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Shanghai Pharmaceuticals (SPH), a vertically integrated Chinese pharmaceutical conglomerate, was considering its strategic options in the context of a rapidly evolving industry, policy, and economic environment. The company-essentially a collection of subsidiaries operating under a unified management structure-was formed through the 2009 merger of several state-owned enterprises, part of a broad policy effort in China to streamline state assets, consolidate the fragmented pharmaceutical sector, and enhance the global competitiveness of domestic firms. As it competed with other large domestic firms to become one of the few national champions that the government hoped to create, SPH was also considering an acquisition in the U.S. or Europe. This case allows students to consider the broad trends sweeping China's pharmaceutical industry and health care sector and assess future opportunities there for domestic and foreign businesses.

Cancer Treatment Centers of America (CTCA), a U.S. network of four privately owned oncology focused factory hospitals, was weighing options for growth. CTCA was entirely cancer focused and specialized in treating patients with complex and advanced-stage cancers, who were reached through advertising its integrative, team-based approach to care. CEO Stephen Bonner needed to decide whether to focus future expansion on building additional full-scale hospitals or pursuing a hub-and-spoke model, in which numerous oncology outpatient centers would be built in the region of each CTCA hospital. His decision would be made in the context of CTCA's unique business model and treatment philosophy and the public policy landscape, including certificate-of-need laws and the advent of Accountable Care Organizations (ACOs) and bundled payments. CTCA's for-profit status and direct-to-consumer advertising made it a target, he knew.

This case illustrates the implications of using stringent performance measurement systems to create performance pressure, motivate employee achievement, and sharpen a firm's competitiveness. It opens by describing the downsides of the ruthlessly competitive culture at Zynga, a young, successful online gaming company. A similar data-driven performance measurement system is employed at Dovernet, a Vancouver-based provider of enterprise communications and social-networking technologies. Dovernet's founder and CEO sees performance measurement systems as vital for cultivating the competitive, innovative workforce necessary for Dovernet to win in a fiercely competitive industry. Dovernet uses quarterly top-down reviews and stack ranking (with major implications for bonuses), as well as bottom-up reviews, to reward top achievers and put low performers on notice. The practical challenges of applying this system are illustrated in three brief vignettes. In the first two, students can assume the role of a manager charged with interpreting and acting on the negative reviews given to two employees with unique (but are they mitigating?) personal circumstances. The third vignette puts students in the role of an employee conducting a bottom-up review, as he struggles to balance honesty with the potential repercussions of giving his manager less-than-perfect feedback. The case allows students to consider the benefits and risks of different performance evaluation strategies and their implications for a firm's performance, culture, and employee morale. Are there certain types of firms or industries for which such systems are more appropriate? Do the integrity and effectiveness of a performance measurement system depend on managers' applying cold objectivity, or is there room for flexibility? In highly competitive industries, can firms lacking a strong performance emphasis beat competitors like Dovernet and Zynga?

In 2008 and 2009, a period of severe economic turmoil, Macy's CEO Terry Lundgren led a large-scale transformation of the iconic department store. Having previously converted the many department stores owned by Macy's to the Macy's names (except Bloomingdale's), Lundgren and his team set out to create a more efficient, dynamic organization. Their "One Macy's" initiative consolidated and centralized all key functions, while their "My Macy's" initiative focused on customizing the offerings of individual stores to local markets. By 2011, Macy's had many advantages, including an energized, highly experienced executive team; a nationwide presence and strong brand in the U.S.; a competitive offering of private label and exclusive brands; and, following the execution of One Macy's and My Macy's, a fresh, unique foundation for future growth. However, the company still faces significant challenges, including low sales productivity (in part due to the large size of its stores), the decline of mall-based shopping, poor floor-level sales capabilities, lack of appeal to younger consumers, intensifying competition, and an overall dearth of future growth opportunities. This case allows students to assess Lundgren's leadership to date and options for the future, as well as the overall viability of the department store business model.

This case illustrates a CEO-led organizational transformation driven by stretch goals, performance measurement, and accountability. When Kasper Rorsted became CEO of Henkel, a Germany-based producer of personal care, laundry, and adhesives products, in 2008, he was determined to transform a corporate culture of "good enough" into one singularly focused on winning in a competitive marketplace. Historically, Henkel was a comfortable, stable place to work. Many employees never received negative performance feedback. Seeking to overturn a pervasive attitude of complacency, Rorsted implemented a multi-step change initiative aimed at building a "winning culture." First, in November 2008, he announced a set of ambitious financial targets for 2012. As financial turmoil roiled the global economy, he reaffirmed his commitment to these targets, sending a clear signal to Henkel employees and external stakeholders that excuses were no longer acceptable. Rorsted next introduced a new set of five company values-replacing the previous list of 10 values, which few employees could recite by memory-the first of which emphasized a focus on customers. He also instituted a new, simplified performance management system, which rated managers' performance and advancement potential on a four-point scale. The system also included a forced ranking requirement, mandating that a defined percentage of employees (in each business unit and company-wide) be ranked as top, strong, moderate, or low performers. These ratings significantly impacted managers' bonus compensation. In late 2011-the time in which the case takes place-Henkel is well on its way to achieving its 2012 targets. Having shed nearly half its top management team, along with numerous product sites and brands, Henkel appears to be a leaner, more competitive, "winning" organization.

In mid-2011, the management of Brasil Foods, a leading Brazilian branded foods producer and protein exporter, is evaluating strategies for international and domestic growth. The team has just received approval from Brazil's antitrust authorities to complete the merger of Perdigao and Sadia, the two massive food producers that had combined to form Brasil Foods in 2009. Now, the team is free to focus on their ambitious plan to double revenues by 2015. Domestically, the plan calls for Brasil Foods to maintain its allowed retail market share and expand its presence in the fast-growing food service sector. Internationally, the plan sets out a vision of Brasil Foods evolving from an exporter to a true multinational. The team believes their operational expertise and scale combined with Brazil's booming economy and vast agricultural resources form the ideal platform for achieving their vision. Yet, amid a wealth of possibilities, they face tough choices, such as which emerging markets to pursue first. They also face serious personnel issues, including integrating employees from Perdigao and Sadia-longtime industry rivals-and developing an international team that understands foreign markets.

In 2010, PepsiCo India's management is working to translate PepsiCo's new mission, "Performance with Purpose," into practice in the India market. The mission calls for continued financial performance and market leadership, as well as greater emphasis on healthy products, natural resource management, and employee empowerment. PepsiCo India and other regional PepsiCo business units have significant discretion over how to implement Performance with Purpose in their local markets. PepsiCo India has made progress under the mission but continues to be challenged by the inherent tension between short-term financial performance and long-term investments in socially responsible initiatives.

This case focuses on the Alternative Quality Contract (AQC), a novel payment program designed to incentivize providers to deliver less costly, high quality health care. Under the AQC, offered by Blue Cross Blue Shield of Massachusetts, providers received a fixed-dollar budget to cover all care provided to a specific patient population, as well as incentive payments for quality. The AQC was piloted in 2009 by a handful of provider organizations, including a group of physicians belonging to the Lowell General Physician Hospital Organization (LGPHO). The case describes the LGPHO physicians' experience during their first two years under the AQC, allowing students to assess the group's performance as well as potential challenges in the remaining three years of the contract and future contracts and the AQC's value as part of the solution to untenably high U.S. health care costs.

McKesson, a large, diversified drug distribution and health care IT company, is considering development of new business offerings to help private practice physicians remain independent. The company, with $122 billion in 2010 revenues, just made its first foray into health care services with the acquisition of U.S. Oncology, an integrated cancer care company, whose expertise it could leverage in offerings catered to other physician specialties. With a vast portfolio of products and services serving a wide spectrum of health care stakeholders, McKesson appears uniquely positioned to understand and capitalize on the needs of health care businesses. With the recent passage of health care reform adding to the pressures already squeezing the health care industry-including new payment models requiring significant coordination and IT capabilities-independent physicians are migrating in droves to large health care organizations, abandoning the private practice model. McKesson could potentially provide them with an alternative. McKesson is an exceedingly large company with somewhat autonomous business units, making the prospect of collaborating to create a "cross-disciplinary" offering for independent practices difficult. Moreover, doing so would potentially extend McKesson into the clinical health services (and potentially risk-sharing) business, the strategic merits of which can be debated. Given the uncertainty surrounding the physician practice environment, the ideal shape of a solution to help these customers remains unclear, and competitors with a different product mix could be better positioned than McKesson to provide it. Finally, it could be too late altogether to reverse the trends eroding the private practice model.

This case describes the economic development problems faced by the small Caribbean-island country of Jamaica over most of the past half-century. The Jamaican economy showed relatively strong growth in the 1960s but stagnated in the 1970s. By the end of that decade, Jamaica was forced to turn to the International Monetary Fund (IMF) for balance-of-payments support. Over the 1980s and early 1990s, the unpopular policy conditions associated with IMF loan programs made the Fund a lightning rod for criticism over Jamaica's lack of economic progress. Jamaicans celebrated the end of IMF borrowing in the mid-1990s, but a severe financial crisis later that decade created a new layer of economic problems. In 2010, in the context of the global economic downturn, Jamaica once again returned to the IMF for financing support. This case allows students to explore the complicated economic difficulties faced by Jamaica, which remains burdened by a self-reinforcing set of interrelated factors, including high public debt, a sluggish private sector, an inefficient public sector, poverty, and crime, among others.

Daniel Kim was considering "blowing the whistle" on his friend, the CEO of a fast-growing startup where Kim had spent most of his professional career. When Kim joined the company, called Cardio-Metric, in 2002, it consisted of seven young engineers (including its two 25-year-old founders) working from a one-bedroom Minneapolis apartment. By 2008, when the venture capital-backed company recorded $110 million in revenues, Kim had become close friends with the founders, who served as CEO and chairman. Cardio-Metric's success, however, concealed troubling internal developments. Since 2002, the CEO's management style had progressed from unconventional, to questionable, to egregious. Kim, Cardio-Metric's on-and-off CFO, had repeatedly confronted the CEO over his behavior-including charging large purchases with no clear business purpose to Cardio-Metric and presenting unrealistic financial projections to investors-but the CEO dismissed Kim's concerns and ordered him not to share them with others at the company. By April 2009, Kim believed the problem had grown out of control, and he was considering disclosing the CEO's actions to the board of directors and a team of external auditors. There was much at stake. Kim's disclosure would undoubtedly ruin his friendship with the CEO, endanger Kim's own role at the company, and even jeopardize the future of Cardio-Metric itself.

Daniel Kim was considering blowing the whistle on his friend, the CEO of a fast-growing start-up where Kim had spent most of his professional career. When Kim joined the company, called Cardio-Metric, in 2002, it consisted of seven young engineers (including its two 25-year-old founders) working from a one-bedroom Minneapolis apartment. By 2008, when the venture capital-backed company recorded $110 million in revenues, Kim had become close friends with the founders, who served as CEO and chairman. Cardio-Metric's success, however, concealed troubling internal developments. Since 2002, the CEO's management style had progressed from unconventional to questionable to egregious. Kim, Cardio-Metric's on-and-off CFO, had repeatedly confronted the CEO over his behavior-including charging large purchases with no clear business purpose to Cardio-Metric and presenting unrealistic financial projections to investors-but the CEO dismissed Kim's concerns and ordered him not to share them with others at the company. By April 2009, Kim believed the problem had grown out of control, and he was considering disclosing the CEO's actions to the board of directors and a team of external auditors. There was much at stake. Kim's disclosure would undoubtedly ruin his friendship with the CEO, endanger Kim's own role at the company, and even jeopardize the future of Cardio-Metric itself.

This case describes Latvia's transition from a Soviet republic into an EU member, its economic boom and subsequent bust in 2008, and its policy response. After implementing significant economic and political reforms in order to qualify for EU membership in 2004, Latvia had turned its sights toward joining the single-currency eurozone, pegging its currency to the euro in 2005 as a step toward that goal. From 2000 to 2007, Latvia achieved faster GDP growth than any EU state. However, when large inflows of capital suddenly dried up in 2008, Latvia had to obtain a financial rescue package from the IMF, World Bank, EU, and several regional countries in order to avoid a full-blown financial and currency crisis. Latvia then adopted an aggressive economic adjustment program centered on maintaining its currency peg, which meant competitiveness would have to be restored by reducing domestic prices, wages, and public expenditures in order to drive down the real exchange rate. Latvia's policy program and initial results are discussed in the case.

How the International Monetary Fund (IMF) defined and carried out its mandate has evolved considerably since 1944, when it was founded to serve a vital but narrow function in maintaining the global foreign exchange system and thus enabling international trade. This note gives an overview of the IMF's evolution by describing key phases in its history, including the Bretton Woods system and its collapse, the international debt crisis of the 1980s, the Washington Consensus era, and reform efforts in the 2000s.

This case describes barriers to adoption of malaria rapid diagnostic tests in Zambia and highlights the importance of understanding end users in promoting product adoption. Rapid diagnostic tests (RDTs) are simple, easy-to-use tools that provide a relatively reliable, inexpensive way to confirm diagnoses of malaria. In addition to ensuring that patients' febrile illnesses are properly diagnosed and treated, confirming malaria diagnoses has broader public health benefits, including promoting the efficient use of limited malaria medications and preventing increased resistance to first-line malaria treatment. However, despite the evident potential benefits of RDTs, many clinicians in Zambia do not use them or simply ignore their results. Why don't they trust these tools, and what can be done to improve adoption? Various barriers to uptake and methods to overcome these challenges are explored, with broad implications for technology adoption and health policy. A particular emphasis is placed on the role of behavioral preferences.

For Asian Agri and other Indonesian palm oil producers, the future promised rising demand from fast-growing Asian populations, but also intensifying criticism from environmental groups. With the highest yield and lowest production cost of any edible oil, palm oil constituted an abundant, inexpensive source of food for Asian and, to a lesser extent, international markets. Its production had soared from 1970 to 2010, sparking concern from environmentalists over the conversion of high-value conservation land in Malaysia and Indonesia (where nearly 90% of palm oil was produced) into palm oil plantations. Critics had intensified their campaigns in recent years, urging-at times successfully-packaged food makers and investors to boycott palm oil suppliers accused of environmental mismanagement. While noting that some accusations were unjustified, palm oil producers argued the industry was making strides towards greater sustainability and cited the unique advantages of palm oil: it was free of unhealthy trans fats, for example, and required less land to produce more oil than any known substitute. Asian Agri, an established Indonesian palm oil grower and exporter, had thus far avoided public scrutiny. The company was a key source of employment in many rural communities, had extensive experience negotiating the complex Indonesian regulatory environment, and was moving to certify its operations according to industry-set sustainability guidelines. In 2010, Asian Agri appeared well positioned to capitalize on the growing palm oil market, but the broad-strokes vilification of the palm oil industry was a source of serious concern. In the face of great uncertainty, the management team needed to devise a strategy for the future.

Kent Thiry, CEO of dialysis provider DaVita, is considering how to integrate employees from recently acquired Gambro Healthcare without damaging DaVita's robust, unconventional internal culture. When Thiry joined DaVita in 1999, breaking an important promise to his family in order to do so, he was determined to create a differentiated company with a community-like culture. Over six years, he had engineered an impressive financial turnaround and successfully developed the strong culture he had envisioned. In late 2004, DaVita acquired arch-rival Gambro Healthcare, whose 12,000 employees would nearly double DaVita in size once the integration is completed in fall 2005. Confident that the deal makes business sense but worried about potential adverse impacts of the integration-especially in light of rumors that Gambro employees are suspicious of Thiry's authenticity and critical of DaVita's arguably eccentric culture-Thiry is considering whether to impose DaVita's culture on the new arrivals, or just allow Gambro to operate independently for a period of time.

This Case describes a controversial 2010 decision by the International Criminal Court (ICC) and alludes to some of the broader challenges of building international institutions. The case briefly highlights certain milestones in international relations preceding the ICC's formation; provides an overview of the ICC and its activities as of March 2010; and outlines Kenya's post-election crisis in 2007-2008 and the ICC's decision to intervene. The ICC's involvement was a divisive issue: some argued it would destabilize Kenya, while others claimed it was an important step towards lasting peace. The Kenya scenario presents many aspects for consideration, including the wisdom of the ICC's involvement (given the complex historical, economic, and cultural issues underlying the 2007-2008 crisis), as well as the likelihood that Kenyan officials will cooperate with the ICC. Students can also weigh the broader implications for the ICC as it seeks to establish itself as a legitimate, fair, and just institution.

This case examines the various considerations relevant to selecting and compensating workers in a context where their work involves a pro-social component. This is relevant to not only health care in Zambia, but to NGO and public sector workers who are both motivated by the mission of their positions and the remuneration. Zambia was facing a healthcare human resource crisis with less than half of the healthcare workers needed to meet health needs. Yet, it was simultaneously burdened by high incidence of diseases such as HIV/AIDS, TB, malaria, malnutrition, and respiratory and diarrheal diseases. The Zambian Ministry of Health (MoH) realized that in the short term, it would be impossible to train the number of doctors and nurses needed to fill this gap. Thus, they were considering incorporating the primarily volunteer community health worker (CHW) force into salaried health workers of the MoH. Given the high level of personal commitment and dedication combined with the proper education and skill needed to be an effective community health worker, the MoH was struggling to identify the best strategy to recruit and retain motivated and capable CHWs.

To grow Phirbol, a telecom retail franchise chain in Delhi, India's underdeveloped markets, its founders were exploring ways to offer more value to the franchisees. In mid-2009, the Phirbol franchise was comprised of some 150 franchisees that had converted their small "mom-and-pop" shops into Phirbol-branded stores. Entrepreneurs Meghna Modi and Glenn Wong had launched the franchise in 2007, two years after they founded Go Mobile, a company-owned mobile retail chain. While Go Mobile stores were located in higher-income neighborhoods and focused primarily on selling phone handsets, Phirbol stores could be found in less-developed areas-most were not accessible by car-and focused on selling service connections (SIM cards) and recharges. Phirbol added value to the franchisees by streamlining some of their business processes, offering them a consistent product supply, sales support and incentives, and providing them with education on the constantly changing dynamics of India's mobile market. But as the founders looked towards expanding, they knew they would have to enhance their offering to franchisees in order to recruit some of the more established "mom-and-pop" stores they planned to target as franchisees. In addition, they would need to adjust their business model such that more responsibility was delegated to franchisees and staff. Looking forward, what should Modi and Wong do to ensure Phirbol's success?