That dear reader, is philanthrocapitalism in a silly, sardonic, soliloquy.
But if you want a bit more detail and a bit more seriousness, using the illustrious Bill and Melinda Gates Foundation as an example, read on…
Oh, and I’m making some strong statements, so I’ve backed myself up with some proper references 🙂
The term philanthrocapitalism was first coined in an article in the Economist magazine in 2006 to describe a trend by newer philanthropists to apply free-market, for-profit business practices to charity work to maximise their investments, as opposed to the relatively passive, traditional philanthropy of simply donating money to charities – without trying to make money out of giving money. Whilst the term is newish, the practice? Not so much (check out Andrew Carnegie and the Rockefellers if you’re keen).
Philanthrocapitalism isn’t simply a case of good intentions gone wrong. It’s a deliberate perpetuation of structural violence (systems organized for exploitation) to centralise more power in the hands of very rich, very unelected individuals. Yes, I’m going to back that up 🙂
About now I should tell you that I did try to get chatGPT to write this article but it just couldn’t stop assuming philanthrocapitalists had good intentions (even when I asked for a “very critical article”)…sigh, guess I’m still doing my own writing.
Global elites dressing themselves up as self-sacrificing paragons of all that is good, “shield[s] growing wealth concentration from criticism and sanctif[ies] the claim that individual mega-wealth is collectively beneficial” (McGoey & Thiel, 2018, pg 111).
The income, opportunities and influence philanthrocapitalism generates for the wealthy also create a fundamental conflict of interest; gross inequity needs to persist so the mega-rich can keep reaping the financial and other benefits of their own charity. In this way, among others, charity is an industrial complex.
A bit about international health charity before we go on
International health charity has its roots in colonial medicine (Green et al, 2013). Initially, health efforts in colonies were just for the white colonists but then hey, turns out it’s a good idea to take care of the health of your forced/indentured/exploited/enslaved labour force so they can work more/longer/harder for you.
Hence, colonial medicine expanded to focus on the health issues of native populations, but in the same way colonial medicine failed to identify colonisation as the major cause of ill health in native populations, global health philanthrocapitalists also tend to ignore the root causes of health issues in the global south where they like to play the hero.
They prefer to diagnose global health issues as bio-physical or vectoral (biting bugs) in origin so that, wow, check this, the solutions must be bio-technical and there’s money in them there hills pills (Birn & Richter, 2017). Inconveniently though, global health issues are actually rooted in the structural violence of extreme poverty and inequality (Butt, 2002; Farmer, 2004; Kleinman, 2010): the very thing philanthrocapitalists built their wealth on.
Try telling that to philanthrocapitalists. They tend to hire experts that will agree with their existing plans, ignore the voices of experts who do not, and particularly ignore the voices of those they’re supposedly trying to help. (Amarante, 2018; Eckl, 2014).
Seems like a good time to introduce one such international health philanthrocapitalist venture…
The Bill and Melinda Gates Foundation
An exemplar of modern philanthrocapitalism. Let me count the ways…
Resulting from a merger of the William H. Gates Foundation and the Gates Learning Foundation in 2000, the Bill and Melinda Gates Foundation (BMGF) emerged at a time of increasingly bad press for Bill Gates. Amidst lawsuits for anti-competitive practices in the European Union, and class actions in the United States (Birn & Richter, 2017), the BMGF started giving away large sums of money, apparently “Guided by the belief that every life has equal value, the Bill & Melinda Gates Foundation works to help all people lead healthy, productive lives.” (Gatesfoundation.org, 2020).
Since its inception, the BMGF has granted over 50 billion dollars, spread operations to 138 countries, (Gatesfoundation.org, 2020) and with an endowment of over 46 billion dollars, is considered the wealthiest charity in the world.
The BMGF rhetoric suggests they are driven by a humanitarian impulse (red flag) and many of their programs superficially reflect the humanitarian biomedicine approach to global health which “targets diseases that currently afflict the poorer nations of the world” (Lakoff, 2010, pg 50), supposedly motivated by an ethical stance of “common humanity” and a commitment to “provide care to suffering victims of violence, disease, and political instability” (Lakoff, 2010, pg 66).
What the BMGF don’t mention so much is that they also take a global health security approach that aims “to create a real-time, global disease surveillance system that can provide “early warning” of potential outbreaks in developing countries…that will protect…the rest of the world” (Lakoff, 2010, pg 59).
So basically, one of the main reasons they pay attention to the health issues in the global south is to protect the global north. Oh, and to make lots of money.
Philanthropy is also fundamentally antidemocratic, being “the unilateral decision of a wealthy person to spend money or resources to address a particular issue” (Amarante, 2018, pg 16) and the BMGF is no exception. Whilst outwardly claiming to cooperate with nation-states, the BMFG is criticized for frequently either bypassing national government processes and/or coercion (Adams et al, 2008; Amarante, 2018).
Bill Gates makes no secret of it – directly expressed his doubts about the capacity of democratic governments to deal with complex issues (Waters, 2013).
Not only does the BMGF bypass governments, but it also gathers little to no input from the local communities, the supposed beneficiaries of the BMGF grants, about what they perceive their most pressing needs are and how to resolve them (Youde, 2016). More of the same ‘ole paternalistic, colonial patterns of charity.
As if that wasn’t enough, there are a few problems with accountability. Are you shocked? I’m shocked.
It’s actually a bit of a common issue in the aid sector, aid organisations lacking sufficient external accountability processes (Gourevitch, 2010), but the extreme lack of external accountability in family charity ventures such as the BMGF is next level worrying (Birn & Richter, 2017; Curtis, 2016), and self-congratulated: “[we] don’t have to worry about being voted out at the next election or board” (Gates, 2009, pg 16).
So how can anyone assess their effectiveness? They can’t.
How can anyone assess their ethics in practice? They can’t.
And I’m sorry, but there’s more.
Large philanthrocapitalist ventures like BMGF also have waaaay too much political influence given their extreme un-electedness (Curtis, 2016; Eckl, 2014).
BMFG have a whole department for it – the BMGF’s “Global Policy & Advocacy Division seeks to build strategic relationships and promote policies that will help advance our work” (Gatesfoundation.org, 2020). By the sheer might of their endowment, governments and NGOs take notice of BMFG and they are now arguably “the most influential agenda-setter[s] in global health (Birn & Richter, 2017, peah.it).
Global health priorities are increasingly being decided by the global elite, who (another shock) usually have no training in health, global or local!
It goes on but I’ll just mention two more parts of this cluster-f*ck of structural violence…
Whilst BMGF makes it sound like they are granting money to the poor, the majority of the BMGF grants are to research and development organisations in high-income countries (Birn & Richter, 2017; McGoey, 2012), usually to develop products to sell to the global south to alleviate their problems. Ka-ching. This also happens to exacerbate the inequity of research work between the global north and south.
And the cherry on top: once the BMGF has decided on a research area, it dominates that field of research so that its solutions appear to be the only viable solutions. Not by merit of course, but by stifling meaningful scientific debate and inputs from local actors (Amarente, 2018; Bate, 2008). In this way, the BMGF can ignore the “underlying social, political, and economic causes of ill health, including the unprecedented accumulation of wealth” (Birn & Richter, 2017, peah.net) despite clear evidence that it is improvements in living and working conditions that have the most significant impact on health, not medicines (Birn, 2005).
Lastly, you’d think a foundation so dedicated to doing good would have a squeaky-clean investment portfolio right? Snortle.
In 2007, the Los Angeles Times published an investigation into the investment practices of the BMGF trust and found it invests in “companies that contribute to the human suffering in health, housing and social welfare that the foundation is trying to alleviate” (cited in Beckett, 2010).
The idea that you can profit from systems of inequality whilst trying to lessen the impacts of these systems is the central irrational, and violent paradox of philanthrocapitalism: it “depends on profits amassed from financial speculation, tax shelters, monopolistic pricing, exploitation of workers and subsistence agriculturalists, and destruction of natural resources” (Birn & Richter, 2017, peah.it).
The BMGF also have significant financial interests in big pharma, creating not only a financial conflict of interest in the Foundation’s activities but also profiting from pharmaceutical companies that prevent access to affordable medications in the global south (Birn & Richter, 2017).
Eugh. Enough. Let’s stop there.
Given all the opportunistic practices of organisations like the BMGF and their wilful disregard and suppression of sound evidence as to the causes of global health issues, they clearly aren’t actually interested in resolving these issues.
If they were genuinely interested in resolving global health issues, they would engage in activities to rectify global wealth inequity and work to decolonise global health. Changes such as these will not be led by the wealthy elite such as the BMGF.
As a business, philanthrocapitalism, at best, sells atonement and the preservation of a moral identity for those who benefit from grossly inequitable capital flows, at worst, provides cover for increasing this inequality.
So the next time you see/hear someone defend Bill Gates or claim his critics are conspiracy theorists (as I have seen/heard a few times), send ‘em over here and show them my reference list 🙂
References
Adams, V., Novotny, T.E., and Leslie, H. 2008. Global Health Diplomacy. Medical Anthropology: Cross-Cultural Studies in Health and Illness, 27(4), pp 315-323.
Amarante, E. 2018. The perils of philanthrocapitalism. Maryland Law Review, 78(1), pp 1-72. HeinOnline.
Bate, R. 2008. Stifling Dissent on Malaria. The American, December 8. Accessed 30 May 2020. http://www.aei.org/publication/stifling-dissent-on-malaria.
Beckett, A. 2010. Inside the Bill and Melinda Gates Foundation. The Guardian. Accessed 30 March 2020. https://www.theguardian.com/world/2010/jul/12/bill-and-melinda-gates-foundation.
Birn, A. 2005. Gates’s grandest challenge: transcending technology as public health ideology. The Lancet, 366(9484), pp 514-519.
Birn, A. and Richter, J. 2017. U.S. Philanthrocapitalism and the Global Health Agenda: The Rockefeller and Gates Foundations, Past and Present. Accessed 11 April 2020. http://www.peah.it/2017/05/4019/.
Butt, L. 2002. The Suffering Stranger: Medical Anthropology and International Morality. Medical Anthropology: Cross-Cultural Studies in Health and Illness, 21(1), pp 1-24.
Curtis, M. 2016. Gated Development: Is the Gates Foundation always a force for good? Global Justice Now. Accessed 30 March 2020. https://www.globaljustice.org.uk/sites/default/files/files/resources/gjn_gates_report_june_2016_web_final_version_2.pdf.
Eckl, J. 2014. The power of private foundations: Rockefeller and Gates in the struggle against malaria. Global Social Policy, 14(1), pp 91-116.
Farmer, P. 2004. An Anthropology of Structural Violence. Current Anthropology, 45(3), pp 305-325.
Gates, B. 2009. 2009 Annual Letter from Bill Gates. Accessed 30 May 2020. http://docs.gatesfoundation.org/Documents/2009-bill-gates-annual-letter.pdf.
Gatesfoundation.org. 2020. Foundation Fact Sheet. Accessed 30 March 2020. https://www.gatesfoundation.org/who-we-are/general-information/foundation-factsheet.
Green, J., Basilico, M.T., Kim, H. and Farmer, P. 2013. Chapter 3 – Colonial Medicine and Its Legacies, In Reimagining global health: an introduction. Farmer P, Kleinman A, Kim J, & Basilico M, (eds). Vol. 26. University of California Press.
Gourevitch, P. 2010. Alms Dealers. The New Yorker.
Kleinman, A. 2010. Four Social Theories for Global Health. The Lancet, 375 (9725), pp 1518–1519.
Lakoff, A. 2010. Two regimes of global health. Humanity: An International Journal of Human Rights, Humanitarianism, and Development 1(1), pp 59-79.
McGoey, L. 2012. Philanthrocapitalism and its critics. Poetics, 40(2), pp 185-199.
McGoey, L. and Thiel, D. 2018. Charismatic violence and the sanctification of the super-rich. Economy and Society, 47(1), pp 111-134. Taylor and Francis Online. DOI: 10.1080/03085147.2018.1448543.
Waters, R. 2013. An Exclusive Interview with Bill Gates. Financial Times. Accessed 30 March 2020. http://www.ft.com/cms/s/2/dacd1f84-41bf-11e3-b064-00144feabdc0.html
Youde, J. 2016. Private actors, global health and learning the lessons of history. Medicine, Conflict and Survival, 32(3), pp. 203-220.
I’ve written a lot here. Over to you…
That was a big, well-referenced rant. If it makes you feel like ranting too, go for it in the comments (no need for citations).
Or maybe other thoughts about philanthrocapitalism?