The C.E.O. of H.I.V. – The New York Times

Directors of health care nonprofits are traditionally cautious and courtly, fearful of choking the funding streams that issue from nit-picking grant committees and image-conscious donors. Weinstein, an ex-Trotskyite, is no courtier. He runs his organization as a “social enterprise,” meaning that it generates most of its revenue not from grants and fund-raising but from adjacent businesses. A.H.F.’s main business is a network of pharmacies and clinics that provide primary care to more than 41,000 patients in the United States, most of whom have their insurance claims paid by government insurance programs like Medicaid. The excess income from these patients helps the AIDS Healthcare Foundation provide free care to more than 700,000 H.I.V. patients internationally — the greatest reach of any AIDS organization. This prodigiously successful model has both insulated A.H.F. from typical funding woes and helped it to expand at an astonishing clip. Over the last six years, A.H.F.’s budget has grown from $300 million to more than $1.4 billion, about the size of Planned Parenthood. If their projections hold, it will reach $2 billion by 2020, giving A.H.F. — a private entity effectively under the control of one man — a budget nearly half the size of the World Health Organization’s.

Paradoxically, that projected growth depends in part on whether drug costs remain high. While cutting drug prices is an ideological objective for Weinstein, his pharmacies stand to lose revenue should he succeed in that mission. “Most of the time when people benefit from something, they don’t lobby against it,” he told me recently. “But we’re Robin Hood. If someone was writing an epitaph for this organization some day, it will be: ‘Bit the hand that fed it.’ ”

A.H.F.’s rapid ascent has made Weinstein an object of scorn among his peers, who deplore not only his tactics but also his unorthodox positions on public-health issues. Unlike nearly all other…

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