2007-12-17 13:07:38.0 Jane: What prompted you to write this piece? It's received some harsh comments from those affronted at the idea of criticizing the generousity of the Gates Foundation; did you anticipate this outcry?
2007-12-17 13:09:15.0 Charles Piller: The Gates Foundation deserves a lot of credit for attempting to tackle very tough problems. We tried to be clear that the work is very important, despite strong challenges to its effectiveness. I'm not surprise some disagreed.
2007-12-17 13:09:32.0 Sarah: I just returned from a year spent in Lesotho working in an HIV/AIDS clinic. As I imagine you know, in Lesothi, CHAI, the Clinton Foundation's AIDS Initiative, is far more actively involved in HIV prevention and treatment than the Gates Foundation. In fact, Lesotho's health minister, quoted in your article, was, until recently, an employee of the Clinton Foundation. Why don't you mention the work of the Clinton Foundation in your article? Does your criticism of the Gates Foundation extend to the Clinton Foundation?
2007-12-17 13:10:44.0 Charles Piller: I did know about the Clinton work. It's very important there, and dedicated to taking a comprehensive approach to healthcare and health systems. CHAI supports Partners in Health to that end. Thanks for pointing this out.
2007-12-17 13:10:51.0 Jane: What gave you the idea for this story? What was your goal in writing it?
2007-12-17 13:11:54.0 Charles Piller: The Gates Foundation is the most important private philanthropy. We felt that because of its influence and importance, that a close look at its programs would be helpful to understanding whether they are as effective as they can be.
2007-12-17 13:12:52.0 Stephen: It's hard to calculate its effectiveness though in such a complex envirnoment where so many others are working, don't you agree?
2007-12-17 13:13:42.0 Charles Piller: The goal was to shine a light on those programs in the spirit of contributing to overall understanding of how to tackle the important issue of health. And yes, effectiveness can be a hard thing to measure. That's why we took months to both scrutinize the available data and try to find some "ground truth" in field reporting.
2007-12-17 13:15:14.0 Chris: it seems, however, that your primary point was that while the GF is doing some things that are really worthwhile, there are other things it is not addressing, and without those other things, the overall impact is less than it could be. This sounds like you are expecting the GF to solve all the world's problems at once.
2007-12-17 13:16:18.0 Charles Piller: This is also a moving target--the Gates Foundation and its grantees are continually doing course corrections. We hope that the issues raised in our story might contribute to improved programs over time. I don't think that Gates can do it all. But as so influential an organization, what they do has a great impact.
2007-12-17 13:16:20.0 Stephen: It's too bad that you did not provide at least some kind of landscape in which to present Gates' contribution though.
2007-12-17 13:17:02.0 Stephen: Well then
2007-12-17 13:17:05.0 pcharles: I was very turned off by the unnecessarily provocative title, and the intentionally inflammatory (and negative) choice of words throughout the piece.
2007-12-17 13:17:19.0 Sarah: A lot of people are focusing on what they perceive to be your negative opinion of the Gates Foundation. Do you think you might have written a better article if you had focused more broadly on the issue of how to address the complex issues surrounding vertical vs. horizontal health interventions in the developing world?
2007-12-17 13:17:22.0 Charles Piller: Yes, our story could have presented more than it did about Africa and the Gates Foundation. We hope to tackle the issues more in the future.
2007-12-17 13:17:40.0 Stephen: Well then, how about giving credit to Gates for being a catalyst to prompt so many other organisations and donors to join the caue of tackling the serious issues of global health. You did not do that.
2007-12-17 13:18:53.0 Charles Piller: Actually, we tried to give them credit. The story was tyring to tackle the additional issues in more detail.
2007-12-17 13:18:57.0 Stephen: PCharles, I completely agree with you and the LA Times editors should be taken to task for this just as much as the reporters. Very irresponsible I thought.