One hand gives, the other takes

The cheerful countenance of the world’s biggest philanthropist and founder of Microsoft, Bill Gates, creates an impression that his philanthropic enterprise in the area of agriculture and health has no side-effects. This is balderdash. Gates, along with his wife, Melinda, set up the Bill and Melinda Gates Foundation (BMGF), which has invested in agriculture and health. It is increasingly drawing flak for trying to skew government agenda to help big pharma.

With assets worth $43 billion, the BMGF exercises inordinate influence over governments. In fact, it distracts them from doing their job in the proper way by presenting an alternative techno-economic fix to sort out the problems of poverty and deprivation through vaccines and nutritional products manufactured by multinational pharma companies – in some of which the BMGF has invested. Gates believes his foundation’s intervention will help in fighting poverty and also reducing the global population. His claim that vaccines will reduce population is feeding suspicion amongst his detractors about the real motive behind BMGF operations in high-population countries such as India.  

Cash-strapped governments, when presented with funds by philanthropic foundations, smell nothing wrong and are happy to shoehorn their policies and their implementation along suggested lines. State governments such as those of Andhra Pradesh, Uttar Pradesh and Gujarat and even some central ministries are enamoured of Gates and take great pride in the periodic endorsements they get from him or BMGF-funded NGOs. He is treated as the God of philanthropy whose benevolence is essential to deliver the sick, infirm and poor to a better life.

A report presented by Global Justice Now on January 20 asked a sombre question: “Gated Development – Is the Gates Foundation always a force for good?” Nearly all governments should ask this question before vacating their mandated governance space for the BMGF.

When Gates sold off half of his Microsoft stocks to devote himself to philanthropy it was big news. It made the Indian media, like media in other parts of the world, question why our fat cats run away from doing charity. How much has an Ambani or a Birla spent on charity? Until Azim Premji announced his billion dollars for promoting education, there were very few examples to match Gates’ effort or even intent.

The BMGF believes that vaccines help in saving lives and it has invested millions to develop and distribute them in different parts of the world. The vaccines pushed by the foundation range from those for malaria and cervical cancer to contraception.

Gates has given $2.5 billion to Gavi, the Vaccine Alliance, to immunise children against diseases in 73 poor countries. The BMGF also helped in the trials of the Human Papillomavirus (HPV) vaccine, which prevents cervical cancer. It funded an American NGO, PATH, for trials of Merck’s Gardasil vaccine against HPV in some states of India. A parliamentary committee in 2013 discovered that the trials were conducted through subterfuge and the NGO had slyly used Indian government agencies like the Indian Council of Medical Research (ICMR) and the National Health Mission to add legitimacy to their projects. It was found that in 2009 some 24,000 girls were vaccinated in Khammam district of Andhra Pradesh and in Vadodara in Gujarat. About 1,200 developed chronic health problems. The parliamentary committee stated that if PATH had succeeded in including HPV in the immunisation programme, it would have helped the companies earn windfall profits year after year. Despite PATH’s ethical violations, the trials are likely to return soon.

The BMGF has shifted focus to women and child development in India. Entities funded by it are providing free software for all Integrated Child Development Services (ICDS) programmes. Later, this will be linked with the database of the Ministry of Women & Child Development. Thus, they will get free access to a database of 10 crore women. The implications of this unequal exchange are enormous.

BMGF-funded entities such as the Global Alliance for Improved Nutrition (GAIN) are putting together a communications strategy to recommend nutritional products to app users, who can order through smartphones. Had the enterprise been a ‘Make in India’ start-up, we would have been proud of it. But it will help companies like Abbott and GlaxoSmithKline, which are investing in this sector to make a killing. This is the new face of philanthro-capitalism that cash-strapped countries are finding difficult to counter.

The point is that it should not happen in India at least, where there is an active civil society, adversarial media and a robust understanding of pharma issues. But it is happening due to a malleable bureaucracy and a lethargic political class that is comfortable with outsourcing its job to multinational philanthropies.