Doctor to take helm at CARE

Dr. Helene Gayle, a leading strategist in the global fight against AIDS, is leaving the Gates Foundation to become president and chief executive officer of CARE USA.

As head of CARE, an anti-poverty humanitarian organization, she will oversee an annual budget of $624 million and a staff of 12,000 in 70 countries.

In her five years as director of HIV, tuberculosis and reproductive health at the Gates Foundation, Gayle led a $200 million program to keep AIDS from overwhelming India, helped draft a plan to find an HIV vaccine and ramped up TB prevention, treatment and research. Projects in her $1.5 billion portfolio also touch a range of people from truck drivers in Botswana to sex workers in China.

Patty Stonesifer, foundation co-chairwoman and president, said she would miss Gayle's leadership, intelligence and humor. "It has been a joy to work with Helene, both personally and professionally," she said.

Gayle's departure from the world's largest philanthropy leaves two top jobs there unfilled.

In September, Dr. Richard Klausner resigned as the foundation's executive director of global health. Klausner is under congressional investigation for alleged conflict of interest in a $40 million contract awarded to Harvard University when he was director of the National Cancer Institute.

Gayle, 50, was rumored to be on the short list to replace him, but said that taking the helm of CARE was irresistible. She e-mailed foundation colleagues Friday:

"The hardest question was ... how do I leave the Gates Foundation — a place where you give out large sums of money, everyone loves you (or pretends to) and you get to work on important things with wonderful people.

"My only answer is that I firmly believe one must be true to knowing and following one's own path and passion ... Finally, I hope I have been a good colleague, because I want to be remembered fondly as I move to the 'other side of the check.' "

Gayle will leave her foundation job in February and take over at CARE in the spring.

Known for her dynamic presence and distinctive laugh, Gayle brought pizazz to a place known for understatement.

"Helene is the only person who could force me to go kayaking," said Jose Esparza, the foundation's senior adviser on HIV vaccines, who paddled Lake Union with her even though he can't swim.

Gayle said she has wanted since childhood to improve life for the poor and powerless, a value instilled by a social-worker mother and a father who owned a beauty- and barber-supply shop in the heart of Buffalo's black community.

Gayle holds a medical degree from the University of Pennsylvania and a master's degree in public health from Johns Hopkins University.

In 1984, she joined the Centers for Disease Control and Prevention in Atlanta, eventually directing the center's vast AIDS program and rising to the rank of rear admiral, as an assistant surgeon general.

She has worked on HIV/AIDS issues for nearly 20 years and is known as a strong advocate for HIV prevention and women's health issues.

Early on, when AIDS prevention was an unglamorous and underfunded cause, "many people wondered why you'd go into such a discouraging field," said William Foege, former CDC director and a Gates Foundation Fellow who is one of Gayle's mentors.

Gayle stuck with it, he said, always upbeat, even while negotiating the disease's cultural minefield — sex, drugs, gender, prostitution, exploitation, poverty. "She's as comfortable talking with people in an African village as she is meeting with [United Nations Secretary-General] Kofi Annan or presidents," Foege said.

Once, over strenuous objections from embassy security, Gayle took Donna Shalala, then secretary of health and human services, on a stroll through Calcutta's red-light district to chat with sex workers.

"Helene was not afraid to go into a brothel, nor was she afraid to invest U.S. resources in AIDS at the ends of the Earth, to give actual hope," Shalala said.

Gayle says social justice and inequities were why she went into medicine to begin with. "Now I get to attack the root causes of poor health."

As CEO of CARE, Gayle will replace Peter Bell, 65, who is leaving after 10 years.

She was selected after an international search in part because of her track record leading complicated organizations and partnering with sovereign nations on development issues, said Bowman Cutter, CARE board member who chaired the search committee.

Among her challenges will be dealing with security for aid workers, a sensitive topic at CARE, whose director in Iraq was kidnapped and murdered.

At the Gates Foundation, Dr. Nicholas Hellmann will be interim director of HIV, tuberculosis and reproductive health.