My term paper for my global health governance course looks at the power of the Gates Foundation. ‘King Bill’ because Gates is the most powerful man in global health and is accountable to nobody but himself. ‘Magic’ because it focuses on breakthrough ‘magic bullet’ technical solutions.
As global philanthropic funds rise, see, e.g. the Billionaire’s Giving Club, understanding the power of organisations like Gates’ becomes increasingly important for maintaining an accurate picture of global governance.
The argument goes like this:
- The foundation sets the global health agenda through providing vast research funds and its media and PR projects.
- It deliberately uses its funds in attempt to ‘leverage’ greater funds from governments.
- It relentlessly pursues technological solutions to health problems, such as vaccines, while not attending to the social determinants of health, such as infrastructure and staffing problems.
Other criticisms are discussed in the paper, but the main ‘governance’ point is that the foundation’s great power is wielded ultimately by a board of just three people: Bill, Melinda and William Gates Sr. They are accountable only to their consciences. It’s operating like a global public body in which the global public get no say in what it does.
This paper didn’t have space to examine the efforts that the Foundation is making to be more transparent. The efforts of the Gateses to join twitter and blog / curate, may demonstrate a willingness for openness. And clearly they are well intentioned. But that’s not always enough.
Accountability and legitimacy – to the people they aim to help, to the elected governments whose policies they influence, to the global public whose media they sponsor – are still severely lacking.
flickr credit: LesterPublicLibrary