Editors’ Note: Jonathan E. Cohen introduces the Health and Human Rights Oral History Project, a new collection of oral histories documenting thirty years of investment in the field of global public health by George Soros’s Open Society Foundations, housed at the University of Southern California Digital Library.

Oral history offers a powerful and underutilized tool for documenting and learning from philanthropy’s role in social change—including for foundations that remain open and active, but that either exit or modify work in a particular field or region. By the time private foundations tell their story to the public, years of strategic planning, internal debate, grant evaluation, and other forms of deliberation have transpired behind closed doors. The public record left by foundations often omits the motivations, philosophies, experiences, and even identities of many of the field’s most influential decision-makers – the program officers, operations specialists, grantees, board members, and others who “get the money out the door” and exert enormous sway over how philanthropic capital is applied to the service of a charitable mission. By eliciting the stories, memories, and emotions of these actors, oral history both sheds light on a sector thought by many to be opaque and unaccountable, as well as offers countless lessons to future philanthropic actors as they confront new challenges.

The Health and Human Rights Oral History Project, a new collection of oral histories documenting thirty years of investment in the field of global public health by George Soros’s Open Society Foundations, provides a compelling case in point. Created in 2022 and housed at the University of Southern California Digital Library, this collection features 25 long-form interviews with former staff and grantees of Open Society’s former Public Health Program, as well as four additional interviews with pioneers of the health and human rights field. Available in video and transcript form and accompanied by archival photographs and biographical information about each narrator, these interviews tell vivid stories about the decisions and dynamics that lay behind George Soros’s three-decade investment in the field of public heath—an area of investment little known by most followers of public health, philanthropy, or even of Soros’s career.

Indeed, while George Soros’s philanthropy is perhaps best known for its investment in human rights and democracy movements, the Public Health Program at his Open Society Foundations was for many years one of the largest and most geographically spread programs of his philanthropic empire. At its peak in 2013, the core program budget exceeded $50 million annually, not counting significant matching contributions by national and regional foundations within what was then called the Soros Foundation Network. The program made lasting investments in a range of health fields, including access to essential medicines, harm reduction, mental health, palliative care, Roma health, and sexual and reproductive health. Housed within a foundation committed to rights and democracy, it approached public health through this lens and funded tactics such as legal reform, narrative change, and social accountability in the pursuit of its strategic objectives. Examples of the hundreds of investments made over three decades include the development of the first harm-reduction networks for people who use drugs in Eastern Europe and post-Soviet Central Asia, campaigns to lower the cost of essential medicines through challenging monopoly patents and other strategies, and sustained organizational grants to movements and networks of sex workers and transgender communities in low and middle-income countries.

When Open Society embarked on a large-scale reorganization of its programming in 2021, the leadership of the foundation set aside funds to document the experiences and lessons gleaned from many of the programs that were slated to close. However, rather than replicate modes of documentation that are commonly used in philanthropy, such as books, documentary films, and reports, the Public Health Program chose to capture its experience through oral history. This choice of format stemmed not only from the opportunity for oral history to supplement the written record, but also from a long tradition of oral history within the field of public health itself. An inspiring example is the ACT-UP Oral History Project, which includes nearly 200 testimonies of AIDS activists about the intricate history and political dynamics behind the AIDS Coalition to Unleash Power (ACT-UP), a grassroots movement formed in response to political failure to address the AIDS epidemic in the 1980s. Additional inspiration came from foundations such as the Carnegie Corporation of New York and Atlantic Philanthropies, both of which collaborated with the pioneering Columbia Center for Oral History Research in developing oral history collections. Within the sub-field of philanthropy and public health, the leading resource is the medicine and public health collection of the Rockefeller Archive Center, which draws on a range of primary sources, from interviews to strategy documents, to document the history of dozens of philanthropic investments made by the Rockefeller Foundation and other depositors into its vast collection.

Open Society entrusted the task of creating this archive to the Institute on Inequalities in Global Health (IIGH), an interdisciplinary center at the University of Southern California dedicated to addressing the broad social inequalities that shape health outcomes worldwide. (I joined IIGH as a faculty member and director of the oral history project following 16 years with the Open Society Public Health Program.) This enabled the project to be hosted within the USC Digital Library, a world-class platform that houses multiple oral history collections and sorts multi-media assets with metadata for easy use by researchers. IIGH enlisted the oral history expertise of Thaler Pekar and Partners, a firm that had conducted multiple oral histories of leadership and staff of The Atlantic Philanthropies in the context of that foundation’s spend-down. The opportunity to apply Atlantic’s pioneering use of oral history to a context in which a foundation was restructuring but not spending down provided added impetus to the project. Three USC students, all studying different aspects of the health sciences, conducted the interviews over a roughly six-month period in 2022. The students also reflected on-camera about their experience interviewing leaders of the health and human rights field, particularly how it shaped their understanding of and attitude toward their respective fields of study.

Thus, we see in the collection a first-year USC medical student interviewing the former Prime Minister of Haiti and President of the Soros-funded Fondation Connaissance et Liberte (FOKAL), Michele Duvivier Pierre-Louis, about the time a group of villagers hiked for miles to her office in Port-au-Prince and placed a bag of cash on her desk. Stunned to be receiving money when it was her job to make grants, Pierre-Louis asked what the money was for:

“They said … ‘We have saved three years what is now in front of you.’ When I counted, it was 79,000 Gourdes, which at the time was like $7,000 … ‘Because people are sick in our communities and we want to build a health center. And we know that it’s because you are at FOKAL, that the health center will be built.’”

Pierre-Louis goes on to suggest that it is more important for philanthropy to extend solidarity and respect than money or aid:

“We never got engaged in humanitarian aid. Never. Even after the earthquake [in 2010], we refused to get into humanitarian aid, because humanitarian aid is charity. And charity most often…stems from pity. And we are not pitying the people we are working with. We uphold their dignity, which is extremely important to us. We consider them as full-fledged human being capable of everything I’m able to do.”

In another testimony, we encounter a fourth-year global health major interviewing one of the architects of Open Society’s investments in palliative care, Dr. Kathleen Foley, about why failure was an important part of George Soros’s approach to philanthropy:

“[George] also very, very strongly argued about the fact that you had to have grants that failed and if they didn’t fail, then you weren’t funding the right people. And so, there was a wonderful cynicism because he said the people that could come to you could be able to write the best grants, but maybe they’re not the people that you want to fund … I always was moved by this concept that it was okay for us to fail and that we needed to acknowledge our failures and understand what had failed. And, in looking back over it, we had some failures, but they were pretty trivial compared to the amazing successes.”

Elsewhere, we witness a second-year undergraduate studying biomedical engineering interviewing the former head of Open Society’s Public Health Program, Nina Schwalbe, about why George Soros decided to fund tuberculosis programs in Russian prisons, and why the Russian authorities allowed it:

“One of the things that Soros decided on early was part of that money was going to be for a TB program in Russia … I don’t think anybody particularly cared about TB, but again, it was a way into doing justice in prison reform … It was a way to go in, and I think it was going to be part of a bigger project.

“The reason why we were let into the Russian prison system at all wasn’t because the prison people cared about the prisoners. What they cared about was the staff. So, what was happening in the Russian prison system is that because it is a transmissible disease, the staff in these prisons were getting sick and dying of tuberculosis, both drug susceptible and drug resistant tuberculosis.”

When pressed, Schwalbe speculates that Soros might have been moved by an intrinsic belief in the human right to life:

“For me, I noticed [Soros’s] interest peak or change when it wasn’t about TB, or disease control, it was about… Do certain groups in society deserve life-saving access to treatment?… It felt to me that that was where he got hooked, and where the shift came. That it wasn’t about treating TB…It was about, do particular populations deserve a right to live, essentially.”

The confluence of history, philanthropy, and pedagogy these exchanges document—and there are countless more examples—will provide guidance to those invested in the transmission of movement knowledge to a generation yearning to learn how to effect social change. Moreover, they challenge conventional ideas about philanthropy, from the exclusive role of money as a driver of change, to the importance of success and failure, to the motivations of philanthropists.

What this collection also recognizes is that oral histories of philanthropy must include the perspective of grantees, who not only do the difficult work on the ground, but also have a unique perspective on the funding relationship and the impact of foundation decision-making. About a third of the collection features grantee partners working on a variety of health and human rights issues in Colombia, Kenya, Mozambique, Russia, South Africa, Ukraine, the United States, and Vietnam, as well as three regional and global networks working on issues from access to medicines to sex workers’ rights. These testimonies at times challenge our assumptions about the impact of funders’ power and will over their grantees. A Vietnamese HIV/AIDS advocate, for example, describes at length her differences of opinion with an Open Society program director about the definition of harm-reduction programs for people who use drugs. A Colombian lawyer shares that it was in part through being funded by a team of women leaders at Open Society that she and her colleagues felt inspired to explore access to medicines for Colombian women and girls. Through testimonies such as these, the funder-grantee relationship is illuminated in ways often illegible in the written record, and unlikely to be appreciated or narrated by funders themselves. Ultimately, the Health and Human Rights Oral History Project not only offers a rich primary resource for scholars and students of many disciplines, such as public health, philanthropy, social justice, political science, and history. It also represents the birth of a field at the intersection of oral history, philanthropy, and public health. Indeed, while oral history has long been used as a tool to practice and learn about public health (as in the ACT-UP example above), and while public health philanthropy is an established field (with a renowned documentary history gathered in in the Rockefeller Archive Center), rarely have all three of these fields been brought together. The task ahead is clear—for scholars and students to make use of this unique source of public health history; and for additional funders to use oral history as a method of learning and legacy making.

-Jonathan E. Cohen

Jonathan E. Cohen, a former Director of the Open Society Public Health Program, is Professor of Clinical Population and Public Health Sciences at the University of Southern California and Director of Policy Engagement with the USC Institute on Inequalities in Global Health. He wishes to thank Michelle Anderson, Maylis Basturk, Michelle Duvivier Pierre-Louis, Laura Ferguson, Casey Fern, Kathleen Foley, Sharon Fonn, Danielle Fulfree, Carolina Gomez, Sofia Gruskin, Lillie Guo, Oanh Khuat, Sharmila Mhatre, Trevor Nelson, Noor Nieftagodien, Kitty Overton,Summer Peet, Thaler Pekar, Nina Schwalbe, and Asna Tabassum. The Health and Human Rights Oral History was funded through a grant from the Open Society Foundations.