Balancing Nonprofit Interests
By Jessica Silliman
Paul Champion works in the nonprofit sector at a grassroots
HIV/AIDS program in the Bay Area. As with many such organizations,
this small nonprofit struggled with funding and had to reorganize
its programs.
"Given the limited resources, there were often debates
amongst leaders under financial pressure in the HIV/AIDS nonprofit
world about what resources should be given priority: prevention
or treatment," says Paul. Supporting prevention would mean
devoting funds to educational efforts and condom distribution.
Supporting treatment would mean devoting funds to medical care
for the already infected. With limited funds, the organization
couldn't support both approaches. As a lobbyist for the organization,
Paul had a heavy hand in the process. He advocated for a small
advancement in both the prevention and treatment sector of the
organization, instead of a large change to favor one or the
other. Paul felt this would best serve the community they were
charged with helping because it would put funds toward two segments
that surround the issue of HIV/AIDS-those who are at risk and
those who have been diagnosed.
But those above Paul felt differently. "We play a more
beneficial role by focusing on treatment," said Paul's
boss. The upper management reasoned that money and services
would have a greater impact if it focused on the treatment option.
Those needing treatment were a defined population, whereas those
in prevention were hard to define or narrow as an area to serve.
With so little money to work with, the upper management felt
that it would be better to devote significant funds to one faction,
with the possibility of making a difference, rather than splitting
their time and money, thereby reducing the effectiveness and
possible impact on the community. Their reasoning was sharply
questioned by others who felt favoring prevention was a better
option, even if the long-term result would reduce the number
of infections.
"HIV infections are more likely to continue absent strong
prevention programs," says Paul. "But a focus on treatment
comes at the expense of the prevention programs-even at the
national level."
Paul's job changed with the decision. He no longer was able
to advocate for both treatment and prevention. Instead, his
grant writing and petitions for government funding were focused
on treatment. The organization still supported prevention, but
only in theory.
After fighting a losing battle for six months, Paul left the
non-profit. "Even guys in white hats-organizations designed
to do good-face ethical challenges created by financial pressures,"
said Paul.
Discussion Questions:
- What should the goal of a nonprofit HIV/AIDS organization
be?
- Once the upper management made its decision to favor treatment,
should Paul have resigned?
- Do you think Paul's decision was fair to the community served?
- Should Paul have gone to the newspaper or other media outlets?
Jessica Silliman was a 2006-07 Hackworth Fellow at The Markkula
Center for Applied Ethics.
June 2007
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