October 19, 2023

The individuals who serve as Directors of the American Diabetes Association (ADA) and the Juvenile Diabetes Research Foundation (JDRF) are of the highest level of authority and leadership. While they often do not get involved in day-to-day operations, they are accountable for strategy, direction, ethics, and executive compensation for achieving their organizational missions. Their decisions and leadership either accelerate or decelerate speed to a cure.

This report addresses the importance of the boards of directors, identifies several key challenges they face today, and provides a few recommendations.


Post-COVID Challenges and Opportunities

The years during COVID presented many unique challenges to executives and board members alike. Both the ADA and JDRF reduced their respective infrastructures, reducing personnel, offices, meetings, and research grants. Today, board members of both organizations face a number of essential strategic challenges and opportunities.

The JDRF has built up a huge cash and short-term investment stockpile. The board must decide and give clear guidance about how and when to allocate those funds. If deployed for Functional/Practical Cure research, it could greatly expedite progress to a cure.

The ADA faces a steadily declining revenue stream and a slow decay in relevance to the T1D community. The board must decide how important it is to rebuild its reputation and influence with the T1D community or whether it will continue focusing on T2D.


Board Size Has Reduced Considerably—A Good Thing

Both the ADA and the JDRF have reduced their number of board members in recent years, consistent with the recommendation provided in prior editions of this report. This is a good thing.

A lean board of directors allows full engagement and participation of each member. Many academics who study this topic conclude that a board size between ten and twenty is optimal—a group too small limits diversity of perspective, and too large can lead to fragmentation.

Over the past two years, JDRF cut the size of its board in half from thirty people to thirteen. The ADA has reduced its size from nineteen directors to sixteen. However, in the most recent year, the ADA began reverting and grew by three people, from thirteen in 2021.

Board members for both organizations are listed in the appendix below, alongside source links.

Editorial Recommendations

At this crucial juncture for both organizations, the JDCA offers four key recommendations. These recommendations are informed by best practices from the corporate world, while acknowledging the unique circumstances of the nonprofit environment:

  • Hold board members externally accountable. Today, nonprofit board members can only be appointed or removed by fellow members. Board member election by a broad base of donors would create accountability and ensure alignment with the donors who fund the organizations.
  • Deploy resources in line with donor priorities. Nine out of ten T1D donors want cure research to be the top priority for diabetes charities.
  • Consider a ‘say on pay’ executive compensation structure. A ‘say on pay’ initiative would allow donors to vote on aspects of executive compensation such as pay structure, base pay, and bonus amounts.
  • Public tracking of cure progress. Clear and transparent performance metrics toward cure progress would enable the board to hold executives accountable for tangible results to donors. Today, neither organization makes public what informs their executives' performance pay.


Appendix: Board of Directors Members 
JDRF 2023 International Board of Directors
Michael Alter
Elizabeth Caswell
Claudia Graham, Ph.D., MPH
Karen Jordan
Joseph P. Lacher, Jr.
Carlton McMillan
Jeff Plumer
Jennifer Schneider, M.D.
Christopher H. Turner
Matt Varey
Drayton Virkler
Lisa Wallack
Karey L. Witty



ADA 2023 Board of Directors
Rone Luczynski
Charles Henderson
Todd F. Brown, PMP
Rodica Pop-Busui, MD, PhD
Janet Brown-Friday, RN, MSN, MPH
Rhodes B. Ritenour, JD
James Tai
Mandeep Bajaj, MBBS
Patti Urbanski, MEd, RD, LD, CDCES
Marshall Case
Otis W. Kirksey, PharmD, RPh, CDCES, BC-ADM
Sean Pittman, JD
Francisco Prieto, MD
Madi Rajulapalli, MD, MBA
Christopher K. Ralston, JD
Robin Richardson