[Ip-health] Dark side of giving: The rise of philanthro-capitalism
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Fri Mar 25 23:49:23 PDT 2011
Dark side of giving: The rise of philanthro-capitalism
Economic times, 25 MAR, 2011, 08.16AM IST, NAREN KARUNAKARAN,ET BUREAU
A few years ago, Paul Kagame, president of Rwanda, had a chance meeting with Som Pal, former member of the Planning Commission and earlier minister of state for agriculture, and was bowled over by his sage-like views on developmental issues. The president promptly invited Som Pal to his blighted country to suggest policy measures to get out of a developmental quagmire. Som Pal travelled to Rwanda; he was hosted at the presidential palace and allocated an entire office during two long stints.
Rwanda was sitting on a food security crisis in spite of having fertile land and favourable climatic conditions. "A set of policy guidelines and an action plan were quickly crafted. I held out a promise to Kagame - Rwanda could be food surplus in a short time," recalls Som Pal.
His plans were, however, rendered futile, as a hostile system overwhelmed him, even attempting to buy water hand-pumps at $12,500 apiece. "Most African leaders are only keen on projecting the agony of their people for international support in dollars," laments Som Pal. "A complete nexus between institutions, large corporations and narrow, vested interests are at work." Elements of this trend can be seen in India too.
Since then, Som Pal has had several brushes with Kenya and Zambia too; the story runs along similar lines. How then would he evaluate the much celebrated Alliance for a Green Revolution in Africa (AGRA) - an initiative driven by the Rockefeller Foundation and the Bill & Melinda Gates Foundation, the oldest and the largest philanthropic repositories, respectively, in the world? The Gates Foundation alone has committed $264.5 million to AGRA.
"They are using the pitiable condition of the African people to get a foothold into the continent," explains Som Pal. "Their large philanthropic resources are being utilised to further the interests of business." In countries with weak governance mechanisms, like in Africa, it becomes a lot easier.
Proponents of chemical-free and GMO-free (genetically modified organisms), sustainable agricultural practices like Som Pal are beginning to feel uncomfortable about AGRA and a host of big-ticket philanthropic initiatives across developing countries. As are an increasing number of independent policy wonks and scientists across the world.
For instance, the Gates Foundation's sheer clout is taking it, intentionally or unintentionally, to places where policy, business and philanthropy intersect. There are its business and investment links with large companies that are driven by the profit motive. There is its growing stranglehold in the policy-making space across emerging markets, especially in education, healthcare and agriculture.
The $23.1-million investment by the Gates Foundation in Monsanto, the world's largest producer of GM seeds, is a small example of a trend.
Civil society organisations see it as vindication of what they had always suspected: the unstated agenda of pushing GM crops into Africa. In recent times, though, following strident protests, Bill Gates appears to have tempered his views on agriculture; he talks about picking the best from organics and tech-driven agriculture.
The Gates Foundation's insistence that its investments and grants ought to be seen separately has also attracted considerable flak. The question is asked: how can it be a 'passive investor' in companies such as Monsanto when its avowed goal is doing good with philanthropic monies? "Doubts about his (Bill Gates) larger motives, despite some good outcomes of his charity, are beginning to cloud my thinking," concedes Mira Shiva, a public health activist. Two emails sent by ET to the Gates Foundation, on December 29 and March 22, went unanswered.
In his blog postings and writings, Eric Holt-Gimenez, director of the US-based Food First: Institute for Food and Development Policy, labels it 'Monsanto in Gates' clothing'.
He describes how AGRA, as a prelude to the introduction of GMOs, is laying the ground for a conventional breeding programme - labs, experiment stations, agronomists, extensionists, biologists and farmer seeds. He points out that about 80% of the Gates Foundation's allocation to Kenya has gone into biotech research; in 2008, about 30% of its agri-development funds went into promoting and developing GM seeds.
GRAIN, an international non-profit that supports community-controlled and biodiversity-based food systems, has been wary of public-private coalitions like AGRA and the Consultative Group on International Agricultural Research (CGIAR).
It says their research programmes feed into the growth strategies of corporations; further, the programmes often adopt elements of business models of those very companies. Delhi-based Shalini Bhutani, till recently representing GRAIN, sees a design in the Gates Foundation's announcement of the Borlaug Institute for South Asia in Bihar, following a recent visit by Bill Gates. "The involvement of this set of players in the promotion of GM
rice is too well known," she says. AGRA, it is often charged, has been created with little civil society or farmer engagement. Protests are now breaking out across the continent. The Kenya Biodiversity Coalition, with a membership of 65 civil society and farmer organisations, tried to block the import of a 40,000 tonne consignment of GM maize into the country last year.
Food First is concerned that US agencies, acting in tandem with MNCs, are gaining muscle by the day. The Casey-Lugar Global Food Security Act - a legislation that seeks to tie foreign aid to GMOs - is often cited. Or, that the newly appointed head of USAID is a former Gates Foundation employee.
A set of powerful voices - in business and in philanthropy - are beginning to talk of a new GM-led green revolution despite the ravages of the previous green revolution techniques, which were grounded in similar principles, in India. In the Punjab, Haryana and western UP belt, soils are degraded, and yields and groundwater levels are plunging, causing deep socio-economic challenges.
The onslaught continues despite numerous studies indicating that GM crops are no panacea. A few years ago, the International Assessment of Agricultural Knowledge, Science and Technology for Development (IAASTD) - a multi-stakeholder consultation that lasted three years, and involved 900 experts from 110 countries - concluded GM crops are no solution to the world's food security challenges.
Second Only to the US
Concerns aired by agriculturists are finding an echo in another arena in which philanthropic capital, in recent years, has catalysed remarkable progress: healthcare.
It has delivered results in access to medicines, research in neglected and tropical diseases, development and distribution of vaccines to low-income countries, maternal, neonatal and child health, and nutrition.
The Gates Foundation and its partners have re-invigorated health issues and given them a global profile like never before. Since 1994, the foundation has invested over $13 billion in healthcare alone, representing 60% of its giving to date.
In public health, other than the US government, there is no donor as influential as the Gates Foundation. It has emerged as the second largest donor to the World Health Organisation (WHO). This can be seen both ways: donor money has infused life into a nearly bankrupt entity, but it is also causing much consternation.
Effects of the structural changes being pushed by the new interests will be seen years or decades down the line.
"The very mandate and constitution of the WHO is being undermined," says KM Gopakumar, legal advisor and senior researcher of the Third World Network in India.
Speaking to the media in Bangalore this week, Warren Buffett, who has committed most of his $50 billion wealth to the Gates Foundation, admitted it takes a long time to see the full results of philanthropic work.
While it is conceded that it would be downright impudent to look a gift horse in the mouth, the concentration of power in the hands of new philanthro-capitalists is causing alarm; especially on issues around equity and social justice, on the accountability of donors and its impact, maybe unintended, on global institutions and processes.
"The rapid demise of public sector policy-making in key areas of public health, and the reliance on the Gates family and its staff, is impoverishing debate over public health priorities," says James Love, director, Knowledge Economy International (KEI), a US-based not-for-profit that seeks better outcomes to the management of knowledge resources. It is borne out by occasional outbursts from people within the system.
Concentration of Power
Some time ago, the head of WHO's malaria research revealed that the increasing dominance of the Gates Foundation was stifling diversity of views among scientists and that it could seriously impede the policy-making function of the world body. He was dismayed by the foundation's decision-making process: "A closed, internal process.accountable to none other than itself".
More recently, in January 2011, the Peoples Health Movement, a grassroots campaign for health for all, wrote to members of the WHO's executive board, calling attention to a number of issues. This included innovation, intellectual property rights (IPR), millennium development goals, and also the future of financing WHO, especially the unhealthy trend of donor money increasing in proportion to that of contributions from member states.
WHO's recent over-reliance on medicines, diagnostics and other technological fixes is being criticised. "Allocations to the social determinants of health have shrunk greatly," says Mira Shiva. "Water, food, sanitation and other social circumstances have a greater play on the health of the poor." Shiva has been an ardent proponent for the rational use of medicines.
In contrast, a humungous push on vaccines is underway. The Gates Foundation, for example, has allocated $10 billion to this field and describes this as the decade of vaccines. However, the GAVI Alliance, and some of the mechanisms it has fostered, is now under fire.
One such mechanism is the Advance Market Commitments (AMC), inspired and supported by the Gates Foundation. The AMC seeks to provide pharma companies a captive market for 10 years, provided they agree to develop and supply vaccines to developing countries, in millions of doses, at a deep discount.
The pilot AMC of $1.5 billion, funded by the Gates Foundation and G7 countries, for pneumococcal diseases, which kills almost a million children annually, pays $3.50 per dose to the companies in the mechanism (GlaxoSmithKline and Pfizer-Wyeth, among others). Recipient countries make a small co-payment. However, instead of developing new vaccines, the AMC brought in vaccines already developed by big pharma, for which costs had been recovered substantially from sales in western markets.
Donald W Light, a distinguished academic and visiting professor at Stanford University, was part of the AMC process, but found himself out of it when his views crossed that of big pharma. Light often dubs it the "advance procurement commitment" for its overwhelming bias towards big pharma and profits. "GAVI is basically setting the markets for big pharma," says Leena Menghaney, campaign co-ordinator (India), Medecins Sans Frontieres (MSF), a medical humanitarian organisation that won the Nobel Peace Prize in 1999.
The GAVI Alliance is already in a deep funding crisis. It is expected to scour for $4.1 billion this year, primarily because of action skewed in favour of big pharma. "Leaders of donor nations and GAVI board members should sit with the chairman of Pfizer
and GSK to negotiate a new price near $2," says Light. "In the longer run, they should negotiate licensing, technology transfer and other ways to foster price-competition from other low-cost producers."
The suggestion is indeed relevant for the AMC, which disregards the immense potential of small pharma companies in developing countries to bring cheaper vaccines to the world. The Pune-based Serum Institute of India participates in the AMC, but when it requested funding support during its R&D process for a vaccine, it was turned down. Light is in favour of companies in the Serum Institute mould.
The Gates influence and stranglehold on global institutions and mechanisms in healthcare are quite evident. It doesn't stop here. Numerous proposals for a 'Medical R&D Treaty' as a more egalitarian alternative to the existing one, which links R&D costs to product prices, has been systematically snuffed out.
The treaty seeks to place global, and country-specific obligations, on funding medical R&D. Each country is expected to extend support on the basis of its national income. "It's regrettable that the Gates Foundation opposes discussions at the WHO on a possible treaty on medical R&D," says James Love. "An initiative that can create new global sustainability standards, promote access to knowledge, and usher much-needed transparency and ethical norms." At a press conference in New Delhi on Wednesday, Gates said: "I don't know about this treaty. I don't have a position on this."
Interestingly, while large organisations such as the WHO bare a tendency to capitulate easily to pressure, smaller, newer outfits show more spunk. The Drugs for Neglected Diseases Initiative (DNDi), a product development partnership, which also seeks funds from the Gates Foundation, has clear firewalls in place.
"We limit funds from a single donor to not more than 25% of our total requirement," says Bernard Pecoul, executive director, DNDi, which is seeking to raise euro 274 million by 2014. The Gates Foundation has committed around $40 million to DNDi. It demanded a board position, but DNDi refused.
But such instances of refusing to bow to big philanthropy are rare. "It's a crisis of accountability today," says Shiva. "It's no more accountability of corporations or philanthropists alone; the government too has a lot to answer."
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