The Nonprofit Sector Band Aids, Treatments, Healing, and Cures

The Nonprofit Sector Band Aids, Treatments, Healing, and Cures

I’ve just finished reading Wayne Elsey’s new book The Rise and Fall of Charities in the 21st Century: How the Nonprofit World Is Changing and What You Can Do To Be Ready (2015). 

The argument Elsey makes—that nonprofit organizations (in general) have failed, are failing, or are being forced by competition from new philanthropic models like social enterprise to innovate or close is not a new argument, nor is it an argument that Elsey makes alone.  See, for example, my discussion here of Paul Klein’s call in the Stanford Social Innovation Review earlier this year for an end of corporate social responsibility because, he asserts, corporations can do philanthropy better than nonprofits . I’d like to respond to a couple of common criticisms running through the arguments of Elsey, Klein, and others.

Roots of the Problems

Elsey, Klein, and others have criticized nonprofits for treating, but not curing society’s ills.  By taking a band aid-type approach—for feeding the hungry and housing the homeless, but not eliminating poverty, for example, they argue, we’ve treated the symptoms, but not provided a cure for the disease. We haven’t really gotten to the roots or the underlying causes of problems.

I understand these criticisms. However, I also believe that we collectively—not nonprofits alone—need to address the roots of society’s ills. Many actors—governments (local, state, national, international), multinational trade agreements, tax policies, immigration policies, environmental policies, multinational corporations, labor unions, political parties, and so many others—have played a role in creating or perpetuating societal problems like poverty or global warming.

I think it’s at least somewhat unfair for anyone to say to the nonprofit sector in general or to any one nonprofit organization in particular “Here, we’ve made this problem. Now, it’s your role to fix it!” and, then, of course, to chide the sector or specific organizations for their inability to do so.  

The problems with which we in the sector have been charged with correcting are not of our making and will take people outside the third sector to correct which is not to say that there is not a role for the third sector at the table, but rather, that we cannot do it alone.

Further, the changes that are needed are not quick fixes. Like dieters who want to maintain weight loss, to permanently end global problems like poverty, we will need to make dramatic, systemic changes and then stick to those changes forever, not reverting to our former bad habits. Believing this is possible may be unrealistically utopian.

Treatment Alone Insignificant

I would also like to challenge the criticism that Elsey and so many have offered of nonprofits, suggesting that the band aid approach of so many nonprofits has accomplished nothing significant; that by nonprofits offering treatment for the symptoms of society’s problems (e.g. hunger) without getting to the roots of society’s ills (such as poverty), we’ve accomplished nothing.

My perspective about this is different because of my upbringing. I grew up in the shadow of a well-respected pharmaceutical company.

My father was a chemical engineer who worked in one of the world’s leading pharmaceutical companies during my childhood. The company he worked for was listed in the top 50 of almost all global corporate lists as “most respected,” “most admired,” often one of the “most profitable,” and “fastest growing” pharmaceutical companies in the world.

Both then and now, the company worked on some of the world’s most deadly diseases. For many of the diseases the company worked on finding cures for or immunizations to prevent, it first found treatments.

No one criticized this company for “only” finding treatments. On the contrary, this company was lauded for its treatments. Healing a debilitating disease is a noble thing.

And, in business, healing—even when one is not preventing—is very profitable.

With health, those who have ever been sick or had a family member who has been affected by cancer, arthritis, MS, muscular dystrophy, ALS, Alzheimer’s disease, Autism, HIV, malaria, or (less commonly) Ebola—to name just a few health challenges—would much rather have prevention than treatment. However, effective treatment is definitely preferable to no meaningful intervention at all which is the case today with many of these conditions.  What some of those affected by these conditions—like Alzheimer’s disease—wouldn’t give for an effective Band Aid!

Why would treatment in the form of a high-priced, patented pill from Merck, Pfizer, Genentech, or Eli Lilly be respected and valued, but a life-saving treatment offered in the form of medical treatment by a free clinic for the working poor; safe haven for a battered woman and her traumatized children; or therapy and life skills for a methamphetamine addict—be considered by pundits like Elsey to be inconsequential?

I value and respect pharmaceutical treatments. I know they have done many good things for the world in which we live, and in my own family and personal life one particular pharmaceutical company has been a positive influence for which I’m grateful. But I also respect and value the work of all those organizations that save the addicts, the working poor, the battered and traumatized, and so many others and I think the treatments that they dispense—often free or offered at low cost or on a sliding scale basis and rarely patented or trademarked—are also valuable.

Having grown up in a home where compassionate treatment was a value I was taught to embrace, it baffles me to hear the arguments of those who would negate the delivery of care and compassion when it comes from a charitable organization. It seems to me to be nothing short of prejudice, our collective prejudice for market solutions and against third sector solutions that causes any of us to argue otherwise.

The ideal in our world is certainly to get to the root of societal problems and weed them out, to prevent problems from re-occurring or occurring in the first place.  In partnership with local, national, and international actors, nonprofit organizations need to work to identify and implement solutions to the social diseases that plague our populations. In the meantime, though, compassion dictates that we do apply bandages. This application of bandages is not worthless. It is not nothing. It should not be discounted. It is noble. I believe, if we were a for-profit pharmaceutical company, the dollars would be flowing and our names would be praised on Fortune 500 lists.  

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