Power and Money in Global Health: A conversation with Tim Schwab
According to the latest data from Oxfam, the top 1% own 43% of the world’s wealth. Not only does this concentration of economic power distort political agendas, but it also has an enormous impact on equity and accountability in global health. Tim Schwab, investigative journalist and author, joined Alicia Ely Yamin, JD, MPH, PhD, Lecturer on Law and Senior Fellow on Global Health and Rights at the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, at an event jointly hosted by the Harvard Global Health Institute (HGHI) and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics on February 22nd to discuss why the myth of the good billionaire is problematic.
Who is the “good billionaire”?
Yamin pointed out that while the super-wealthy from earlier eras—Carnegie, Rockefeller, Frick and the like—were denominated as “robber barons”, Bill Gates, one of the present-day richest of the rich and the founder of the Gates Foundation, has been lauded for his philanthropy in global health. But, as Schwab argues in his exhaustively researched book, The Bill Gates Problem: Reckoning with the Myth of the Good Billionaire, when governments are increasingly unable or unwilling to invest in health as a global public good, private philanthropies such as Gates can create institutions, set agendas, and shape development in ways that were inconceivable only a matter of decades ago.
“The Gates Foundation in recent years has become the second largest funder of the World Health Organization (WHO), which is part of the United Nations and is ostensibly organized as a democratic organization. But then you also have a private billionaire from Seattle who can come into the sidelines with billions of dollars in donations and shape what the WHO works on and what it doesn’t work on,” said Schwab.
“It’s not enough to have good intentions. You have to have accountability, too.”
Schwab explained that the rise of “philanthrocapitalism” allowed someone like Bill Gates to acquire great political influence and to remake the world according to his own narrow ideologies with very few checks and balances. So what has the Gates Foundation accomplished? Is their philanthropic work actually making the world a better place?
According to Schwab, there is increasing criticism that the Gates Foundation is doing more harm than good. The Gates Foundation, by its own admission, has failed to improve public education, one of the many issues the Foundation has worked on in the U.S. and abroad. Educators, scholars, and activists argue that the failed efforts from the Gates Foundation were causing a great deal of collateral damage. Farmer groups across the African continent are calling on the Gates Foundation to end its charitable crusade because it has caused a lot of harm.
Schwab proposed that we need to move the conversation beyond the idea of philanthropy. “It’s not enough to have good intentions. You have to have accountability, too.”
The Two Bill Gates
Another example of how the “good billionaire” is causing more harm than good is the Gates Foundation’s handling of the Covid vaccine distribution.
Yamin commented that when Gates pushed the idea of pooling fully made vaccines with the ability to have advanced market commitments over an incentivized voluntary sharing of intellectual property and technology transfer, he was making an enormous impact on entrenching inequity in vaccines.
“When South Africa and India proposed a TRIPS waiver under Covid, Bill Gates weighed in and said, ‘Intellectual property is not the problem here. It’s really that these countries in the global South just don’t have the manufacturing capacity.’ But advocates knew that they had to deconcentrate manufacturing capacity as well as address intellectual property,” said Yamin.
Schwab believed that Bill Gates had a dogmatic belief in the sanctity of intellectual property and patents, which tracked back to his first career at Microsoft.
“Bill Gates was the head of a giant tech company that was one of the most storied monopolies the world has ever seen. And it was at the height of a public relations crisis that Bill Gates changed directions and announced he was going to give all of his money away for philanthropy,” Schwab said. “We imagine that there are two different Bill Gates: there is the cold-hearted cutthroat capitalist who ran Microsoft, and there’s the kind, soft-spoken philanthropist. But it’s a mythology. It’s a fairy tale. He is exactly the same man. He’s the same bully; he’s the same monopolist; and he has the same dogmatic views about intellectual property and patents.”
The Bill Gates Solution
The Bill Gates problem, as Schwab saw it, needed to be addressed sooner than later because other billionaires, including Jeff Bezos and Mark Zuckerberg, had already announced their intention to follow Bill Gates’s footsteps. He believed it was time to reexamine the Bill Gates model, where the ultra-rich can transform themselves from embattled tech CEOs into heroic humanitarian philanthropists.
One obvious solution, Schwab suggested, was to think about regulating philanthropy, bringing checks and balances to private foundations.
“The world we have today, where you have giant tech companies that are super rich and maybe aren’t paying their fair share in taxes. And you have founders of these companies who are becoming extraordinarily wealthy. Those are political choices that we made, but we can also make different political choices,” Schwab concluded.
About the event: Power and Money in Global Health: A conversation with Tim Schwab about “The Bill Gates Problem: Reckoning with the Myth of the Good Billionaire”
This event is part of HGHI’s Scholarly Working Group Initiative. It is being co-hosted by the Harvard Global Health Institute (HGHI) and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, and in partnership with the François-Xavier Bagnoud (FXB) Center for Health and Human Rights and the Program on Law and Political Economy at Harvard Law School.
About the HGHI Scholarly Working Group
The Harvard Global Health Institute’s Scholarly Working Groups are designed to encourage a collaborative environment, promote inter-faculty gatherings, and explore and accelerate research areas in topics critical to the advancement of “Health for All”. Each Scholarly Working Group includes faculty from at least two schools across Harvard University. Through these working groups, we aim to catalyze ideas, inspire the writing of grants, policy briefs, or working papers, or build networks to advance a program of work.
Through our events and programs, the Harvard Global Health Institute provides a platform for different perspectives and debates within the field of global health through a variety of media. The views expressed in these events and programs are solely those of the speakers, authors, researchers, and participating audience, and do not imply endorsement by the Harvard Global Health Institute.
