I’m Back from the Future and Hillary is President

I’m back from the future and Hillary is President.  It’s not important how I got back from the future.  The point is that I am here and there is something important I have to share with you.  I lived a normal life and returned to this date by chance by might as well be considered magic.  However, I think that this date is important as it is right before the elections which were our country’s last hope.  This may be a chance to get this story out to help give a perspective of what happened once Hillary became president of the United States.

The date was August 10^th, 2019 before I left.  Much had changed since the election in 2016. Our country, as corrupt as it already was, was in great shape in 2016 compared to 2019.  It seemed that right after the November elections and the regime change in January that everything went downhill and fast.  Firstly other nations abroad declared Hillary a threat, right as they were, and false flags, “terrorist attacks”, and even the start of the One Nation World War which they called it (World War III) was beginning just as I arrived here.  I hope by sharing this with you that we can prevent this future that I have just traveled back from.

 

Election Process

The election process stumped the nation.  Hillary won against Donald Trump and all of the other presidential candidates by a landslide which showed the country officially that the election process was rigged.  Mainstream media could no longer hide the fact that Hillary was not accepted by the public as no one but major corporations, the media and other corrupt political officials supported her.  Not one person in the general populace supported Hillary. Hillary Clinton was the butt of jokes throughout alternative media outlets.

To counter this dislike throughout the internet propaganda campaigns were initiated by mainstream media that promised instant fame for Hillary supporters.  From reality television shows to internet podcasts those internet celebrities that hopped on this bandwagon quickly lost their audience’s respect and viewership.

 

First Changes

Some of the first changes after the inauguration were that the U.S. military were to remain in the conflicts happening abroad. More support was to be sent.  This started the draft, or as the media called it, ‘The Great Patriotic Duty.’  The government focused on high school students, promising 17 year olds an early diploma if they joined only the Army or the Marine Corp.  Tours were extended indefinitely and entire military families began residing in allied occupied areas of warzones in order to keep the soldiers focused.  The United States began occupying and building military bases in countries such as Jordan, Syria, Iraq, Afghanistan and Libya. Attacks on Iran began with no evidence to who fired first.  Russia officially intervened and skirmishes between United States and Russian troops began on small scale with most of the battles being hid from the public and only broadcasted through alternative media outlets.

By 2018 more than half of Congress was personally picked by Hillary and the first laws passed ratified the Constitution overnight making all handguns illegal according to their “Easy Concealment” and all rifles became illegal, including hunting rifles, because of their “Destructive Capabilities.”  All registered firearm owners were investigated and ordered to report to their local police departments for confiscation or seizure of their weapons within 20 days.  No compensation was ever given.  Arrest warrants were issued by Supreme Court Judges for all those who failed to comply with the new laws.  All police officers who didn’t enforce the new laws were fined and even jailed.  This led to many domestic skirmishes that started rumors of civil war but were propagandized quickly by the mainstream media as homegrown terrorists and Russian sympathizers.

 

Interstate and International Travel

All international travel was immediately banned which destroyed many businesses overnight and put huge restrictions on all imports and exports.  Even the food on store shelves became scarce. Most individuals had to resort to government aid in order to be placed in a line just to enter a grocery store.  All grocery store chains became guarded by the police and huge gates were installed around them which forced many families to grow food from home or to begin raising livestock.  However, restrictions were added and entire families, including children, were arrested for not meeting unattainable requirements that the government had set for such activities.  In short, crime increased due to starving families and the Black Market grew.

This crime led to attacks on police departments by small guerilla armies.  The public began to see these attacks immediately as a comparison of Robin Hood stories because the food taken was quickly distributed to the public in order to create even more resentment against the overbearing regime.  All states passed an Interstate Highway ban of travel for ‘public safety’ which further destroyed commerce as a whole.  It was quickly realized by the government and the people that there wasn’t a large enough police force to deal with the ongoing domestic disturbances throughout the nation while simultaneously sending the youth forcibly overseas to war.

False Flags, Insurgencies and Destabilization

False flag bombings began in every major metropolitan area in order to give a more heightened police presence.  The “official” reports are that they are from terrorist related cells but everyone knows that they are inside jobs being conducted by shadow operatives of our own government.  Many of these attacks are also being done by heavily armed and equipped groups of men that are masked and look remarkably similar to special forces or paramilitary groups.  Many average citizens have been surfacing and fighting back but the mainstream media is quickly labeling these individuals as insurgents that are to be also considered terrorists.  It is well understood by the general population that the point of these attacks is to destabilize major cities such as New York, Seattle, Los Angeles, Tampa and Houston while elected officials of these cities are stressing that everything is fine.  Canada has taken in American refugees in secret or so the word on the street is but everyone knows anybody caught crossing the border will disappear indefinitely.

United Nations Cooperation and Occupation

As I left the last bastion of hope was still alive.  The internet is still active and government groups are continuously working to quiet and delete all information circulating that doesn’t fit into their agenda.  A special directive was passed that allowed troops representing the United Nations to occupy and provide supplies in major cities but reports have come down saying that this has caused more harm than good.  Entire families are to report to special housing centers while U.N. troops go door to door arresting and even killing all those they deem an insurgent.  This was already happening in New York but never broadcasted.  These rumors only circulated through the internet with the occasional video here and there.  The majority of the nation has declared that the United States is occupied by foreign troops.

Although many coups have occurred amongst the military ranks they are all considered rumors because no proof of these events have been announced or shown to the public.  Militia groups are organized and are actively defiant but are considered worse than criminals. For the most part no one knows where they are much less who they are.  It has been said that Mexican troops have been seen occupying some of the Southern states. Apparently they are laying claim to land that once belonged to them while the government announced a new form of currency will take place that strengthens the bonds between North and South America.  No one has seen this currency yet.  Beijing and Israel have become power centers of the globe as many celebrities have denounced their American citizenship publically and have moved themselves, their families and private security overseas.

All I can say is the United States I just came from looked no different than the pictures and videos I saw of Syria back in 2015.  Bombings throughout the nation have occurred not just by terrorists but by the remaining armed forces in conjunction with the U.N. troops that are not overseas fighting illegal wars.  They have skipped declaring war on the American people and just started.  No one knows when or where the government will attack.  Russian troops have threatened to annihilate any Western troops that they see intervene with Iran.  Our citizens are no longer able to defend themselves.  Shadow forces of the government are purposefully destabilizing our once great cities that were some of the world’s largest tourist’s attractions.  Travel is pretty much illegal and impossible as no food, gas or money is available in excess and most families are either eating a whole lot less while growing their own food, committed to crime or have just disappeared altogether because they reported to a housing center.  Hillary claims our country is great.  On every channel she holds a special message once a week as her “Weekly Update”.  Please help to change this future.

 

Authors Note: I’m not really back from the future.

I’m Back from the Future and Hillary is President

How the World Bank’s biggest critic became its president | Andrew Rice

In a shanty town perched in the hilly outskirts of Lima, Peru, people were dying. It was 1994, and thousands of squatters – many of them rural migrants who had fled their country’s Maoist guerrilla insurgency – were crammed into unventilated hovels, living without basic sanitation. They faced outbreaks of cholera and other infectious diseases, but a government austerity program, which had slashed subsidised health care, forced many to forgo medical treatment they couldn’t afford. When food ran short, they formed ad hoc collectives to stave off starvation. A Catholic priest ministering to a parish in the slum went looking for help, and he found it in Jim Yong Kim, an idealistic Korean-American physician and anthropologist.

In his mid-30s and a recent graduate of Harvard Medical School, Kim had helped found Partners in Health, a non-profit organisation whose mission was to bring modern medicine to the world’s poor. The priest had been involved with the group in Boston, its home base, before serving in Peru, and he asked Kim to help him set up a clinic to aid his flock. No sooner had Kim arrived in Lima, however, than the priest contracted a drug-resistant form of tuberculosis and died.

Kim was devastated, and he thought he knew what to blame: the World Bank. Like many debt-ridden nations, Peru was going through “structural adjustment”, a period of lender-mandated inflation controls, privatisations and government cutbacks. President Alberto Fujimori had enacted strict policies, known collectively as “Fujishock”, that made him a darling of neoliberal economists. But Kim saw calamitous trickledown effects, including the tuberculosis epidemic that had claimed his friend and threatened to spread through the parish.

So Kim helped organise a conference in Lima that was staged like a teach-in. Hundreds of shanty town residents met development experts and vented their anger with the World Bank. “We talked about the privatisation of everything: profits and also suffering,” Kim recalls. “The argument we were trying to make is that investment in human beings should not be cast aside in the name of GDP growth.” Over the next half-decade, he would become a vociferous critic of the World Bank, even calling for its abolition. In a 2000 book, Dying for Growth, he was lead author of an essay attacking the “capriciousness” of international development policies. “The penalties for failure,” he concluded, “have been borne by the poor, the infirm and the vulnerable in poor countries that accepted the experts’ designs.”

Kim often tells this story today, with an air of playful irony, when he introduces himself – as the president of the World Bank. “I was actually out protesting and trying to shut down the World Bank,” Kim said one March afternoon, addressing a conference in Maryland’s National Harbor complex. “I’m very glad we lost that argument.”

Medical staff treat people with Ebola in Kailahun, Sierra Leone, 2014. Photograph: Carl de Souza/AFP/Getty Images

The line always gets a laugh, but Kim uses it to illustrate a broader story of evolution. As he dispenses billions of development dollars and tees off at golf outings with Barack Obama – the US president has confessed jealousy of his impressive five handicap – Kim is a long way from Peru. The institution he leads has changed too. Structural adjustment, for one, has been phased out, and Kim says the bank can be a force for good. Yet he believes it is only just awakening to its potential – and at a precarious moment.

Last year, the percentage of people living in extreme poverty dropped below 10% for the first time. That’s great news for the world, but it leaves the World Bank somewhat adrift. Many former dependents, such as India, have outgrown their reliance on financing. Others, namely China, have become lenders in their own right. “What is the relevance of the World Bank?” Kim asked me in a recent interview. “I think that is an entirely legitimate question.”

Kim believes he has the existential answers. During his four years at the bank’s monumental headquarters on H Street in Washington, he has reorganised the 15,000-strong workforce to reflect a shift from managing country portfolios to tackling regional and global crises. He has redirected large portions of the bank’s resources (it issued more than $ 61bn in loans and other forms of funding last year) toward goals that fall outside its traditional mandate of encouraging growth by financing infrastructure projects – stemming climate change, stopping Ebola, addressing the conditions driving the Syrian exodus.

Yet many bank employees see Kim’s ambitions as presumptuous, even reckless, and changes undertaken to revitalise a sluggish bureaucracy have shaken it. There have been protests and purges, and critics say Kim’s habit of enunciating grandiose aspirations comes with a tendency toward autocracy. The former bank foe now stands accused of being an invasive agent, inflicting his own form of shock therapy on his staff. “The wrong changes have been done badly,” says Lant Pritchett, a former World Bank economist.

Pritchett argues that, beyond issues of personality and style, Kim’s presidency has exposed a deep ideological rift between national development, which emphasises institution-building and growth, and what Pritchett terms “humane” development, or alleviating immediate suffering. Kim, however, sees no sharp distinction: he contends that humane development is national development – and if the bank persists in believing otherwise, it could be doomed to obsolescence.

The hardest thing to learn is mud-between-your-toes, on-the-ground development work

Jim Yong Kim

Kim likes to say that as a doctor with experience of treating the poor, his humanitarian outlook is his strongest qualification for his job – an opinion that probably vexes critics who point out that he knew little about lending before arriving at the bank. “Finance and macroeconomics are complicated, but you can actually learn them,” he says. “The hardest thing to learn is mud-between-your-toes, on-the-ground development work. You can’t learn that quickly. You can’t learn that through trips where you’re treated like a head of state. You have to have kind of done that before.”

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Kim talks fast and he walks fast. Following him – a lithe, balding 56-year-old surrounded by a deferential, suited entourage – you can easily imagine him in a white coat as a physician making his rounds. He has a doctor’s diagnostic mindset too; he talks about ascertaining “the problem”, or what public-health experts call the “cause of the causes”. He thinks of poverty as an ailment and is trying to devise a “science of delivery”. It’s a philosophy built on a life-long interest in the intersection of science and humanities. Born in Seoul in 1959 to parents displaced by the Korean war, Kim emigrated to the US with his family when he was a child, eventually ending up in Muscatine, Iowa. His was one of two Asian families in the small town. His mother was an expert in Confucian philosophy, his father a dentist. Kim excelled at his studies while playing quarterback in high school. He attended Brown University in Providence, Rhode Island, where he studied human biology. His father wanted him to be a doctor, but he gravitated toward anthropology. Because Harvard let him pursue a medical degree and a PhD simultaneously, he landed there. Kim struck up a friendship with Paul Farmer, a fellow student, over shared interests in health and justice. In 1987, they formed Partners in Health.

The two came of age when the World Bank’s influence was arguably at its most powerful and controversial. Conceived along with the International Monetary Fund at the 1944 Bretton Woods conference, the bank was meant to rebuild Europe. However, it found its central mission as a source of startup capital for states emerging from the demise of colonial empires. The bank could borrow money cheaply in the global markets, thanks to the creditworthiness of its shareholders (the largest being the US government), then use that money to finance the prerequisites for economic growth – things such as roads, schools, hospitals and power plants. Structural adjustment came about in response to a series of debt crises that culminated in the 1980s. The Bretton Woods institutions agreed to bail out indebted developing states if they tightened their belts and submitted to painful fiscal reforms.

A wall dividing shanty towns and rich neighbourhoods in Lima, Peru, where Kim’s journey to the World Bank began. Photograph: Oxfam/EPA

To Kim and Farmer, the moral flaw in the bank’s approach was that it imposed mandates with little concern for how cutting budgets might affect people’s health. They thought that “the problem” in global health was economic inequality, and in Haiti Partners in Health pioneered a grassroots methodology to tackle it: improve the lives of communities by training locals to provide medical care (thus creating jobs) and by expanding access to food, sanitation and other basic necessities. Though hardly insurgents – they were based at Harvard, after all – the friends passionately argued that policy discussions in Geneva and Washington needed to be informed by ground truths, delivered by the people living them.

Farmer’s impressive work ethic and pious demeanour made him famous – and the subject of Tracy Kidder’s acclaimed book Mountains Beyond Mountains – but Kim was the partner with systemic ambitions. “For Paul, the question is, ‘What does it take to solve the problem of giving the best care in the world to my patients?’” Kim says. “But he doesn’t spend all his time thinking about, ‘So how do you take that to scale in 188 countries?’” (Both men, who remain close friends, have won MacArthur Foundation “genius grants” for their work.)

Kim’s desire to shape policy landed him at the World Health Organisation (WHO) in 2003, overseeing its HIV/Aids work. The job required him to relocate to Geneva with his wife – a paediatrician he had met at Harvard – and a son who was just a toddler. (They now have two children, aged 16 and seven.) In the vigorously assertive style that would become his hallmark – going where he wants to go even if he’s not sure how to get there – Kim pledged to meet an audacious goal: treating three million people in the developing world with antiretroviral drugs by 2005, a more than sixfold increase over just two years. The strategy, in Kim’s own words, was, “Push, push, push.” The “three-by-five pledge,” as it was known, ended up being impossible to reach, and Kim publicly apologised for the failure on the BBC. But the world got there in 2007 – a direct result, Kim says, of the pledge’s impact on global-health policymaking: “You have to set a really difficult target and then have that really difficult target change the way you do your work.”

Kim left the WHO in 2006. After a stopover at Harvard, where he headed a centre for health and human rights, he was hired to be president of Dartmouth College in New Hampshire. He arrived in 2009, with little university management experience but characteristically high hopes. With the global recession at its zenith, however, Kim was forced to spend much of his time focused on saving Dartmouth’s endowment.

He hardly knew the difference between hedge funds and private equity, so a venture capitalist on the college’s board would drive up from Boston periodically to give him lessons, scribbling out basic financial concepts on a whiteboard or scratch paper. His tenure soon turned stormy as he proposed slashing $ 100m from the school’s budget and clashed with faculty members who complained about a lack of transparency. Joe Asch, a Dartmouth alumnus who writes for a widely read blog about the university, was highly critical of Kim. “He is a man who is very concerned about optics and not so concerned about follow-through,” Asch says now. “Everyone’s sense was that he was just there to punch his ticket.” Soon enough, a surprising opportunity arose.

The way Kim tells it, the call came out of the blue one Monday in March 2012. Timothy Geithner, another Dartmouth alumnus who was then the US treasury secretary, was on the line asking about Kim’s old nemesis. “Jim,” Geithner asked, “would you consider being president of the World Bank?”

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When the government contacted him, Kim confesses, he had only the foggiest notion of how development finance worked. He had seen enough in his career, however, to know that running the bank would give him resources he scarcely could have imagined during his years of aid work. Instead of agonising over every drop of water in the budgetary bathtub, he could operate a global tap. “When I really saw what it meant to be a bank with a balance sheet, with a mission to end extreme poverty,” Kim says, “it’s like, wow.” His interest was bolstered by the bank’s adoption, partly in response to 1990s-era activists, of stringent “safeguards”, or lending rules intended to protect human rights and the environment in client states.

Barack Obama nominates Kim for the presidency of the World Bank, Washington DC, 2012. Photograph: Charles Dharapak/AP

By custom, the World Bank had always been run by an American, nominated by the US president for a five-year term. But in 2012 there was a real international race for the post. Some emerging-market nations questioned deference to the United States, and finance experts from Nigeria and Colombia announced their candidacies. After considering political heavyweights such as Susan Rice, John Kerry and Hillary Clinton – who were all more interested in other jobs – Obama decided he needed an American he could present as an outsider to replace the outgoing president, Robert Zoellick, a colourless former Goldman Sachs banker and Republican trade negotiator. Clinton suggested Kim and “championed Jim as a candidate”, says Farmer. (Partners in Health works with the Clinton Foundation.)

Embedded within the dispute over superpower prerogatives was a larger anxiety about what role the World Bank should play in the 21st century. Extreme poverty had dropped from 37% in 1990 to just under 13% in 2012, so fewer countries needed the bank’s help. With interest rates at record lows, the states that needed aid had more options for borrowing cheap capital, often without paternalistic ethical dictates. New competitors, such as investment banks, were concerned mainly with profits, not safeguards. As a result, whereas the World Bank had once enjoyed a virtual monopoly on the development-finance market, by 2012 its lending represented only about 5% of aggregate private-capital flows to the developing world, according to Martin Ravallion, a Georgetown University economist. And while the bank possessed a wealth of data, technical expertise and analytical capabilities, it was hampered by red tape. One top executive kept a chart in her office illustrating the loan process, which looked like a tangle of spaghetti.

At Kim’s White House interview, Obama still needed some convincing that the global-health expert could take on the task of reinvigorating the bank. When asked what qualified him over candidates with backgrounds in finance, Kim cited Obama’s mother’s anthropology dissertation, about Indonesian artisans threatened by globalisation, to argue that there was no substitute for on-the-ground knowledge of economic policies’ impact. Two days later, Obama unveiled his pick, declaring that it was “time for a development professional to lead the world’s largest development agency”.

Kim campaigned for the job with the zeal of a convert. In an interview with the New York Times, he praised the fact that, unlike in the 1990s, “now the notion of pro-poor development is at the core of the World Bank”. He also embarked on an international “listening tour” to meet heads of state and finance ministers, gathering ideas to shape his priorities in office. Because votes on the bank’s board are apportioned according to shareholding, the US holds the greatest sway, and Obama’s candidate was easily elected. Kim took office in July 2012, with plans to eradicate extreme poverty. Farmer cites a motto carved at the entry to the World Bank headquarters – “Our dream is a world free of poverty” – that activists such as Kim once sniggered at. “Jim said, ‘Let’s change it from a dream to a plan, and then we don’t have to mock it.’”

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Kim still had to win over another powerful constituency: his staff. Bank experts consider themselves an elite fraternity. Presidents and their mission statements may come and go, but the institutional culture remains largely impervious. “The bank staff,” says Jim Adams, a former senior manager, “has never fully accepted the governance.” When Robert McNamara expanded the bank’s mission in the late 1960s, doing things such as sending helicopters to spray the African black fly larvae that spread river blindness, many staffers were “deeply distressed to see the institution ‘running off in all directions’”, according to a history published in 1973. When James Wolfensohn arrived in the mid-1990s with plans to move away from structural adjustment and remake the bank like a consulting firm, employees aired their gripes in the press. “Shake-up or cock-up?” asked an Economist headline. Paul Wolfowitz, whose presidency was marred by leaks, was pushed out in 2007 after accusations of cronyism resulted in a damning internal investigation.

Recognising this fraught history, Kim went on a second listening tour: he met representatives of every bank department and obtained what he describes, in anthropologist-speak, as “almost a formal ethnography” of the place. What he lacked in economic knowledge, he made up for in charm. “Dr Kim is personable, Dr Kim is articulate, Dr Kim looks very moved by what he has to say,” says Paul Cadario, a former bank executive who is now a professor at the University of Toronto.

The funeral of a woman who died of Aids on the outskirts of Kigali, Rwanda. Photograph: Sean Smith for the Guardian

The initial goodwill, however, vanished when Kim announced his own structural adjustment: a top-to-bottom reorganisation of the bank. It wasn’t so much the idea of change that riled up the staff. Even before Kim took office, respected voices were calling for a shakeup. In 2012, a group of bank alumni published a report criticising an “archaic management structure”; low morale was causing staff turnover, and there was an overreliance on consultants, promotion on the basis of nationality, and a “Balkanisation of expertise”. Where Kim went awry, opponents say, was in imposing his will without first garnering political support. “One famous statement is that the World Bank is a big village,” says Cadario, now a Kim critic. “And if you live in a village, it is a really bad idea to have enemies.”

The bank had been designed around the idea that local needs, assessed by staff assigned to particular countries and regions, should dictate funding; cooperation across geographical lines required internal wrangling over resources. So Kim decided to dismantle existing networks. He brought in the management consulting firm McKinsey & Co, which recommended regrouping the staff into 14 “global practices”, each of which would focus on a policy area, such as trade, agriculture or water. Kim hired outsiders to lead some departments and pushed out several formerly powerful officials with little explanation. To symbolise that he was knocking down old walls, he had a palatial, wood-panelled space on the World Bank’s executive floor retrofitted as a Silicon Valley-style open-plan office, where he could work alongside his top staff.

Kim also announced that he would cut $ 400m in administrative expenses, and eliminate about 500 jobs – a necessary measure, he said, because low interest rates were cutting into the bank’s profits. Kim says he “made a very conscious decision to let anyone who wanted… air their grievances.” His opponents detected no such tolerance, however, and their criticisms turned ad hominem. Around Halloween in 2014, a satirical newsletter circulated among the staff, depicting Kim as Dr Frankenstein: “Taking random pieces from dead change management theories,” it read, “he and his band of external consultants cobble together an unholy creature resembling no development bank ever seen before.” Anonymous fliers attacking Kim also began to appear around bank headquarters.

Kim portrayed internal dissent as a petty reaction to perks such as travel per diems being cut. “There’s grumbling about parking and there’s grumbling about breakfast,” he told the Economist. Meanwhile, bank staffers whispered about imperial indulgences on Kim’s part, such as chartering a private jet. (Kim claims this is a longstanding practice among bank presidents, which he only uses when there are no other options.)

A French country officer named Fabrice Houdart emerged as a lead dissenter, broadcasting his frustrations with Kim in a blog on the World Bank’s intranet. In one post, he questioned whether “a frantic race to show savings… might lead to irreversible long-term damages to the institution.” (This being the World Bank, his sedition was often illustrated with charts and statistics.) The staff went into open rebellion after Houdart revealed that Bertrand Badré, the chief financial officer, whom Kim had hired and who was in charge of cutting budgets, had received a nearly $ 100,000 bonus on top of his $ 379,000 salary. Kim addressed a raucous town hall meeting in October 2014, where he told furious staffers, “I am just as tired of the change process as all of you are.”

A few months later, Houdart was demoted after being investigated for leaking a privileged document. The alleged disclosure was unrelated to Kim’s reorganisation – it had to do with Houdart’s human rights advocacy, for which he was well known at the bank – and Kim says the investigation began before Houdart’s denunciations of his presidency. Critics, however, portray it as retaliatory. “Fabrice has become a folk hero,” Cadario says, “because he was brave enough to say what many of the people within the bank are thinking.” (Houdart is currently disputing his demotion before an internal administrative tribunal.)

In the heat of the staff revolt, Kim was devoting attention to a very different crisis: Ebola

“It’s never fun when large parts of the organisation are criticising you personally,” Kim admits. Yet he maintains that his tough decisions were necessary. “In order to do a real change, you have to put jobs at risk,” he says. “And completely understandably, people hate that.”

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In the heat of the staff revolt, Kim was devoting attention to a very different crisis: Ebola. In contrast with the bank’s historically cautious, analytical approach, Kim was pushing it to become more involved in emergency response. He committed $ 400m to confront the epidemic immediately, a quarter of which he pushed out in just nine days. He dispatched bank employees to afflicted west African countries and reproached the head of the WHO for the organisation’s lack of urgency. “Rather than being tied up in bureaucracy, or saying, ‘We don’t do those things,’ Jim is saying that if poor people’s lives are at risk… then it is our business,” says Tim Evans, whom Kim hired to run the bank’s new global practice for health.

Some bank veterans disagreed, vehemently. Nearly two years on, they still worry that in trying to save the day, Kim runs the risk of diverting the bank from its distinct mission. “Pandemic response is important – but it’s not the WHO, it’s the World Bank,” says Jean-Louis Sarbib, a former senior vice-president who now runs a nonprofit development consultancy. “I don’t think he understands the World Bank is not a very large NGO.” Referencing Kim’s work with Partners in Health, Sarbib adds, “The work of the World Bank is to create a system so that he doesn’t need to come and create a clinic in Haiti.”

In reply to this critique, Kim likes to cite a study co-written by a former World Bank economist, Larry Summers, that found that 24% of full-income growth in developing countries between 2000 and 2011 was attributable to improved public health. Put simply, Kim says, pandemics and other health deficits represent enormous threats to economic development, so they should be the World Bank’s business. The same goes for climate change, which the bank is fighting by funding a UN initiative to expand sustainable energy. As for violent conflicts, rather than waiting until the shooting has stopped and painstakingly preparing a post-conflict assessment – as the bank has done in the past – Kim wants to risk more capital in insecure zones.

“We… bought into this notion that development is something that happens after the humanitarian crisis is over,” Kim said at a recent event called the Fragility Forum, where he sat next to representatives of various aid groups and the president of the Central African Republic in the World Bank’s sun-soaked atrium. “We are no longer thinking that way.”

After the forum, amid a whirlwind day of meetings and speeches, Kim stopped at a hotel cafe with me to unwind for a few minutes. As a counterweight to his life’s demands, he practices Korean Zen-style meditation, but he also seems to blow off steam by brainstorming aloud. Goals and promises came pouring out of him like a gusher. Besides eliminating extreme poverty, which he has now promised will be done by 2030, Kim wants to raise incomes among the bottom 40% of the population in every country. He also wants to achieve universal access to banking services by 2020.

Long past our allotted interview time, Kim told me he had just one more idea: “Another huge issue that I want to bring to the table is childhood stunting.” At the Davos World Economic Forum this year, he explained, everyone was chattering about a “fourth industrial revolution”, which will centre on artificial intelligence, robotics and other technological leaps. But Kim thinks whole countries are starting out with a brainpower deficit because of childhood malnutrition. “These kids have fewer – literally fewer – neuronal connections than their non-stunted classmates,” he said. “For every inch that you’re below the average height, you lose 2% of your income.”

“This is fundamentally an economic issue,” he continued. “We need to invest in grey-matter infrastructure. Neuronal infrastructure is quite possibly going to be the most important infrastructure.”

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To World Bank traditionalists, addressing nutrition is an example of the sort of mission creep that makes Kim so maddening. Despite its name and capital, the bank can’t be expected to solve all the world’s humanitarian problems. (“We are not the UN,” is an informal mantra among some staffers.) Poor countries may well prefer the bank to stick to gritty infrastructural necessities, even if Kim and his supporters have splashier goals. “The interests of its rich-country constituencies and its poor-country borrowers are diverging,” Pritchett says. “It’s like the bank has a foot on two boats. Sooner or later, it’s going to have to jump on one boat or the other, or fall in the water. So far, Jim Kim is just doing the splits.”

The World Bank headquarters in Washington. Photograph: Lauren Burke/AP

Kim’s defenders insist the bank hasn’t abandoned its core business. In fact, as private investment in emerging markets has contracted recently, due to instability in once-booming economies such as Brazil, countries have found more reasons to turn to the World Bank. Its primary lending unit committed $ 29.7bn in loans this fiscal year, nearly doubling the amount from four years earlier. “There is so much need in the world that I’m not worried we’re going to run out of projects to finance,” Kim says. He also hopes the worst of the tumult within the bank is over. A few elements of his reorganisation have been scaled back; after the new administrative structure proved unwieldy, the 14 global practices were regrouped into three divisions. Some of his more polarising hires have also left.

A five-year term, Kim says, is hardly sufficient to implement his entire agenda, and he has conveyed his desire to be reappointed in 2017. Though internal controversies have been damaging, and America’s domination of the bank remains a source of tension, the next US president (quite possibly Kim’s friend Hillary Clinton) will have a strong say in the matter. If he keeps his job, Kim wants to show that the World Bank can serve as a link between great powers and small ones, between economics and aid work – retaining its influence as old rules and boundaries are erased and new ones are scribbled into place.

Kim thinks he can succeed, so long as he keeps one foot rooted in his experiences as a doctor with mud between his toes. But he also wants to share his revelations about capital with his old comrades. “I really feel a responsibility to have this conversation with development actors who, like me 10 years ago, didn’t really understand the power of leverage,” Kim says with a guileless air.

“God,” he adds, “it is just such a powerful tool.”

• This article first appeared in Foreign Policy magazine.

• Follow the Long Read on Twitter at @gdnlongread, or sign up to the long read weekly email here.

How the World Bank’s biggest critic became its president | Andrew Rice

Abbott willing to rethink $seven Medicare co-payment, says AMA president

The Abbott government is prepared to rethink the design of its proposed $ 7 GP co-payment, the Australian Health-related Association (AMA) has declared, after a meeting in Canberra on Wednesday.

In a possibly significant shift on a budget measure that was most likely to encounter Senate defeat, Tony Abbott and his overall health minister, Peter Dutton, are explained to have signalled their willingness to consider different designs at a meeting with the AMA leadership at Parliament Home.

The AMA president, Brian Owler, described the meeting as “constructive” and said the prime minister and the health minister had listened to the organisation’s worries about the influence of the proposed new charge on vulnerable patients.

“I feel the message that was clear today was a dedication on behalf of the prime minister and the minister to look at substitute designs, something that we have not heard prior to, or since the price range was announced, and I believe that’s a really optimistic move,” Owler explained at a press conference right after the meeting.

Asked to confirm the government had indicated it was prepared to modify the GP co-payment, Owler stated: “The prime minister and the minister produced it relatively clear in the meeting that they have been willing to appear at different models and contemplate those on their merits.

“Obviously if there is a model that is acceptable to the AMA that we’re capable to assistance I’m hoping the government will support that model, and so I believe for the 1st time [there"s] an indication at least that there’s a willingness to revisit the model that they’ve place forward in the budget.”

Guardian Australia is seeking comment from Abbott and Dutton’s offices about the government’s stance on likely adjustments.

The government’s proposed GP co-payment, due to commence in July next 12 months, was set to encounter Senate defeat given the opposition by Labor, the Greens and Palmer United. The government has repeatedly defended the measure, saying the money raised would go into a healthcare analysis future fund. But the co-payment has attracted widespread community concern and spurred reports that some individuals were already placing off visits to the GP fearing the fee had previously begun.

Owler explained the prime minister and the minister had shown a “willingness to work with the AMA to come up with a answer that protects vulnerable folks, that supports common practice and makes certain that we assistance issues like preventive well being care and persistent condition management”.

He mentioned the AMA agreed that there have been men and women in society who could contribute to their overall health care, noting that twenty% of GP providers already attracted a co-payment and it was often bigger than $ 7. But the AMA could not help a cut to the Medicare rebate and was worried about the effect of the fee on vulnerable groups.

Owler explained the AMA also did not support making it possible for state and territory governments to charge co-payments for emergency division visits. He said the concept was “impractical” and he did not want to force individuals to make a decision whether their chest pain may possibly be a heart attack or merely indigestion.

“What we want to do is operate with the government to come up with a model that not only promotes overall health care and promotes the health of our sufferers but protects those that are most vulnerable,” he explained.

“We have to make certain that we protect those most vulnerable in our society and we should make positive that funding is maintained for standard practice which is about maintaining people out of costly wellness care.”

Abbott willing to rethink $seven Medicare co-payment, says AMA president

President Obama To Convene White House Summit On Youth Concussions

Amid the expanding concern of mother and father, coaches and athletic trainers about the potential prolonged term results of concussions in children engaged in sports routines, the president is scheduled to convene convene a summit right now at the White Home which aims to not only advance investigation, but also spot a spotlight on approaches, along with prevention, detection and awareness of sports activities-connected concussion in children

The “Healthy Youngsters and Safe Sports Concussion Summit” is also a step towards addressing the developing public well being demand for viable approaches and remedies to concussion identification, evaluation and management at the youth level—something that was in no way addressed adequately in the previous decades. In reality, latest research has suggested that younger brains may be more vulnerable than adult brains to repeated “hits”, due to the fact the window for injury is drastically lengthened for youth who encounter repeated blows.

DSC_0383 (Photograph credit score: Brian J. McDermott)

Numerous professionals are now more concerned about the idea of repetitive injury in kids because this may involve basic differences in the real makeup or structure of a developing brain in contrast with the far more developed structures and anatomy in an adult brain. Even so, other researchers have challenged the concept that so-referred to as “sub-concussive blows”—blows not sturdy sufficient to generate headaches, dizziness, nausea or stability issues-actually outcome in any proof of prolonged injury simply because of a lack of published data on this entity.

As a end result, the Institute of Medicine (IOM) and the National Investigation Nationwide Study Council published a report last fall detailing that we have a lack of usable data about concussions predominately in youth sports, along with a “culture of resistance” in which some kids and teen athletes do not self-report concussions or concussive signs to steer clear of “being positioned on the bench.”

As a mother or father of two young daughters who are energetic in athletics, President Obama needs to make it clear that sport-related concussions are a national priority and so deserve a area in our nationwide discussion.  As an avid sports activities fan, Obama understands and appreciates the dangers of sports associated concussions and desires all parents to have a discussion with their youngsters to guarantee their overall health and security not only even though engaged in sports, but in the many years to come right after they may not be competing.

By convening the summit, the President’s objective is to produce a united hard work amongst essential stakeholders which includes the NCAA, NFL and MLS and to forge new research and collaborative efforts that will end result in novel ways for parents, trainers, coaches, and doctors to not only stop, but spot concussions earlier and react with more efficient treatment options.

Some of the efforts detailed in today’s press conference include a collaboration in between the Department of Defense (DOD) and the NCAA to fund a key clinical examine evaluating effects of head impacts and resulting concussions in youth going forward. In addition, one hundred Pop Warner teams will get portion in a prolonged term venture monitoring the cumulative effects of concussions suffered at a younger age into the higher school many years. The NFL has also made the decision to pledge 25 million dollars more than the up coming three many years to design and employ youth security projects aimed at concussion security and awareness. An lastly, Major League Soccer and US Soccer program to convene a conference that will emphasis on increasing  awareness and management of concussions.

Clearly, many would argue that the 25 million dollar sum pledged by the NFL for investing in youth concussion analysis for this initiative–in light of the 765 million dollar settlement in the previous year for gamers who have suffered the effects of traumatic brain injury–is not in trying to keep with a fiscal investment that may possibly be expected for this kind of an endeavor. It is clear that the league will have to reflect on this as a starting stage and gauge their investment in our youth as the program grows.

While there have been no significant advances in the treatment method and management of concussions in the past 30 years, there is now a push to unite government resources, academia, and the private sector to share so-called “common information elements” in the hope of developing a shared national database of individuals who have suffered concussions.  The believed is that this may support accelerate the approach of discovery and lead to viable mechanisms to aid lead to far more powerful care and identification of concussions.

1 location of study for concussion awareness and thus management has involved the use of scalp and helmet- mounted sensor technologies as a approach to detect the force of a hit, and therefore create a cumulative “hit count”.

X2Bio, a  specialized engineering organization based in Seattle, has been at the forefront of advancing such technologies for use in youth sports.  Their scalp-mounted sensors and accelerometers have been tested exhaustively during college football more than the previous several years, executing properly as predictors of considerable head trauma warranting more evaluation by trainers and healthcare personnel for concussion. In truth, X2’s specialized ICE concussion application was just lately adopted by all 32 NFL teams for sideline evaluation for gamers with suspected concussion.

Dr. Geoffrey Manley, Professor and Vice Chairman of Neurosurgery at UCSF, chief of Neurosurgery at UCSF and lead investigator for the Transforming Investigation and Clinical Knowledge in Traumatic Brain Damage (TRACK–TBI) study, has utilized magnetic resonance imaging to identify structural abnormalities in practically 30% of 135 sufferers with mild TBI and a regular computed tomographic (CT) scan. The existence of these abnormalities witnessed n MRI predicted unfavorable outcome at three months. This represents an essential phase towards far better identification of complex patient subgroups within the population typically classified as having mild TBI or concussion.

Total, Track-TBI represents portion of a national effort made to generate a unified database of so-named “common data elements” which can be shared among researchers in purchase to result viable options to the complexities of concussions an traumatic brain injury (TBI). This dataset will help to populate the Federal Interagency Traumatic Brain Injury Study (FITBIR) databank, an informatics technique that offers a collaborative platform for imaging, evaluation, and genomics investigation.  The goal is to have so- known as “big data” produce considerable advances in an location that has yet to see any appreciable gains.

And an organization primarily based in Seattle, A single Mind, is at the forefront of selling the idea of shared information.  As CEO of 1 Mind, Common Peter Chiarelli [Ret] has helped to advance the nationwide conversation towards promoting a unified database for clinicians to draw on to make a united front. At a recent conference in Crystal City Virginia in early May possibly, Chiarelli thorough an aggressive strategy to website link industry, academia and numerous branches inside the National Institutes of Overall health (NIH) in a collaborative style to help perform towards advertising shared data with frequent information components.

The long term seems to be very promising, with the President taking an essential first step towards having an open and ongoing nationwide conversation about the potentially life changing effects of traumatic brain injuries and concussions that could get started in childhood.

President Obama To Convene White House Summit On Youth Concussions

World in a week: Malawi president demands recount amid hacking fears

Good week for …

José Mourinho, who has been awarded the role of UN ambassador towards hunger.

A group of kids in Tanzania, who have been located to be naturally immune to malaria and are helping scientists to build a new vaccine.

Undesirable week for …

Yingluck Shinawatra, Thailand’s former prime minister, who has been detained along with a variety of members of her household, as leaders of the nation’s military coup tighten their grip on power.

Joyce Banda, the Malawi president, has named for a recount just days right after a basic election, amid allegations of vote-rigging and computer hacking.

What you’re saying

On Wednesday the Gates Foundation hosted a discussion on the rights of girls and girls. This sparked an fascinating discussion on twitter employing the hashtag #womenandgirls. Observe a video of the debate on the web here.

The week in numbers

$ 150bn is made in profit each yr from forced slavery across the globe – much more than 3 occasions the prior estimation – according to a research by the UN’s Worldwide Labour Organisation.

$ 7.5bn is the amount needed by the GAVI Alliance to help safeguard much more than 300 million young children from existence-threatening conditions and conserve up to twelve million lives by 2020.

2.five million folks viewed this week’s Conserve the Youngsters video “Can sex promote poverty?” in which the producers advised versions to make poverty sound attractive.

two million malnourished children across the globe have been manufactured a priority by the U.S. Company for Global Growth, who announced a new “multi-sectoral nutrition strategy” which aims to preserve acute malnutrition beneath 15% in places experiencing humanitarian crisis.

34,105 situations of measles have been reported in a recent outbreak in sub-Saharan Africa, amid weak vaccination coverage.

Image of the week

Refugee ladies wash their clothing in Gbiti, Cameroon, soon after months strolling in Central African Republic (Vehicle).

To escape violence in Vehicle, refugee ladies stroll for months to reach Cameroon. Photograph: Schmitt/UNHCR/C

Milestones

It is been five years because Sri Lankan forces declared victory above the Tamil Tigers (LTTE), who had fought for an independent Tamil homeland considering that 1983. However overcoming the divisions triggered by the decades-lengthy civil war stays a work in progress.

This week the Ghana Nation Workplace of the African Advancement Financial institution (AfDB) is marking its 50th anniversary with an open day event at its premises in Ridge, Accra.

At the Planet Health Assembly on Wednesday, EU member states accepted a worldwide monitoring framework on maternal, infant and youthful kid nutrition.

Infographic

This week the Overseas Advancement Institute published an infographic on ten items you want to know about EU help.

Collectively, the EU and its members give the most aid in the globe. Photograph: ODI

Reading through record

Coming next week: have your say

• Our live chat on Thursday 29 Might is on gender and nutrition. Numerous interventions close to decreasing child malnutrition emphasis on the position of mothers, does this location an unfair burden on women? Get in touch with us at globaldevpros@theguardian.com to advocate an individual for the panel.


• Search out for our witness assignment #MyClimateAsk which picks up pace as much more of you submit photographs and tweet us your messages for worldwide leaders.
  
  

Join the community of worldwide development pros and specialists. Become a GDPN member to get much more stories like this direct to your inbox.

World in a week: Malawi president demands recount amid hacking fears

Newly Elected President Of Institute of Medication Is On The Pepsico Board Of Directors

A group of Duke students protested the excessive compensation provided to some best Duke officials, including cardiologist Victor Dzau, who is the Chancellor for Well being Affairs at the University. In response to the protest, one mentioned advocate for overall health care reform says that Dzau has enriched himself even even more through support on four separate corporate boards, and that Dzau or Duke has been much less than forthcoming about completely disclosing Dzau’s board memberships.

The protesters took issue with Dzau’s total compensation for 2009 of more than $ two.2 million. The figure appears excessive, especially in the context of latest monetary difficulties at Duke, resulting in “frozen pay and eliminated jobs,” in accordance to newsobserver.com.

But Dzau’s compensation at Duke is far from uncommon, according to Roy Poses, creating  on Health Care Renewal. He notes that compensation for “leaders of not-for-profit organizations, which includes academic institutions, is now frequently in the millions per 12 months selection.”

But what is striking in this situation, in accordance to Poses, is the large sums of funds Dzau receives from sources outside of Duke. In particular, Dzau serves on many corporate boards, Alynlam Pharmaceuticals, Genzyme, Medtronic, and PepsiCo, even though his biography on the Duke website lists only his Genzyme affiliation.

Right here are the specifics of Dzau’s corporate compensation for 2009, as reported by Poses:

• In accordance to the Alnylam Pharmaceuticals 2010 Proxy Statement, Dr Dzau’s compensation as a director in 2009 was $ 234,433.  In 2009, Dr Dzau owned the equivalent of 45,000 shares, well worth $ 424,800 at today’s $ 9.44 price per share.


• According to the Genzyme 2010 Proxy Statement, Dr Dzau’s compensation as a director in 2009 was $ 412,942.  In 2009, Dr Dzau owned the equivalent of 75,137 shares, well worth $ five,312,937 at today’s $ 70.71 price tag per share.


• According to the Medtronic 2010 Proxy Statement, Dr Dzau’s compensation as a director in 2009 was $ 173,698.  In 2009, Dr Dzau owned the equivalent of 14,552 shares, worth $ 493,895 at today’s $ 33.94 value.


• In accordance to the PepsiCo 2010 Proxy Statement, Dr Dzau’s compensation as a director in 2009 was $ 260,000.  In 2009, Dr Dzau owned the equivalent of 25,065 shares, worth $ 1,622,458 at today’s $ 64.73 value per share.


• So, in summary, in 2009, Dr Dzau received  $ 1,081,073 in compensation to be a director of these four companies.  In 2009, Dr Dzau owned stock or equivalent in these 4 firms valued at $ seven,854,090.  He has turn out to be what most individuals would take into account rich just from his work on these boards, in addition to the hundreds of thousands he has acquired from Duke.

Poses raises numerous critical queries about these problems, but focuses on the conflict of interest angle. He asks why Duke doesn’t totally disclose all of Dzau’s relationships and observes that all these firms signify “severe conflicts of interest” for Dzau:

Dr Dzau’s service on the board of each of these businesses implies he has fiduciary duties to every single business, and is supposed to show unyielding loyalty to the companies’ stockholders…. Even in the ideal case, showing unyielding loyalties to the stockholders of companies that make medication, medical units, and sugary drinks appears to be likely to influence a leader of an academic medical institution in ways that chance degrading the leader’s responsibilities to uphold the institution’s mission, i.e., to create significant conflicts of curiosity.

Poses then asks what is Dzau’s degree of responsibility for some of the troubling, properly publicized episodes that have plagued Genzyme and Medtronic in latest years. He points out, for instance:

Medtronic has been the source of several alleged conflicts of interest involving influential doctors. (see posts about Medtronic here).   Possibly someone could ask Dr Dzau what he imagined about such actions, and whether he would get any obligation for them.

Remarkably, Poses does not focus on Dzau’s involvement with PepsiCo, which strikes me as the most troubling of all. As a prominent and influential health care leader, how could Dzau treat a tax on soda, or a ban on vending machines in schools, or any of a multitude ofother well being policy problems relating to the weight problems and diabetes epidemic? In addition, might Dzau’s involvement with PepsiCo (and the other companies) make a chilling effect on the free speech and activities of Duke faculty and affiliated medical professionals?

Newly Elected President Of Institute of Medication Is On The Pepsico Board Of Directors

A day in the daily life of ... the president of the Royal School of Doctors and Surgeons of Glasgow

I wake at 6.40am and typically commence my day with a stroll to acquire a morning paper. I locate this 30-minute round trip supplies a useful opportunity to emphasis and strategy for the issues of the day ahead.

My week requires 4 days at the Royal University of Physicians and Surgeons of Glasgow in my position as president and a single day – Fridays – at Stobhill hospital exactly where I have worked for 30 years as a cardiologist.

The NHS has been an integral part of my life. I lived in the grounds of Stobhill hospital until finally the age of eight as my father worked there as assistant healthcare superintendent. My father, collectively with the health care superintendent and the matron, ran the 1,000-bed hospital.

The hospital lay in gorgeous grounds tended by thirty gardeners. It was a privilege to return there as a advisor cardiologist in 1983 and experience that exact same family members ambiance coupled with higher quality of care.

In spite of current shortcomings, the overall health services stays a jewel inside British society. I locate my continued clinical involvement, albeit on an outpatient basis, is rewarding and relevant to other factors of my work. Some patients I have cared for for more than thirty years.

The Royal University of Doctors and Surgeons of Glasgow is special in the United kingdom in that we have obligation for both doctors and surgeons. I truly feel this is an benefit offered the a lot of shared interests and problems. We also have faculties of dental surgical treatment, travel medication and podiatric medication. Our university prospects in the setting of examination specifications and the provision of schooling and a range of membership services for wellness pros. It plays a part in Scotland, the rest of the United kingdom and during numerous elements of the planet in influencing decision-producing, with the priority of enhancing requirements of care for individuals.

On a normal day I generally arrive at the university at close to 8am. The 1st two hrs are typically invested dealing with administrative duties and emails. I will then attend meetings, for instance with essential members of our executive board, fellows and members from diverse disciplines, and groups such as universities, deaneries and wellness boards, with which we have a whole lot of shared interests and objectives.

I am usually asked to chair educational events which we run for a variety of people, from college-age youngsters proper by way of to senior and retired consultants.

Lunch normally consists of oatcakes with cheese and tomatoes laced with pepper and a Diet Coke. A quick energy nap typically follows.

I am frequently in Edinburgh or London for meetings with the other royal schools. As a president of a royal college with each physicians and surgeons I have several meetings to attend. I uncover it notably fascinating as a consultant cardiologist to be the only physician all around a table of surgeons. My surgical colleagues accept me without evident suspicion.

A quantity of my evenings are taken up with college occasions. We consider to accomplish a excellent balance amongst learning and socialising and I have lately launched musical evenings with the Royal Conservatoire of Scotland which have proved really common. Our global links are essential to us and we are committed to offering education, examinations and occasions to colleagues in several components of the globe. Final yr I was fortunate to pay a visit to the US.

Every single 3 years we run a massive worldwide conference in Glasgow. We are at the moment preparing for Advancing Excellence in Healthcare 2014, which will get area in June with a main theme of sports activities medication and will precede the Commonwealth Video games. We have been fortunate sufficient to entice professionals in the discipline of sports activities medicine and athletics to share their experiences with us.

When not at the college, I chill out by currently being with my family and enjoying golf. We are a golf-mad family and we discover that this game, like life itself, has numerous ups and downs. I have also had a turbulent lifelong romantic relationship with Clyde Football Club who are at the moment languishing in the reduced echelons of Scottish Football. Relaxation would not be a word I would use for this pastime!

I am extremely lucky to have had a most satisfying job as a advisor cardiologist culminating in my present part. Medicine stays for me a most stimulating job. I would happily start once again tomorrow.

If you would like to characteristic in our Day in the Daily life series, or know somebody who would, electronic mail healthcare@theguardian.com

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A day in the daily life of ... the president of the Royal School of Doctors and Surgeons of Glasgow