Inside the sprawling philanthropy founded by former President Bill Clinton, its health initiative, run by a longtime friend and policy adviser to the Clintons, holds a vaunted place, with the largest budget of any program in the foundation and a distinguished record of fighting diseases like AIDS and tuberculosis in underdeveloped countries.
Its chief executive, Ira C. Magaziner, who is admired as a brilliant and farsighted leader, has long alienated co-workers at the Clinton Foundation. But a harsh new set of complaints about Magaziner were captured this year in a performance review, with most of the grievances coming from the board of the Clinton Health Access Initiative, or CHAI, of which Chelsea Clinton is a member.
The review said Magaziner had shown "disdain" for the health initiative's board, exhibited "duplicitousness with management," and displayed a "lack of transparency" and "dismissive behavior" toward Clinton family members. Board members also accused Magaziner of "paranoia," according to the review.
And a separate, broader organizational review revealed that efforts had been made to start considering possible successors to Magaziner, although it noted he had no plans to leave voluntarily anytime soon.
Together, the two reviews offer a rare look at the tensions and complicated politics inside the Clinton Foundation, where Chelsea Clinton, the only child of Bill and Hillary Rodham Clinton, has steadily asserted influence since joining the organization in 2011--occasionally colliding with veterans of her father's White House--even as Magaziner has clamored for greater independence from the foundation and the Clintons.
The reviews, which were hurriedly prepared in January and February by Nygren Consulting of Santa Barbara, Calif., also cited concerns about potentially adverse consequences of Hillary Clinton's presidential campaign on her husband's legacy projects. "Whether correct or not," one of the documents warned, leaders of the health initiative "believe that government donors will see a Clinton presidential race as a conflict of interest and potentially withdraw funding should she run." Among the ideas considered was removing Clinton Foundation appointees from the health initiative's board as a way to soothe potentially nervous donors.
Chelsea Clinton, a board member of both the health initiative and the larger foundation, where she is the vice chairwoman (her father and Bruce R. Lindsey, the foundation's chief executive, are the only others to sit on both), initiated the reviews, according to two people with direct knowledge of them. A person close to Chelsea Clinton denied this, saying that she was no more involved than any other board member, all of whom voted for the reviews.
Either way, the reviews praised Magaziner as a "visionary" who has had a "transformational impact" on the field of global health, with a clear sense of the Clinton health initiative's mission and a deep knowledge of the way nongovernmental organizations operate.
But Magaziner's performance review also said that his underlings could find him prickly, intimidating, abrasive and arrogant. And it cited interviews with unnamed board members who savaged Magaziner, saying he treated them with disrespect and suspicion, had created needless divisions, and was overly concerned with gaining independence from the Clinton family.
"Ira's 'paranoia' was mentioned by several board members to encompass Ira's general mistrust of the Board and its intentions," the review found. "This was cited as particularly prevalent when it comes to the Clintons. Several board members indicate that Ira has misrepresented the board and the Clinton Foundation to management and others, which has resulted in an unhealthy relationship and tension."
His disdain for the initiative's board, the report added, "is damaging and unnecessary, and perceived to be motivated by his drive for independence from the Clintons."
In an interview, Magaziner acknowledged the review's harsher elements but said the fuller picture it painted was positive. "Am I intimidating at times?" he added. "Am I prickly? Sure."
A Rhodes Scholar at Oxford with Bill Clinton, Magaziner was put in charge, alongside the first lady, of trying to overhaul the nation's health-insurance system in 1993. Since 2002 he has spearheaded the Clinton Health Access Initiative, seeking to expand access to drugs and treatment to combat AIDS, malaria, tuberculosis and other diseases around the world. It was the Clinton Foundation's premiere endeavor until the Clinton Global Initiative was created in 2005.
In 2010, in a sign of Magaziner's efforts to gain independence for the health initiative, it was spun off as a separate nonprofit under the Clinton Foundation's umbrella, and relations between the two entities--the foundation is based in New York, CHAI in Boston--grew somewhat strained over the health initiative's budget, among other things.
In the interview, Magaziner contrasted the $170 million health initiative's on-the-ground work in 34 countries with the larger Clinton Foundation's emphasis on building an endowment. "If you look at the actual programmatic work, we are three or four times bigger than the rest of the foundation," he said. "And we're a different kind of organization."
Magaziner, who did not take a salary until 2008, earned roughly $308,000 in compensation overseeing the Clinton health initiative in 2014. Until last year, he also ran the Clinton Climate Initiative, for which his consulting firm, SJS Advisors, was paid $114,565 by the Clinton Foundation.
Magaziner said it was only logical for an organization as large as the health initiative to plan for a succession of leadership.
Still, at least one other review of a top foundation executive's performance shortly preceded his exit: The handpicked chief executive of the Clinton Foundation, Eric Braverman, who was friendly with Chelsea Clinton, abruptly left after his tenure there soured. Nygren's consultants also conducted a performance evaluation of Braverman, although it was not immediately clear if he was ever shown it. Braverman did not respond to emails seeking comment.
Yet Magaziner could prove more difficult to replace. For all his friction with the health initiative's board members, they acknowledged in the Nygren reviews that "duplicating Ira's strengths" would be "impossible."
But Magaziner stopped short of saying the same about the Clintons.
Asked whether the health initiative would have been so successful, and could continue on, without the Clinton name in its title, Magaziner, in an email, replied: "President Clinton and I founded CHAI together in 2002. The people of CHAI are very proud that CHAI bears his name."
Editorial on 11/29/2015