In his groundbreaking non-fiction book published in November 2023, The Bill Gates Problem, investigative journalist Tim Schwab presents strong arguments against the philanthropic mission of the formerly known, ‘Bill and Melinda Gates Foundation.’ Renamed now as ‘The Gates Foundation’ following Melinda Gates’s stepping down after power couple’s divorce, the foundation has received a lot of criticism in recent years.
According to the Foundation’s website, through its health programs, ‘38 million lives have been saved’ by providing ‘prevention, treatment and care services to hundreds of millions of people’. Schwab however in his book makes a compelling case that the Foundation has done more harm than good. Through facts and figures, and narratives from a lot of people who preferred to remain anonymous, he unveils the man behind the Foundation, whom he considers as a power-hungry, narcissistic individual, who treats the Foundation like a business – drawing from his experience of heading Microsoft.
Through an interesting dig into Bill Gates’s past including how he treated his employees at Microsoft, as well as his treatment of his friend who co-founded Microsoft, Schwab illustrates that the Foundation remains a façade, and emerges as a way for Bill Gates to yield power. He also presents economic calculations that through philanthropic missions such as the Foundation, the public in the US ought to feel cheated since their tax dollars are being misused, and through tax breaks that philanthropists get, there is actually no real equitable distribution of wealth that occurs.
But why should we, in Pakistan, be concerned about what is happening in the United States? Primarily, because the Foundation works quite intensively in the country, through a variety of different partners including The Vital Trust as well as the Aga Khan University in Karachi. According to the book, the Foundation has donated about five hundred million dollars in total to Pakistan. Schwab includes a whole chapter about what the work that the Gates Foundation has done in Pakistan, and it is an eye opener. International funding in the past two decades has received intense criticism particularly in the areas of health and education for multiple reasons primarily because under-developed countries often are used merely as a means to an end to push certain ‘agendas’. While this may read as a conspiracy theory, Schwab provides evidence to back his claims that the Gates Foundation work in Pakistan, more centered in Sindh, has actually not made a difference to improving the lives of women and children, as it claims to do so. Another area that the Foundation works is in the area of child malnutrition, and considering that Pakistan remains in an acute stage of malnutrition despite intense pouring of money into this area, should raise some red flags.
In his chapter centered on Pakistan, Schwab also uncovers classical cases of financial conflicts of interest with money being directed to essentially the same group of people who are linked to the Foundation in some way thereby negating the values of equity. In times when there are calls for global health to be decolonised, the Foundation through their donations impedes these goals by pushing its own agenda. Schwab presents the example of polio eradication programs which receive major funding but at the risk of neglecting other tropical diseases that kill more people in Pakistan than polio. This stands as a big hurdle for Pakistan to be de-colonised completely, as Schwab writes, ‘[this] is one of the ways that [shows] that Pakistan is not standing on its own two legs but is, rather, leaning on a crutch of foreign aid and following the public health priorities of a billionaire in some distant land’.
And therein stands part of the problem with Gates funding projects either in Asia or Africa – the White Man’s Burden. As the Covid-19 pandemic illustrated (and Schwab includes a chapter on this as well), developed countries fought for themselves and despite the Gavi, The Vaccine Alliance that seeks to increase access to immunisation in poor countries, large parts of Africa were ignored for Covid-19 vaccine coverage. This is despite the fact that Gavi works through tax-payers money, and that Covid vaccines were made possible through research, some of which was conducted in low-middle income countries.
Organised into fifteen chapters, this book is groundbreaking in many ways. For an academic like me working in the field of health ethics, it provides crucial insights into how international funding mechanisms work, and the negative ramifications of these. While some of the evidence presented may appear as fiction, and could be considered slanderous as Schwab makes personal digs at Bill Gates’s personality, how he spoils his children and treats women who work at the Foundation, the book is a must read for those who work in the area of health and education. It also provides an opportunity to self-reflect – in terms of how enmeshed all of us are in the world of global politics and power.
The writer is our Managing Editor and Assistant Professor at CBEC-SIUT.
