thenation--2020-12-03--Are Bill Gates’s Billions Distorting Public Health Data?

A perennial feature of the Covid-19 pandemic has been the guessing game of whether things are getting better or worse—and how policy approaches ( masks , shutdowns ) and changes in the weather will affect the coronavirus .
Dozens of research institutes have published educated guesses about what ’ s coming next , but none have had the impact or reach of the University of Washington ’ s Institute for Health Metrics and Evaluation.1 In the early days of the pandemic , the IHME projected a far less severe outbreak than other models , which drew the attention of Donald @ @ @ @ @ @ @ the danger .
At a March 31 press briefing , the White House ’ s coronavirus response coordinator , Debbie Birx , with the president at her side , used IHME charts to show that the pandemic was rapidly winding down.2 “ “ Throughout April , millions of Americans were falsely led to believe that the epidemic would be over by June because of IHME ’ s projections , ” the data scientist Youyang Gu noted in his review of the institute ’ s work .
“ I think that a lot of @ @ @ @ @ @ @ 3 The IHME brushed aside the widespread criticism that emerged— “ Many people do not understand how modeling works , ” its director , Chris Murray , explained in a Los Angeles Times op-ed—and continued to push headline-grabbing projections that drew alarm from its peers .
For example , while many researchers limit their projections to a few weeks into the future , Murray used his regular appearances on CNN to chart the course of the pandemic many months in advance , putting the IHME ’ s highly contested estimates in a position @ @ @ @ @ @ @ “ It seems to be a version of the playbook Trump follows , ” says Sam Clark , a demographer at Ohio State University .
“ Absolutely nothing negative sticks , and the more exposure you get , the better , no matter what .
It ’ s really stunning , and I don ’ t know any other scientific personality or organization that is able to pull it off quite like IHME.
” 5 The institute ’ s uncanny resilience , unconventional methods , and media savvy have long made it controversial @ @ @ @ @ @ @ scholars have watched its meteoric rise over the past decade with a mix of awe and concern .
Years before Covid , the IHME gained outsize influence by tracking hundreds of diseases across the planet and producing some of the most cited studies in all of science.6 But it has also spawned a legion of detractors who call the IHME a monopoly and a juggernaut and charge the group has surrounded itself with a constellation of high-profile allies that have made it too big to peer review , the traditional method of self-regulation @ @ @ @ @ @ @ $ 600 million in funding from the Bill & Melinda Gates Foundation—a virtually unheard-of sum for an academic research institute—the IHME has outgrown and overwhelmed its peers , most notably the World Health Organization ( WHO ) , which previously acted as the global authority for health estimates.7 Today the IHME ’ s sprawling estimates have become the gold standard for understanding an increasingly broad array of topics related to health and development—particularly in the data-poor developing world , where record keeping is sparse .
Its website offers interactive maps that allow users @ @ @ @ @ @ @ in sub-Saharan Africa , for example , to find out how many years of education people have ; how malaria , HIV , and lower respiratory infections are changing over time ; who has access to piped water ; or how many men are circumcised .
These estimates—educated guesses , really—help guide billions of dollars in aid spending and tell health ministers , charities , researchers , and journalists where things are getting better or worse.8 “ In a relatively short period of time , the IHME has exerted a certain kind of @ @ @ @ @ @ @ production , ” says Manjari Mahajan , a professor of international studies at the New School .
“ It ’ s a kind of monopoly of knowledge production , of how to know global health trends in the world .
And that produces a concentration of…power that should make anybody uncomfortable.
” 9 Critics say this monopoly power can be seen in the ways the IHME appears to play by a different set of rules from the rest of the scientific community .
Many describe its estimates as a black box.10 “ It @ @ @ @ @ @ @ indeed comment on their methods , since they are completely opaque , ” says Max Parkin , from the International Network for Cancer Treatment and Research.11 While the Poor Get Sick , Bill Gates Just Gets Richer Bill Gates Gives to the Rich ( Including Himself ) In 2019 , Peter Byass , then a professor of global health at Sweden ’ s Umeå University , told The Nation , “ From a scientific point of view , that makes it impossible for anyone to replicate or verify the estimates.
” 12 Despite @ @ @ @ @ @ @ dominion keeps expanding—thanks in large part to Richard Horton , the editor in chief of The Lancet , who has put the credibility of the famed medical journal behind it , publishing more of the institute ’ s studies than any other periodical .
While most scholars are lucky to publish one research article in The Lancet during a decades-long career , the IHME ’ s Murray has published more than 100.13 The relationship between The Lancet and the institute was further underscored last year when Murray nominated Horton to receive the $ @ @ @ @ @ @ @ It was a striking conflict of interest that raised eyebrows among scholars but virtually no public criticism .
Challenging Horton could mean foreclosing on future publishing opportunities in a leading journal.14 Some experts are also reluctant to criticize the IHME for fear of upsetting the Gates Foundation , one of the most important funders in global health and academic research more generally .
According to the Web of Science database , more than 20,000 academic papers cite funding from the Gates Foundation , which has poured over $ 8 billion into universities in @ @ @ @ @ @ @ The Nation ’ s analysis of its charitable giving .
Scholars have even used the term “ the Bill chill ” to describe their reluctance to bite the hand that feeds them.15 “ We are receiving millions of dollars for our polio campaign in Afghanistan and Pakistan from the Gates Foundation .
We can not jeopardize that campaign .
Publicly criticizing the work of the IHME could potentially alienate the Gates Foundation , ” one UNICEF official , who asked for anonymity , admitted to Mahajan in a study she published in 2019.16 @ @ @ @ @ @ @ criticism , the Gates Foundation ’ s influence isn ’ t absolute and doesn ’ t travel very far into the social sciences , where scholars like Mahajan have taken a magnifying glass to the IHME .
Even in research fields that the foundation funds , scholars appear increasingly willing to voice criticism of the IHME , including assertions that the powerful triumvirate of Gates , Horton , and Murray has advanced its work in a way that routinely sidesteps the checks and balances that govern scientific enterprise.17 “ Who is making such @ @ @ @ @ @ @ been published or stated publicly ?
” an IHME spokesperson responded when asked about the institute ’ s controversial reputation .
After The Nation forwarded several scholarly reviewss , the institute struck a different tone : “ This criticism is not new… .
Part of the process over the past 12 years of creating a leading source of global health data is reckoning with criticism .
IHME welcomes it and other critiques as one aspect of improving the Institute ’ s work.
” 18 Murray is the IHME ’ s driving force and @ @ @ @ @ @ @ global health—one of the rare scientists about whom biographies are written while they are still alive .
19 The 2015 book Epic Measures : One Doctor .
Seven Billion Patients , by Jeremy M. Smith , describes Murray ’ s approach to health estimates as an extension of his medical training .
Instead of treating individual patients , he ’ s diagnosing the globe , using Big Data to show governments and aid groups which diseases need the most attention and money.20 Gates has long been a fan of Murray ’ s work @ @ @ @ @ @ @ he coauthored on the global burden of disease .
“ I saw…that 12 million children are dying every year , ” Gates told Scientific American in 2014 .
“ Wow !
It was mind-blowing to me that these preventable diseases—pneumonia , diarrhea , malaria and some other infections that infants get—had such a huge impact .
That was the first time it dawned on me that it ’ s not hundreds of different diseases causing most of the problem—it ’ s a pretty finite number.
” 21 Based on Murray ’ s estimates @ @ @ @ @ @ @ a big impact , and his foundation went on to donate almost $ 40 billion to global health and development , becoming one of the most powerful political actors in the field.22 Though the WHO already had a robust health metrics program in place , Gates decided to create a competing group in 2007 , luring Murray from Harvard to the University of Washington in Seattle , where the Gates Foundation is headquartered .
Gates described his support of the IHME as designed “ to make sure that everybody views this as the @ @ @ @ @ @ @ Gates Foundation and the IHME refused multiple interview requests and did not respond to most questions sent by e-mail . )
23 A renowned technocrat , Gates undoubtedly liked Murray ’ s Big Data approach , but may also have seen him as someone cut from the same cloth : entrepreneurial , combative , and hard-driving , someone with the rare combination of technical know-how and business acumen—and a desire to dominate.24 “ Chris is supergood , but he likes controversy—and he doesn ’ t back down , ” Gates acknowledged in 2014 @ @ @ @ @ @ @ the normative database , he ’ s not absolutely the perfect person.
” 25 To be sure , the field of global health is littered with war stories of researchers who have had run-ins and blowups with Murray , many of them beginning the same way : with a request to Murray to show his work .
Colin Mathers is one of them .
These days a private consultant , he says that in his previous position managing health statistics at the WHO , he worked as a scientific adviser to the IHME @ @ @ @ @ @ @ basic information about how he formulated the estimates .
“ We felt that without access to the data , we couldn ’ t put our names to the results , ” Mathers explains.26 Sam Clark of Ohio State University says that when he asked the institute to provide the source code for a tool it used in its estimates , it engaged in years of “ obfuscation and blatant noncooperation ” and later published a scientific paper attacking his work.27 Another academic researcher asked to speak anonymously , saying he wanted to avoid @ @ @ @ @ @ @ disagreements into personal accusations.
” 28 Even the hagiographic Epic Measures describes Murray as believing that “ scientific progress relies on picking fights.
” The book recounts an incident in which he accused an academic researcher of inflating child mortality estimates 10 percent higher than his own .
“ He knows that deaths translate into money for child health programs .
Deaths are money , ” Murray is quoted saying .
“ Who ’ s right ?
That ’ s the only question .
All that matters is being right.
” 29 Yet @ @ @ @ @ @ @ s early projections proved dramatically wrong—and damaging to public health , some say .
But this reckoning has come only because the high stakes of Covid have brought a new level of scrutiny and competition from other researchers and because the institute has had to contend with the emergence of actual data on infections and deaths.30 In much of the IHME ’ s other work in health metrics , these feedback mechanisms do not come to bear in the same way , even though its estimates may be just as influential and , @ @ @ @ @ @ @ .
This includes its efforts to track hundreds of diseases in the most remote corners of the planet.31 “ It ’ s impossible to do what they ’ re trying to do rigorously… .
The data is just not there to really quantify the impact of some of these diseases , ” notes Ruth Etzioni , a professor of public health sciences at the Fred Hutchinson Cancer Research Center .
“ Instead of saying , ‘ You know what ?
That ’ s not possible , ’ [ the IHME says , ] @ @ @ @ @ @ @ ’ ve naturally got yourself in an overpromising situation.
” 32 The IHME counters that “ no estimate of a problem is interpreted as an estimate of no problem.
” And in an e-mail , it defended its estimates as transparent and published with statistical confidence intervals that inform users about the limitations of its work.33 But Etzioni sees a pattern in the IHME ’ s pushing its findings into the limelight while relegating “ key caveats and uncertainties ” to the fine print .
She points out that even when the institute @ @ @ @ @ @ @ Covid projections—it had been using a bad model—it never issued a clear mea culpa.34 “ Instead of being straightforward and telling the public that they had a new model , Chris Murray told everyone that the numbers had gone up because we were reopening [ from lockdowns ] and not socially distancing anymore , ” Etzioni says via e-mail .
“ What happened early in the summer when the IHME revised its estimate downward dramatically ( which served the White House and consequently gave the IHME huge press ) and…then turned out to @ @ @ @ @ @ @ a debacle.
” 35 In a normal year on the planet , approximately 60 million people die .
Fewer than half of these deaths , including many in the developing world , will have medical records citing a cause .
Knowing why and where people are dying is crucial to improving global health , which is what makes the IHME ’ s estimates are so important and influential .
36 Gates extols the way the IHME ’ s work on global health “ democratizes information , ” bringing together 281,586 global data sources @ @ @ @ @ @ @ , and the scientific literature at a public-facing academic institute.37 The problem , according to global health scholars , is that even if all of the IHME ’ s data were publicly available ( it ’ s not ) , they would not have the capacity—or the endless philanthropic patronage—to trace the institute ’ s steps as it turns this mess of numbers into meaning.38 “ It is a great thing that [ Murray ] has done this , but there has to be some way of being more democratic , ” says @ @ @ @ @ @ @ Technology in Delhi , who adds that the IHME can ’ t be held accountable in the absence of competitors and peers .
“ I would love to see more such initiatives and more openness and discussion without being called spoilsports.
” 39 Some critics go further , describing the IHME as data imperialism—a Seattle-based organization , funded by a multibillionaire , that has too much control over the numbers that guide health planning for poor people of color in the Global South.40 Parkin , who formerly worked on cancer estimates for the @ @ @ @ @ @ @ granular mapping of global health gives “ the impression that everything is known , ” which is “ progressively disempowering countries ” from improving their own data collection infrastructure—and from building toward a global health landscape driven by actual data instead of estimates.41 The IHME pushes back on allegations that it has too much power , insisting that “ for nearly all outcomes that we publish , there are alternative sources of estimates.
” ( Elsewhere , it has called itself “ arguably the de facto source for global health accounting.
” ) @ @ @ @ @ @ @ in health metrics , the IHME ’ s reputation as a monopoly stems from its ability and willingness to put a number on anything and everything , which has made it a go-to source for researchers , journalists , and governments .
Stéphane Helleringer , a demographer at New York University , says the overreliance on the IHME ’ s numbers may be inadvertently distorting global health through what he calls “ circular research.
” 43 Because the IHME often doesn ’ t have clear data—for example , comprehensive records about malaria deaths @ @ @ @ @ @ @ other data points , such as the distribution of bed nets that protect people from malaria-carrying mosquitoes .
( The more bed nets in a given region , the less malaria there should be . )
Helleringer points to a 2015 study that refers to the IHME ’ s malaria mortality estimates—based in part on bed net distribution—to show that lives are being saved through an aid program that distributes bed nets.44 One of the study ’ s authors , Eran Bendavid from Stanford University ’ s School of Medicine , doesn ’ @ @ @ @ @ @ @ research as circular .
“ This is a real issue for my paper and increasingly for the global health research agenda , ” he says via e-mail .
“ Because data is often scarce , and because IHME produces reams of it for the parts of the world where it is the scarcest , there is an enormous temptation to use their estimates as the gold standard .
This is increasingly so as they have gained in prominence and visibility , with ( often ) multiple Lancet ( + sub-journals ) publications weekly @ @ @ @ @ @ @ people , and Bill Gates ’ support has enabled them to attract even more top talent , but users of that data should be very cautious in deciding what that data can and can not be used to infer… .
And everyone could do better , including IHME and Lancet , with the recognition that highlighting the limits of their data has a cost to them , so they may be reluctant to accept it.
” 45 For its part , the IHME wouldn ’ t comment on the study , saying it @ @ @ @ @ @ @ are used.46 Bendavid ’ s study could also be seen as circular in its close orbit around the Gates Foundation , which funds the IHME estimates he used and the aid effort he evaluated , the Global Fund to Fight Aids , Tuberculosis , and Malaria , to which Gates has given more than $ 2 billion.47 As a leading medical journal , The Lancet is one of the most important venues for researchers to discuss , debate , and debunk developments in health and medicine .
And in his time as its @ @ @ @ @ @ @ a public intellectual who isn ’ t afraid to speak truth to power—or to follow the money when it reveals conflicts of interest.48 In a 2003 editorial , The Lancet questioned whether Gates was a “ philanthropist or commercial opportunist , ” observing that his foundation had announced a $ 100 million charitable donation to fight HIV in India the day before Microsoft unveiled a $ 400 million investment expanding its market presence in that country.49 Six years later , Horton admonished the Gates Foundation for its growing power in global health , @ @ @ @ @ @ @ doesn ’ t value…every voice that wants to contribute to the debate about public health.
” 50 Over the past decade , however , mentions of the Gates Foundation have appeared less frequently in The Lancet ’ s critical commentaries than in its funding disclosures .
In 2010 the foundation gave more than $ 700,000 to the University of North Carolina and the Mater Medical Research Institute to create content for The Lancet , beginning a trend of funding— $ 13.5 million to Harvard , Johns Hopkins , the WHO , and others—that @ @ @ @ @ @ @ has a particularly close relationship with the IHME , Gates ’ s signature project in science , and some see perverse incentives driving this relationship .
Publishing the institute ’ s influential estimates has brought attention and esteem to The Lancet , whose “ impact factor ” —a measure of its relative importance in the scientific literature—doubled over the past decade .
The IHME boasts that more than 16,000 scientific studies have cited its work .
These citations boost The Lancet ’ s growing impact factor and have also likely increased subscriptions and @ @ @ @ @ @ @ Elsevier.52 Horton acknowledges the “ very special relationship ” The Lancet has with the IHME but defends it as good science .
“ The reason why it ’ s very important to publish these papers in our journal is because it holds IHME accountable , ” he says in an interview .
“ If you publish a paper in The Lancet…scientists can look at that paper and say , ‘ OK , do I think this is high-quality science ?
Do I agree with what they said ?
And do I agree with @ @ @ @ @ @ @ write letters to us , and they can say , ‘ Actually we strongly disagree with X , Y , and Z , ’ and we will publish those letters , and that holds Chris Murray and IHME accountable for their work , ” Horton said .
“ This is the way the science is done .
It ’ s self-corrective… .
You publish the best work you can , then you see who over time falls out of view.
” 53 The Lancet also publishes estimates from other research institutes , Horton @ @ @ @ @ @ @ has historically been missing in global health , including during the WHO ’ s reign as the leading purveyor of estimates .
( The WHO and the IHME produced competing estimates for years but recently agreed to work together . )
54 Yet scholars cite a number of irregularities in The Lancet ’ s oversight of the IHME , including its peer review process—in which scientists scrutinize one another ’ s work before publication.55 “ You can ’ t go through the 5,000 pages of tables and figures for The Lancet and say @ @ @ @ @ @ @ mistake on page 3,556 , line 25 , ’ ” said Peter Byass , referring to the IHME ’ s very long and complex papers .
“ That ’ s just not going to happen.
” Nevertheless , The Lancet publishes 5000-page appendices that are labeled as having been peer reviewed.56 Patrick Gerland , a demographer in the United Nations ’ population division , says The Lancet compounds the problem by sometimes publishing IHME studies on a fast track .
“ At the end of the day , [ the peer-review process ] @ @ @ @ @ @ @ it is not , ” he adds.57 Horton says he believes reviewers have “ ample time ” and notes that the IHME ’ s studies go through extensive revisions .
He also points to another robust accountability measure : the vast network of scientific collaborators who check the institute ’ s work .
“ This is not a little cabal of American academics at one university funded by the Gates Foundation , ” he said.58 Indeed , the IHME boasted in an e-mail of having “ more than 4,300 collaborators from 147 countries @ @ @ @ @ @ @ to disclose their names.59 Colin Mathers , echoing many other scholars , calls the network “ window dressing , ” saying that many scientists join simply because doing so allows them to become coauthors on the IHME ’ s Lancet studies—a feather in any scholar ’ s cap .
“ You could sign on as a collaborator to IHME , and they ’ ll send out draft papers to you , ” he explains .
“ You may or may not read them , you may or may not comment on them , @ @ @ @ @ @ @ included as ] an author in the end , and IHME can then claim there are 1,200 people from [ various ] countries who have reviewed all the results .
I don ’ t know how The Lancet squares that…with the standard scientific authorship requirements.
” 60 Standard ethical guidelines in science limit authorship to those researchers who make specific , meaningful contributions .
Listing hundreds of authors , as the IHME does in The Lancet and sometimes in other journals , is extremely uncommon .
( The Lancet did not respond to @ @ @ @ @ @ @ When you have this many people and their roles are ill-defined , you ’ re losing the accountability and responsibility for it , ” says David Resnik , a bioethicist at the National Institutes of Health .
“ It ’ s not really telling [ you ] who did what or who did more.
” 62 The IHME insists that it complies with proper authorship guidelines , but days before offering this defense—and shortly after The Nation raised questions—it issued an internal memo announcing new guidelines and a strict new auditing process.63 Perhaps @ @ @ @ @ @ @ ’ s relationship with the IHME concerns the $ 100,000 Roux Prize , which Horton accepted in 2019—and which prompted alarm even within the institute.64 “ I would like to understand what the long term thought process was in awarding Horton the prize , ” one IHME employee said in an internal e-mail , “ and how we are expected to defend that decision as staff when criticized for buying our way into the Lancet rather than being published based on the merit of our work.
” 65 Horton argues that the award @ @ @ @ @ @ @ of directors , which he views as independent of the institute .
He notes that IHME board member Dave Roux , a cofounder of the private equity firm SilverLake , funds the award.66 “ I see it as completely separate , personally , ” Horton says.67 So does the IHME , which offered its own parsing : “ IHME does not award the Roux Prize ; it is the custodian of the prize.
” 68 Before becoming the IHME ’ s director in 2007 , Murray worked at the WHO , from 1998 @ @ @ @ @ @ @ one of its fiercest critics , arguing that its work is compromised by political influence from member states , which sometimes have an interest in presenting their countries ’ health as better than it really is.69 “ For health evidence to be useful , it also must be credible , generated by a scientific process unimpeded by political , financial , or other types of interference , ” states the IHME ’ s website , which cites impartiality as one of the institute ’ s five guiding principles.70 It ’ s a bold @ @ @ @ @ @ @ interests surrounding the IHME ’ s work—from the Gates Foundation , one of the most powerful actors in global health , to Big Pharma and Big Oil , which have been quietly pouring millions of dollars into the institute for years.71 An internal memo that Murray sent in early 2018 announced the creation of the IHME ’ s “ client services unit ” and added , “ This development has the strong support of IHME ’ s Board , of the Bill and Melinda Gates Foundation and of the University , all of @ @ @ @ @ @ @ sector will increase the global impact and reach of our work , as this sector has great influence over health.
” 72 Murray went on to sign a three-year , $ 1.5 million deal between the IHME and Chevron , one of the world ’ s largest fossil fuel companies , “ to establish the Health Measurements Strategy for Global Corporations Program.
” The same month , he published a paper in The Lancet Planetary Health announcing a new initiative looking at the effects of pollution and climate change—two areas where Chevron has @ @ @ @ @ @ @ health .
Murray made no disclosures about his ties to Chevron in this or subsequent papers , though most academic journals have transparency requirements regarding financial conflicts of interest.73 Since 2014 , the IHME has contracted extensively with pharmaceutical companies—Merck , Pfizer , Novo Nordisk , Gilead , GlaxoSmithKline , Novartis , and others—that research and develop treatments for the diseases the IHME tracks around the globe , including Covid-19 .
It does not appear to have ever disclosed these ties in scholarly work or in the many media appearances that Murray has @ @ @ @ @ @ @ the largest influence over the IHME ’ s work comes from the Gates Foundation .
A spokesperson there told The Nation that the foundation has given $ 613 million to support the IHME through late 2019 and an additional $ 210 million to construct a building to house the institute and other global health researchers .
These donations account for the large majority of the IHME ’ s funding , even though it stresses its diverse roster of sponsors , including the National Institutes of Health , which public records suggest has given @ @ @ @ @ @ @ A public records request revealed one funding agreement in which the Gates Foundation was given approval over new hires for the IHME ’ s executive leadership team as well as oversight of press releases related to the work it funds ( which is to say , most of the institute ’ s research ) .76 Gates ’ s influence over the IHME can also be seen in a map of Seattle .
Though the institute is part of the University of Washington , it is was until very recently far off campus , @ @ @ @ @ @ @ ’ s headquarters .
( According to Epic Measures , the IHME ’ s first temporary offices were in the foundation ’ s former headquarters . )
One former IHME employee , asking to speak anonymously , says the foundation regularly requests bespoke charts and graphs for Gates ’ s presentations and conferences , prompting entire teams of IHME researchers to drop everything else77 “ It really did feel like we were consultants for the Gates Foundation , and the scientific methods we used were often in service of getting the results we @ @ @ @ @ @ @ thought the Gates Foundation wanted , ” the source continues .
“ There are thousands of hours cumulatively spent each year just on one-off requests from Bill Gates that trickle through from the Gates Foundation.
” 78 The IHME also publishes favorable research about its sponsor , estimating that the Gates Foundation has saved 1.5 million children through its vaccination efforts and helped prevent more than 100,178 HIV infections in India through another charitable program.79 The foundation , in turn , uses its bully pulpit to elevate the IHME ’ s work .
@ @ @ @ @ @ @ , for example , features keynote speakers like Barack Obama and leans on IHME estimates to chart progress in global health and to lobby for the next places where aid groups and governments should spend their money.80 Marlee Tichenor of the University of Edinburgh sees a fundamental conflict of interest in the Gates Foundation ’ s role as a leading “ financier of global health initiatives ” while controlling the “ means by which we judge whether they succeed or not.
” It ’ s a criticism that applies more broadly to all @ @ @ @ @ @ @ global health , given that it funds many of the researchers , academic journals , and think tanks best positioned to evaluate its work—or to criticize its influence.81 “ There is not a single organization working in global health that is not somehow related—most likely financially related—to the Gates Foundation , ” says Adam Moe Fejerskov of the Danish Institute for International Studies .
“ And , of course , that is a huge problem , because it makes us ask who is setting the agenda in terms of what is being researched @ @ @ @ @ @ @ 82 This summer , The Lancet published an IHME study projecting that the human population would peak far earlier ( 2064 ) and at a lower level ( 9.73 billion ) than the prevailing estimates from the United Nations had indicated .
Released with an elaborate press package—including a video endorsement from Horton—the study enjoyed widespread news coverage highlighting some of its more sensational findings , such as Horton ’ s remark that Nigeria will become a geopolitical rival of the United States over the next century.83 More than 170 scholars and advocates @ @ @ @ @ @ @ Lancet ( thus far unpublished ) citing contradictions and questionable assumptions in the paper , which the signatories say reduced complex demographic issues to simplistic terms .
Stuart Gietel-Basten , a demographer at the Hong Kong University of Science and Technology , observes that even if the letter eventually appears in print—months after the initial Lancet publication—it ’ s unlikely to have much of an impact .
He offers this prediction with the world-weary fatalism not uncommon among scholars who have faced off with the IHME.84 “ There is this issue of it @ @ @ @ @ @ @ You ’ ve got this big journal , lots of people involved , ” Gietel-Basten says .
“ I don ’ t want to say it ’ s a gravy train , but it ’ s a big thing .
It ’ s got so many people involved in it .
But you think about it as , ‘ How would we express our concerns ?
What are the mechanisms by which we can express our concerns ?
’ ” 85 Jeremy Shiffman , a political scientist at Johns Hopkins University , coauthored @ @ @ @ @ @ @ that examined the “ uneven playing field ” surrounding the IHME and found that “ many valid concerns of critics are being overlooked because metrics proponents—including the Bill & Melinda Gates Foundation , the [ IHME ] , and The Lancet—wield far more power than critics.
” 86 Even so , criticism of the institute is long-standing and well understood by its supporters , including the University of Washington and the Gates Foundation .
In 2012 the two commissioned an external IHME evaluation , which found that the institute is “ not consistent @ @ @ @ @ @ @ methods , data sources , authorship and this is perceived as not being transparent ” and that “ the extensive resources of IHME relative to other institutions have created an unhealthy imbalance in the field.
” The evaluators called on the Gates Foundation , as the IHME ’ s primary funder , to improve its accountability and transparency .
The foundation would not comment on if or how it had done so.87 Peter Byass of Umeå University told The Nation that if the IHME were publicly funded , it would have to operate @ @ @ @ @ @ @ manner .
“ If you ’ ve got enough billions , you can set up a foundation , and you can make the rules entirely as you wish , ” he said .
The Gates Foundation “ is both the rule maker and the rule keeper , in terms of how they choose to scrutinize grant holders .
That ’ s their privilege , because that ’ s where they are in the marketplace.
” 88

This article appears in the December 14/21, 2020 issue.
A perennial feature of the Covid-19 pandemic has been the guessing game of whether things are getting better or worse—and how policy approaches (masks, shutdowns) and changes in the weather will affect the coronavirus. Dozens of research institutes have published educated guesses about what’s coming next, but none have had the impact or reach of the University of Washington’s Institute for Health Metrics and Evaluation.1
In the early days of the pandemic, the IHME projected a far less severe outbreak than other models, which drew the attention of Donald Trump, who was eager to downplay the danger. At a March 31 press briefing, the White House’s coronavirus response coordinator, Debbie Birx, with the president at her side, used IHME charts to show that the pandemic was rapidly winding down.2 Looking for holiday gifts with a conscience? Check out The Nation Shop and help support The Nation’s journalism while you complete your gift list.
““Throughout April, millions of Americans were falsely led to believe that the epidemic would be over by June because of IHME’s projections,” the data scientist Youyang Gu noted in his review of the institute’s work. “I think that a lot of states reopened based on their modeling.”3
The IHME brushed aside the widespread criticism that emerged—“Many people do not understand how modeling works,” its director, Chris Murray, explained in a Los Angeles Times op-ed—and continued to push headline-grabbing projections that drew alarm from its peers. For example, while many researchers limit their projections to a few weeks into the future, Murray used his regular appearances on CNN to chart the course of the pandemic many months in advance, putting the IHME’s highly contested estimates in a position to guide policy-making ahead of other models.4
“It seems to be a version of the playbook Trump follows,” says Sam Clark, a demographer at Ohio State University. “Absolutely nothing negative sticks, and the more exposure you get, the better, no matter what. It’s really stunning, and I don’t know any other scientific personality or organization that is able to pull it off quite like IHME.”5
The institute’s uncanny resilience, unconventional methods, and media savvy have long made it controversial in the global health community, where scholars have watched its meteoric rise over the past decade with a mix of awe and concern. Years before Covid, the IHME gained outsize influence by tracking hundreds of diseases across the planet and producing some of the most cited studies in all of science.6 Popular "swipe left below to view more authors"Swipe → The Evisceration of a Public University The Evisceration of a Public University Lisa M. Corrigan The Patronizing Moralism of David Brooks The Patronizing Moralism of David Brooks Chris Lehmann “The Blind Side” Was Always Trash “The Blind Side” Was Always Trash Dave Zirin My Homeland Is Being Ruled by Terror. The World Must Pay Attention. My Homeland Is Being Ruled by Terror. The World Must Pay Attention. Manny Maung Popular "swipe left below to view more authors"Swipe → The Evisceration of a Public University The Evisceration of a Public University Lisa M. Corrigan The Patronizing Moralism of David Brooks The Patronizing Moralism of David Brooks Chris Lehmann “The Blind Side” Was Always Trash “The Blind Side” Was Always Trash Dave Zirin My Homeland Is Being Ruled by Terror. The World Must Pay Attention. My Homeland Is Being Ruled by Terror. The World Must Pay Attention. Manny Maung
But it has also spawned a legion of detractors who call the IHME a monopoly and a juggernaut and charge the group has surrounded itself with a constellation of high-profile allies that have made it too big to peer review, the traditional method of self-regulation in science. Fueled by more than $600 million in funding from the Bill & Melinda Gates Foundation—a virtually unheard-of sum for an academic research institute—the IHME has outgrown and overwhelmed its peers, most notably the World Health Organization (WHO), which previously acted as the global authority for health estimates.7 Current Issue View our current issue
Today the IHME’s sprawling estimates have become the gold standard for understanding an increasingly broad array of topics related to health and development—particularly in the data-poor developing world, where record keeping is sparse. Its website offers interactive maps that allow users to drill down to virtually any village in sub-Saharan Africa, for example, to find out how many years of education people have; how malaria, HIV, and lower respiratory infections are changing over time; who has access to piped water; or how many men are circumcised. These estimates—educated guesses, really—help guide billions of dollars in aid spending and tell health ministers, charities, researchers, and journalists where things are getting better or worse.8
“In a relatively short period of time, the IHME has exerted a certain kind of hegemony or dominance on global health metrics production,” says Manjari Mahajan, a professor of international studies at the New School. “It’s a kind of monopoly of knowledge production, of how to know global health trends in the world. And that produces a concentration of…power that should make anybody uncomfortable.”9
Critics say this monopoly power can be seen in the ways the IHME appears to play by a different set of rules from the rest of the scientific community. Many describe its estimates as a black box.10
“It’s quite impossible to criticize or indeed comment on their methods, since they are completely opaque,” says Max Parkin, from the International Network for Cancer Treatment and Research.11 More From Tim Schwab Will the Gates Foundation’s Board Ever Hold Bill Accountable? February 2, 2022 The Gates Foundation Avoids a Reckoning on Race and Power October 6, 2021 Meet MacKenzie Scott, Our New Good Billionaire July 9, 2021
In 2019, Peter Byass, then a professor of global health at Sweden’s Umeå University, told The Nation, “From a scientific point of view, that makes it impossible for anyone to replicate or verify the estimates.”12
Despite such criticisms, the IHME’s dominion keeps expanding—thanks in large part to Richard Horton, the editor in chief of The Lancet, who has put the credibility of the famed medical journal behind it, publishing more of the institute’s studies than any other periodical. While most scholars are lucky to publish one research article in The Lancet during a decades-long career, the IHME’s Murray has published more than 100.13
The relationship between The Lancet and the institute was further underscored last year when Murray nominated Horton to receive the $100,000 Roux Prize from the IHME. It was a striking conflict of interest that raised eyebrows among scholars but virtually no public criticism. Challenging Horton could mean foreclosing on future publishing opportunities in a leading journal.14
Some experts are also reluctant to criticize the IHME for fear of upsetting the Gates Foundation, one of the most important funders in global health and academic research more generally. According to the Web of Science database, more than 20,000 academic papers cite funding from the Gates Foundation, which has poured over $8 billion into universities in the past two decades, according to The Nation’s analysis of its charitable giving. Scholars have even used the term “the Bill chill” to describe their reluctance to bite the hand that feeds them.15
“We are receiving millions of dollars for our polio campaign in Afghanistan and Pakistan from the Gates Foundation. We cannot jeopardize that campaign. Publicly criticizing the work of the IHME could potentially alienate the Gates Foundation,” one UNICEF official, who asked for anonymity, admitted to Mahajan in a study she published in 2019.16
While the Bill chill may have diminished criticism, the Gates Foundation’s influence isn’t absolute and doesn’t travel very far into the social sciences, where scholars like Mahajan have taken a magnifying glass to the IHME. Even in research fields that the foundation funds, scholars appear increasingly willing to voice criticism of the IHME, including assertions that the powerful triumvirate of Gates, Horton, and Murray has advanced its work in a way that routinely sidesteps the checks and balances that govern scientific enterprise.17
“Who is making such criticism, and where has the criticism been published or stated publicly?” an IHME spokesperson responded when asked about the institute’s controversial reputation. After The Nation forwarded several scholarly reviews, the institute struck a different tone: “This criticism is not new…. Part of the process over the past 12 years of creating a leading source of global health data is reckoning with criticism. IHME welcomes it and other critiques as one aspect of improving the Institute’s work.”18
Murray is the IHME’s driving force and a towering figure in the world of global health—one of the rare scientists about whom biographies are written while they are still alive. 19
The 2015 book Epic Measures: One Doctor. Seven Billion Patients, by Jeremy M. Smith, describes Murray’s approach to health estimates as an extension of his medical training. Instead of treating individual patients, he’s diagnosing the globe, using Big Data to show governments and aid groups which diseases need the most attention and money.20
Gates has long been a fan of Murray’s work, including a 1993 World Bank study he coauthored on the global burden of disease. “I saw…that 12 million children are dying every year,” Gates told Scientific American in 2014. “Wow! It was mind-blowing to me that these preventable diseases—pneumonia, diarrhea, malaria and some other infections that infants get—had such a huge impact. That was the first time it dawned on me that it’s not hundreds of different diseases causing most of the problem—it’s a pretty finite number.”21
Based on Murray’s estimates, Gates saw an opportunity to make a big impact, and his foundation went on to donate almost $40 billion to global health and development, becoming one of the most powerful political actors in the field.22
Though the WHO already had a robust health metrics program in place, Gates decided to create a competing group in 2007, luring Murray from Harvard to the University of Washington in Seattle, where the Gates Foundation is headquartered. Gates described his support of the IHME as designed “to make sure that everybody views this as the definitive source of information.” (The Gates Foundation and the IHME refused multiple interview requests and did not respond to most questions sent by e-mail.)23
A renowned technocrat, Gates undoubtedly liked Murray’s Big Data approach, but may also have seen him as someone cut from the same cloth: entrepreneurial, combative, and hard-driving, someone with the rare combination of technical know-how and business acumen—and a desire to dominate.24
“Chris is supergood, but he likes controversy—and he doesn’t back down,” Gates acknowledged in 2014. “For the job of administering the normative database, he’s not absolutely the perfect person.”25
To be sure, the field of global health is littered with war stories of researchers who have had run-ins and blowups with Murray, many of them beginning the same way: with a request to Murray to show his work. Colin Mathers is one of them. These days a private consultant, he says that in his previous position managing health statistics at the WHO, he worked as a scientific adviser to the IHME but left because Murray would not share basic information about how he formulated the estimates. “We felt that without access to the data, we couldn’t put our names to the results,” Mathers explains.26
Sam Clark of Ohio State University says that when he asked the institute to provide the source code for a tool it used in its estimates, it engaged in years of “obfuscation and blatant noncooperation” and later published a scientific paper attacking his work.27
Another academic researcher asked to speak anonymously, saying he wanted to avoid provoking Murray, who turns “professional disagreements into personal accusations.”28
Even the hagiographic Epic Measures describes Murray as believing that “scientific progress relies on picking fights.” The book recounts an incident in which he accused an academic researcher of inflating child mortality estimates 10 percent higher than his own. “He knows that deaths translate into money for child health programs. Deaths are money,” Murray is quoted saying. “Who’s right? That’s the only question. All that matters is being right.”29
Yet during the pandemic, the IHME’s early projections proved dramatically wrong—and damaging to public health, some say. But this reckoning has come only because the high stakes of Covid have brought a new level of scrutiny and competition from other researchers and because the institute has had to contend with the emergence of actual data on infections and deaths.30
In much of the IHME’s other work in health metrics, these feedback mechanisms do not come to bear in the same way, even though its estimates may be just as influential and, in some cases, just as wrong. This includes its efforts to track hundreds of diseases in the most remote corners of the planet.31
“It’s impossible to do what they’re trying to do rigorously…. The data is just not there to really quantify the impact of some of these diseases,” notes Ruth Etzioni, a professor of public health sciences at the Fred Hutchinson Cancer Research Center. “Instead of saying, ‘You know what? That’s not possible,’ [the IHME says,] ‘Here are some numbers.’ You’ve naturally got yourself in an overpromising situation.”32
The IHME counters that “no estimate of a problem is interpreted as an estimate of no problem.” And in an e-mail, it defended its estimates as transparent and published with statistical confidence intervals that inform users about the limitations of its work.33
But Etzioni sees a pattern in the IHME’s pushing its findings into the limelight while relegating “key caveats and uncertainties” to the fine print. She points out that even when the institute made a major mistake in its early Covid projections—it had been using a bad model—it never issued a clear mea culpa.34
“Instead of being straightforward and telling the public that they had a new model, Chris Murray told everyone that the numbers had gone up because we were reopening [from lockdowns] and not socially distancing anymore,” Etzioni says via e-mail. “What happened early in the summer when the IHME revised its estimate downward dramatically (which served the White House and consequently gave the IHME huge press) and…then turned out to be utterly wrong was nothing short of a debacle.”35
In a normal year on the planet, approximately 60 million people die. Fewer than half of these deaths, including many in the developing world, will have medical records citing a cause. Knowing why and where people are dying is crucial to improving global health, which is what makes the IHME’s estimates are so important and influential. 36
Gates extols the way the IHME’s work on global health “democratizes information,” bringing together 281,586 global data sources from national health ministries, private insurers, and the scientific literature at a public-facing academic institute.37
The problem, according to global health scholars, is that even if all of the IHME’s data were publicly available (it’s not), they would not have the capacity—or the endless philanthropic patronage—to trace the institute’s steps as it turns this mess of numbers into meaning.38
“It is a great thing that [Murray] has done this, but there has to be some way of being more democratic,” says Dinesh Mohan of the Indian Institute of Technology in Delhi, who adds that the IHME can’t be held accountable in the absence of competitors and peers. “I would love to see more such initiatives and more openness and discussion without being called spoilsports.”39
Some critics go further, describing the IHME as data imperialism—a Seattle-based organization, funded by a multibillionaire, that has too much control over the numbers that guide health planning for poor people of color in the Global South.40
Parkin, who formerly worked on cancer estimates for the WHO, says the IHME’s granular mapping of global health gives “the impression that everything is known,” which is “progressively disempowering countries” from improving their own data collection infrastructure—and from building toward a global health landscape driven by actual data instead of estimates.41
The IHME pushes back on allegations that it has too much power, insisting that “for nearly all outcomes that we publish, there are alternative sources of estimates.” (Elsewhere, it has called itself “arguably the de facto source for global health accounting.”)42
While there are other groups working in health metrics, the IHME’s reputation as a monopoly stems from its ability and willingness to put a number on anything and everything, which has made it a go-to source for researchers, journalists, and governments. Stéphane Helleringer, a demographer at New York University, says the overreliance on the IHME’s numbers may be inadvertently distorting global health through what he calls “circular research.”43
Because the IHME often doesn’t have clear data—for example, comprehensive records about malaria deaths in a given region—it makes estimates from other data points, such as the distribution of bed nets that protect people from malaria-carrying mosquitoes. (The more bed nets in a given region, the less malaria there should be.) Helleringer points to a 2015 study that refers to the IHME’s malaria mortality estimates—based in part on bed net distribution—to show that lives are being saved through an aid program that distributes bed nets.44
One of the study’s authors, Eran Bendavid from Stanford University’s School of Medicine, doesn’t disagree with the criticism of his research as circular. “This is a real issue for my paper and increasingly for the global health research agenda,” he says via e-mail. “Because data is often scarce, and because IHME produces reams of it for the parts of the world where it is the scarcest, there is an enormous temptation to use their estimates as the gold standard. This is increasingly so as they have gained in prominence and visibility, with (often) multiple Lancet (+ sub-journals) publications weekly. IHME has a lot of talented people, and Bill Gates’ support has enabled them to attract even more top talent, but users of that data should be very cautious in deciding what that data can and cannot be used to infer…. And everyone could do better, including IHME and Lancet, with the recognition that highlighting the limits of their data has a cost to them, so they may be reluctant to accept it.”45
For its part, the IHME wouldn’t comment on the study, saying it doesn’t police how its estimates are used.46
Bendavid’s study could also be seen as circular in its close orbit around the Gates Foundation, which funds the IHME estimates he used and the aid effort he evaluated, the Global Fund to Fight Aids, Tuberculosis, and Malaria, to which Gates has given more than $2 billion.47
As a leading medical journal, The Lancet is one of the most important venues for researchers to discuss, debate, and debunk developments in health and medicine. And in his time as its editor, Horton has positioned himself as a public intellectual who isn’t afraid to speak truth to power—or to follow the money when it reveals conflicts of interest.48
In a 2003 editorial, The Lancet questioned whether Gates was a “philanthropist or commercial opportunist,” observing that his foundation had announced a $100 million charitable donation to fight HIV in India the day before Microsoft unveiled a $400 million investment expanding its market presence in that country.49
Six years later, Horton admonished the Gates Foundation for its growing power in global health, writing, “Sometimes [it] doesn’t value…every voice that wants to contribute to the debate about public health.”50
Over the past decade, however, mentions of the Gates Foundation have appeared less frequently in The Lancet’s critical commentaries than in its funding disclosures. In 2010 the foundation gave more than $700,000 to the University of North Carolina and the Mater Medical Research Institute to create content for The Lancet, beginning a trend of funding—$13.5 million to Harvard, Johns Hopkins, the WHO, and others—that has reached dozens of publications.51
The Lancet has a particularly close relationship with the IHME, Gates’s signature project in science, and some see perverse incentives driving this relationship. Publishing the institute’s influential estimates has brought attention and esteem to The Lancet, whose “impact factor”—a measure of its relative importance in the scientific literature—doubled over the past decade. The IHME boasts that more than 16,000 scientific studies have cited its work. These citations boost The Lancet’s growing impact factor and have also likely increased subscriptions and advertising revenue for its for-profit publisher, Elsevier.52
Horton acknowledges the “very special relationship” The Lancet has with the IHME but defends it as good science. “The reason why it’s very important to publish these papers in our journal is because it holds IHME accountable,” he says in an interview. “If you publish a paper in The Lancet…scientists can look at that paper and say, ‘OK, do I think this is high-quality science? Do I agree with what they said? And do I agree with their interpretation?’ And they can write letters to us, and they can say, ‘Actually we strongly disagree with X, Y, and Z,’ and we will publish those letters, and that holds Chris Murray and IHME accountable for their work,” Horton said. “This is the way the science is done. It’s self-corrective…. You publish the best work you can, then you see who over time falls out of view.”53
The Lancet also publishes estimates from other research institutes, Horton notes, creating a robust debate that has historically been missing in global health, including during the WHO’s reign as the leading purveyor of estimates. (The WHO and the IHME produced competing estimates for years but recently agreed to work together.)54
Yet scholars cite a number of irregularities in The Lancet’s oversight of the IHME, including its peer review process—in which scientists scrutinize one another’s work before publication.55
“You can’t go through the 5,000 pages of tables and figures for The Lancet and say, ‘I’ve noticed a mistake on page 3,556, line 25,’” said Peter Byass, referring to the IHME’s very long and complex papers. “That’s just not going to happen.” Nevertheless, The Lancet publishes 5000-page appendices that are labeled as having been peer reviewed.56
Patrick Gerland, a demographer in the United Nations’ population division, says The Lancet compounds the problem by sometimes publishing IHME studies on a fast track. “At the end of the day, [the peer-review process] pretends to be a validation of something it is not,” he adds.57
Horton says he believes reviewers have “ample time” and notes that the IHME’s studies go through extensive revisions. He also points to another robust accountability measure: the vast network of scientific collaborators who check the institute’s work. “This is not a little cabal of American academics at one university funded by the Gates Foundation,” he said.58
Indeed, the IHME boasted in an e-mail of having “more than 4,300 collaborators from 147 countries and territories,” although it refused to disclose their names.59
Colin Mathers, echoing many other scholars, calls the network “window dressing,” saying that many scientists join simply because doing so allows them to become coauthors on the IHME’s Lancet studies—a feather in any scholar’s cap. “You could sign on as a collaborator to IHME, and they’ll send out draft papers to you,” he explains. “You may or may not read them, you may or may not comment on them, but your name gets to be [included as] an author in the end, and IHME can then claim there are 1,200 people from [various] countries who have reviewed all the results. I don’t know how The Lancet squares that…with the standard scientific authorship requirements.”60
Standard ethical guidelines in science limit authorship to those researchers who make specific, meaningful contributions. Listing hundreds of authors, as the IHME does in The Lancet and sometimes in other journals, is extremely uncommon. (The Lancet did not respond to questions about authorship.)61
“When you have this many people and their roles are ill-defined, you’re losing the accountability and responsibility for it,” says David Resnik, a bioethicist at the National Institutes of Health. “It’s not really telling [you] who did what or who did more.”62
The IHME insists that it complies with proper authorship guidelines, but days before offering this defense—and shortly after The Nation raised questions—it issued an internal memo announcing new guidelines and a strict new auditing process.63
Perhaps the most striking irregularity in The Lancet’s relationship with the IHME concerns the $100,000 Roux Prize, which Horton accepted in 2019—and which prompted alarm even within the institute.64
“I would like to understand what the long term thought process was in awarding Horton the prize,” one IHME employee said in an internal e-mail, “and how we are expected to defend that decision as staff when criticized for buying our way into the Lancet rather than being published based on the merit of our work.”65
Horton argues that the award came from the IHME’s board of directors, which he views as independent of the institute. He notes that IHME board member Dave Roux, a cofounder of the private equity firm SilverLake, funds the award.66
“I see it as completely separate, personally,” Horton says.67
So does the IHME, which offered its own parsing: “IHME does not award the Roux Prize; it is the custodian of the prize.”68
Before becoming the IHME’s director in 2007, Murray worked at the WHO, from 1998 to 2003. But he subsequently became one of its fiercest critics, arguing that its work is compromised by political influence from member states, which sometimes have an interest in presenting their countries’ health as better than it really is.69
“For health evidence to be useful, it also must be credible, generated by a scientific process unimpeded by political, financial, or other types of interference,” states the IHME’s website, which cites impartiality as one of the institute’s five guiding principles.70
It’s a bold proclamation, given the political and financial interests surrounding the IHME’s work—from the Gates Foundation, one of the most powerful actors in global health, to Big Pharma and Big Oil, which have been quietly pouring millions of dollars into the institute for years.71
An internal memo that Murray sent in early 2018 announced the creation of the IHME’s “client services unit” and added, “This development has the strong support of IHME’s Board, of the Bill and Melinda Gates Foundation and of the University, all of which believe that engagement with the private sector will increase the global impact and reach of our work, as this sector has great influence over health.”72
Murray went on to sign a three-year, $1.5 million deal between the IHME and Chevron, one of the world’s largest fossil fuel companies, “to establish the Health Measurements Strategy for Global Corporations Program.” The same month, he published a paper in The Lancet Planetary Health announcing a new initiative looking at the effects of pollution and climate change—two areas where Chevron has had huge and negative effects on human health. Murray made no disclosures about his ties to Chevron in this or subsequent papers, though most academic journals have transparency requirements regarding financial conflicts of interest.73
Since 2014, the IHME has contracted extensively with pharmaceutical companies—Merck, Pfizer, Novo Nordisk, Gilead, GlaxoSmithKline, Novartis, and others—that research and develop treatments for the diseases the IHME tracks around the globe, including Covid-19. It does not appear to have ever disclosed these ties in scholarly work or in the many media appearances that Murray has made during the pandemic.74
Yet by far the largest influence over the IHME’s work comes from the Gates Foundation. A spokesperson there told The Nation that the foundation has given $613 million to support the IHME through late 2019 and an additional $210 million to construct a building to house the institute and other global health researchers. These donations account for the large majority of the IHME’s funding, even though it stresses its diverse roster of sponsors, including the National Institutes of Health, which public records suggest has given it around $10 million in grants.75
A public records request revealed one funding agreement in which the Gates Foundation was given approval over new hires for the IHME’s executive leadership team as well as oversight of press releases related to the work it funds (which is to say, most of the institute’s research).76
Gates’s influence over the IHME can also be seen in a map of Seattle. Though the institute is part of the University of Washington, it was until very recently far off campus, a few blocks from the Gates Foundation’s headquarters. (According to Epic Measures, the IHME’s first temporary offices were in the foundation’s former headquarters.) One former IHME employee, asking to speak anonymously, says the foundation regularly requests bespoke charts and graphs for Gates’s presentations and conferences, prompting entire teams of IHME researchers to drop everything else77
“It really did feel like we were consultants for the Gates Foundation, and the scientific methods we used were often in service of getting the results we wanted…or the story he [Murray] thought the Gates Foundation wanted,” the source continues. “There are thousands of hours cumulatively spent each year just on one-off requests from Bill Gates that trickle through from the Gates Foundation.”78
The IHME also publishes favorable research about its sponsor, estimating that the Gates Foundation has saved 1.5 million children through its vaccination efforts and helped prevent more than 100,178 HIV infections in India through another charitable program.79
The foundation, in turn, uses its bully pulpit to elevate the IHME’s work. Gates’s annual splashy Goalkeepers event, for example, features keynote speakers like Barack Obama and leans on IHME estimates to chart progress in global health and to lobby for the next places where aid groups and governments should spend their money.80
Marlee Tichenor of the University of Edinburgh sees a fundamental conflict of interest in the Gates Foundation’s role as a leading “financier of global health initiatives” while controlling the “means by which we judge whether they succeed or not.” It’s a criticism that applies more broadly to all of the foundation’s work in global health, given that it funds many of the researchers, academic journals, and think tanks best positioned to evaluate its work—or to criticize its influence.81
“There is not a single organization working in global health that is not somehow related—most likely financially related—to the Gates Foundation,” says Adam Moe Fejerskov of the Danish Institute for International Studies. “And, of course, that is a huge problem, because it makes us ask who is setting the agenda in terms of what is being researched and what is not being researched.”82
This summer, The Lancet published an IHME study projecting that the human population would peak far earlier (2064) and at a lower level (9.73 billion) than the prevailing estimates from the United Nations had indicated. Released with an elaborate press package—including a video endorsement from Horton—the study enjoyed widespread news coverage highlighting some of its more sensational findings, such as Horton’s remark that Nigeria will become a geopolitical rival of the United States over the next century.83
More than 170 scholars and advocates signed a letter of complaint to The Lancet (thus far unpublished) citing contradictions and questionable assumptions in the paper, which the signatories say reduced complex demographic issues to simplistic terms. Stuart Gietel-Basten, a demographer at the Hong Kong University of Science and Technology, observes that even if the letter eventually appears in print—months after the initial Lancet publication—it’s unlikely to have much of an impact. He offers this prediction with the world-weary fatalism not uncommon among scholars who have faced off with the IHME.84
“There is this issue of it being almost too big to fail. You’ve got this big journal, lots of people involved,” Gietel-Basten says. “I don’t want to say it’s a gravy train, but it’s a big thing. It’s got so many people involved in it. But you think about it as, ‘How would we express our concerns? What are the mechanisms by which we can express our concerns?’”85
Jeremy Shiffman, a political scientist at Johns Hopkins University, coauthored a commentary in The Lancet this spring that examined the “uneven playing field” surrounding the IHME and found that “many valid concerns of critics are being overlooked because metrics proponents—including the Bill & Melinda Gates Foundation, the [IHME], and The Lancet—wield far more power than critics.”86
Even so, criticism of the institute is long-standing and well understood by its supporters, including the University of Washington and the Gates Foundation. In 2012 the two commissioned an external IHME evaluation, which found that the institute is “not consistent in when and to whom it shares methods, data sources, authorship and this is perceived as not being transparent” and that “the extensive resources of IHME relative to other institutions have created an unhealthy imbalance in the field.” The evaluators called on the Gates Foundation, as the IHME’s primary funder, to improve its accountability and transparency. The foundation would not comment on if or how it had done so.87
Peter Byass of Umeå University told The Nation that if the IHME were publicly funded, it would have to operate in a far more open and accountable manner. “If you’ve got enough billions, you can set up a foundation, and you can make the rules entirely as you wish,” he said. The Gates Foundation “is both the rule maker and the rule keeper, in terms of how they choose to scrutinize grant holders. That’s their privilege, because that’s where they are in the marketplace.”88


thenation--2020-12-03--The Baltimore Ravens’ Cautionary Covid Tale

It ’ s 2020 , so of course a NFL game was just played at 3:40 pm on a Wednesday .
The Baltimore Ravens lost 19-14 to the unbeaten Pittsburgh Steelers , but the real story is why this Thanksgiving matchup was played on a weekday afternoon in December .
It ’ s a story of a pandemic and a possible labor protest .
For six consecutive days leading up to the contest , a multitude of Ravens players were diagnosed with Covid-19 .
The game was moved three times as the positive tests rolled in .
All told , @ @ @ @ @ @ @ after contracting the virus , including a whopping seven players who have been to a Pro Bowl .
This included the team ’ s MVP quarterback , Lamar Jackson .
At its height , the Ravens had more than 20 players on the “ Covid list.
” And the players are pissed off .
Their rage stems from the fact that this outbreak is believed to have been caused by the team ’ s head strength-and-conditioning coach , Steve Saunders , who was disciplined by the team for not consistently wearing a mask @ @ @ @ @ @ @ .
The organization ’ s response to the crisis has been tepid .
Meanwhile , fans have created an online petition to have Saunders fired , which is gathering steam .
Baltimore Sun columnist Mike Preston called for “ heads to roll ” as a result of the outbreak , writing , “ More than 250,000 people in this country have died from this pandemic , so there should be zero tolerance .
Either follow the protocol or find a new job.
” Instead , the Baltimore team has adopted the approach of @ @ @ @ @ @ @ if a strain of sprained ankles were being spread around the clubhouse .
That this outbreak occurred among the Ravens should not be a surprise .
Chekhov ’ s gun was brandished in the off-season when Head Coach John Harbaugh , with a macho swagger , said of the virus , “ You can look at it any way you want to look at it , but I ’ m not going to run for cover and I don ’ t think the NFL is either.
” But this isn ’ t a @ @ @ @ @ @ @ isn ’ t about bravery or fear .
The virus doesn ’ t care how many times you can bench press 225 pounds , and it doesn ’ t give a damn if a healthy football player gives it to someone far less able to fend off the worst effects .
Now , the gun has gone off , and the team was ravaged right before facing their bitterest division rival in what so far was their most important game in their season .
The Ravens players are not happy with the organization @ @ @ @ @ @ @ There was even talk of refusing to play and choosing instead to engage in a wildcat strike and forfeit the game in protest .
They were that angry .
If the Ravens had flexed their labor power , they would have continued the actions by NBA and WNBA players over the summer who struck for racial justice following the shooting of Jacob Blake in Kenosha , Wis .
The Politics of Maradona ’ s Iconic ‘ Hand of God ’ Goal The Ravens threatened to join other workers in using the strike to @ @ @ @ @ @ @ during this pandemic .
Had they gone through with it , they would have been in direct conflict with their union , the NFL Players Association , which signed on to this idea that games would be delayed but not canceled , or players on both teams would be forfeiting game checks .
It would have been a radical act in defense of their own health , because who really knows if more players have Covid at this point ?
That puts the Steelers players at risk as well .
Announcers have fallen @ @ @ @ @ @ @ the union for playing every game on the schedule without cancellation , even though many teams have had players ruled ineligible ; even though 28 of the 32 clubs , according to Sports Illustrated , have been in the league ’ s Covid protocol ; even though the Broncos had to play Sunday without a quarterback ; and even though the Ravens were beaten—albeit barely—with just half a team on the field .
If there is one thing we have learned about sports in the pandemic , it is that unless you are @ @ @ @ @ @ @ in a hermetically sealed bubble to play and also to live , outbreaks are inevitable .
The NFL has tried to brazen its way through the pandemic .
Given the right-wing , macho ethos of the league ’ s franchise owners , this is not surprising .
But it is another example of the unmitigated disaster that has been the United States ’ response to the pandemic under Trump ’ s leadership .
Sportswriter Jane McManus was correct when she wrote that sports are the reward for a functioning society .
Our society @ @ @ @ @ @ @ will suffer just as surely as the rest of us .

It’s 2020, so of course a NFL game was just played at 3:40 pm on a Wednesday. The Baltimore Ravens lost 19-14 to the unbeaten Pittsburgh Steelers, but the real story is why this Thanksgiving matchup was played on a weekday afternoon in December. It’s a story of a pandemic and a possible labor protest.
For six consecutive days leading up to the contest, a multitude of Ravens players were diagnosed with Covid-19. The game was moved three times as the positive tests rolled in. All told, 16 players on the Ravens were out after contracting the virus, including a whopping seven players who have been to a Pro Bowl. This included the team’s MVP quarterback, Lamar Jackson. At its height, the Ravens had more than 20 players on the “Covid list.” And the players are pissed off. sports in a pandemic NBA Bubble Postmortem Dave Zirin
Their rage stems from the fact that this outbreak is believed to have been caused by the team’s head strength-and-conditioning coach, Steve Saunders, who was disciplined by the team for not consistently wearing a mask at the team’s indoor facility. The organization’s response to the crisis has been tepid. Meanwhile, fans have created an online petition to have Saunders fired, which is gathering steam. Baltimore Sun columnist Mike Preston called for “heads to roll” as a result of the outbreak, writing, “More than 250,000 people in this country have died from this pandemic, so there should be zero tolerance. Either follow the protocol or find a new job.” Instead, the Baltimore team has adopted the approach of “next man up,” as if a strain of sprained ankles were being spread around the clubhouse.
That this outbreak occurred among the Ravens should not be a surprise. Chekhov’s gun was brandished in the off-season when Head Coach John Harbaugh, with a macho swagger, said of the virus, “You can look at it any way you want to look at it, but I’m not going to run for cover and I don’t think the NFL is either.” But this isn’t a gunfight at the OK Corral. This isn’t about bravery or fear. The virus doesn’t care how many times you can bench press 225 pounds, and it doesn’t give a damn if a healthy football player gives it to someone far less able to fend off the worst effects. Now, the gun has gone off, and the team was ravaged right before facing their bitterest division rival in what so far was their most important game in their season.
The Ravens players are not happy with the organization’s culpability in this outbreak. There was even talk of refusing to play and choosing instead to engage in a wildcat strike and forfeit the game in protest. They were that angry. If the Ravens had flexed their labor power, they would have continued the actions by NBA and WNBA players over the summer who struck for racial justice following the shooting of Jacob Blake in Kenosha, Wis. More From Dave Zirin “The Blind Side” Was Always Trash August 15, 2023 Why the Right Wanted the USWNT to Lose August 10, 2023 Carli Lloyd’s Attacks on the USWNT Are Personal—and Political August 1, 2023
The Ravens threatened to join other workers in using the strike to make demands about their health and safety during this pandemic. Had they gone through with it, they would have been in direct conflict with their union, the NFL Players Association, which signed on to this idea that games would be delayed but not canceled, or players on both teams would be forfeiting game checks. It would have been a radical act in defense of their own health, because who really knows if more players have Covid at this point? That puts the Steelers players at risk as well. Announcers have fallen over themselves to praise the NFL and the union for playing every game on the schedule without cancellation, even though many teams have had players ruled ineligible; even though 28 of the 32 clubs, according to Sports Illustrated, have been in the league’s Covid protocol; even though the Broncos had to play Sunday without a quarterback; and even though the Ravens were beaten—albeit barely—with just half a team on the field.
If there is one thing we have learned about sports in the pandemic, it is that unless you are able to convince the players to get in a hermetically sealed bubble to play and also to live, outbreaks are inevitable. The NFL has tried to brazen its way through the pandemic. Given the right-wing, macho ethos of the league’s franchise owners, this is not surprising. But it is another example of the unmitigated disaster that has been the United States’ response to the pandemic under Trump’s leadership.
Sportswriter Jane McManus was correct when she wrote that sports are the reward for a functioning society. Our society is not functioning, and our athletes will suffer just as surely as the rest of us.


thenation--2020-12-03--Do Not Hire This Man

Do Not Hire This Man

Anyone who has ever been close to presidential power knows that personnel is policy .
Nothing makes so strong a statement about the direction of a new administration as the people a president-elect chooses for the cabinet and the myriad boards and commissions that can seize or relinquish governing mandates .
And no statement from President-elect Joe Biden could be worse than the selection of former Chicago Mayor Rahm Emanuel for a top job on the team Biden is now assembling .
There is widespread speculation that Emanuel might be selected as secretary of transportation or as the next United @ @ @ @ @ @ @ nominate the Chicagoan for either post , he would signal a callous disregard for concerns raised about a record of governing malpractice so egregious that Representative Alexandria Ocasio-Cortez rightly identifies it as “ disqualifying for public leadership.
” But this is not just about adding insult to injury .
If past is prologue , empowering Emanuel would undermine not just Biden ’ s presidency but also his party ’ s prospects in the 2022 and 2024 elections .
Emanuel ’ s service in the last two Democratic administrations—as senior adviser to President Bill @ @ @ @ @ @ @ s White House chief of staff—was crudely divisive .
He went out of his way to stamp on those administrations a neoliberal brand that would haunt the party for decades after he headed off to pursue his own personal and political ambitions .
It was Emanuel who was the lead strategist in bitter fights for the North American Free Trade Agreement and a host of other economic arrangements that divided the party against itself and left Democrats vulnerable to attack for selling out working-class Americans .
It was Emanuel who battled against an @ @ @ @ @ @ @ at a time when bold reform was not just possible but necessary .
It was Emanuel who was accused of spewing obscenities at union members who wanted to do more to save the domestic auto industry ( “ Fuck the UAW !
” ) and at progressives who wanted to ramp up the fight for a public option in the ACA ( “ fucking retarded ” ) .
People ’ s Action Director George Goehl summarized some of the reasons Biden should reject Emanuel : “ Under the Clinton and Obama administrations , @ @ @ @ @ @ @ poverty and blocked immigration reform .
Appointing Rahm Emanuel would show that the Democratic Party sees no harm in its culture of ‘ failing up ’ which gives more power to electeds who fail to govern and consultants who fail to win elections.
” Donald Trump Just Paid $ 3 Million to Expand Joe Biden ’ s Margin of Victory Trump ’ s Trying to Take the Internet Down With Him Want to Be Like FDR , Joe Biden ?
Make Your Thanksgiving Proclamations Rallying Cries But Emanuel ’ s D.C. record is @ @ @ @ @ @ @ his selection .
After leaving the Obama White House just prior to the disastrous 2010 mid-term election , Emanuel took his cruel blend of neoliberal politics and personal vindictiveness to Chicago .
His two terms as mayor were characterized by reckless and politically self-serving responses to police violence and to demands for education , health care , and housing .
Emanuel ’ s mayoral tenure was so divisive that more than 7,000 Chicagoans and their allies have signed a “ Keep Rahm Away from the White House ” petition promoted by City Council @ @ @ @ @ @ @ case you ’ re unaware , ” the petition reads , “ allow us to acquaint you with Rahm ’ s resume in some key policy areas ” : • Covered up the police murder of 17-year-old Laquan McDonald in 2014 .
McDonald ’ s killing—police shot him 16 times , including while he lay on the ground—was a catalyst of the Black Lives Matter movement and doomed Rahm ’ s political future in the city .
• Closed 50 elementary schools—the single largest school closure in US history—over an outcry from parents @ @ @ @ @ @ @ of the schools served African American children on the south and west sides of the city .
• Shuttered half of Chicago ’ s public mental health clinics , leaving patients in need of care literally sitting on the sidewalk outside of the locked doors and pleading for help .
• Lavished wealthy neighborhoods and pet projects with public dollars through Tax Increment Financing ( TIF ) .
Rahm ’ s greatest TIF hits—this is an economic development tool that ’ s supposed to fight “ blight , ” mind you—include $ 55 @ @ @ @ @ @ @ basketball stadium , millions funneled to Navy Pier through an elaborate shell game , and another $ 1.3 billion given in subsidies for luxury mega-developments on his way out the door .
• Repeatedly broke the city ’ s promises to rebuild public housing , while blocking an ordinance improving transparency in the mismanaged Chicago Housing Authority .
The deficit in affordable housing , combined with staggering and deeply regressive property-tax hikes , were factors in the exodus of tens of thousands of Black residents from Chicago during his term .
• Hyped @ @ @ @ @ @ @ train from downtown Chicago to O ’ Hare airport that would bypass the transit used by actual Chicagoans .
The boondoggle , hatched by Rahm campaign donor Elon Musk , was widely panned ; one alderman called it a scheme “ mostly for tourists and Musk ’ s reputation.
” • Oversaw a police department that cost taxpayers more than $ 540 million in abuse and misconduct settlements during his time in office .
• Rejected public referenda calling for an elected school board , instead handpicking school CEOs such as Barbara Byrd-Bennett @ @ @ @ @ @ @ after pleading guilty on a multimillion-dollar kickback scheme involving Chicago Public Schools money .
• Went on a privatization spree , to disastrous effect .
Selling off everything from school janitorial services to trash collection , privatization left Chicago with indignities such as dirty classrooms and one of the nation ’ s most abysmal recycling rates .
The opposition in Chicago , where people know Emanuel best , is so intense that Streetsblog Chicago , a news site that covers sustainable transportation issues , recently warned , “ Hiring Rahm Emanuel as U.S. @ @ @ @ @ @ @ refuses to go away .
Joe Biden , you really don ’ t want to kick off your administration with hundreds or thousands of justifiably angry Chicagoans marching in protest.
” Chicagoans are particularly upset over the idea of handing Emanuel the Department of Transportation post because , Chicago Alderman Carlos Ramirez-Rosa notes , “ as Mayor of Chicago , Rahm Emanuel ’ s big transportation idea was to give Elon Musk public resources to put a car in an over-priced and unnecessary tunnel from downtown to O ’ Hare Airport .
The @ @ @ @ @ @ @ Secretary of Transportation is asinine.
” The prospect stirs opposition beyond Chicago , as well .
“ We do not need a union buster setting the rules for workers in aviation , ” argues Association of Flight Attendants president Sara Nelson .
“ That just doesn ’ t reflect Joe Biden ’ s deep commitment to workers and our unions.
” That goes double for the trade representative job , where Emanuel would again be positioned to promote Wall Street–friendly agreements , such as NAFTA and permanent normalization of trade relations with China @ @ @ @ @ @ @ dislocated workers , which would eventually be exploited by Donald Trump , who made an argument that Democrats had abandoned working-class communities central to his 2016 campaign .
Should Biden Hire Rahm Emanuel ?
Chicago Says , ‘ Never !
Never !
Never !
’ Bringing Emanuel into a third Democratic administration “ would be perceived as a slap in the face to labor , ” explains Shane Larson , the senior director for government affairs for the powerful Communication Workers of America union .
“ It would be received very poorly.
” @ @ @ @ @ @ @ than the usual jockeying over whether a Democratic administration tilts to the left or the center .
Indeed , as AOC notes , it is “ a truly embarrassing indictment of what ’ s considered ‘ center ’ politics in the US that objecting to the appointment of an official who helped cover up the murder of a Black child is deemed the ‘ progressive , far left ’ position.
” This is about the very real damage Emanuel has done—on matters of policy and politics—and that he will again do if he @ @ @ @ @ @ @ common sense indicates Representative-elect Jamaal Bowman of New York , is right when he says , “ Rahm Emanuel should not be considered for any position within the Biden administration .
”

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Anyone who has ever been close to presidential power knows that personnel is policy. Nothing makes so strong a statement about the direction of a new administration as the people a president-elect chooses for the cabinet and the myriad boards and commissions that can seize or relinquish governing mandates. And no statement from President-elect Joe Biden could be worse than the selection of former Chicago Mayor Rahm Emanuel for a top job on the team Biden is now assembling.
There is widespread speculation that Emanuel might be selected as secretary of transportation or as the next United States trade representative. Were Biden to nominate the Chicagoan for either post, he would signal a callous disregard for concerns raised about a record of governing malpractice so egregious that Representative Alexandria Ocasio-Cortez rightly identifies it as “disqualifying for public leadership.” But this is not just about adding insult to injury. If past is prologue, empowering Emanuel would undermine not just Biden’s presidency but also his party’s prospects in the 2022 and 2024 elections.
Emanuel’s service in the last two Democratic administrations—as senior adviser to President Bill Clinton and as President Barack Obama’s White House chief of staff—was crudely divisive. He went out of his way to stamp on those administrations a neoliberal brand that would haunt the party for decades after he headed off to pursue his own personal and political ambitions. It was Emanuel who was the lead strategist in bitter fights for the North American Free Trade Agreement and a host of other economic arrangements that divided the party against itself and left Democrats vulnerable to attack for selling out working-class Americans. It was Emanuel who battled against an expansive vision of the Affordable Care Act at a time when bold reform was not just possible but necessary. It was Emanuel who was accused of spewing obscenities at union members who wanted to do more to save the domestic auto industry (“Fuck the UAW!”) and at progressives who wanted to ramp up the fight for a public option in the ACA (“fucking retarded”).
People’s Action Director George Goehl summarized some of the reasons Biden should reject Emanuel: “Under the Clinton and Obama administrations, he attacked public benefits for people in poverty and blocked immigration reform. Appointing Rahm Emanuel would show that the Democratic Party sees no harm in its culture of ‘failing up’ which gives more power to electeds who fail to govern and consultants who fail to win elections.” Popular "swipe left below to view more authors"Swipe → The Evisceration of a Public University The Evisceration of a Public University Lisa M. Corrigan The Patronizing Moralism of David Brooks The Patronizing Moralism of David Brooks Chris Lehmann “The Blind Side” Was Always Trash “The Blind Side” Was Always Trash Dave Zirin My Homeland Is Being Ruled by Terror. The World Must Pay Attention. My Homeland Is Being Ruled by Terror. The World Must Pay Attention. Manny Maung Popular "swipe left below to view more authors"Swipe → The Evisceration of a Public University The Evisceration of a Public University Lisa M. Corrigan The Patronizing Moralism of David Brooks The Patronizing Moralism of David Brooks Chris Lehmann “The Blind Side” Was Always Trash “The Blind Side” Was Always Trash Dave Zirin My Homeland Is Being Ruled by Terror. The World Must Pay Attention. My Homeland Is Being Ruled by Terror. The World Must Pay Attention. Manny Maung More From John Nichols A GOP Debate Without Trump Is the Definition of Pointlessness August 11, 2023 A Win for Abortion Rights, a Win for Democracy: Ohio Voters Reject Issue 1 August 9, 2023 The Biggest Threat to Donald Trump Could Be the Constitution Itself August 4, 2023
But Emanuel’s D.C. record is just the beginning of the case against his selection.
After leaving the Obama White House just prior to the disastrous 2010 mid-term election, Emanuel took his cruel blend of neoliberal politics and personal vindictiveness to Chicago. His two terms as mayor were characterized by reckless and politically self-serving responses to police violence and to demands for education, health care, and housing. Emanuel’s mayoral tenure was so divisive that more than 7,000 Chicagoans and their allies have signed a “Keep Rahm Away from the White House” petition promoted by City Council member Rossana Rodriguez Sanchez.
“In case you’re unaware,” the petition reads, “allow us to acquaint you with Rahm’s resume in some key policy areas”:
The opposition in Chicago, where people know Emanuel best, is so intense that Streetsblog Chicago, a news site that covers sustainable transportation issues, recently warned, “Hiring Rahm Emanuel as U.S. transportation chief is the bad idea that refuses to go away. Joe Biden, you really don’t want to kick off your administration with hundreds or thousands of justifiably angry Chicagoans marching in protest.” Current Issue View our current issue
Chicagoans are particularly upset over the idea of handing Emanuel the Department of Transportation post because, Chicago Alderman Carlos Ramirez-Rosa notes, “as Mayor of Chicago, Rahm Emanuel’s big transportation idea was to give Elon Musk public resources to put a car in an over-priced and unnecessary tunnel from downtown to O’Hare Airport. The thought of Emanuel as Biden’s Secretary of Transportation is asinine.”
The prospect stirs opposition beyond Chicago, as well. “We do not need a union buster setting the rules for workers in aviation,” argues Association of Flight Attendants president Sara Nelson. “That just doesn’t reflect Joe Biden’s deep commitment to workers and our unions.”
That goes double for the trade representative job, where Emanuel would again be positioned to promote Wall Street–friendly agreements, such as NAFTA and permanent normalization of trade relations with China. Those deals stirred deep frustration among dislocated workers, which would eventually be exploited by Donald Trump, who made an argument that Democrats had abandoned working-class communities central to his 2016 campaign. Chicago Says ‘No’ Should Biden Hire Rahm Emanuel? Chicago Says, ‘Never! Never! Never!’ John Nichols
Bringing Emanuel into a third Democratic administration “would be perceived as a slap in the face to labor,” explains Shane Larson, the senior director for government affairs for the powerful Communication Workers of America union. “It would be received very poorly.”
The debate over Emanuel is about more than the usual jockeying over whether a Democratic administration tilts to the left or the center. Indeed, as AOC notes, it is “a truly embarrassing indictment of what’s considered ‘center’ politics in the US that objecting to the appointment of an official who helped cover up the murder of a Black child is deemed the ‘progressive, far left’ position.” This is about the very real damage Emanuel has done—on matters of policy and politics—and that he will again do if he joins a new Democratic administration.
Political common sense indicates Representative-elect Jamaal Bowman of New York, is right when he says, “Rahm Emanuel should not be considered for any position within the Biden administration.”