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World Bank’s Jim Yong Kim: A doctor’s bold prescription to cure poverty

Illustration of Jim Yong Kim, president of the World Bank.

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Jim Yong Kim, the Harvard-trained physician who completed his first year as World Bank president earlier this month, must be the only person in history who has gone on television to apologize for saving lives.

In 2003, when Dr. Kim was the World Health Organization's point man on HIV-AIDS, he rallied the world's governments to endorse an audacious plan to treat three million victims of the disease with antiretroviral therapy by 2005. (Former prime minister Paul Martin's government donated $100-million in May, 2004, to keep the effort from failing.)

There was internal resistance to Dr. Kim's "3 by 5" initiative. The careerists at the WHO said failure was certain. To clinch the necessary support, Dr. Kim said he would take personal responsibility if the initiative flopped.

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By June, 2005, one million people in developing countries were receiving treatment. That was a 230-per-cent increase from 2003, but the target of three million clearly was out of reach. Keeping his pledge, Dr. Kim went on the British Broadcasting Corp. to apologize for the miss.

"It was a totally impossible goal in retrospect," Dr. Kim acknowledges now, although with a gigantic smile on his face. "But my goodness, it sped up our process!"

Our conversation has turned into a brief oral history of "3 by 5" because Dr. Kim has a new mission. In April, he convinced Finance Minister Jim Flaherty and the 24 other economic and development ministers who set the World Bank's agenda to endorse a pledge to eliminate extreme poverty by 2030.

I had pointed out that targets can come back to haunt. In concrete terms, Dr. Kim's pledge amounts to lifting the incomes of more than one billion people above $1.25 (U.S.) a day in 17 years. Nothing like that has ever been achieved. Why risk the embarrassment of failure?

Dr. Kim steamrolls over my question, probably in the same way he flattened objections from his WHO bureaucrats a decade ago.

Dr. Kim, who also has a PhD in anthropology, says one of his great interests is organizational theory. The "3 by 5" gambit wasn't about seeking glory for the WHO.

Rather, his intent simply was to get more out of the organization's resources. When Dr. Kim launched his initiative, 300,000 people in the poorest countries were receiving treatment for AIDS victims. Today, the number is more than eight million.

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"He has an endlessly creative mind," said Stephen Lewis, who was the UN secretary-general's special envoy for HIV-AIDS in Africa at the same time Dr. Kim was at the WHO, an agency of the United Nations.

"He has a very strong sense of focus on how to get things done," Mr. Lewis added in a telephone interview from Toronto.

"What he has set out for himself, he will move heaven and earth to achieve."

There are plenty of restaurants near the World Bank headquarters in Washington's Foggy Bottom neighbourhood that cater to power brokers.

Yet Dr. Kim has denied me the opportunity to inflate my expense account. Instead, we are sitting around a small work table eating roasted vegetables and salad from the World Bank's cafeteria.

This being a lunch profile, he says he thought it would be appropriate that our meeting reflect his usual eating habits.

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He explains that he knocked down some walls outside his office to facilitate conversation between his senior advisers, who carry on with their work even as their boss eats with a stranger.

As for the menu, Dr. Kim says he is fairly disciplined about eating a healthy diet. Breakfast almost always is fruit and lunch almost always is vegetables. "I am a physician," he says. And dinner? "I cheat."

By convention, the World Bank president is an American. When the institution was established at the end of the Second World War, the U.S. stood alone as the world's global power, and the White House insisted on naming the World Bank's leader. Nothing has changed in the decades since.

The World Bank's mandate is to reduce poverty by lending and investing in the parts of the world that private investors deem unprofitable. The institution, which counts 188 countries as members, extended concessional loans worth $35.3-billion (U.S.) in the fiscal year that ended June 30, 2012.

The U.S. remains the dominant shareholder, giving it a veto over major decisions, including who sits in the president's office. The result of U.S. influence is a pantheon of bankers and political apparatchiks that is exclusively white and male.

The only thing Dr. Kim shares with this group is citizenship. He was born in Seoul in 1959, but moved to Muscatine, Iowa when he was five years old so that his mother could pursue a PhD at the University of Iowa. His father, a dentist, set up a practice.

In his American youth, Dr. Kim excelled at school, was the quarterback of the high school football team and played point guard for the basketball team. He suffered little discrimination even though he was forced to grow up in one of the whitest parts of the country.

"As you might imagine there weren't a lot of Asians in Iowa in the '60s and '70s, but happily, one of the most popular shows at that time was Kung Fu," Dr. Kim told graduates at Northeastern University's commencement ceremony in May, referring to the 1970s U.S. television series that chronicled the travels of a Chinese Shaolin monk in a fictionalized American old West.

"So while we were outsiders in Iowa in a profound sense, at least the bully kids left us alone because they thought all Asians knew Kung Fu."

Still, Dr. Kim's All-American upbringing was coupled with a visceral understanding of struggle and deprivation unlike anything most Americans have experienced.

His father escaped North Korea as a 19-year-old and started a new life, alone and penniless, in the south. Dr. Kim's mother was a refugee of the Korean War whose own mother disappeared one day after going outside to hang laundry.

Yet she managed to earn a scholarship to study at Morehead State College in Nashville. She and Dr. Kim's father met in New York one Christmas when Korean students in the United States gathered for the holidays.

That family history might explain Dr. Kim's unfettered hopefulness, a characteristic that differentiates him from many global leaders, who seem worn down by a decade marked by war, economic upheaval and environmental destruction.

So effusive are his answers to my questions that the pile of asparagus, squash and lettuce on his plate remains mostly untouched for the 40 minutes he spared to talk to me.

"What would be really frightening to me is if people like me, people like the World Bank staff, were so concerned about their own lives that they would not grab the opportunity to set a bold target," he says.

"It took a very long time to convince people that we should have this target, but now that we do, I just see it as a huge gift," he continues, increasingly excited.

"I feel pressure! Feeling pressure, feeling that sense of urgency, that's what it's all about!"

Mr. Lewis said his friend is the first World Bank president who "knows what he's talking about" when it comes to poverty. Lilianne Ploumen, a former AIDS and women's rights activist who now is the Dutch minister of trade and international development, said in an interview in Washington that Dr. Kim is "the right man at the right place at the right time."

In 1987, Dr. Kim helped create Partners In Health, which revolutionized the delivery of health care in poor countries by immersing itself in the communities it serves with standard practices that include hiring and training locals as health workers.

After starting with a project in the mountains of Haiti, the group, whose board of trustees includes Chelsea Clinton and Régine Chassagne (a founding member of the Grammy-winning rock band Arcade Fire), now has projects in a dozen countries and a staff of 13,000.

Still, Dr. Kim has yet to win a full embrace from his former comrades in the development community.

There are grumbles about whether a physician is up to the task of running a bank and there is a concern that Dr. Kim's emphasis on economic growth could lead to a watering down of World Bank standards on issues such as pollution and human rights.

Nancy Birdsall, the head of the Center for Global Development, a Washington-based think tank, observed that people who live on $1.25 a day still are on the verge of misery. Others note that Dr. Kim has yet to present a detailed strategy for how he'll achieve the 2030 goal.

Some of this is Pavlovian: So many of the World Bank's detractors have been criticizing the institution for so long, they know no other way.

Regardless, one gets the impression that Dr. Kim is paying his critics little mind.

In pursuit of the 2030 target, he says he intends to shun cookie-cutter solutions in favour of country-by-country approaches. Progress will be assessed every year, a shift from the World Bank's practice of measuring poverty every three years. The change will force accountability and allow for more rapid assessments on what's working and what isn't.

Like Mr. Lewis said, Dr. Kim has done this before.

"I'm not interested in any dilution of safeguards," Dr. Kim says.

"But I am interested, very interested, in maintaining our safeguards while moving more quickly. In emergency situations we've been able to do that, so the question I've been asking is why can't we move at emergency speed all the time?"

(Editor's Note: An earlier online version of this story incorrectly stated that it was former prime minister Jean Chrétien's government that donated $100-million in May, 2004, to a plan to treat three million victims of HIV-AIDS with antiretroviral therapy by 2005.)

CURRICULUM VITAE

Background

Age: 53

Hometown: Muscatine, Iowa.

Personal: Married to Younsook Lim, a pediatrician. They have two sons, aged 14 and 4.

Education: A.B. from Brown University in 1982; M.D. from Harvard Medical School in 1991; PhD in anthropology from Harvard University in 1993.

Career

1987-2003: Helped create Partners In Health, a non-profit organization that provides medical care in developing countries.

2003: Received a $500,000 (U.S.) MacArthur Fellowship, awarded by the MacArthur Foundation to "talented individuals who have shown extraordinary originality and dedication in their creative pursuits."

2003-2006: Advised the director-general of the World Health Organization and led the WHO's HIV-AIDS department.

1993-2009: Taught medicine, social medicine and human rights at Harvard University.

Led the Department of Global Health and Social Medicine.

2009-2012: Served as president of Dartmouth College.

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About the Author
Senior fellow at the Centre for International Governance Innovation

Kevin Carmichael is a senior fellow at the Centre for International Governance Innovation, based in Mumbai.Previously, he was Report on Business's correspondent in Washington. He has covered finance and economics for a decade, mostly as a reporter with Bloomberg News in Ottawa and Washington. A native of New Brunswick's Upper St. More

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