The localization wars

For years, foreign aid donors and the organizations that receive their money existed in a state of uncomfortable suspension — generally aware of the problematic power dynamics at the heart of their work, but wary of inviting full scrutiny lest they call the whole fragile enterprise into question. The global reckoning with systemic racism that followed George Floyd’s murder by police in Minnesota in 2020 changed that. Suddenly, it became riskier to ignore the lingering tendrils of white supremacy and colonialism than to expose them to the light. In the global development sector, languishing calls to shift more funding and decision making to local communities — translated into aid-speak as “localization” — took on new urgency and entered the mainstream. So did efforts to address racial discrimination and increase diversity inside development organizations. While many international NGOs have embraced these priorities in principle, putting them into practice has proven more complicated. For Pathfinder International, an influential reproductive health organization headquartered in Watertown, Massachusetts, navigating this uncertain moment has consumed the last five years. Pathfinder implements more than $100 million per year in reproductive health and family planning programs, most of which are supported by the U.S. Agency for International Development. Under CEO Lois Quam, the organization has undergone a tumultuous transformation that she says is about building an international NGO ready for a future of localization, but that others describe as a self-destructive power grab cloaked in progressive rhetoric. Quam has created new leadership positions in the global south, tweaked the organization’s model so that country offices keep more project funding, and welcomed an overhaul of the board of directors to increase its diversity. “We're building a Pathfinder that's country-led, where we're shifting power and resources to our country leaders and teams in Africa, South Asia and the Middle East,” Quam told Devex in an interview for this article. In the process, Pathfinder — which employs nearly 1,300 people, more than 90% of whom work in its country offices around the world — has seen many of its staff laid off or resign, with some alleging mismanagement by the CEO and negligence by the board of directors. In 2021, those internal struggles over transparency, leadership, and power spilled into public view after a contentious process to examine Pathfinder’s historic ties to the racist ideology of eugenics led to a messy breakup with the organization’s founding family. Where Quam describes the necessary and difficult work of positioning Pathfinder for a new era, others see a personal branding exercise that has hollowed out the organization at a critical moment in the global fight for reproductive rights. “If you disagreed with her, you got removed,” a former employee told Devex. “It was one of the most toxic things I've ever experienced in my life,” said another. The gap between these competing narratives says a lot about the ambiguity and contradiction characterizing the global health and development sector right now. Progressive organizations like Pathfinder are battling to define the future of their work. At the same time they’re confronting a global right-wing resurgence, they are also sparring over what it means to be a good international NGO in an era of locally led development. “Everyone tries to put a happy face on this by saying that INGOs will still have an important role to play, but we’re kind of vague about what that role is and completely unrealistic or ignorant of the fact that changing the business model implies shrinking the INGOs in a way that would make most unsustainable,” a recently retired global health CEO told Devex. Quam said her goal is not to shrink, but rather to grow Pathfinder by positioning it as a uniquely country-led organization at a time when donors are also moving in that direction. “I think part of the reason we were able to expand our services in the pandemic was that our country leaders and country teams had more power and authority,” Quam told Devex. But it has also come with a cost. This story is based on interviews with key leaders at Pathfinder, including current and former board members; a dozen current and former employees, most of whom spoke on condition of anonymity due to fear of retribution; and internal documents and emails shared with Devex. Shifting power Quam took over as Pathfinder’s CEO on Jan. 26, 2017, five days after former U.S. President Donald Trump’s inauguration. At the time, few inside the organization predicted that some of their biggest battles would be internal. A Rhodes scholar, former health care executive, and longtime Hillary Clinton ally, Quam has appeared three times on FORTUNE's list of the most influential women leaders in business. In global health circles, she was known for leading the Global Health Initiative, an Obama administration effort to break down silos between U.S. global health programs that ultimately fell victim to bureaucratic turf battles. For many at Pathfinder, the first red flags appeared at an all-staff meeting. In May 2017, four months into the job, Quam joined her staff in the Gamble conference room — named for Clarence Gamble, the Procter and Gamble heir who founded the organization — and informed them that 26 of their colleagues were in another room getting laid off. “I just remember there were a lot of tears,” a former employee told Devex. One day earlier, Trump’s White House proposed slashing U.S. foreign aid by a third and eliminating international family planning funding altogether. Pathfinder’s layoffs were motivated by these threats, but Quam said they also came with a silver lining. They would help “reduce expenses in ways that were consistent with moving to a ‘Community First’ way of working,” Quam wrote in an email to staff later that day, describing plans to reduce expenses at headquarters and invest in Pathfinder’s country offices. “What that really meant was firing all of our technical staff in Boston,” said the former employee. For many Pathfinder employees — who refer to themselves as Pathfinders — it felt like a rash decision by a CEO who hadn’t taken the time to appreciate why these U.S.-based experts mattered to an organization that prided itself on technical proficiency in areas such as sexual and reproductive rights, adolescent health, and environmental justice. The first round of layoffs marked the beginning of a disorienting and stressful period, multiple former Pathfinders told Devex. And for some inside the organization, it was hard to see how the disruption they experienced was part of a clear plan to shift power from headquarters to country offices. “Teams were dissolved, new ones with unclear mandates emerged, staffed with new people hand-picked by Lois. A new HQ dynamic emerged that was rooted in fear, lack of direction, and one rife with disorganization,” another former Pathfinder told Devex. “There was a lot of talk of ‘country-first,’ but no one in the U.S. office really understood what that meant,” they added. Quam’s critics describe a different power shift — not from the U.S. to other countries, but from everyone else at Pathfinder to the CEO. Quam repeatedly singled out favorites who would be temporarily elevated, only to fall out of favor, multiple people recounted. Others, they said, were laid off after voicing disagreement with Quam or concerns about other senior managers. “These moves were very much about power and control and demanding fealty,” a former Pathfinder told Devex. Quam denied that any layoffs targeted people who disagreed with her or raised concerns, noting that the organization had been discussing a country-led strategy for years. One of the people tasked with implementing that shift was Anne Scott, who served as Pathfinder’s chief operating officer until she left the organization in 2020. In July 2019, during another round of restructuring, Scott wrote to staff in an email shared with Devex that the leadership’s “top priority is to do all that we can to support those transitioning from the organization.” But two years later, Scott told Devex that under Quam, Pathfinder suffered from a “toxic workplace culture.” “People [were] not being heard and not feeling safe to express their opinions. People were fearful they would be retaliated against if they state what they feel,” she told Devex at the time. Pathfinders began keeping a list of U.S.-based staff who quit or were laid off so they would not lose contact with former colleagues. The document, which was shared with Devex and has not been recently updated, lists 145 departures beginning in February 2017, out of roughly 1,300 total employees. Many were asked to sign nondisclosure agreements, or NDAs, and some received sizable severance payments in exchange. For instance, Pathfinder’s former chief people officer, Lee Gelb, received $214,072 in severance in 2019, making her the organization’s 11th highest-compensated person that year despite no longer working there. Quam said the organization provided severance “to leaders who departed Pathfinder in appreciation for their service” and that these packages included NDAs “as a part of that standard process, working with our outside counsel.” Collin Mothupi, Pathfinder’s current board chair, told Devex that a “very neutral” legal firm looked into both the severance payments and the organization’s turnover rate and concluded that neither raised major red flags. Going local? Quam portrayed the turbulence as a byproduct of Pathfinder’s board-approved decision to shift power from the organization’s U.S. headquarters to its country offices around the world. “Any time you're making a shift and shifting power from one part of an organization to another, it's difficult,” she told Devex. In Quam’s telling, that shift has unfolded over the course of her tenure and is still ongoing. It involves shifting roles and authorities that were previously concentrated in Pathfinder’s U.S. headquarters to its country offices. More recently, Quam has given up her own title as “president” — she is now just CEO — to appoint two international “presidents” — one for South Asia, the Middle East, and North Africa; and the other for Africa — who report to her but lead revenue generation strategies for their countries and regions. Quam is also adjusting Pathfinder’s revenue model so that when the organization wins funding to implement a project in a particular country, the country office is able to retain some of that money to invest in its own capabilities instead of returning it to headquarters. In response to a request from Devex, Pathfinder arranged an interview with a current employee who agreed that the organization has made meaningful changes. “I would be lying if I said there was no discomfort, but I also felt like discomfort sort of meant we were on the right track,” said Jodi DiProfio, a senior technical adviser working on gender. DiProfio explained that while her team — sexual and reproductive health and rights — was formerly made up of about a dozen technical experts in the U.S., she is now one of only a few working from headquarters, with the rest based in Pathfinder’s country offices. The organization works in more than 20 countries, the majority of which are in Africa. “I'm now in an iteration of a team that is globally representative,” DiProfio said, while noting that she spoke “with the privilege of having remained” at the organization. “We're a few years into this model, and I'd be lying if I said it doesn't strengthen our work. It really does,” she said. Ground truth Devex contacted a local organization that is currently working with Pathfinder to better understand what the power-shifting agenda looks like from the perspective of a partner in one of the countries where Pathfinder implements programs. Expecting to hear an account of how Pathfinder has worked with a national organization to build its capacity and transfer project leadership, Devex instead heard a more complicated story that raised as many questions as it answered. N'weti is a relatively large national organization in Mozambique that is currently partnering with Pathfinder on a USAID-funded family planning project. Denise Namburete, N'weti’s executive director, told Devex that USAID designed the project to transition leadership from the international NGO — Pathfinder — to its local partner — N'weti — after a period of capacity building. But Namburete said that Pathfinder and N'weti are currently at an impasse over how and when that transition should happen. N'weti believed the capacity building was going to take three years, after which they would take over the project. Pathfinder’s position, she said, is that it should lead the project for its full five-year duration, positioning N'weti to lead a potential follow-on project after this one concludes. “We are sitting in this debate now, and we don't know exactly what's going to happen,” said Namburete, who is also a member of the Modernizing Foreign Assistance Network, a group that advocates for aid reforms including localization. N’weti’s collaboration with Pathfinder hit a major setback in January 2022, when Pathfinder fired its local country director and five others at the Mozambique office over sexual harassment allegations, causing further delays for the project. Three years into the partnership, Namburete told Devex the capacity-building still hasn’t started. Namburete said Pathfinder’s local leadership in Mozambique seems open to transitioning the project to N’Weti, but she isn’t sure how senior leaders at headquarters view the situation. “I don't think they are in favor,” she said. In response to an inquiry from Devex about the project, Pathfinder sent a statement from the project’s director, Luc Veken. “We value our partnership with N’weti, and we are following the transition plan we co-designed with them that provides a timeline for handing over increased responsibilities and funding to N’weti throughout the life of the project,” he wrote. On board For those Pathfinders who found Quam’s actions more damaging than visionary, there seemed to be little they could do about it. Several took their concerns to members of the board but found little appetite there to question Quam’s leadership. Ben Kahrl was an exception. One former Pathfinder described Kahrl, a grandson of Pathfinder’s founder Clarence Gamble, as an “activist board member” whose eagerness to get involved could provoke some eye rolling but seemed to reflect genuine commitment. “What is the place of someone like me — middle-aged, rich, white, male — in this movement? It is not to go in and tell people how to do their job,” Kahrl told Devex. “It is to listen, support, and also trumpet the importance of the work.” Kahrl said he increasingly found himself listening to complaints about Quam. He pushed for the board to get access to an internal performance evaluation from Quam’s first year as CEO. He said his fellow board members weren’t interested, describing them as “asleep at the wheel.” Quam was “feeding them what they think they want to hear — namely, ‘We're doing localization,’” Kahrl said, adding that the board failed to ask what that meant. Kahrl said that if the organization was serious about implementing a localization plan, it would have worked to build capacity in its country offices, reduce its U.S. staffing footprint, and hire people for those positions in other countries. “That's not what was happening, but that was the rationale. In fact, staffing levels in the United States were going up, not down,” he told Devex. Pathfinder’s staffing numbers do not point to easy answers about whether the organization has “localized” or not — and they can be interpreted in different ways. Kahrl shared an internal staffing chart with Devex that showed that between July 1, 2018, and June 30, 2021, the number of U.S.-based employees increased from 101 to 143. The same chart shows that the number of staff in country offices decreased from 1,425 to 1,342 between July 1, 2019, and June 30, 2021, the two years with available data. But in response to an inquiry from Devex, Quam called those numbers “out of date” and said they did not include the “relevant facts.” Instead she shared a chart that focused on staffing levels for Pathfinder’s “global divisions,” a subset of between 136 and 181 employees who provide technical and administrative support for the organization’s country programs and leadership. In 2019, only 6% of those “global roles” were based outside the U.S., and today that number has risen to 37%. “That trend continues as part of our localization strategy,” Quam wrote to Devex. Pathfinder currently has 101 employees based in the U.S. and 1,175 based in other countries, according to the organization’s communications director, Laurel Lundstrom. But while Quam speaks about devolving power, according to Kahrl, her tenure has been defined by self-promotion and tight control over the flow of information inside Pathfinder. “Lois' purpose is Lois,” he said. Kahrl — whose family has donated tens of millions of dollars to Pathfinder and served on the board since Gamble founded the organization in 1957 — said the large severance payments and removal of highly regarded staff made him increasingly uncomfortable asking other donors for money, a key responsibility of board members. It didn’t help, Kahrl said, when the board authorized up to $400,000 from Pathfinder’s budget for Forbes Books to ghostwrite a book for Quam. “It's a vanity project about sharing power,” Kahrl told Devex. In response to an inquiry from Devex, Mothupi, the chair, wrote that the board “supports the book project because we have experiences to share that are important to the future of our field and the localization of development programs.” “The book is a reflection of our deep commitment to our country-led strategy and the fact that reproductive health care is more important than ever,” he added. But the issue that ultimately caused an irreparable fissure between Kahrl and Pathfinder’s leadership was more personal. It was about his grandfather. Past and present The post-George Floyd reckoning forced nearly all global health and development NGOs to wrestle with questions about systemic racism, unconscious bias, and the ways that historic violations are woven into the fabric of American institutions. But it posed particular challenges to the surprising number of organizations with close ties to the American eugenics movement. This subset had to answer for a nationalist, colonialist, and racist agenda that sought to limit population growth among “undesirable” populations. At Pathfinder, the founding family’s complicated legacy was fairly common knowledge, but until the summer of 2020, the organization had not tackled it head-on. Born in 1894, Clarence Gamble was an heir to the Procter and Gamble consumer goods fortune, a medical doctor, and an early financier and promoter of birth control in the U.S. and abroad. He was also a key part of an influential campaign to limit population growth among minorities, people with disabilities, and others deemed “unfit” — by mostly wealthy, white men. In Puerto Rico in the 1930s, Gamble ran a network of clinics that provided birth control to people living in rural and impoverished areas, where he was “principally concerned with limiting the number of Puerto Ricans of the lower classes,” writes historian Laura Briggs. In what eugenics historian Nancy Ordover calls “one of the most notorious abuses of medical power in birth control technology’s history,” Gamble invited pharmaceutical companies to use his clinics for human trials of the birth control pill. They chose not to inform their subjects that it was, at that time, an experimental drug with potentially harmful side effects, and which they were administering in unregulated doses. In North Carolina, Gamble joined forces with other wealthy eugenicists — such as “hosiery king” James G. Hanes — to establish the Human Betterment League. Together they backed one of America’s most aggressive sterilization programs, out of concern for “how much welfare mothers and the mentally ill were costing taxpayers,” writes Kevin Begos in his book on North Carolina’s sterilization programs. In 1957, Gamble established the Pathfinder Fund to consolidate his increasingly international work. Gamble died in 1966, but the organization’s activities continued to reflect the international family planning movement’s association with a population control agenda into the 1970s. Pathfinder, Planned Parenthood, and other international family planning organizations with roots in American eugenics have transformed in the intervening decades. Their work is now grounded in a commitment to reproductive rights, the principle that people have the power to make their own decisions about having or not having children. In the last few years, many of the nonprofit and philanthropic groups with legacy ties to eugenics have sought to examine and account for their histories. The Rockefeller Foundation, Ford Foundation, and MacArthur Foundation have worked with the Anti-Eugenics Project, a network of academics who study these legacies, to try and figure out how to atone for their sins. “All of the great names of legacy philanthropy are implicated in this movement,” said Ford Foundation President Darren Walker in 2021. ‘The devil-angel scale’ For Pathfinder, history seeped into the cracks between the founding family and the organization’s leaders — and broke them apart. Quam and Roslyn Watson, Pathfinder’s board chair at the time, didn’t want Gamble’s descendants involved in examining his legacy. “It was very important for the integrity of the process that it be a Pathfinder process and free of any real or perception of conflicts of interest,” Quam told Devex. Kahrl said he understood their position but disagreed, arguing that Pathfinder’s confrontation with history would have been more powerful with the founding family standing behind it. They also sparred over questions of transparency. Ben Kahrl, his mother Judy Kahrl, and uncle Walter Gamble — all board members — wanted Pathfinder to make all of Clarence Gamble’s archives public. People whose forebears were involved in eugenics “have a special and particular obligation to come forward and demand historical reckoning and demand full transparency,” Ben Kahrl told Devex. Quam and Watson, meanwhile, argued for more limited disclosure. Quam told Devex the organization needed to focus on Gamble’s “legacy as it related to Pathfinder specifically, versus something much broader about his life and all of his work.” Kahrl said his family’s desire to make the documents public had nothing to do with exonerating his grandfather. “It doesn't matter to me where he sits on the devil-angel scale,” Kahrl told Devex. Pathfinder has since donated the archives to the Harvard Medical Library where they can be accessed by researchers. Kahrl lost all faith in the legacy process Quam and Watson were leading when they turned Gamble’s papers over to a Washington, D.C.-based consulting firm called the Mirror Group, which came back with research reports that drew from deeply right-wing sources and seemed to call Pathfinder’s entire mission into question. To Kahrl and multiple former employees, Pathfinder’s approach felt more like political theater than a real reckoning with Gamble’s and Pathfinder’s complicity in the historic violations of people’s rights. Late last year, in conjunction with the organization’s 65th anniversary, Pathfinder published a more extensive account of its history on its website. It states that “Pathfinder’s early activities were undergirded by a eugenics agenda,” which is “in direct opposition to the rights-based work we do today.” It also details how the transformation Quam has led represents a new era of country-led development. End of an era The relationship between Ben Kahrl and Pathfinder’s leadership reached a breaking point in the summer of 2021. Ben and Judy Kahrl made repeated attempts to access Quam’s performance evaluation and were repeatedly denied. In July, Kahrl wrote to the board asking that they consider him for chair when Watson’s term ended four months later and promising “a leadership style of transparency and vision.” In September, Watson and Jessie Druga, the chair of the board’s governance committee, wrote to Kahrl requesting his resignation and informing him that if he did not offer it they would recommend the board vote to remove him. They accused Kahrl of using his "privilege and power" to undermine the organization's two female leaders, Quam and Watson, the latter of whom is African American. Instead of a resignation letter, Kahrl wrote a speech. “The issue at hand is board oversight, whether it is both able and willing to exercise it,” he said at the Sept. 23 board meeting where his removal was on the agenda. “The choice is yours as to what you want the next chapter of Pathfinder’s history to look like,” he said. The board voted to remove Kahrl. His uncle and mother resigned days later. They wrote to Pathfinder’s biggest financial donors urging them to reconsider their support. They also shared their story with news outlets, including Devex. Watson declined to speak with Devex for this article, but wrote in a message that Pathfinder “couldn’t be in better hands.” When her term ended in November 2021, the board elected Mothupi as its new chair. A new path Mothupi grew up as a refugee, born to a South African political exile living in Uganda. He began his career as a child actor, starring in the 1989 Walt Disney film “Cheetah.” He plays Morogo, a Maasai boy who accompanies two American children “into the unknown wilds of Africa” to rescue their adopted cheetah from poachers. From Uganda, Kenya, Tanzania, and South Africa, Mothupi’s journey led to St. Paul, Minnesota, where he attended Macalester College — and where, as president of the student government, he met Lois Quam. Quam also attended Macalester and was a member of the college’s board, which Mothupi joined after graduation. “She was a mentor to me,” he told Devex. Mothupi — who works with the Nashville-based health care data firm MedeAnalytics — said that after Quam took over as Pathfinder’s CEO in 2017, she called him and described the “transformational journey” the organization was embarking on. Quam was looking for new board members who could add diversity. Of Pathfinder’s 17 volunteer board members, 10 have joined since Quam took over. The overhaul was assisted by executive search firm Egon Zehnder, which the board paid $250,000 to help recruit more diverse members, according to board documents shared by Kahrl in which he also objected to that expenditure. Mothupi’s tenure as board chair coincides with a moment of significant reform for Pathfinder’s largest donor, USAID. The agency has set a target of directing 25% of its funding to local organizations. As an international NGO, Pathfinder’s funding would not contribute to that goal, but Mothupi said the organization is considering whether to establish local affiliates in the countries where it works, which could meet USAID’s definition of a “local” organization. “We might have local entities or local chapters that are registered locally but benefit from the foundation and the breadth of Pathfinder,” he said, adding that they would likely approach these questions on a country-by-country basis. In the meantime, Pathfinder has continued to win funding from USAID, including a $40 million award announced last October through which the organization will lead the U.S. government’s first family planning project in Pakistan in seven years. “We have this name Pathfinder for a reason,” Quam said. “We are Pathfinders. We are looking for the way forward in a changing world.”