Living with the Gates Foundation

Alliance magazine, September 2011

Raise the issue of the Bill and Melinda Gates Foundation and, as Michael Alberg-Seberich from Active Philanthropy succinctly puts it: “People are impressed with the donor, they see the strategic work, but they find the size of the organisation tremendous and wonder about issues of power”.

In the September 2011 edition of Alliance magazine, editor Caroline Hartnell, ran a special focus on ‘Living with the Gates Foundation’.  Controversially the cover of the magazine showed a picture of a big gorilla, which was reprinted later in the magazine as a very direct reference to the Bill and Melinda Gates Foundation.

This series of articles – many of which were provocative – included titles such as:

  • ‘Gates: a benevolent dictator for public health?’
  • ‘How much difference it is making?’
  • ‘Private actors in the public arena’
  • ‘Inspiring, off-putting or irrelevant?’
  • ‘How do other donors see Gates?’

In addition to these articles, the magazine included an interview with Jeff Raikes, CEO of the Bill and Melinda Gates Foundation.

In one way or another, all the articles dealt with the issues of power, influence and accountability – and not just of the Gates Foundation, but of philanthropy in general. Importantly, and unusually, these articles air a variety of quite different opinions and concerns.

The most common criticism of the Gates Foundation is that, given its vast resources, it doesn’t fund ‘X’.  As Timony Ogden, Editor in Chief of Philanthropy Action, points out: “the root of that unhelpful critique is to be found in the fact that the foundation actually followed the general advice given everywhere to new philanthropists and foundations:  find a focus”.

Richard Horton, the editor of the Lancet, cautions that while the Gates Foundation has the right to spend its money how it wishes, because of the size of the foundation, it has the potential to distort the research field and government priorities. Richard worries that Bill Gates’ singular belief in technology to change people’s lives over simplifies the solutions to many of society’s problems. Horton says that social and behavioural issues are not amenable to single technological solutions require much more subtle and complex interventions.

On the other hand, Amanda Glassman, Director of the Global Health Policy Program at the Centre for Global Development, is not concerned that the Gates Foundation’s single-minded investments may squeeze out diversity in both approaches to problems like vaccination and in attention to other areas. “For me,” she says, “vaccination is the quintessential public health intervention. If we can’t get that right, we probably shouldn’t be doing other things.”

Laura Freschi, New York University Development Research Institute in USA and Alanna Shaikh, a global health consultant based in Dushanbe, Tajikistan, state that the Gates Foundation has been able to achieve a great deal in public health in a short time precisely because it is unencumbered by many of the typical constraints of the aid bureaucracies. They argue it has been a valuable catalyst to a slow-moving community. They point out that another clear strength of the Gates Foundation is its willingness to fund programs that others can’t or won’t.

However, they are also concerned with its power, influence and accountability. They highlight that, currently, the foundation is ultimately accountable for its success or failure only to the four decision-makers on its board.

They conclude that: “For now, we know that Gates had done a lot of good in revitalising public health, and there’s no conclusive evidence that they’ve done any harm. But in a possible future where a significant majority of voices involved with public health either receive Gates money or would like to, how will we know?”

Indeed who will be able to offer objective feedback on its goals, practices and impact?

For many, particularly the Europeans, the issue of public benefit is crucial.

Luc Tayart de Borms, King Baudouin Foundation in Belgium, asks: “is the money being spent for public benefit and is it in partnership with governments or imposing on them?” This, he felt, was especially important in a developing country where partners may be weaker.

On a similar theme, Megan Tompkins from the Gerald R. Ford School of Public Policy at the University of Michigan in the USA, posits that possibly the greatest impact the Gates Foundation will have is fostering a debate on appropriate policy for foundations in a democratic society.

In answer to these concerns, Jeff Raikes says: “Philanthropy has entered the public consciousness in new ways that means it is also open to public scrutiny. One should not take it on faith that critics and honest feedback will automatically emerge. But in the days of social media, it is easier for ideas to find a voice and travel across continents in seconds.”

Edward Skloot, Duke University’s Center for Strategic Philanthropy and Civil Society notes that: “Whatever one’s view of its operation, it is clear that the Gates Foundation is absolutely unique – a spectacularly wealthy organisation of talented, determined and proactive individuals, energetically pursing a vast, progressive social-change mission. It has pushed well past the boundaries of traditional foundation behaviour, intervening in and influencing public policy on both domestic and international matters – for good or ill, or very likely for a mixture of both. It is like no other foundation seen since the emergence of modern philanthropy a century ago, and its behaviour will have consequences that will be felt for years to come.”

For my part, I believe that the most significant effect of the Bill and Melinda Gates Foundation is that it has substantially increased the visibility of philanthropy. Through initiatives such as the Giving Pledge and its promotion world-wide, it has created interest and raised the expectations of citizens of all societies of the wealthy to contribute.

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