The WSJ blogs posted yesterday about Patty Stonesifer stepping down as Gates Foundation CEO. They note that giving away $3 billion a year is a lot tougher than it sounds. That is certainly true. The post didn’t give contact information for those hoping to apply. But I highly recommend giving the comments a look.
The Economist commented this week on the recent controversies over the Gates Foundation’s global health work. The most recent example of this controversy was when the head of the WHO malaria program asserted that Gates is becoming a monopoly and driving inappropriate research in malaria.
Our Economist correspondent defends the Gates Foundation. In doing so, he (because all Economist correspondents are male, right?) points out that Gates competes with other major donors like the US Government and the Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria (GFATM). He also believe that Gates has the resources to fund comprehensive programs, and therefore the worry that their influence will limit a diversity of work is unfounded.
Ultimately, the Economist believes that the distrust of Gates is based in jealousy from smaller organizations, like the WHO. The presumption is that the UN wants to be the monopoly on policy, and that they are just being catty to resent the status that Gates now has.
There’s definitely something to that, but I think the WHO would say that it has the right to its special influence. It gains its authority from the General Assembly and is answerable to them. The Gates Foundation is answerable to Bill, Melinda, and Bill’s Dad (also named Bill). Isn’t that an important difference?
UN agencies are certainly hampered by their need to work within the demands of member states (sometimes being forced to publish only “official” data, for example), but there is also a value to their semi-insider status. Because they speak for the international community, the UN speaks with authority in the developing world and is able to influence policy in a positive way. It is worth preserving that influence.
In closing, the Economist has this to say, and I think says it very well:
“A big new non-government organisation, crashing into the jungle like a young elephant, is bound to cause resentment, and perhaps bound to have unintended ripple effects. But without this elephant’s input of new money and ideas, the battle-front against malaria and other deadly diseases might present an even worse picture, especially if the field were left to governments and inter-governmental bodies.”
The fiesty WHO malaria chief, Dr. Arata Kochi, thinks that the Gates Foundation’s $1.2 billion supporting for malaria research gives them too much influence over the field. He believes that it is now becoming difficult to find non-biased scientists to peer review research, and that the Foundation using its weight to to ensure that research from its scientists is put into policy instead of letting the best research win.
Dr. Kochi is apparently known for being undiplomatic, and this could easily just be a turf war - he might simply be worried that the WHO will lose some of its clout as the health policy arbiter for the world. But that doesn’t mean he’s necessarily wrong, either. It’s definitely something to watch.
This online Op/Ed by David Dickson originally comes from scidev.net, but I found it on an interesting blog called Gates Keepers. It keeps an unbiased eye on the Gates Foundation, as is worth a read if you have interest in what Gates is up to.
The Op/Ed makes a sound argument that the Gates contribution is welcome, but that they shouldn’t become so dominant that they completely drive the development agenda. Among his reasons I am particularly drawn to the critique that Gates seems drawn to technical fixes, and the belief that science can solve all of our problems. Science can do a lot, and a good deal more research is needed in a lot of areas. But there continues to be a need for the less exciting long-term work like education.
Even as a I say this, though, I wonder if Dr. Dickson and I are just shouting to stop the sun from coming up. Gates and Google are in the development field now, and they will bring their technology/business perspective with them. There isn’t anything we can do about it. But I also think that there may be something good in this change (in addition to the money).
As business people and computer guys they are used to problems that can be solved, and seem to be treating development in the same way. That’s a pretty radical departure from the way we normally think about development - as a situation to be improved, not fixed. I still think that Dr. Dickson and I are right and not all problems have solutions, but it is going to be fun working with the newcomers and their frame of mind.
The Gates Foundation got some more insults today. It’s a little depressing that something as fundamentally positive as the world’s richest man giving away billions of dollars to benefit the world’s poor gets so much negative press and so little positive. All the positive articles I turn up for Gates Foundation are obvious press releases, and therefore not all that interesting to read. It isn’t that I think the world has it out for Gates, but I do think that it is somehow more fun to point out the negative.
The criticism this time has to do with a series of public service announcements that Gates supported to raise awareness of HIV in China. The entire campaign is under the slogan, “Life is Too Good”. One of the PSAs features Jackie Chan. It is a good ad, from an entertainment perspective. It features a well-choreographed fight seen and some nice camera work. Unfortunately, this analysis in the Guardian has got a really good point on the PSA’s effectiveness - or lack thereof. The ad doesn’t give the viewer any information on the threat or tell them what they can do to protect themselves. Instead it just gives a vague rallying cry.
To be fair to Gates, Chan, and UNAIDS (who were also involved in making and distributing the campaign), I can’t imagine that it is easy to get Chinese government approval for an HIV awareness campaign. They have been very timid about their HIV problems for a long time. I have some experience working on this issue in other tightly-controlled media environments, and believe that there is a value in putting out a vague ad, if only for the implicit message that the central government now approves public discussion of HIV. By airing these ads, they may be making it clear to provincial health officials, doctors, and school principals that HIV is an issue they are allowed to deal with. It still isn’t an optimal use of HIV prevention money, but I don’t think it was a waste of money either.
Here’s a pro-Gates perspective in the Herald Sun, an Australian morning tabloid owned by News Corp.
Pranay Gupte isn’t so impressed with Bill Gates’s “creative capitalism. He rightly points out that Gates isn’t being quite so creative as the press corps thinks.
But I’m personally not convinced by the reductio ad absurdum that Gupte uses to imagine corporate CEOs tromping through the “mud of Madagasgar” with tins of foie gras strapped to their backs. We should give Gates a little more credit than that. His idea is considerably more complex than a corporate Peace Corps. I think he is more talking about changing the incentive structures that drive corporate life in order to better serve the poor.
Gupte also points out that Foreign Direct Investment has great potential to create jobs. His analysis is worth reading, but I worry that like Gates is with a new kind of capitalism, Gupte is setting up FDI as a silver bullet.
Bill Gates spoke at the Davos Conference yesterday and made a call for a kinder, more creative form of capitalism that will provide services and products that the poor need. He’s absolutely right, the medicines and agricultural technologies needed by those in poor countries don’t get the attention they deserve. There are profits to be made from these services, and the poor could still benefit. I worry that Gates might think that reforming capitalism is a silver bullet, though. There isn’t a silver bullet for global poverty. Pro-poor capitalism would be another great tool, but it isn’t going to solve everything on its own.
The WSJ asked former World Bank economist (and all around dour pessimist) William Easterly to comment, and he was skeptical. “There’s a lot of people at the bottom of the pyramid but the size of the transactions is so small it is not worth it for private business most of the time.”
Finally, my favorite quote, because it could only come from the WSJ. “With today’s speech, Mr. Gates adds his high-profile name to the ranks of those who argue that unfettered capitalism can’t solve broad social problems” (italics mine). Next, Mr. Gates is going to take the controversial, forward-thinking position that the common cold is actually caused by a virus.
According to new research published in The Lancet, early childhood nutrition has even more impact on an individual’s lifetime health, education, and earning potential than previously thought. The journal published a series of five reports on the topic. They are available for free download. I recommend the executive summary, which is only 12 pages long and gives most of the key findings.
The fourth and fifth articles discuss the global and national systems for improving early childhood nutrition. They are worth reading, but don’t expect to find anything earth shattering. The four recommendations to the international community are: 1) stewardship of national programs, 2) mobilization of financial resources, 3) direct provision of nutrition services when local organizations are unwilling or unable to do so, and 4) human and institutional resource strengthening. All of these things are already happening, and make up a large part of overall health sector development activities.
To be fair, The Lancet isn’t claiming that these are original ideas, they are all apt suggestions, and it is reiteration of important points is often justified. Two things that struck me:
1) The journal argues that increased resources are due to nutrition. A particularly useful point made is that the world community spends approximately $250-300 million each year on nutrition, but $5.7 billion on HIV/AIDS, even though they are approximately equal in terms of Disability Adjusted Life Years (DALYs) lost. (A DALY is a public health statistic used to compare the relative severity of health problems.)
This argument isn’t enough to justify equal emphasis of HIV and nutrition, but the disparity between the two funding amounts is staggering. As a small step towards correcting it, the Gates Foundation has donated $38 million to the Global Alliance for Improved Nutrition to increase public-private partnerships for nutrition.
2) The third recommendation (direct provision of nutrition services) is accompanied by a caveat that it is a distant second choice to national governments handling the problem with their own systems. I doubt they will get much disagreement there. But if the articles have a central argument I think it is that childhood nutrition deserves to be treated as a health emergency. That means vigorously addressing immediate problems while laying the groundwork for sustained activities.
Doing this will require a large scale service provision by the international community in many of the countries named in the report. If their systems were up to the challenge they would be doing better. Making this balance is a tricky thing and aid agencies are pretty bad at it. The decision to go ahead can be justified, but it isn’t as simple a call as The Lancet makes it out to be.
The LA Times seems to have appointed itself the official Gates Foundation watchdog. Last week they printed a scathing report on the negative effects of the investments the Foundation makes with its endowment funds. To give you the flavor of what it says:
“The Gates Foundation has poured $218 million into polio and measles immunization and research worldwide, including in the Niger Delta. At the same time that the foundation is funding inoculations to protect health, The Times found, it has invested $423 million in Eni, Royal Dutch Shell, Exxon Mobil Corp., Chevron Corp. and Total of France — the companies responsible for most of the flares blanketing the delta with pollution, beyond anything permitted in the United States or Europe.”
This is sad, not unexpected, but sad. A smaller foundation investing in less-than-ethical companies would be identified as hypocrits, but with tens of billions to invest the Gates Foundation can really muck things up if it isn’t careful. It’s big enough to face the same consistency questions that the major government donors face with their foreign policies. But Gates has the luxury that it doesn’t have to balance national interest or domestic politics with development goals. They should be able to change their investment strategies quickly.