By Laurie Strongin
Laurie Strongin is founder and chief executive of the Hope for Henry Foundation, a nonprofit organization leveraging behavioral economics to improve outcomes and quality of life for pediatric patients, based in D.C.
I was refueling my car at a gas station near my D.C. office recently when a prompt appeared on the pump: It urged me to donate to St. Jude Children’s Research Hospital, one of the nation’s largest and wealthiest pediatric cancer charities, based in Memphis.
The sight of that prompt was so frustrating because my office is the headquarters of the Hope for Henry Foundation, a local nonprofit organization I founded two decades ago to enhance health outcomes for Washington’s most vulnerable children. How, I thought, can Hope for Henry have the best chance of finding support for its work when the fundraising behemoth St. Jude is essentially knocking on doors in our neighborhood from nearly a thousand miles away?
The well of charitable support in this country is both deep and broad, and raising money is not a zero-sum game among nonprofits. But because fundraising can also be a business — with the biggest nonprofits spending the most money to make the most money — it’s worthwhile to remind folks now and again to think about how they choose the organizations they support.
Last year, the investigative journalism outlet ProPublica reported that of the $2 billion St. Jude raised to much fanfare in fiscal 2021, nearly half went unspent, and that by the end of that period, the hospital’s reserve fund had grown to $7.6 billion. In related articles, ProPublica questioned the charity’s financial management and mission fulfillment as it documented families sleeping in their cars to access treatment.
Local institutions that are closest to the needs of their communities, start-ups that offer new energy and innovation in their field and other midsize nonprofits often find themselves overshadowed by the colossal presence of the St. Judes of the world. Large national organizations certainly do plenty of good work serving many people, and charitable donations are the oxygen they need. It is only when they start hoarding the oxygen tanks — or leaving billions unspent — that potential donors should consider whether their dollars are making a difference in someone’s life.
St. Jude’s formidable fundraising arm, the American Lebanese Syrian Associated Charities, spent $626 million in fiscal 2021, accounting for 35 percent of all the organization’s expenses that year. Among other things, ALSAC’s money buys hundreds of millions of direct-mail solicitations and celebrity-endorsed commercials that blanket television and social media. Shouting loudly in this way has helped give St. Jude the image as the preeminent children’s cancer charity. And, indeed, in 2020, it attracted more funding than the nine hospitals ranked higher in pediatric cancer care in the U.S. News & World Report rankings combined.
And it’s not just a matter of competition for dollars. Spreading news, information and, yes, appeals around our message and mission is challenging, especially in children’s health care, where St. Jude has trademarked the common phrases “Finding cures. Saving children.” These kinds of monopolistic tactics can hamper the fundraising efforts of other nonprofits, especially those working in the children’s cancer research and treatment space, including Hope for Henry and this community’s own cutting-edge Children’s National Hospital.
In addition to being home to such world-class hospitals as Children’s, MedStar Georgetown’s Lombardi Comprehensive Cancer Center and Inova Children’s Cancer Program, which treat local children fighting cancer every day, the Washington area is replete with nonprofit organizations that focus on the care of sick kids. These include such groups as Horizon Day Camp, Children’s Inn at NIH and DC Candlelighters Childhood Cancer Foundation, all of which rely on the generosity of their neighbors and corporate support to do the great work they do to help our area’s sickest children heal and thrive.
As St. Jude continues on its fundraising course — including with an inaugural Global Gala to be held at Washington National Cathedral in June — perhaps it’s time for the local businesses, philanthropies and individuals who plan to attend to pause and reflect. I encourage them to have a good time and learn about critical issues in pediatric health care. But I also urge them to make informed giving decisions, prioritizing factors such as local impact — and an equitable distribution of resources.