Last month Warren Buffet, financier and one-time adviser to Arnold Schwarzenegger, pledged $44 billion to the Bill and Melinda Gates Foundation. He made the first contribution at the beginning of this month by handing over a single stock certificate worth $11 billion. Buffet’s $44 billion will bring the Gates Foundation’s assets to a cool $91 billion.
When I was in graduate school studying economics, this is what we called “a boatload of money.”
The Gates Foundation is dedicated to solving health problems in developing countries, principally Africa. They fund research into treatments for diseases like malaria and HIV/AIDS. The treatments will most likely be drugs.
No doubt lives will be saved as a consequence of the Gates boatload of money, at least in the narrow sense that people will suffer and die without the new treatments if nothing else changes. So I suppose in that very narrow sense, the money is well spent. What “nothing else changes” means to me is that corporations won’t take action because there’s not money in it, that public institutions, both national and international, are incapable of taking action because of politics or economics or corruption or stupidity, and that the people at risk are incapable of taking action because of politics or economics or lack of information. It seems that only “can-do” philanthropists like Bill and Melinda Gates and Warren Buffet who turn their entrepreneurial talents to critical health issues are able to find solutions and save lives.
Of course, that boatload of money came from you and me, one way or another. While many resist tax increases to support the prevention and treatment of illness, they will celebrate the generosity of men and women who tax us by making a profit on what they sell us and then doling out a little or a lot of it as philanthropy. It’s a fairly stupid way to solve social problems.
Back in December when the Gates Foundation was getting cranked up, Anne-Emanuelle Birn, who is on the Faculty of Medicine at the University of Toronto, published an article in the Lancet titled “Gates’s grandest challenge: transcending technology as public health ideology.” In it she challenges the idea that a boatload of money can really solve health problems, at least in the way the Gates Foundation is going about it.
The money is targeted at developing new technologies, principally drugs. But as Dr. Birn argues, the epidemiological record shows that it was rising incomes and living standards and not new medical technologies that brought health to people in now-industrialized nations at the end of the 19th Century and start of the 20th Century. The Gates Foundation explicitly prohibits funding for research into anything that smacks of social or political change. Only technology.
Warren? Bill? Melinda? Do you really want to help people get healthy and stay healthy? Forget about the technology. Steer a boatload of money, even a small one, toward people building livable communities that are safe and clean. Steer a modest boatload of money toward sustainable agriculture that gives people cheap, healthy food. Otherwise, we’ll do it ourselves.
Related resources are available on the Food and Nutrition page, the Environmental Health page, and the Health Politics page.
