Gates Again

“Gratuitous and thoughtless” is how Dave McCoy wrongly sums up our characterisation of his views about the Bill & Melinda Gates Foundation. He has posted a detailed comment on our previous post “Attacking Gates” (you can read both here), where we discuss the Global Health Watch 2 report. We disagree with Dave, and the GHW2 report, on a number of areas but have never, as he accuses, derided these views as gratuitous and thoughtless.

Part of the disagreement is that we take a more positive view of capitalism than Dave does. We specifically reject the zero-sum view that wealth and poverty are two sides of the same coin – wealth creation has been the most powerful engine of poverty reduction in the past 30 years, particularly when allied with effective government policies funded through taxation to share the wealth. It also seems strange to use Gates as the object of an attack on the power of the wealthy when he is using his vast fortune to help others – as we say in the book, there are better targets of that criticism.

Nor do we think that Gates comes high up the list for legitimate scepticism of donors’ motives. We still believe that impact is the more important issue – the key yardstick by which Gates, other philanthropists, governments and civil society should all be measured.

Moving on to the concrete issues about the way the Gates Foundation actually works on global health, the criticism that its programmes are too focused on “stovepiped” technological interventions rather than health systems reappears. Dave acknowledges that the Gates “rhetoric” on health systems has changed, as has its programming. This sounds like words and deeds to us, but we agree with Dave that we should all keep an eye on how this develops.

Dave genuinely misunderstands us if thinks we are deriding his views or those of GHW2. We wrote the book because we believe there needs to be public debate about philanthropy that focuses on impact.  We very much hope we can take up his invitation to show us first hand about the issues he raises.