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Sudden opportunity
Farmer, Kim and Murray were all residents together at Harvard Medical School. Farmer’s and Kim’s work, particularly in Haiti, was vividly portrayed in Mountains Beyond Mountains, last year’s “common book” at the UW (see “Spreading the Word”).

Murray could have joined his friends in attacking a specific health problem, but took a different path. “I’ve spent a lot of time wondering how one could make a bigger difference than simply providing care in a particular community, in a particular place,” Murray says.

“The higher up you go in the problems—the broader you look—the less work there is under way up there,” he says. “There is a role for this super generalist looking broadly…There’s a place for this role of stepping back and saying ‘what’s What’s actually happening in the world? Where are we making progress? What are we missing in understanding that? And are there any lessons we can learn from that?’”

“… How do you deal with the fact that different countries—and communities—have different health problems and varying amounts of money?’ ”

“Without the big picture, without measuring our efforts, I don’t think our work has much sense,” Farmer says.

These are tough questions that Murray hopes will be answered through the institute. He had planned to start his institute at Harvard, but funding for the institute abruptly fell through in the summer of 2006.

News of Murray’s setback reached UW Medical School Dean Paul Ramsey, who is also CEO of UW Medicine. He had been following Murray’s work for many years. “Global health is a high priority for us, and bringing the institute here was an opportunity. I chose to move quickly,” Ramsey says. And move quickly, he did.

Ramsey began talking with Murray in November 2006. A month later, Murray bought Emmanuela Gakidou, his wife and colleague, a raincoat. “You might need this,” he told her.

New Zealand
Chris Murray and his wife, Emmanuela Gakidou, take time off from global health issues by biking, skiing and other outdoor activities. Above: Murray and Gakidou on their honeymoon in New Zealand, photo courtesy of Emmanuela Gakidou.
By late last spring, a generous $105 million grant from the Gates Foundation—the largest private donation in UW history—was in place, along with an additional $20 million from the UW, to fund the institute over 10 years. Murray was hired for $420,000 a year, a hefty salary by state standards. But Ramsey says Murray is worth it.

“He would be making much more if he did this in a private setting,” Ramsey explains. “We needed to pay him a competitive salary. He made a choice to work in a public research university.”

Losing Murray was a huge blow to Harvard University, where Murray had been director of the Harvard Initiative for Global Health since 2003. Prior to that, Murray worked as executive director of the Evidence and Information for Policy cluster at the World Health Organization in Geneva, Switzerland.

“We lost one of the world leaders in global health,” says Kim. “It was a personal loss for Paul Farmer and me as we had plans for major collaboration. We’ll still work together, but the distance will be an issue.”

The UW—a public institution—is the ideal setting for the health metrics and evaluation institute, Ramsey says, because it offers academic freedom to researchers and total transparency, meaning that all research becomes public information.

For the Gates Foundation, it was important to back an institute that will provide objective research on how money is being spent worldwide on global health and how effective those efforts are, says Tachi Yamada, president of the foundation’s global health division. The institute, he notes, is not funded by the health organizations it evaluates.

The Gates Foundation last year donated $30 million to begin the UW Department of Global Health. That previous commitment, along with the strong commitment from the state of Washington, the UW School of Medicine and the UW School of Public Health, made the university an ideal location for the institute, Yamada says.

And for Murray, Seattle was the perfect place.

“The attraction of doing it in Seattle is that iIncreasingly over the last five or six years, Seattle has become an alternative hub for global health—an alternative to Geneva,” Murray says. “Five or six years ago anybody who wanted to start anything in global health wanted to be based in Geneva because that’s where the World Health Organization is.”

He cites the growth in research at the UW and affiliated institutions like Seattle Biomedical Research Institute; PATH, a non-profit that helps deliver health care around the world; the Infectious Disease Research Institute, a non-profit biotech group; the Fred Hutchinson Cancer Research Center and the Gates Foundation.

“It was an ideal fit to establish the institute as part of the University of Washington,” he says.