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Some who have experienced it from the inside, however, disagree. Dr. Gerald Keusch, former director of the Fogarty International Center at the National Institutes of Health (NIH), says he saw a marked change in its operations as the government moved from the Clinton to the Bush administrations. Under Clinton, Keusch says, he never encountered resistance in appointing experts to the advisory board that conducted peer reviews of grant proposals to the center, which focuses on international health issues, particularly in developing countries. He made seven nominations, and all were approved by the Department of Health and Human Services (HHS) within three weeks. Under Bush, his first four nominations were quickly endorsed by NIH but then, says Keusch, "it's 10 months before I hear from HHS, rejecting three of the four, including a Nobel laureate, with no reasons given." In return, HHS sent him the résumés of other people, many of whom had no expertise in infectious diseases or developing countries. Over the next three years, Keusch recalls, he had to nominate 26 people to fill seven vacancies and "came close to having a very dysfunctional advisory committee. I couldn't get a quorum anymore."
Keusch, now associate dean for global health at Boston University's School of Public Health, says ultimately he couldn't take the "disdainful and disparaging" way in which he was treated--and adds that he is not the only one. "People who have done extremely well in their positions have left because they're being disregarded," he says. But others, like Hansen, say that hostility is all the more reason to stay and speak out about what they are convinced are growing dangers to the world's health and environment. "I don't want my grandchildren in the future to say, 'He understood what was going to happen, but he didn't explain it to the people,'" Hansen says. "So I'm going to try to explain that story."