Tufts Report on Sackler Giving Offers Cautionary Tale for Dealing With Controversial Donors

Tufts University last month announced it would cut ties to the Sackler family — the owners of Purdue Pharma, which makes the opioid pain medicine OxyContin — and began removing the Sackler name from buildings its members had helped finance across the campus as part of more than $15 million in donations that they and Purdue provided over several decades.

Important as that was symbolically for critics, Tufts played down another important development, one that sheds far more light on the university’s actions.

Near the end of the 11-paragraph announcement, Tufts noted its public release of a report on its decades-long relationship with Purdue Pharma and the Sacklers.

Veteran fund raisers say the findings reveal a surprising lack of policies and controls, and a problematic culture in the university’s advancement department, that offers a cautionary tale for other nonprofit organizations.

The report details an agreement that gave Purdue the opportunity to manipulate a master’s program it anonymously funded. And it points to lapses that allowed Tufts to pursue donations from the company and the Sacklers, even as lawsuits, investigations, and front-page news articles examined Purdue’s role in fueling the epidemic of prescription opioid use.

“It seems like Tufts is rife with a culture of ‘Look the other way; just get the money,’” said Ann Boyd-Stewart, former assistant vice president for advancement at Stony Brook Medicine and founder of the advisory firm Cairn Philanthropic.

Tufts commissioned the investigation and report from Donald Stern, a former U.S. Attorney for Massachusetts, and Sanford Remz, the managing shareholder at the law firm Yurko, Salvesen & Remz, after Purdue’s funding of the master’s program became public knowledge as part of the Massachusetts attorney general’s lawsuit against the company. Massachusetts is one of 2,000 states, counties, and cities that have sued Purdue, members of the Sackler family, and other opioid makers over an epidemic that led to 218,000 prescription-opioid overdoses from 1999 to 2017.

But the company’s role in the opioid crisis did little to disrupt the university’s long association with the family. Its biomedical-science school bore the Sacker name, as did several other campus buildings. According to the report, the university has received $15 million from the family and the company since 1980. Tufts gave Raymond Sackler, one of the company’s owners, an honorary degree in 2013.

Though the report found that Purdue’s undisclosed funding of the master’s program did not materially alter it, the report concluded there was “an appearance of too close a relationship between Purdue, the Sacklers, and Tufts.”

But the university should not be let off so easily, said Boyd-Stewart. “It’s sad that these people were using Tufts to benefit themselves, but this was a symbiotic relationship. Everybody benefited except for the students who took the courses and paid the tuition and the public who was deceived.”

The university’s efforts to calm criticism from alumni and others by ending its relationship with the Sacklers are not going down well with the family. A letter from Daniel Connolly, a lawyer representing some members of the Sackler family, charges that by changing the name of buildings and programs they had financed, Tufts is in breach of agreements it made when it accepted the donations.

In a statement to The Chronicle of Philanthropy, Connolly wrote that he had requested a meeting with Tufts, saying, “We are confident that when the facts are fully known and understood, there will be no basis for an objection to the use of a family name that has supported the work of the university for over 40 years.”

An Unusual Agreement

One of the most problematic philanthropic relationships between Purdue and Tufts detailed in the report was the anonymously funded master’s program. It was conceived by Daniel Carr, a pain expert at Tufts medical school. In 1998 he and a colleague approached Purdue with a proposal for the Pain Research, Education, and Policy program. Purdue gave the school $330,000 a year over five years and in 2004 renewed the funding, providing $500,000 over three years.

The agreement was unusual, according to several fund-raising experts. For its donation, Purdue was allowed to appoint one person to the steering committee that oversaw the program. Purdue had the option to collaborate with Tufts on research projects. It could also help develop curricula for the master’s program, receive assistance with marketing surveys, and have a presence at pain-management symposia held by the school.

The institution gave an anonymous donor a level of control over a program aligned with its business that most universities would avoid because of concerns about transparency and academic freedom.

“Who signed this thing?” said Audrey Kintzi, vice president for advancement and communication at Saint Mary’s University of Minnesota and a member of the ethics committee of the Association of Fundraising Professionals. “Yikes. Who wrote this thing?”

The agreement was written on Purdue letterhead. Sanford Remz, the lawyer who investigated Sackler ties for the Tufts-commissioned report, said there was no clear paper trail indicating who had given input to the agreement from Tufts, and he could not determine who had written it.

Though the report makes no mention of who signed the agreement, Remz said it had been signed by John Harrington, who was then dean of the medical school and has since died. Remz said the agreement had been approved institutionally by Tufts so the report does not name Harrington. The report says the policies were “limited and not well documented or preserved,” so it is not clear if the agreement violated the university’s gift-acceptance policies at the time.

In a written statement, the university’s current president, Anthony P. Monaco, said the funding agreement for the master’s program had been poorly drafted and Tufts should not have agreed to it. The university did not find other programs with similar agreements. Purdue declined to comment on the report.

Records from 1998 should be electronic and not hard to locate, especially at a large university with a medical school, said Boyd-Stewart. “It can’t be that backward, an institution that’s been around for that long. They have no policies in place? It’s a medical institution,” she said.

Medical schools, in particular, should have a long and well-documented history of conflict-of-interest policies and procedures. “Where are their board members?” she asked. The agreement gave Purdue so much control over the program that Kintzi said it raised questions about whether its donation should have been considered something other than a tax-deductible charitable gift. Federal tax law requires the donor to relinquish control, she said.

“If they make a gift but they’re still calling the shots, that’s really not a gift,” she said.

Well-Hidden Gift

That Purdue’s funding was not disclosed raises more issues. Anonymous donations are not unusual at universities. Kintzi said anonymous donors are most often individuals who don’t want to be inundated with requests for other gifts, though her office generally urges donors to disclose their funding and tout their good deeds.

But a corporation funding a program focused on its area of business is different, and requires more disclosure, experts say.

“Being a silent donor would have been something I would have advised against,” said Suzann Lupton, interim executive director at the Center for Service and Learning at Indiana University and an assistant professor of nonprofit organizations who has researched medical philanthropy. She is also a lawyer who practiced health-care law. The anonymous gift could allow the company to secretly influence an academic program that could affect its business.

Purdue’s donations were so well hidden, the report notes, that none of the 75 students who had earned the degree were aware of the funding until recently.

“I feel for those students at Tufts that paid real money to go to a program that they were really hoodwinked about,” said Boyd-Stewart. “They should get [their money] back.”

Strong Relationship

Once Purdue agreed to sponsor his master’s program, Carr, the pain expert, worked to continue to build his ties to the company and to Richard Sackler, then Purdue’s president, who was also on the Board of Advisers at Tufts medical school.

According to the report, Carr sent emails directly to Sackler many times, on one occasion writing: “Our continued collaboration is a top priority for me.” Carr emailed Sackler again, asking him to evaluate the program. He said he would like to be involved in future projects with Purdue that would “build on what we have invested in our Tufts curriculum.”

In 2004, when funding for the program was renewed, Carr agreed to meet with senior Purdue marketing executives.

With the university’s permission, Carr even appeared in a 2002 Purdue print ad touting the company’s efforts to fight prescription-drug abuse, which prominently featured his Tufts affiliation. In an emailed statement, Carr wrote that he had dedicated his career to advancing the understanding of pain treatment, and he had always tried to help patients in the most reasonable and responsible way. He said he had been pleased to cooperate with the authors of the Stern-Remz report but did not address any of the specifics mentioned in the report.

Other Purdue executives were also involved with the master’s program. According to the lawsuit, in 2000, Purdue employees sent Sackler an email reporting on their visit to Tufts, during which they explored ways the company could contribute to the curriculum and “to find opportunities for Purdue to influence the work of Tufts in the Massachusetts medical marketplace and beyond.”

The lawsuit says that Purdue wielded that influence by getting two “unbranded curricula” approved for teaching to Tufts students. The report, however, says that no such curricula were taught.

Purdue took advantage of the control it was granted in its funding agreement by appointing David Haddox, a senior Purdue executive, to the master’s program’s steering committee. Haddox also became an adjunct professor at Tufts and was a lecturer in two courses required in the program; he disclosed his job with Purdue.

Though the report says that Haddox did not participate in the steering committee, the lawsuit says the committee went to Purdue’s headquarters to learn about “what Purdue would like to see” in the program.

In 2017, after Purdue stopped funding the program, several students complained that Haddox was “an apologist for the pharma industry.”

Haddox declined to be interviewed for the report.

Carr’s courting of Richard Sackler and Purdue are problematic, said Kintzi. “Those emails are really inappropriate. They crossed the line,” she said.

A university and its employees often have necessary communication with a donor to provide updates on a program the donor has supported, for example, but not to ask for direction, as Carr did. They must keep a distance from donors, especially when the donor is a for-profit company. The company’s responsibility to earn a profit can easily conflict with the university’s mission to educate students, she said.

Carr further complicated the relationship by appearing in the ad for Purdue, thereby blurring the line between being an academic with funding from a sponsor and being a spokesman for the donor, said Lupton, the Indiana University professor. Remz said that when Carr was initially obtaining the funding for the master’s program, staff members in the advancement department were involved. But that changed once the program was running. “There was not any regular, ongoing communication between advancement and Dr. Carr once the program was funded,” said Remz.

But in an era when government funding is harder to come by and faculty members are under pressure to raise money, fund-raising professionals can help them understand how to navigate those relationships and avoid the pitfalls documented in the report, Kintzi said.

The report, too, found that Carr should have maintained a greater distance from Purdue. It cited one episode in particular as reflecting “an overly close entanglement or identification with Purdue and an effort to please Purdue and the Sacklers.”

However, the report’s authors conclude that neither the university nor Purdue’s conduct would violate even the university’s current policies. “We did not discover any evidence of improper demands, quid pro quos, conditions on donations or grants, or improper attempts to influence or interfere with research or academic programs.”

In his statement, President Monaco of Tufts said that the university’s policies at the time did not provide adequate guidance for faculty members and that Carr remains a faculty member in good standing.

Family Ties

The university’s relationship with the family goes back to 1980, when the three Sackler brothers who owned Purdue Pharma — Arthur, Mortimer, and Raymond (Richard’s father) — made a donation that put their name on the Sackler School of Graduate Biomedical Sciences.

In 1983, Arthur made a contribution that put the family name on the medical-school building. Those gifts predate sales of OxyContin, which hit the market in 1996. Various family members have made donations since then. And Richard Sackler, Purdue’s former president and chairman, was on the Tufts medical-school advisory board for nearly two decades, until he resigned in 2017.

The university courted the Sacklers in much the way other nonprofits court major donors, with meetings, dinners, events, and correspondence.

But that courting took place in part while Purdue’s legal troubles and role in the opioid crisis were well known. For example, in 2007, Purdue executives pleaded guilty to federal criminal charges, and the company paid $600 million in fines and compensation.

However, the report says, when a board committee considered whether to give Raymond Sackler his honorary degree, in 2013, there was little discussion of the company’s problems.

Sackler was in such poor health that President Monaco traveled to Purdue headquarters for the ceremony. It wasn’t until 2017, after articles in Esquire and The New Yorker detailing the role of Purdue and members of the Sackler family in promoting increased opioid prescribing, that the university reconsidered the relationship. Remz said there were files in the advancement department with news articles about OxyContin. But that information did not prompt debate over the relationship until 2017.

“There was money there,” Boyd-Stewart said. “That’s why they gave the honorary degree.”

The report finds fault, too, with how the university handled the relationship. “There was a failure to consider in sufficient depth the appropriateness of granting an honorary degree to a principal owner of a pharma company that was in the middle of well-publicized public-health crisis,” it says.

The association with the Sacklers is likely to have led to other problems. The report points out that a medical-school committee decided not to assign Dreamland, a book that delves into Purdue Pharma’s role in fueling the opioid crisis, to incoming medical students because of the university’s relationship with the Sacklers.

A Welcome Gesture

After years of agitating for Tufts to cut its ties to the Sacklers, some students welcomed the university’s decision to remove the Sackler name and take other steps to dissociate from the family. The university has announced a $3-million endowment for programs to prevent and treat addiction, and the controversial master’s program will end this year.

“A lot of the graduate students, especially on the medical campus who have been involved in this effort, were quite happy about the Sackler name being taken down,” said Nathan Foster, a recent graduate and an organizer with the campus’s Sack Sackler campaign. “It is very positive. And though it is mainly symbolic, it’s important.”

The report recommends further steps: that the university create a gifts-policy committee, for example, to review donations above a certain size and requests for anonymous gifts, among other things. It should create a more-rigorous review process for major gifts and those receiving honorary degrees. Donors should receive a higher level of scrutiny, it says. It also suggests that the school adopt and publish clear gift-acceptance policies and appoint a compliance officer.

In his statement, Monaco said Tufts had begun developing plans to address the report’s recommendations. It will adopt stronger screening procedures and more-stringent conflict-of-interest policies for donors, and vet gifts more rigorously “to ensure they do not interfere with the university’s research and academic integrity.”

Fund-raising experts agree that those are important safeguards. Many universities the size of Tufts already have similar policies and procedures in place, said Indiana’s Lupton.

But Boyd-Stewart said that while the recommendations are helpful, the report and the university’s response don’t adequately address the damage already done.

“I don’t buy it that there wasn’t financial damage,” she said. “The director, Carr, got paid; the fund raisers got paid; the president got paid; all these people got paid; and a lot of people in the public got hurt because they believed Tufts was objective.”

Jim Rendon is a senior writer who covers nonprofit leadership and fund raising for The Chronicle of Philanthropy. The Chronicle of Philanthropy, also published by The Chronicle, serves leaders, fund raisers, grant makers, and others involved in the philanthropic enterprise, including those in university development and advancement. See more of The Chronicle of Philanthropy’s coverage on philanthropy.com. Rendon recently wrote about grant makers’ efforts to see that their giving does more to benefit people of color and about the fresh tactics of the new youth advocates. Email him, or follow him on Twitter.