The Tuberculosis Initiative: A Catalytic Role for Princeton Project 55

By Jim Lynn ’55

Gordon Douglas, Jr. ’55, TBI Program Leader

Most people think of Princeton Project 55 as a matchmaker, not an incubator. After all, it’s spent 20 years pairing up hundreds of idealistic young Princeton alumni with nonprofit agencies that need smart people to fill challenging jobs at low pay for a year or two.

But in those 20 years PP55 has also hatched and sent into the world half a dozen programs that other organizations have picked up and run with. And perhaps the most surprising success among them – at least to Gordon Douglas, Jr. ’55 – was the Tuberculosis Initiative, which emerged abruptly in 1997.

Dr. Douglas was president of the Vaccine Division at Merck & Co. for most of the 1990s. His wife, Ann, was a PP55 board member for six years, and in 1996 she was enthusiastic about Ralph Nader ’55’s proposal to involve Project 55 in a campaign against tuberculosis.

“She came home and told me about it,” Douglas told an interviewer years later, “and I said, ‘He’s nuts! This is a crazy idea – there’s no way! This is an enormous world health problem. We don’t have the capability of going out and handing out pills or giving vaccines to millions of people. It’s not what we can do.’”

Nevertheless, PP55 hosted a conference entitled, “Tuberculosis: A Global Emergency” at the Woodrow Wilson School on a cold, rainy Sunday in February 1997. “We wanted to vet this idea with some experts,” Douglas said. Two dozen TB control organizations sent representatives. An audience of 150 or so showed up too. “And,” Douglas recalled, “the meeting demonstrated, as Ralph had thought, that advocacy for tuberculosis was an important issue and by itself would accomplish a lot.” Before long the Tuberculosis Initiative – soon abbreviated to “TBI” – was officially in business, and Gordon Douglas became its program leader.

Later that year, PP55 was a convener at the Johns Hopkins School of Hygiene and Public Health, of a symposium of world-class experts with an even more ambitious title: “The Global Tuberculosis Pandemic: A Strategy for Unified Global Control and Ultimate Elimination.” PP55 then went on to become a founding member of the Global Alliance for TB Drug Development.

“When we started,” Douglas said long afterward, “there was really nothing being done on tuberculosis. If you asked a private citizen they’d say, ‘Well, we thought tuberculosis was cured years ago.’ But the true issue is that worldwide it’s as big a killer as AIDS. It’s an enormous problem, and the things that have helped solve it here are not working in the developing world.”

“The biggest thing was acting as a catalyst to bring people together,” Douglas continued. We wrote a lot of op-ed pieces in newspapers. We talked about TB whenever we could. We brought the issue before key congressional people, the executive branch, White House staff, and Health and Human Services. And every time they mentioned AIDS – which has an enormous advocacy group – we would just piggyback on it, and say, ‘Well, you can’t deal with the AIDS problem if you don’t deal with the TB problem. Most of the patients in Africa who die from HIV infection actually die of TB.’”

Funding from the government and the Gates Foundation improved dramatically after 1997. Well funded lobbying organizations like the American Lung Association took up the cause with renewed vigor. There were fewer opportunities for TBI to “do something unique, like we did in the beginning,” Douglas said. But one unique PP55 resource was its fellows and interns, and he argued for pointing them toward organizations doing work on tuberculosis – an idea that later bore fruit in the Public Health Fellowship program.

TBI itself – made expendable by its own success – was officially shut down in 2003. It had played a key role in escalating the campaign against TB, and other, much larger organizations were better fitted to take it to the next level. As Douglas put it, “Either we were very lucky and got in there at a time when change was happening regardless of what we did, or – as we think – we actually had something to do with effecting that change.”

Jim Lynn ’55 spent his working life as a reporter, writer, and editor in and around New York City. He has been secretary of the Class of 1955 and an Alumni Schools Committee interviewer, and is secretary and board member of PP55.

The Tuberculosis Initiative
(1997-2003) TBI focused on the worldwide eradication of tuberculosis at a moment when multi-drug resistant TB was threatening to explode. PP55 initially served as the convener for organizations like the World Health Organization, the US Constitutional Defense Council, USAID, the United States Department of Health and Human Services, and the American Lung Association. Princeton Project 55 was a founding member of the Global Alliance for TB Drug Development.

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