[Ip-health] Does the Gates Foundation do more harm than good?

Thiru Balasubramaniam thiru at keionline.org
Wed Dec 16 22:24:26 PST 2015

Caitlin Chandler reviews Linsey McGoey's "No such thing as a free gift: the
Gates Foundation and the price of philanthropy."



Does the Gates Foundation do more harm than good?

December 16, 2015

In July 2010, I attended the International AIDS Conference in Vienna,
Austria. Representatives of the Gates Foundation’s HIV team set-up shop
inside the venue with a private conference room. For those of us working
for civil society organizations, a meeting with the Gates Foundation was
highly coveted yet illusive – you had to know someone who knew someone. A
friend secured an appointment and labored for days over how, in her five
minute allotted slot, she could present her nonprofit. I waited for her
anxiously outside the venue, knowing this was a make or break meeting for
her small organization, which seeded activism around HIV and human rights
worldwide. “How did it go?,” I asked when she emerged. “No idea,” she
replied. “They asked me what our competitive advantage was; I don’t think
they understood what we actually do.”

In a new book, No Such Thing as a Free Gift: The Gates Foundation and the
Price of Philanthropy, the sociologist Linsey McGoey traces the evolution
of private philanthropy’s ‘father knows best’ approach to giving. As McGoey
explains, foundations used to have a hands off approach to their grantees,
with the understanding that those working closely on social issues best
understood how to affect change. Now, most foundations are intimately
involved in trying to shape their grantees’ methods, including the Gates
Foundation.  “The question is whether the practices associated with the new
philanthropy – such as tighter control of grantee decision-making; a demand
for swifter indicators of project success – might be stifling ingenuity and
progress rather than engendering it.”

The first half of the book approaches philanthropy from both a
philosophical and historical perspective, questioning the power imbalance
implicit in giving and charity, then interrogating the rise of foundations
in the U.S. McGoey reveals that the new religion of ‘philanthrocapitalism’
– applying business models to giving – is nothing new. What is different
though is the scale of private giving and the power philanthropists now
wield over governments. The second half of the book focuses on the Gates
Foundation in particular because of their endowment and the lack of
independent analysis about their impact.

McGoey reviews available literature and conducts interviews around three of
the Gates Foundation’s major areas of investment – education in the U.S.,
global health and agriculture –to paint a loose picture of the Foundation’s
portfolio and highlight areas where the Foundation’s performance needs
independent appraisal (less time is devoted to the Foundation’s successes,
although some are briefly mentioned). She questions whether Bill Gates’s
methods are in line with his aims – for example, the Foundation wants to
end AIDS, yet also believes in upholding the intellectual property regimes
of pharmaceutical companies which then prevents access to affordable HIV
treatment for millions of people.

When you have as much money as the Gates Foundation, it turns out you can
buy your way into some pretty powerful places – Bill and Melinda Gates
regularly advise world leaders on everything from global warming to family
planning, despite having no prior background on these issues. They are also
essentially unaccountable, reporting only to their trustees – themselves,
plus Warren Buffett. McGoey wants us to understand the danger in having
private individuals, no matter how good their intentions are, influencing
policy decisions. (In a recent interview, Melinda Gatesdefended her new
role as a self-appointed global ambassador for women’s issues. “I
considered other women leaders. But I couldn’t find the one who embodied to
me the voice of women around the world. And so I thought, ‘If I’m the one,
then I just need to do it. I have to have courage and not worry.”)

In addition, McGoey raises critical questions about how the Gates
Foundation approaches its work. An emphasis on human rights has long been
noticeably absent from the Gates Foundation’s methods; one of the most
alarming examples in the book concerns the Gates Foundation’s support for
HPV trials in India. The Gates Foundation funded PATH – a Seattle based
health and technology organization that it frequently partners with – to
conduct the HPV trials on thousands of girls aged 10-14 in Gujarat and
Andhra Pradesh, India. The Indian government halted the trials mid-way
through over concerns of improper conduct – turns out PATH had violated a
number of ethical protocols, like not getting witness signatures on consent
forms and not providing health insurance to the girls during the trial. The
Gates Foundation press office told McGoey it was a problem of
misinformation and that she should speak to PATH (but they did not respond
to her inquiries).

McGoey’s book does not attempt to thoroughly assess the full impact of
Gates’s giving. Rather, it lays out a blueprint for future work that is
urgently needed to answer a set of interrelated questions: what are the
harms caused by the Gates Foundation and what are the true benefits? And
can the Gates Foundation ever achieve its lofty aims without first
admitting its own role in perpetuating structural inequality and then
investing in political organizing to overturn it?

Recently, one of the Gates Foundation’s fellow philanthropic institutions,
the Ford Foundation, announced after some soul searching a major shift in
its strategic direction: Ford will now do everything possible to address
economic inequality. It remains to be seen how this vision will play out in
funding decisions, but on the surface it is an interesting move from a
Foundation that used to be a champion of the business approach to
philanthropy. Wrote Ford Foundation President Darren Walker in an e-letter
earlier this year,

We foundations need to reject inherited, assumed, paternalist instincts—an
impulse to put grant-making rather than change making at the center of our
worldview… we need to interrogate the fundamental root causes of
inequality, even, and especially, when it means that we ourselves will be

So, what could the Gates Foundation do differently? It could start by
engaging publicly and reflectively on the questions asked in McGoey’s book.
Bill Gates was just in Paris for the climate change negotiations, where he
told French President Francis Hollande what heads of state should do
differently and launched a new fund. Outside the nexus of power, people who
have worked on climate change for decades protested around the world before
and after the summit because they want more than investing in companies to
solve climate change, they want climate justice. Sometime, it would be nice
to see Bill and Melinda out there on the streets marching, learning from
people who are not just the recipients of programs or in thrall to their
millions but politically organized, already aware of appropriate solutions
for their communities. Bill and Melinda just might learn something.

*No such thing as a free gift: the Gates Foundation and the price of
philanthropy(2015) by Linsey McGoey is published by Verso Books.

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