When my alma mater—Meharry Medical College (one of only three historically black colleges and universities that produces physicians, dentists, and biomedical researchers)—welcomed a $7.5 million donation from Juul/Altria, the world’s leading e-cigarette company, it felt like we had accepted Kryptonite. The unpopular decision connects two diametrically opposed missions: one that seeks to improve the health and healthcare of nonwhite and underserved communities, and the other that seeks to profit from the behaviors of smoking and nicotine dependence.
The decision also represents a critical juncture for Meharry, every Meharrian to date, the communities which we serve, and the countless future Meharrians whose trajectories may be impacted by this investment. Although our president & CEO, Dr. James Hildreth tackled the broad criticism of the grant in a recent Op-Ed, concerns about ethics and integrity continue to mount. As an alum, I cannot ignore the piercing question in my mind: Why, Meharry?
On its surface, this feels like a truce—the advocates for wellness and those profiting from its absence putting their differences aside to explore the intersection of smoking and social determinants of health through the creation of a dedicated research center. But an alternate conclusion is that Juul/Altria desires to shift the narrative around e-cigarettes, nicotine-dependence, and youth (specifically youth of color) via the Meharry brand. For this outcome, Meharry alumni have a crystal-clear message for Juul/Altria: You did not buy us, and you are not exonerated by pledging money to our cause. We are still champions for the poor and underserved, a community that you have historically marginalized.
I admit it is difficult to digest what seems like a crime of moral turpitude. After all, service-driven institutions shoulder a heavy burden. They must strike a balance between identifying the resources essential to their mission and ensuring that dollars accepted never compromise the commitment to the communities served. But just as there is no perfect institution, there is no perfect donor. Microsoft, Apple, Coca-Cola—they all have enough skeletons in their closets to resemble our cadaver lab in West Basic Sciences Center. Likewise, many institutions have embarked upon funding opportunities nestled in moral gray areas.
However, Historically Black Colleges and Universities ARE perfect targets for corporations like these—not because we are weak or apt prey, but rather because we represent a valued commodity: the long-standing commitment to our people and a legacy of service that makes institutions like Meharry trusted pillars in our community. We’ve accomplished remarkable feats despite being under-resourced, under-funded and underestimated. These companies are well aware of the credibility that aligning with our institutions lends them, and they invest accordingly.
This is not a problem unique to Meharry. Since their inception, HBCUs have struggled with institutional advancement and fundraising. Not a single one of our beloved HBCUs is listed among the institutions of higher education with endowments greater than one billion dollars. Enrollment at HBCUs is also trending downward, making our financial conditions even more tenuous. Then there’s the challenge of alumni giving, where the disproportionate burden of federal loans on HBCU graduates negatively affects crowdfunding within alumni circles.
On the heels of Robert F. Smith’s hallmark gift to the 2019 graduates of Morehouse College, there is a renewed interest in black colleges that we must fully leverage. But first, a proverbial tough pill to swallow: We (HBCUs) are not in a position to be purists when so many of our institutions are struggling to survive. Our institutions perennially operate in the red, making it difficult to trace the origin of every dollar—and even more difficult to reject those that don’t come from a perfect source. However, I believe we can and should say no to money that compromises who we are. Further, we should set unequivocal guidelines and expectations for our investors upfront as the standard. And before donations are accepted, the structure of these relationships should be articulated on the record for every stakeholder as a measure of transparency. This facilitates a broad understanding that our brands and our goodwill aren’t for sale. Moreover, this type of transparency reinforces the fact that investors who contribute to HBCUs know what our communities have known for years: that our institutions produce good returns on their investments, as evidenced by the lives we change and the spaces we help transform.
The op-ed in the Tennessean suggests that Juul and Altria are cognizant of our autonomy, and they accept their limited role in financially supporting the work we’re already doing. If this offering truly comes with no strings attached, then we should treat it like any other donation. But first, corporations like Altria and Juul must know that they cannot sanitize their relationships with the black community through writing checks to our storied institutions. They do not get the privilege of co-opting the Meharry brand—or that of any other HBCU—in exchange for a donation, no matter how generous it is. Simply put: We aren’t going out like that.
Dr. Hildreth now has a great responsibility; he is tasked with keeping Juul/Altria honest. But rest assured, he will not be alone—accountability will come from alumni and other Meharry stakeholders. Every annual or quarterly report from the new Center for Social Determinants of Health at Meharry, every line item, every footnote will be scrutinized by Meharrians to ensure that science and the well-being of our communities is guiding our work—not the interests of donors. Every paper that is produced will be thin-sliced by Meharrians to ensure that our integrity as an institution remains intact. And every reference to or mention of the Center for Social Determinants of Health at Meharry will be inextricably linked to the mission of our institution.
We are Meharry. No matter where the public stands on the issue, we will be Meharry. In that spirit, we must let our compassion for others be their reminder of who we are until the undertones of doubt are drowned out completely. This gift does not absolve Juul, Altria, or any other element of the tobacco industry of its harm particularly relating to black America and the diaspora, nor will it dissuade us from continuing our mission to elevate our communities.
In sum, Meharry you have my support—and they have my attention.
Dr. Italo M. Brown is an emergency medicine physician and social EM fellow at Stanford Hospital. He is passionate about health policy, mental health advocacy, diversity in medicine, and pipeline development.