PHM-Exch> Gates' billions for WHO - no strings attached?

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Gates' billions for you-no strings attached?

Rema Nagarajan<http://blogs.timesofindia.indiatimes.com/staying-alive/page/authorProfile?page=authorProfile>,
09 July 2010, 09:57 PM IST  Times of India

Last week, an article on Bill and Melinda Gates
Foundation<http://timesofindia.indiatimes.com/world/us/Bill-Gates-bigger-funder-of-WHO-than-US-govt/articleshow/6099581.cms>becoming
one of the biggest donors for the World Health Organisation (WHO)
had many exclaiming how wonderful a man Gates is to give away so much money.
Indeed, Gates must be the biggest philanthropist of all times. Yet, there in
unease in the health sector across the world about one person or his
foundation setting the global agenda on health.

The WHO is expected to be an international health agency that would set
global public health priorities, provide uncompromised technical expertise
and fortify the international community's ability to confront global health
risks.

But with more and more of its operational budget dependent on donors, the
danger of WHO becoming an instrument to serve donor interests is a huge
concern.

Ruth Levine, a health economist, put it quite succintly in an open letter
published in British Medical
Journal<http://www.bmj.com/cgi/content/full/333/7576/1015?ijkey=4rwWpReX0pwATcU&keytype=ref>in
November 2006: "… because maintaining WHO's budget requires pleasing
constituencies, the agency's main product-impartial public health
expertise-is undermined."

The Global Health Watch Report-2
(GHW2)<http://www.ghwatch.org/sites/www.ghwatch.org/files/d1.3.pdf>published
in October 2008 points out that the Gates Foundation is governed
by the Gates family with no board of trustees; nor any formal parliamentary
or legislative scrutiny. "There is no answerability to the governments of
low-income countries, nor to the WHO. Little more than the court of public
opinion exists to hold it accountable," says the report.This lack of
accountability and transparency is cited as a major problem by health
experts.

The ties between the Gates Foundation and pharmaceutical industry has also
come under scrutiny as Gates funded organisation like the Global Alliance
for Vaccines and Immunisation (GAVI) has many pharmaceutical companies,
especially those from the vaccine industry, as its members. GAVI has pushed
many expensive vaccines into national immunization programmes in developing
countries. This according to GHW2 has led "health activists to question if
the Foundation is converting global health problems into business
opportunities" for the pharma industry.

The Gates' Foundation's position on intellectual property (IP) rights is
also a cause for concern. After all, Microsoft, along with other
corporations, is pushing to strengthen IP rights and patent laws even
further. Stronger IP rights will affect developing countries' right to allow
generic companies to manufacture essential medicines at affordable prices.
Patents and monopolies only make medicines more expensive and inaccessible
to majority of the people.

In October 2007, without consulting the WHO, other international bodies or
so-called partners, the Foundation launched a new campaign to eradicate
malaria. For many, this was an example of how the Foundation was setting the
global health agenda and making the international health community follow.

The emergence of cash rich players including World Bank, the Gates
Foundation and GAVI, along with the shift to the public-private partnership
mode in health, has left the WHO often following an agenda, rather than
setting it.

If the WHO is perceived to be hijacked by private corporate sector it will
lose its authority as an impartial norm setter on global health issues,
points out GWH2. The report asks: "Has the WHO compromised itself through
its partnership with the private sector? It is hard to say. But there are
certainly reasons for concern."

Levine says the only way out is to reduce dependence on external funding by
demanding an adequate core budget from member states to ensure full funding
for priority functions.
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