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At the national level,
leadership is noticeably fragmented. People become exceptionally
invested in a particular approach and thus, close-minded to others.
Sporadic, unpredictable, and fragmented funding has left orphans
who resent others getting funds ahead of them. They have become
martyrs and it is difficult for them to shed that embattled mentality.
There is infighting and divisiveness, as we saw over the money from
the tobacco settlement, and a sense that some players value being
correct more than being successful.
As I mentioned earlier, the field lacks
sufficient incentives to draw in the best and the brightest. The
leadership suffers from a lack of diversity. I recall an early meeting
we held with Bill Moyers and substance abuse experts as we began
planning for his PBS show on addiction. Every expert was a white
male.
Another formidable obstacle
to effective policy change has been the power of the tobacco and
alcohol industries and the fact that they deal with legal substances.
It loomed in our Board meetings, as it has at all levels of government.
These companies use sophisticated marketing to drive sales and we
all know that they play hardball with anyone who tries to get in
their way. This intimidation has been an enormous weapon.
HOPE NOW AND FOR THE FUTURE
These barriers and frustrations challenge all of us. But looking
at the Foundation, I am heartened by how comfortable our staff and
trustees now feel on this issue. As we came to appreciate the staggering
impact of substance abuse, our engagement and commitment deepened.
When I think back to how controversial tobacco seemed in 1991, I
can laugh at a comment made a couple of years later by a trustee
who had been a vocal opponent of including tobacco. The Foundation
was considering grants regarding health care reform, and he pleaded,
Cant we do something noncontroversial, like smoking?
Just as the hesitation in the philanthropic
world a decade or so ago mirrored the larger society, I think the
commitment and increased sense of possibility we now see at the
Foundation has a promising counterpart there. So I see a number
of reasons for optimism at this stage. Let me mention a few of them.

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