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May-June 2008
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Good-bye to HMIThere is a revolution afoot in international healthcare. Wealthy foreigners still come to the United States—to the Mayo Clinic, say, or to Harvard-affiliated hospitals in Boston—and pay full freight to be treated by the world’s top doctors. But changes in U.S. visa policy, in light of September 11 and the Iraq war, have made such trips more difficult; consequently, these patients increasingly seek world-class healthcare closer to home. Harvard has had a booming business advising in the creation of such hospitals. Harvard Medical International (HMI), created in 1994 to generate revenue for Harvard Medical School (HMS), has projects in 20 countries on five continents. But just as demand is heating up, the University is pulling back. In February, it announced a provisional agreement to transfer HMI to Partners Healthcare, the parent organization for two of the largest Harvard-affiliated teaching hospitals. The announcement allows HMI to come out of a holding pattern, freeing it to enter new contracts. But Andrew A. Jeon, M.B.A. ’89, HMI’s president and CEO since December 2007, says leaving Harvard is beneficial for other reasons. As University administrators also note, Partners operates hospitals, while HMS does not. And as HMI has grown, it has found itself in a Catch-22: the better it did at making money, the more questioning of its worth it faced in some quarters. Through HMI, Harvard professors are advising the design and operation of hospitals and specialty clinics in India, Greece, Turkey, Thailand, and China; guiding the creation and reform of medical-school curricula in Germany, Japan, Hong Kong, India, Egypt, Saudi Arabia, Kuwait, Lebanon, and the Dominican Republic; and advising and staffing continuing-education programs for physicians around the globe. Roughly 250 faculty members—mostly from HMS, but also from the Harvard School of Public Health (HSPH), the Harvard Business School, and the Faculty of Arts and Sciences—engage in contract work each year for HMI, whose 2007 operating budget was $21 million. (See hmi.hms.harvard.edu for more information.) The 4-million-square-foot Dubai Healthcare City (www.dhcc.ae), the largest and in some ways the flagship project, will include hospitals, facilities for clinical and commercial research, and a medical school. The goal is to draw patients from India, North Africa, Moscow, and much of Europe—all within easy flying distance. Although other partners in the project include the Mayo Clinic, Boston University, AstraZeneca, Novartis, and Wyeth, HMI is listed as the “key strategic collaborator.” Its contributions include strategic planning and helping to develop the system of licensing and regulating doctors and healthcare facilities within the complex—and potentially beyond. (HMS will continue to operate the Harvard Medical School Dubai Center, which deals with postgraduate and continuing medical education, and the Dubai Harvard Foundation for Medical Research, which announced its first research awards, for two postdoctoral fellows from the Middle East, last year.) 
Images courtesty of Harvard Medical International The Ibn Sina building in Dubai Healthcare City houses clinic space and medical and administrative offices (top). An artist’s rendering of the university hospital (below) that will be part of the same complex; Harvard Medical International (HMI) advised in designing the 400-bed facility, projected to be completed in 2011. 
Images courtesy of Wockhardt Hospitals HMI affiliates from the Wockhardt Hospitals system in India include (top) a facility in Mumbai with a planned addition (in an artist’s rendering), and another (bottom) in Bangalore.
Some critics of HMI complained that it was unfocused, responding to client requests rather than setting its own agenda. Others said it looked bad for Harvard to make a profit in countries where the vast majority of people have no access to the healthcare system. In the view of Jorge I. Domínguez, the University’s vice provost for international affairs, HMI never should have been part of Harvard in the first place. “It is a consulting company, under the Harvard name and under the Harvard tax exemption,” he says. “It doesn’t belong at an institution whose core mission is research and education.” On entering some HMI-affiliated hospitals, adds Domínguez, “You get the feeling you just walked into a department of the Harvard Medical School—the seal of the school broadly displayed, ‘Harvard’ sometimes in bigger type and more prominent than the name of the local client.” Although allowed within the contracts HMI signed, these uses are not consistent with broader University policy and principles, says Provost Steven E. Hyman: “There’s nothing more precious to us than the Harvard name and what it stands for.…We’re not looking for brand extension.” 1 | 2 | continued >  
 
 
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