What They Are Saying...
Billanthropy: Good or Bad?
A column devoted to what our partners and others in the field of foreign assistance are saying about development
By Matthew Bishop and Michael Green
Matthew Bishop and Michael Green are the authors of Philanthrocapitalism: How the Rich Can Save the World. They blog at: www.philanthrocapitalism.net. A longer
version of this article appeared in the April edition of Developments, the quarterly magazine of Britain’s Department for International Development, and is
reprinted with the authors’ permission. |
Is Bill Gates threatening to dominate global health the way Microsoft once monstered
the computer industry, and would it be such a bad thing if he did?
Having stepped down from Microsoft in the middle of 2008, Gates is now giving most of his time, as well as the $30 billion or more that he has donated to the Bill & Melinda Gates Foundation, to doing good, with a particular focus on eradicating infectious
diseases in the developing
world.
In doing so he has become the de facto leader of a remarkable new movement among rich business people who are dedicating their wealth and business skills to solving some of the world’s most intractable problems.
We call this new movement “philanthrocapitalism.” Our interviews with many philanthrocapitalists
have convinced us that, despite the current economic crisis, they mean business and are becoming a genuine force for good.
For rich people to play such a prominent role in tackling society’s problems
makes many people uncomfortable—Gates’s generosity
has made him a controversial figure to some veterans in the fields of global health and development.
Nevertheless, we believe that it is crucial that everyone from governments to non-governmental
organizations [NGOs] to multinational businesses finds a way to partner effectively with them, so that philanthrocapitalism
can achieve its full potential. Gates’s campaign against malaria shows why.
The problem with malaria is clear, according to Gates. The vaccines and medicines to treat these ailments don’t exist simply because the people who suffer and die from them can’t afford to pay for them, and therefore no one invests in the research and development of these drugs. “How many people work on, say, brownie mix? How many people work on a soft drink?” he complains, to illustrate the point. “Go get 0.1 percent of the scientists working on erectile dysfunction to come and work on malaria and you will be making
a huge contribution.”
The Bill & Melinda Gates Foundation (Gates stresses that his wife is an equal partner) is already starting to turn around the battle against malaria. One thing he brings from his business success is a belief that ambitious goals can be set and achieved. Malaria, for instance, used to be classified as a neglected disease because of the lack of money going into research to find a vaccine or a cure. But last September, Malaria No More—a coalition of governments,
multilateral agencies, NGOs, celebrities, and companies,
catalyzed by the Gates Foundation—pledged $3 billion to reduce deaths from malaria to near zero by 2015, from over 1 million a year now.
Gates’s interest in global health issues goes back to 1993 when he was shocked to discover that millions of people were suffering from diseases that the world had the technology to prevent or cure. He started giving his money away and lobbying
others so that, before long, he says, “People would see me at cocktail parties and wonder ‘is he going to come up and talk to me about TB?’ I was the Tuberculosis Guy.”
Since then Gates’s portfolio of investments in fighting killer diseases has diversified. But, talking to Gates, it soon becomes clear that, for all his vast wealth, he knows that he cannot achieve his ambitious goals on his own. “We’re a tiny, tiny little organization,”
he told us.
As a result, he has become increasingly keen on leveraging
governments to do more to tackle killer diseases. In 2000 he launched the Global Alliance for Vaccines and Immunization (GAVI), supported with $750 million of his own money, to boost aid spending to prevent deaths from communicable diseases. By getting children in developing countries vaccinated, GAVI claims to have already saved more than 3 million lives.
Yet Gates realized that by putting
so much of his own money in up front, he had let governments
off the hook. So when he launched the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2002, he made sure that his donation was contingent
on others chipping in, too. Catalyzing partnerships, with governments and also non-profits,
businesses, and other philanthropists,
is now a core part of the Gates strategy, to ensure that his bucks generate a real bang.
Billanthropy is not without its critics, however. Health professionals have repeatedly claimed that Gates’s interest in technological solutions focuses on particular diseases rather than building up the health systems of developing countries….
Patti Stonesifer, a Microsoft veteran and chief executive of the foundation until last year, acknowledges that the criticism has some validity. “We expected to concentrate on developing drugs and so on,” she says. “We were a bunch of product development-
development people! We assumed that others would focus on getting the products out there.”
Gates says he “gets” the need for health systems. “Just pure sanitation is a huge thing,” he explains. “If you look at the dramatic improvement in infant mortality in the United States, it’s not when antibiotics come along; it’s when toilets and tennis
shoes come along.”…
Critics also worry about Gates’s legitimacy: when he is negotiating with governments, who chose him for this position
of power? If he does the wrong thing, to whom is he accountable?…
The most significant criticism
of the Gates Foundation is that it has grown too big and too dominant in the global health sphere (much like Microsoft did in the personal computing business,
mutter the critics)….WHO’s then malaria czar Arata Kochi said that “a lot of money leads to monopoly, and discourages smaller rivals and intellectual competition.” According to Kochi and other critics, older foundations are being crowded out of the business because there’s no point in putting your money into a problem that is soon to be drowning in Gates’s dollars. No one can speak up against this new Gates “groupthink,” they say, because everyone has grown dependent on his money….
Gates said: “We need to be clear about what we want to take the lead on and where we are happy to be supportive.” He has given $105 million to the University of Washington to provide independent analysis
of all the work going on in global health, including that of his foundation.
Gates has also…called on governments to honor their pledges of increased international
aid that they made at the G8 in 2005…. Gates is leading by example: he is increasing the foundation’s giving in 2009 by over 10 percent to $3.8 billion—the most that any foundation has ever given in one year.
★
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