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David McCoy is positioned at the Center for Primary Care and Public Health of the Queen Mary University in London GB. He has worked 15 years as physician in South-Africa and in the local public health care system.
He is on the board of the NGO Medact as well as member of People's Health

Question:
Mr. McCoy, the Bill & Melinda Gates Foundation is the world-wide most renown philanthropic foundation.
It supports the fight against diseases in poor countries, the development of vaccination and agrarian programs against hunger.
You belong to the few physicians who are criticizing that. Why?

McCoy:
It is important to understand that the foundation is no charity organization, but instead influencing politics, research and even journalistic report. With a funds of 23,3 billion Euro and a similarly sized amount prospected by the Warren Buffet foundation, the Gates foundations is being extremely influential.
I see problems with the shape and approach of these programs and in the way of how the foundations is not being due to report about its conduct.

Question:
You have examined 1000 supports for health care programs of a value of nearly 9 billion dollar, which the foundation has granted in the years from 1998 and 2007. What are your findings?

McCoy:
The foundation supports a broad range of organizations and acts through them. To those orgs belong the WHO, large health partners like Global Fund or the Global Alliance for Vaccinations ( GAVI), international NGOs, research institutes and leading universities in USA and Europe. The foundation even supports the World Bank. It focuses its influence and its money on few selected technologies and diseases, especially HIV, tuberculosis, malaria and such which can be vaccinated against.

Question:
And that is bad?

McCoy:
It certainly is a good thing to have more money for vaccination and treatment of these diseases in poor countries. However, this money has not always been invested efficiently and cost efficiently. Specially at the beginning of the 21 century the Global Fund and GAVI´s focus on vaccination and targeting of only three diseases contributed to the neglecting of other urgent problems. Health care systems in poor countries ought to deal with many important issues. The treatment against diseases, prophylaxis against diseases through bad nutrition, access of clean water, education of HC personnel, improvement of informative systems. When external powers like the Gates-foundation finance programs, which concentrate on only few diseases and technologies, the HC system as a whole can be damaged.

Question:
But isn´t it that a foundation must focus on single aspects?

McCoy:
Imagine you were leading a school in a poor community. And there comes a financier with a lot of money - but only for the subjects of mathematics and physics. He ought to prove his effects, thus brings experts from outside who will help the school to improve on results in mathematics and physics. He even insists on that the teachers of these subjects shall be paid better.
But you have no idea of how long this support will last. This is what happened with HC systems, when such exclusively targeted programs were introduced and financed through external organs like the Gates-Foundation.

Question:
In an ad clip on behalf of the 10th year of the Global Fund VIPs like Bono, Bill Clinton und Bill Gates celebrated that the program rescued 8,7 million lives. Is this number true?

McCoy:
It is exaggerated. The Global Fund rather has rescued three to four mio lives. More important to me seems the message of the ad that the rich would be helping the poor.
This is being countered by the fact that the value with illegal asset streaming which leave Africa is by far larger than the sum of donation received there. With a major part of that going to company or private accounts of the elite, often enough in tax havens.

Question:
It seem undisputed however that people are being rescued.

McCoy:
To react quickly, safe lives and building up institutional capacities; that is the great challenge in the global field of HC. Only that we must not neglect awareness of the causes of poverty, malnutrition and diseases. Otherwise the poor will stay lastingly dependant on help. "Saving lives", is a powerful rhetoric tool for to depoliticize problems: "We are rescuing lives here. Don´´t disturb us with political questions or your objections about justice, economical developments, self-determination or eivironmental suitabilitty."

Question:
Are global public-private programs between states and corporations like the Global Fund or GAVI not being helpful?

McCoy:
Today we are much better positioned with keeping people alive under poverty conditions. However, climate change, resource conflicts and resistances against antibiotics are capable of inverting the improvements achieved in poor countries over the past 15 years.
We for instance are having a higher life expectancy for people with HIV in Africa. However, the conclusion should not be that we shall find ever new meds against diseases, but rather that people must be protected against new threats; through means of securing nutrition, education, clean water, employment and democratic institutions.
Bill Gate´s focus on charity and technology contains no confession to social justice and lasting development. Neither does he question the economical system that is allocating property from bottom to top.

Question:
Supporters say that Bill gates is returning wealth and employing his undertaking talents for support of the poor.
McCoy:
He is not returning money. The funds remain under his control on how they will be invested. I want to draw attention to the whole of which his foundations is being part of: The coherence between enormous wealth and impoverishment.
It is a myth also spread by the Gates Foundation how excessive and concentrated wealth was the outcome of a fair and efficient development - hence it trickling down from top to bottom -. Charity often is an act of generosity. But it can also enhance the relation of power and dependency between rich and poor and be used to maintain unfair and undemocratic structures.

Question:
With private assets of 56 billion Euro Bill Gates is the wealthiest man on earth. Some say his wealth was earned, because of him being a genius.

McCoy:
Sometimes I ask my students to imagine a world without Bill Gates. Would we be having laptops, text editing applications and internet?
It won´t last long until they ask themselves, why a person has made that much of money for a development that would had happened anyhow. Gate´s wealth does not yield so much from his intelligence or his genius rather than on a reckless sense of business which allowed him to monopolize a market and maximize tax avoidance.

Ouestion:
The Gates Foundation conducts partnerships with pharmaceutical combines like Novartis, Glaxo-Smith-Kline, Sanofi and Merck. You critisize that as well. Why?

McCoy:
There exist a lot of market failure in the pharmaceutical sector which instigates exorbitant profits and inefficient research with too much of legacy conflicts. That hurts the public. The key lies in the system of intellectual property rights, which Gates has contributed to building up, in his times with Microsoft. His foundation teams up closely with the pharmaceutical industry. It should be investigated much more intensively about how much private and how much public money is going that way into development of meds and vaccines only to then be privatized and profitably traded on a market of distorted competition.

Ouestion:
The foundation´s funds also stems from capital investments into firms like Monsanto, Coca-Cola, McDonalds and Shell. How does that cope with the aim of supporting health?

McCoy:
How the foundation carries no standards of ethics and lasting policies with its investments is incomprehensible and wrong. It is not only a major shareholder of Coca-Cola, but even advertises the combine as an example of efficient and good company policies. Such, while the company´s contribution to mass overweight and its business policies as well as effects of its fabrics on local communities being questionable. With its investment policies the Gates Foundation is legitimizing acts and laws that should actually not be legitimized. Further, a large part of the foundations funds comes from tax exemption. Public has a right to be informed on how the money is being used.

Question:
In Germany the Gates Foundation supports private-public development partnerships to which companies belong like BASF, Bayer and Syngenta. Precondition for the investment has been that the German government invested 20 mio Euros into this partnership as well.

McCoy:
Basically, partnerships are good. However, many allow and legitimize companie´s access to the public sector. Let´s look at the influence of multi-national combines on the transatlantic trade agreement. That is less negotiations among USA and the EU than it is among groups of industry, finance section and the public.
If we don´t want multimillionairs, banks and combines to influence politics of finance markets and environmental law, why then should we be agreeing into such influence on agrarian and health care programs?

Question:
Notwithstandingly, there exists little critique on the foundations influence. Is that servile obedience in order to gain appropriation?

McCoy:
Amassed wealth and power buy not only influence, but also agreement. Self-censoring and group thinking. Before I started researching on the Gates Foundation I was warned that it could be hurting my career. But after the publishing of my study in the medical journal "The Lancet" many confirmed that the Foundation has a too great influence and is producing a climate in which health experts would not dare to object.

Question:
Why is Bill Gates engaging himself. Is he personally profiting from it?

McCoy:
The foundation was not founded for making money. But it is a means to exert power and influence. Bill Gates calls himself an "impatient optimist". However, I find his hopes to be conservative and unambitious. I want a fair development - not just charity. It´s me who is the impatient optimist. Yet, it appears his true aim to do good for the poor. That is why I would like to discuss with him publicly.

Question:
What would you like to talk about?

McCoy:
About the fact that technology can only be a part of any solution. I would like to talk with him about the shortcomings of the system of intellectual property and challenge him to engage for reforms with banking, bookkeeping and tax collection. So that there be prevention of hundreds of billions of dollars leaving Africa on legal ways. I would like to talk about agreements of trade and investments under which combines are profiting while the people and environment are suffering.
I would ask him if he could economically and ethically justify the wealth of the One Percent of people, and whether the pitiful salary of hundreds of thousands of world-wide nurses and teachers was adequate.
There would be a lot coming to mind. We could discuss for hours.

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It is about actually good intentions, albite without a clue of priority.

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ORIGINAL: aeolus

And there is always one kibitzer who thinks it's being done all wrong.

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. Yet, it appears his[Gates] true aim to do good for the poor.

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ORIGINAL: aeolus

At age 82 I have no worries about a future I will not see but my son is another matter. He is on his own I am afraid.

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