Although Ira Magaziner, CEO of the Clinton Health Access Initiative, is admired as a farsighted, experienced leader, he was the subject of a harsh set of complaints in his most recent performance review, with most of the grievances expressed by members of the CHAI board, the New York Times reports.

An adviser to Bill Clinton during his time in the White House, Magaziner was accused of CHAI board members of exhibiting "disdain" for the board, of "duplicitousness with management," and of promoting a "lack of transparency" and "dismissive behavior" toward Clinton family members. According to the Times, Chelsea Clinton, who, like her father, is on the board of CHAI, has occasionally collided with veterans of her father's White House. At the same time, the review praised Magaziner as a "visionary" who has a clear sense of CHAI's mission and has had a "transformational impact" on the field of global health. The review also noted that board members though that duplicating Magaziner’s strengths would be "impossible."

In 2010, the Boston-based CHAI, which has an annual budget of approximately $170 million, was spun off as a separate nonprofit under the umbrella of the Bill, Hillary, and Chelsea Clinton Foundation. CHAI works in thirty-four countries to expand access to drugs and treatment for AIDS, malaria, tuberculosis, and other diseases. After the split, the relationship between the foundation and CHAI became strained, the Times reports.

Magaziner told the Times he considers it logical for an organization the size of CHAI to make leadership succession plans. And while he acknowledged that he can be prickly and intimidating at times, he said he believed he had a good relationship with Chelsea Clinton. When asked whether CHAI could have succeeded and continued on without the Clinton name in its title, Magaziner said, "President Clinton and I founded CHAI together in 2002. The people of CHAI are very proud that CHAI bears his name."