound impact on the development of the sciences for many decades,” and become one of the most widely recognized examples of a foundation redirecting the course of intellectual discovery in a constructive way.
As early as 1914 the Rockefeller Foundation had dabbled in what was then called “mental hygiene,” but in the 1930s the foundation became the driving force that built psychiatry into a serious academic discipline. In foundation reports, the expressed goal was “to find, to train, and to encourage first-rate [efforts at] correcting nervous disorders and mental behavior.” This would “counter the economic losses” of personal breakdowns and institutionalizations, “integrate into standard medical curricula a neglected field of medicine,” and “improve overall medical care by helping doctors understand connections between the body and mind.”
In its first ten years, this effort poured $12 million of John Rockefeller’s money into things like improving medical-school teaching, endowing university psychiatry departments, building research centers, and distributing fellowships to scientists working on mental health. By 1943, fully three quarters of all of the spending by Rockefeller’s division of medical sciences was being funneled into psychiatry. Among other results, this established full-time departments of psychiatry in a large number of hospitals and medical schools, including at McGill, Chicago, Duke, Harvard, St. Louis, Tulane, Yale, Washington, and other places.
When the influenza pandemic struck in 1918, most scientists and doctors believed it was caused by bacteria. Killing up to 100 million people worldwide, the pandemic was the deadliest in history. This drove many researchers to investigate and study influenza, searching for its cause and cure. A major breakthrough came in the early 1930s, when a young physician from Iowa, Richard Shope, turned his attention to swine influenza. While researching at the Rockefeller Institute for Medical Research, Shope took lung samples from infected Iowa pigs. He was able to isolate the rod-shaped bacterium that seemed always to correlate with their influenza. When the bacterium was injected into other pigs, though, it did not generate disease.
Forced to rethink, Shope referred back to some earlier research by Rockefeller Institute scientists Peter Olitsky and Frederick Gates and used their technique to finally isolate a virus that when injected into healthy hogs caused influenza. The bacterium which coincided with the flu in so many cases turned out to be an opportunistic follower-on which attacked subjects with a secondary infection after the virus had already weakened their defenses.
Shortly after Shope published his swine results, other scientists using his technique isolated the human flu virus. The path was opened to lifesaving flu vaccinations.
When the Harkness family established the Commonwealth Fund in 1918, health care was one of their highest priorities. More than half of all counties in the United States lacked a hospital and overcrowding was a threat in many places that did have a facility. As early as 1919, Edward Harkness, the foundation’s first president, expressed interest in building new hospitals. Fund officers eventually became convinced that hospitals in rural areas or predominantly black communities were particularly urgently needed. The fund decided to require recipient communities to raise one third of the construction costs themselves, and to cover all future hospital expenses—similar to what Andrew Carnegie had demanded to make sure each locality was invested in the libraries he built.
In 1927, the Commonwealth Fund built a pilot hospital, the Southside Community Hospital, in rural Farmville, Virginia. The $180,000 facility was charged with providing medical care regardless of economic status or background, with each patient paying what he was able to. During the next 20 years, the Commonwealth Fund established 15 more rural hospitals with $6.8 million in grants. The resulting facilities provided medical care to millions of people, and every one of the facilities is still operating today.
Though diabetes is one of the most common modern diseases, there was for generations no hope of recovering from it. One merely adopted a radically constricted diet. Or bodily decay and death advanced fairly quickly.
Hunting for something better, Nathaniel Potter applied to the new Carnegie Corporation of New York in 1916 for a grant to study diabetes patients as they underwent different clinical treatments. He received $7,500 annually from Carnegie, on the condition that he also raise $20,000 externally. Potter got Cottage Hospital in Santa Barbara, California, to build a laboratory for his research alongside their medical facility. When Potter died in 1919, William Sansum from the University of Chicago arrived to head the clinic in his stead.
At this same time, the Carnegie Corporation was also funding research in Canada to extract insulin from the pancreas of dogs. Scientists sought to convert the canine research into a possible injectable treatment for human beings. By 1922, insulin administered at Toronto General Hospital brought a diabetic child back to health—the first use of insulin to treat human beings. The Canadian work eventually led to a Nobel Prize for the lead researchers.
Because they were fellow Carnegie grant recipients, Sansum was corresponding with his Canadian counterparts throughout their experimenting. The Torontans offered detailed guidance in the hope Sansum would be able to improve the difficult process of extracting insulin. Soon, Sansum successfully extracted insulin at the Potter clinic, and made rapid progress at increasing its purity and strength. Four months after the Canadians, he became the first doctor to administer insulin to a patient in the United States.
Next, the Carnegie Foundation contributed additional funds to manufacture insulin injections on a large scale. Kits began to appear in drug stores by 1923. In the words of Duke University historians, “hundreds of thousands of patients near death from diabetes…subsequently recovered.” In the years since, millions have had their lives saved or lengthened via insulin treatments.
In the first half of the twentieth century, polio created a heavy demand for orthopedic services for children. In response, the fraternal organization Shriners International placed a $2 yearly assessment on all of its members and opened a special hospital for children in Shreveport, Louisiana. Any child needing orthopedic care and lacking the wherewithal to pay for it would be admitted and treated with no charge. The organization continued opening free hospitals across the country until there were eventually 22 separate facilities. Orthopedic surgical techniques, therapies, and prosthetics developed in Shriners hospitals became standards around the world.
When vaccines and antibiotics pushed polio into sharp decline in the 1960s, the Shriners Hospitals began to focus on new specialties. Seeing that there were no burn facilities in the U.S. for children, four hospitals were dedicated to treating childhood burn victims. These are still the only hospitals focused wholly on pediatric burn care, and since their creation the survival rate for child burn victims has doubled and rehabilitation improvements have made much more normal lives possible. The Shriners also specialized in spinal-cord injuries, cleft palate correction, and orthopedic research (which is funded at about $40 million per year).
In 2011, in response to soaring health costs, the Shriners Hospitals that had always been 100 percent free began to bill insurance companies and to charge some families deductibles. All patients lacking means to pay, however, continue to be served free. Since their founding, nearly 1 million children have received care at Shriners Hospitals.
Henry Ford stood at the center of the manufacturing revolution after he established the Ford Motor Company in 1903. People flooded to Detroit in search of employment, and the swelling population meant rapidly growing health-care needs. In 1909, the Detroit General Hospital Association, of which Ford was the finance chairman, set out to build a new hospital for the working man. When support and funding for the project plummeted in 1914, construction on the new building halted.
At that point, Ford stepped in and assumed the outstanding debt and contracts for construction. In October 1915, Henry Ford Hospital opened with ten physicians, and an initial group of 48 patients. The hospital pioneered many new methods of operation, including employing the first closed staff of salaried physicians who worked exclusively for the hospital. It was also one of the first hospitals to use a standard fee schedule, and to offer private and semi-private rooms to patients instead of large wards.
The hospital continued to grow in succeeding decades and continued to innovate. It popularized the practice of adding iodine to kitchen salt to prevent endemic goiters. The Ford Hospital pioneered administration of purified heparin to treat vein clots. It developed the oxygen tent to assist respiration. In 1952, one of its doctors performed one of the world’s first grafts of an aneurysm. Four years later, another performed the first successful open-heart surgery in Michigan. Today, the hospital is the flagship institution of the Henry Ford Health System.
By the time his company Eastman Kodak became a secure juggernaut in the early 1900s, George Eastman was one of the richest men in the world, but he had lost interest in accumulating wealth. He was gripped by a powerful desire to put his funds to work in the rest of society. Throughout the next couple decades he would give away more than any other American except John Rockefeller and Andrew Carnegie. In current dollars, his gifts totaled in the range of $2 billion.
Two of his most important efforts were medical. Having built extensive hospital complexes throughout his hometown of Rochester, New York, he single-handedly created the University of Rochester School of Medicine and Dentistry and shaped it according to the bold new scientific principles espoused by Abraham Flexner. The pairing of medicine and dentistry was quite intentional. Eastman recognized how painful and socially crippling oral illnesses and disabilities could be. And long before there was research proving this, he suspected that dental problems could lead to wider infections and degrade one’s health generally.
Eastman was ahead of his time in emphasizing prevention in medicine, and especially in dentistry, where preventative care and the professional dental hygienists he promoted were nearly unknown in his day. After founding the Rochester Dental Dispensary in 1915, he went on to establish additional dental clinics serving children—not only throughout the U.S. but also across Europe. He persuaded other philanthropists like the Guggenheims in New York and Lord Riddell in London to subsidize dental facilities as well.
Children up to age 16 could visit any of Eastman’s clinics at a cost to their indigent parents of a nickel per visit. In addition to work on their teeth, all children were checked for nose, throat, and mouth defects. Orthodontia was offered, and it thrilled Eastman that children not only had their appearances improved but also “improvements in speech were obtained.” He pushed to bring hygienists into schools, encouraged the use of X-rays to diagnose dental health, and underwrote scientific training of dental interns.
“There is nothing I am more interested in than public health,” Eastman told the governor of New York in 1922. The dental clinics were his very favorite projects, which brought him satisfaction to the end of his life. “Dollar for dollar, I got more from my investment” in them, Eastman told the Saturday Evening Post, “than from anything else to which I contributed.” In the process, George Eastman did more to elevate modern dental health than perhaps any other giver ever.
John Rockefeller, the son of an itinerant seller of folk medicines, started pouring large sums from his Standard Oil fortune into medical research and treatment long before he founded the Rockefeller Foundation. The Rockefeller Institute for Medical Research (which grew into Rockefeller University—see 1901 entry) was America’s first research institution in support of experimental medicine. After he set up his foundation, Rockefeller’s money began to flow into many other institutions working to advance human health. Collectively, the Rockefeller investments in health gave perhaps the largest jolt to lifesaving and health improvement that any single source has ever exerted.
In 2013, Philanthropy magazine surveyed historical records and discovered that an astonishing 47 Nobel Prize winners working in the fields of medicine, biochemistry, and health received significant professional support from Rockefeller philanthropy before they earned their Nobels. Another 14 Nobel laureates were supported by a Rockefeller-founded entity some time after their award, allowing them to expand their research or to mentor a new generation of scientists.
The influence of Rockefeller funding peaked in the 1960s and ’70s then declined. There were three Rockefeller-linked Nobelists up to 1929, then six in the 1930s, seven in the 1940s, and seven more in the ’50s. There were 11 Rockefeller-related laureates in the 1960s and 13 more in the 1970s. Then came five in the ’80s, four in the ’90s, and three in the 2000s, with two in the 2010s as of this writing.
Just a few of the breakthroughs influenced by Rockefeller giving: Discovery of human blood types. Separate discoveries of Vitamin C and Vitamin K. Studies on polio that led to a vaccine. Evidence that viruses could cause cancer. Explanations of the working of the eye. Understanding the genetic structure of viruses. Mapping the chemistry of antibodies. Findings on RNA structure that paved the way for the biotech revolution. Discovering how retroviruses attack cells. And much more.
In the beginning of the twentieth century, a cancer diagnosis almost certainly meant death. Cancer was such a mortifying subject that doctors sometimes even kept confirmed diagnoses from their patients, and patients at times kept the news from their families. In May 1913, a group of physicians and businessmen met at the Harvard Club in New York City to address the cancer stigma and information blackout. They believed it was important to raise public awareness and reduce taboos if broader progress in fighting cancer was to be achieved.
Led by Dr. Clement Cleveland, the resulting group resolved to promote cancer awareness through an educational campaign of articles in popular magazines and professional journals. They also produced a monthly bulletin called “Campaign Notes.” John Rockefeller Jr. provided the initial funds for the organization, which was named the American Society for the Control of Cancer. Rockefeller’s support eventually led to additional funds from other wealthy donors in the New York area. In its early years, membership was kept low, never surpassing 2,000.
In 1936 Marjorie Illig, a field representative and leader of a women’s public-health committee, suggested the group “wage war on cancer.” The Women’s Field Army wore khaki uniforms and successfully raised money and recruited volunteers. By 1938, the organization grew to ten times its initial size. It had become the premier voluntary health organization in the U.S. The organization continued to grow through small donations and was renamed the American Cancer Society in 1945. A $4 million fundraising campaign initiated a research program, and filled in gaps in the group’s education and prevention efforts. Today, it remains the largest voluntary health organization in the world.
John Rockefeller Jr. poured himself into the philanthropic activities begun by his father, and is responsible for the creation or development of several signature Rockefeller organizations. These include the Rockefeller Institute for Medical Research, the General Education Board, and the Rockefeller Foundation. He was also a catalyst for the “social-hygiene movement” of the early twentieth century that targeted venereal disease and brought topics of sexuality to public consciousness.
Following his service in 1910 on a special grand jury investigating “white slavery” (prostitution) in New York City, Rockefeller established, largely with his own money, an independent organization he called the Bureau of Social Hygiene. His aim was to combat delinquency, crime, and sex trafficking. The bureau was active from 1911 to 1933, awarding education and research grants aimed at controlling prostitution, drug use, juvenile delinquency, and related social ills, plus the crimes and corruption that followed in their wake. For a period, the organization funded studies of the biological and social factors that influence human sexual conduct. Rockefeller provided five and a half million dollars to the bureau during its two decades of activity.
After Rockefeller attended a conference in Buffalo, New York, on the social problems of prostitution and attendant venereal disease, he funded the uniting of several organizations into the American Social Hygiene Association. The association resolved to control and treat diseases such as syphilis and gonorrhea through public education.
The association worked with the War Department to promote a very aggressive anti-venereal disease campaign within the U.S. military. It also helped to establish venereology as a branch of medicine and coordinated national efforts to treat patients, conduct medical studies, and develop school curricula on sexual health. In later years, the Rockefeller Foundation took over some of this work from the bureau and John Jr.’s personal giving.
Andrew Carnegie did not have a strong personal interest in medicine. He believed in the power of education to promote wealth and well-being in society, though, so when the American Medical Association Council on Medical Education approached Carnegie in 1906 he was highly supportive of its efforts to restructure medical education in America. The Carnegie Foundation for the Advancement of Teaching became keenly interested in educator Abraham Flexner, who published a critique of American higher education in the same year. Henry Pritchett recruited Flexner to lead a study of medical education and present a report with recommendations.
Published in 1910, Flexner’s book-length Medical Education in the United States and Canada set off a firestorm of controversy among educators and physicians. Though he praised a few medical schools, Flexner condemned the majority. When he asked a Washington state medical school if they had lab facilities, the dean replied, “Surely, I have it upstairs”—then went up and brought back down a small blood-pressure measuring device.
Flexner called for higher standards, more hands-on clinical work, more research. This prompted Robert Brookings, a wealthy merchant, to request a meeting with him so they could plan a reconstruction of the medical school at Washington University. Yale also instituted changes recommended in the Flexner report. Other universities responded defensively.
The Rockefeller Foundation hired Flexner in 1913 to advise its General Education Board. The foundation then systematically funded reforms at several medical schools, including Washington University at St. Louis, Yale University, the University of Chicago, and Vanderbilt University. In 1923, the Rockefeller Foundation gave additional money to reform public medical schools in Iowa, Colorado, Oregon, Virginia, and Georgia. These efforts established a single high standard for medical education in the United States, and launched American medicine to international prominence, a prestige it continues to possess today.
When John Rockefeller announced that he intended to eliminate hookworm disease in the American South, it was an unheard of notion. Indeed, some of the intended beneficiaries were embarrassed and annoyed to have a spotlight shone on this aspect of their region. Yet in warm-weather sections of the U.S., endemic hookworm among the poor was a real problem. The parasite causes extreme anemia, fatigue, lowered cognitive function, and gastrointestinal distress by leaching vital nutrients and minerals from the host’s body. The resulting lethargy creates economic as well as personal health problems.
Along came Rockefeller with $1 million (about $25 million in current dollars) and a savvy plan. In 1909, he created the Rockefeller Sanitary Commission to lead a public-health campaign. It worked to win the trust and support of local officials. It offered the public information on how to treat and avoid the disease. It sent field agents into infested states to demonstrate preventative hygiene. Because hookworm enters the bloodstream through the soles of the feet, wearing shoes and using sanitary latrines goes far toward preventing infection.
After a five-year campaign, hookworm disease was nearly eliminated in the South. This success led Rockefeller to create an International Health Commission in 1914 to launch similar campaigns in Mexico and Ceylon. Later Rockefeller’s anti-hookworm effort served as the model for other campaigns against diseases like malaria, typhus, scarlet fever, and tuberculosis.
In the first decade of the twentieth century, tuberculosis accounted for about 11 percent of all U.S. deaths. About a quarter of all children were afflicted in cities like New York. Around the middle of that decade, a popular movement arose that convinced millions of small donors to give money to battle the disease. At Christmastime in 1908, a campaign was launched to sell, for pennies, “seals” that could be used to decorate letters, with all the money raised going to the National Association for the Study and Prevention of Tuberculosis, newly founded that same year. The holiday campaign raised $135,000 (the equivalent of several million dollars today). By 1916 this small-scale giving was bringing in more than a million dollars, and by the mid-1960s $26 million.
The mass givers were joined by a few wealthy philanthropists. The Russell Sage Foundation, for instance, which was founded in 1907, made tuberculosis one of its main targets during its early years. The Saranac Sanitarium in New York’s Adirondack Mountains was one of several projects they helped bankroll. John Rockefeller and his charities eventually joined the fight.
But it was mostly small givers and volunteers who elevated the war on TB. Between 1904 and 1916 the number of TB clinics in the nation jumped from 18 to 1,324. The National Association for the Study and Prevention of Tuberculosis organized an “army” of 500,000 Americans at peak times of the year to raise funds for sanitariums, medical research, and relief for afflicted families and individuals. Eventually the development of antibiotics made tuberculosis a less pressing concern. The “people’s philanthropy” launched against this frightening disease became the model, however, for subsequent popular crusades against polio, cancer, heart disease, and other medical scourges.
The Peking Union Medical College was founded in 1906 by American and British missionary groups. It was a rare outpost of modern medicine in a nation with one of the highest mortality rates in the world. A decade later, John Rockefeller assumed financial responsibility for the school. A thorough renovation and expansion began in 1915.
The Peking Union Medical College became the Rockefeller Foundation’s single largest expenditure—almost $45 million was poured into the institution. The effects were equally enormous. The college endured through many upheavals and today remains one of China’s most prestigious institutes of higher education. It has served as the model for improving medical training in countries throughout the world.
In 1901, John Rockefeller founded the first biomedical research institute in the United States. Although he discussed the idea for three years with his scientific adviser, Frederick Gates, it was the death of his three-year-old grandson from scarlet fever that jolted Rockefeller into action. At the time, infectious diseases like tuberculosis, diphtheria, and typhoid posed great threats to human health, and scarcely any organized research was under way to fight back.
Rockefeller initially committed $200,000 over ten years to construct the Rockefeller Institute for Medical Research, then added many millions more over the coming years. The organization, which was renamed Rockefeller University in 1965, produced some of the most important medical discoveries in history, including establishing that DNA is the chemical basis of heredity; discovering blood groups; finding new ways to freeze blood (which led to the creation of the first blood bank); explaining the structure of antibodies; Peyton Rous’s discovery that cancer can be caused by a virus; proving the connection between cholesterol and heart disease; and so forth.
Many lifesaving drugs and therapies emerged from Rockefeller’s walls, for instance: Simon Flexner’s anti-meningitis serum; Hideyo Noguchi’s treatments for syphilis and yellow fever; Louis Pearce’s invention of drugs to treat African sleeping sickness; the use of methadone to manage heroin addiction; and developing anti-AIDS “cocktail” drugs. Fully 24 scientists associated with the institution have received the Nobel Prize, and 20 have been awarded the National Medal of Science. Considered one of the best research centers in the world, Rockefeller University has served as a model for many medical-research facilities elsewhere.
The organization has attracted support from many benefactors beyond its founder, right up to the current day. The Heilbrunn family, for instance, first became interested in the university’s diabetes research, then supported cancer investigations, cellular research, and eventually a center for research nursing. New York City’s Starr Foundation is another philanthropic entity that has donated hundreds of millions of dollars since 1992 to support RU’s biomedical innovations.
Upon his death in 1873, Quaker merchant Johns Hopkins bequested $7 million to build a hospital and university. This sum was unprecedented at the time. He wished for the new institution to uphold a threefold mission. It should produce superior physicians, seek knowledge to advance medicine, and administer free and excellent patient care. In 1889 the Johns Hopkins Hospital opened, followed by the Johns Hopkins School of Medicine four years later. The medical school became the premier educational institution in the country and single-handedly raised the level of medical education in the United States. It instituted rigorous standards for admission and developed a new scientific curriculum. When the Flexner Report came out in 1910 and lambasted most medical schools in the United States, Johns Hopkins was lifted up as an ideal institution. In addition to being the premier medical school for much of its existence, it was the first to admit women, the first to use rubber gloves during surgery, the discoverer of Vitamin D, the first to develop CPR, the first to succeed at “blue baby” surgery, uncoverer of the natural opiates in the brain, researcher of many of the building blocks of genetic engineering, and a leader in numerous other areas.
Mary Elizabeth Garrett was the only daughter of American railroad magnate and philanthropist John Garrett. Having inherited $2 million at her father’s passing in 1884, Garrett became one of the richest women in the United States and promptly devoted herself to advancing women in all spheres of public and civic life. Garrett met regularly with a group of young women determined to open an intensive preparatory school for girls. With Garrett’s financial support, the Bryn Mawr School for Girls was opened in their home town of Baltimore in 1885. Its success spurred them to look towards Johns Hopkins University, the newly opened and highly lauded institution open only to men.
In 1887, Johns Hopkins rejected the application of a young woman, expressing a policy against admitting women. Undeterred, Garrett approached the president and the university’s trustees with an offer to donate $35,000 to build a coeducational school of science. The policy against women was invoked again and her proposal was rejected. Eventually, news emerged that the university did not have sufficient funds to open its planned medical school alongside the new hospital. Garrett’s women’s group approached the president of the university with a proposal to raise the $100,000 needed to open the school; their condition being that the medical school had to be open to qualified female applicants. By 1892 these women had produced more than $300,000 in donations plus an additional $150,000 from Garrett. Johns Hopkins became the first coeducational medical school in the United States, paving the way for women to train in medicine all over the country.
New York City clergyman John Rodgers was a classic charitable leader who honed his coalition-building skills as president of the Society for the Relief of Distressed Debtors, vice-chancellor of the University of New York, and founder of the Brick Church and its charity school. He needed all of those skills to open the second hospital in America ministering to the “laborious and industrious poor.”
Philadelphia’s creation of the nation’s first major facility to distribute medical aid to the poor inspired deep interest (and some jealousy) in New York City. Squabbles among doctors, donors, and others, however, delayed action to replicate Philly’s success. The New York Daily Advertiser ran several articles explaining the workings of the Philadelphia hospital. This persuaded citizens to offer financial contributions, and a cooperative plan finally emerged. The New York Dispensary quite consciously copied Philadelphia’s pathbreaking institution—and ultimately had great success in improving the standard of medical care throughout New York.
Benjamin Rush, physician and signer of the Declaration of Independence, opened a medical practice in Philadelphia in 1769. In 1786, he established the first free walk-in health clinic in the United States, the Philadelphia Dispensary. This organization also offered in-home visits for the poor who were too ill to leave their houses. An on-site apothecary compounded medicines of all sorts, which were offered to patients along with advice and therapies suggested by the dispensary’s physicians. Urban dispensaries like this one in Philadelphia were staffed largely by volunteers, and for many generations were the primary means of providing health care to the urban poor throughout the United States.
At a time when Philadelphia was the fastest-growing city in America (and the second-largest English-speaking city in the British Empire), two city benefactors came together to create a hospital (an institution then coming into vogue in Europe). The institution was intended “to care for the sick poor of the Province and for the reception and care of lunaticks” who were then wandering the streets of the city of Brotherly Love. At a time when many medical institutions were designed simply to remove the ill from the community, the Pennsylvania Hospital aimed to restore them to active health, and toward this end it connected, from its very beginning, medical care and medical teaching.
Thomas Bond, who came up with the idea, was a London-trained physician. When he mentioned his aspiration to his friend Benjamin Franklin, Franklin offered a large personal donation and became a strong public advocate for the plan—offering the seemingly unreachable sum of 2,000 pounds, to be provided from his own pocket and those of friends he would solicit, if the Pennsylvania Assembly would match that amount. Franklin quickly exceeded his goal, and a charter was granted. Franklin remained a strong supporter to the end of his life, writing fundraising appeals, investing the hospital’s endowment, purchasing modern equipment for it when he was in Europe, and continuing to give his own resources.
The seal of the new Pennsylvania Hospital was inscribed with an image of the Good Samaritan and the words “Take care of him and I will repay thee.” Bond became a volunteer physician and manager, offering his professional services from the time of its creation until his death 33 years later. Bond also collaborated with Franklin in creating the educational institution that became the University of Pennsylvania, and beginning in 1766 he shared his own medical knowledge by conducting clinical lectures to students at the hospital. Dr. Bond thus became known as America’s “father of clinical medicine.” The Pennsylvania Hospital pioneered a number of other firsts—the first surgical amphitheater, the first hospital auxiliary, the first apothecary.
Pennsylvania Hospital’s deepest influence, though, came in psychiatric care. In 1783 Benjamin Rush (whose own medical clinic is described in the 1786 entry above) joined the medical staff of Pennsylvania Hospital. Among other contributions at the hospital, Rush dramatically improved the treatment of the insane—who he recognized to be suffering from illness—to be deserving of respect, and to be responsive in some cases to treatment. From his work at Bond and Franklin’s hospital, Rush later wrote the first psychiatric text produced in the U.S. He became known as the “father of American psychiatry.”
“Nothing being more certain than death, and nothing more uncertain than its hour…I bequeath…a hospital for the sick of the City of New Orleans, without anyone being able to change my purpose, and to secure the things necessary to succor the sick.”
So stated the last will and testament of an ailing sailor named Jean Louis who had become a shipbuilder in the new French colony at the mouth of the Mississippi River. Having been founded just 18 years earlier, New Orleans was a ragged corner of civilization when Louis made his gift. By the city’s mere nineteenth year, though, it was distinguished by a pioneering, philanthropically created facility offering free care for the sick.
With New Orleans being settled primarily by people recruited from jails, poorhouses, and urban streets, there was plenty of business for Charity Hospital. The facility “was noted as one of the most efficient and useful charities in the country, given that New Orleans was exposed to greater varieties of human misery, vice, disease, and want than virtually any other American town,” states an official history. Among other maladies, the hospital treated record numbers of cases of venereal disease. In 1834 the Roman Catholic Sisters of Charity assumed control of the hospital, and they gradually built it into a “celebrated institution of healing in the city.” The hospital was 269 years old (and located in its sixth building, a 2,680-bed landmark) when Hurricane Katrina struck. The facility closed and never reopened, though residents reluctant to let go of their beloved institution continue to argue for its revival.