Study Examines Gates Foundation’s Influence on Global Health

A study published on Friday in the journal Lancet examines the Bill & Melinda Gates Foundation's "global reach with spending on health issues, but notes a need for accountability on whether the money is being spent in the most effective way," AP/Washington Post reports. The study is a statistical analysis of the foundation's 1,094 global health grants worth $8.95 billion that it gave away between January 1998 and December 2007.

The AP/Washington Post writes that the study found "65 percent of its total global health grants -- went to only 20 organizations, most of which are based in the United States and some within miles of the foundation's Seattle headquarters. The study acknowledges, however, that it doesn't account for sub-recipients, many of which are located in other parts of the world."

"What we have is a private actor with a huge degree of influence, but not really a mechanism by which that influence is held to public account," lead author David McCoy, a senior clinical associate at University College London, said.  Philip Stevens, director of health policy at the International Policy Network, said although the study is about a pertinent topic, it is marred by ideological assumptions. According to AP/Washington Post, Stevens "said McCoy was a health activist who has written many pieces attacking the principle of private involvement in health."

According to the AP/Washington Post, a statement from the Gates Foundation said, "We welcome this article and its findings. We try to be very thoughtful about how to target our resources, and we constantly seek out feedback from outside experts and stakeholders." It also said, "In the end, we use our best judgment to determine where our funding can achieve the greatest reductions in health inequity around the world" (AP/Washington Post, 5/8).

According to the Seattle Times, Tachi Yamada, president of the foundation's global health program, plans to meet with McCoy in the future. "We think we have a strong global health strategy that really gets to the problems of the developing world," Karen Lowry Miller, the foundation's spokesperson, said. "We're not trying to be everything. We're trying to be where we can have the most value," she said.

A related editorial and comment also ran in the Lancet on Friday (Heim and Doughton, Seattle Times, 5/7).   

EDITORIAL NOTE: The Kaiser Family Foundation receives substantial support from the Bill & Melinda Gates Foundation for the Kaiser Daily Global Health Policy Report.