R: PHA-Exchange> Bill Gates Foundation

[sunil.deepak at aifo.it]

B & M Gates foundation and Microsoft
---------------------------------------------

When reading the review and declarations made by Mr Bill Gates during its
three-day tour in India, Chairman of Microsoft Co., as it is reported by the
UK-based newspaper The Guardian (The Guardian, 12/11/2002) we are 
allowed to wonder whether some current international public health 
concerns (i.e. the HIV/AIDS crisis) are fundable within the Microsoft 
strategic and political agenda?

Thus according to the Guardian "Mr Gates said he had chosen to give money to
India (through his charity - the B&M Gates foundation, a $100 million
initiative to fight the spread of HIV/AIDS in India has been officially
announced during Mr Gates tour in India) because the country had contributed
an amazing amount to the software industry and to Microsoft". Similar
comments have been also reported by the New York Times (November 11, 
2002 edition).

The B&M Gates foundation set up in January 2000 which among others is
focusing its activities on global health (it has an endowment of $24bn with
priorities including the spread of HIV in developing countries and
developing vaccines) is now the world's second largest philanthropic
organisation just after the UK-based Wellcome Trust. Thus through its huge
financial power (much more substantial than the WHO one!), the 
Foundation has a growing impact and influence in the global health 
agenda setting up,
particularly in the pharmaceutical sector through various engagements (e.g.,
GAVI, IAVI, MVI and IVI for vaccines, GATBDD and MMV for tuberculosis and
malaria drugs).

This story - i.e. a confusion between the objectives of a charity and the
ones of a commercial corporation, is not new. We saw in the past, through
the Rockefeller foundation example, the same scenario: in the 1920s the
Rockefeller foundation launched a campaign of hookworm infection eradication
(in cooperation with the Health Organisation of the League of Nations) in
the United States and in Central America, with a similar confusion of
agendas (cf. Birn A, Solorzano A; Public health policy paradoxes: science
and politics in the Rockefeller Foundation's hookworm campaign in Maxico in
the 1920s. Soc. Sc. Med.). This is what we usually call with different
words, neocolonialism, but not charity or development.

Recycling dividends from wealthy corporations through charities becomes
something questionable, once such a charity through its financial powers and
ties is able to informally influence the international health agenda. The
issue is then what is the legitimacy of such structures? So far the unique
legitimate body is the World Health Organisation, created in 1948 to be the
worldwide agency in the field of international health with a constitution
endowing it with regulatory powers, and with a representativeness through
the World Health Assembly.

We have to stay circumspect and pay closer attention to this kind of
conflict of interest, because it is not highly unlikely that next time when
giving a financial assistance to a developing country, one of the
conditionalities defined by the B&M Gates foundation could be its compliance
to intellectual property rights regarding the Windows proprietary operating
system!


Patrice Trouiller, PharmD, MB
University Hospital, Grenoble, France
MSF Access campaign, Geneva, Switzerland
ptrouiller at chu-grenoble.fr