The Lancet, a leading medical journal published out of New York and London, recently ran an editorial which highlights an ongoing concern with governance within The Gates Foundation – one of the most active and generous philanthropic foundations in the world (US$ 3 billion annually).
The editorial starts out by, deservedly praising the invaluable contributions made by the Gates Foundation, particularly for its deep commitment to global health. The Lancet credits the Foundation for adding “renewed dynamism, credibility and attractiveness to global health” as well as “inaugurating an important new era of scientific commitment to global health predicaments”.
Much of the criticisms on the Foundation consist on two areas: the Foundation’s choice of investments; and its alleged lack of transparency in governing process.
On the choice of investment, the article points out following issues:
• “The Foundation gave most of its grants to organizations in high-income countries”
• “The grants made by the Foundation do not reflect the burden of disease endured by those in deepest poverty”
• “Important health programmes are being distorted by large grants from the Gates Foundation. In some countries, the valuable resources of the Foundation are being wasted and diverted from more urgent needs”
On the lack of transparency, the article argues that for such an influential investor in global health like the Gates Foundation should not just be governed by the Foundation’s guiding principle #1 - “This is a family foundation driven by the interests and passions of the Gates family.”
The article then proposes five recommendations for the Gates Foundation: Improve governance, increase transparency and accountability, allocate grants to better reflect disease burdens, invest in health systems and research capacity in low income countries and listen and be prepared to engage with others.
The following is a statement released by the Gates Foundation in response:
“We welcome this article and its finding. We try to be very thoughtful about how to target our resources and we constantly seek out feedback from outside experts and stakeholders. In the end, we use our best judgment to determine where our finding can achieve the greatest reductions in health inequity around the world. We are committed to communicating information about our strategy, grants, and results, and are using our website to make it easier to find this information.”
Read The Gates Foundation's Guiding Principles
Read The Gates Foundation's Approach to Giving
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