No. 57, May 2014

No. 57
(May 2014):

The Real Agenda of the Gates Foundation

The Real Agenda of the Gates Foundation

II. Foundations and Imperialism

When those who have aggressively established and maintained monopolies in order to accumulate vast capital turn to charitable activities, we need not assume their motives are humanitarian.21 Indeed, on occasion these ‘philanthropists’ define their aims more bluntly as making the world safe for their kind. In a letter published on the Foundation's website, Bill Gates invokes  “the rich world's enlightened self-interest” and warns that “[i]f societies can’t provide for people’s basic health, if they can’t feed and educate people, then their populations and problems will grow and the world will be a less stable place.”22

The pattern of such ‘philanthropic’ activities was set in the US about a century ago, when industrial barons such as Rockefeller and Carnegie set up the foundations that bear their names, to be followed in 1936 by Ford. As Joan Roelofs has argued,23 during the past century large-scale private philanthropy has played a critical worldwide role in ensuring the hegemony of neoliberal institutions while reinforcing the ideology of the Western ruling class. Interlocking networks of foundations, foundation-sponsored NGOs, and US government institutions like the National Endowment for Democracy (NED) – notorious as a “pass-through” for CIA funds – work hand-in-hand with imperialism, subverting people-friendly states and social movements by co-opting institutions deemed helpful to US global strategy. In extreme but not infrequent cases, foundations have actively collaborated in regime change ops managed by US intelligence.24

The role of Big Philanthropy, however, is broader. Even seemingly benign endeavors by foundations, such as the fight against infectious diseases, can best be understood when located in their specific historical and social contexts. Recall that schools of tropical medicine were established in and the US in the late 19th Century with the explicit goal of increasing the productivity of colonized laborers while insuring the safety of their white overseers. As a journalist wrote in 1907:

Disease still decimates native populations and sends men home from the tropics prematurely old and broken down. Until the white man has the key to the problem, this blot must remain. To bring large tracts of the globe under the white man's rule has a grandiloquent ring; but unless we have the means of improving the conditions of the inhabitants, it is scarcely more than an empty boast.25

Precisely this reasoning underlay the formation of the Rockefeller Foundation, which was incorporated in 1913 with the initial goal of eradicating hookworm, malaria, and yellow fever.26 In the colonized world public health measures encouraged by Rockefeller’s International Health Commission yielded increases in profit extraction, as each worker could now be paid less per unit of work, “but with increased strength was able to work harder and longer and received more money in his pay envelope.”27 In addition to enhanced labour efficiency – which was not necessarily a critical challenge to capital in regions where vast pools of underemployed labour were available for exploitation – Rockefeller’s research programs promised greater scope for future US military adventures in the Global South, where occupying armies had often been hamstrung by tropical diseases.28

As Rockefeller expanded its international health programs in concert with US agencies and other organizations, additional advantages to the imperial core were realized.  Modern medicine advertised the benefits of capitalism to “backward” people, undermining their resistance to domination by imperialist powers while creating a native professional class increasingly receptive to neocolonialism and dependent on foreign largesse. Rockefeller's president observed in 1916: “[F]or purposes of placating primitive and suspicious peoples medicines have some advantages over machine guns.”29

In the aftermath of World War II, public health philanthropy became closely aligned with US foreign policy as neocolonialism embraced the rhetoric, if not always the substance, of “development.” Foundations collaborated with the US Agency for International Development (USAID) in support of interventions aimed at increasing production of raw materials while creating new markets for Western manufactured goods. A section of the US ruling class, represented most prominently by Secretary of State George Marshall, argued that “increases in the productivity of tropical labor would require investments in social and economic infrastructure including greater investments in public health.”30

Meanwhile, the seminal Gaither Report, commissioned in 1949 by the Ford Foundation, had charged Big Philanthropy with advancing “human welfare” in order to resist the “tide of Communism … in Asia and Europe.”31 By 1956, a report to the US president by the International Development Administration Board openly framed public health assistance as a tactic in aid of Western military aggression in Indochina:

[A]reas rendered inaccessible at night by Viet Minh activity, during the day welcomed DDT-residual spray teams combating malaria. … In the Philippines, similar programs make possible colonization of many previously uninhabited areas, and contribute greatly to the conversion of Huk terrorists to peaceful landowners.32

For a time, therefore, Western philanthropy worked to shape public health systems in poor countries, sometimes condescending to relinquish control of infrastructure and trained personnel to national health ministries.33 Although actual investment in Third World healthcare was meager by comparison with the extravagant promises of Cold War rhetoric, some response to health crises in poor countries was deemed necessary in the context of the postwar struggle for “hearts and minds.”

The fall of the Soviet Union ushered in the present phase of public health philanthropy, characterized by the Western demand for “global health governance” – purportedly as a response to the spread of communicable diseases accelerated by globalization. Health has been redefined as a security concern; the developing world is portrayed as a teeming petri dish of SARS, AIDS, and tropical infections, spreading “disease and death” across the globe34 and requiring Western powers to establish centralized health systems designed to “overcome the constraints of state sovereignty.”35 Imperial interventions in the health field are justified in the same terms as recent “humanitarian” military interventions: “[N]ational interests now mandate that countries engage internationally as a responsibility to protect against imported health threats or to help stabilize conflicts abroad so that they do not disrupt global security or commerce.”36

Providing support for national healthcare operations is no longer on the agenda; to the contrary – in keeping with structural adjustment programs that have required ruinous disinvestment in public health throughout the developing world37 – health ministries are routinely bypassed or compromised via “public-private partnerships” and similar schemes. As national health systems are hollowed out, health spending by donor countries and private foundations has risen dramatically.38 Indeed, the US-based Council on Foreign Relations envisions a withering away of state-sponsored healthcare delivery, to be replaced by a supranational regime of “new legal frameworks, public-private partnerships, national programs, innovative financing mechanisms, and greater engagement by nongovernmental organizations, philanthropic foundations, and multinational corporations.”39

The exemplar of philanthropy in the era of global health governance is the Gates Foundation. Vastly endowed, essentially unaccountable, unencumbered by respect for democracy or national sovereignty, floating freely between the public and private spheres, it is ideally positioned to intervene swiftly and decisively on behalf of the interests it represents.  As Bill Gates remarked, “I’m not gonna get voted out of office.”40 Close working relationships with UN, US and EU institutions, as well as powerful multinational corporations, give BMGF an extraordinary capability to harmonize complex overlapping agendas, ensuring that corporate and US ambitions are simultaneously advanced. To better understand how BMGF operates and in whose interests, it is worth looking closely at the Foundation’s global vaccine programs, where until recently the bulk of its money and muscle was brought to bear.




21. The Gates Foundation’s occasional pretensions to selfless charity are belied by the policies of its Trust, which invests heavily in “companies that contribute to the human suffering in health, housing and social welfare that the foundation is trying to alleviate.” Andy Beckett, “Inside the Bill and Melinda Gates Foundation,” Guardian, July 12, 2010, (back)

22. Bill Gates, Annual Letter 2011, (back)

23. Foundations and Public Policy: The Mask of Pluralism (SUNY Series in Radical Social and Political Theory 2003); see also “New Study on the Role of US Foundations,” Aspects of India's Economy No. 38, Dec., 2004, (back)

24. E.g. “[i]n Indonesia the Ford Foundation-sponsored knowledge networks worked to undermine the neutralist Sukarno government that challenged U.S. hegemony. At the same time, Ford trained economists (both at University of Indonesia and in U.S. universities) for a future regime supportive of capitalist imperialism.” Roelofs, “Foundations and American Power,” Counterpunch, April 20-22, 2012, (back)

25. Quoted in E. Richard Brown, “Public Health in Imperialism: Early Rockefeller Programs at Home and Abroad, Am J Public Health, 1976 September; 66(9): 897–903, 897. (back)

26. From its earliest days Rockefeller’s philanthropy hid a domestic agenda as well. The Foundation was forced to retreat from sponsorship of research into labor relations after the 1916 Walsh Commission Report found it was “corrupt[ing] sources of public information” in an effort to whitewash predatory business practices and industrial violence. Jeffrey Brison, Rockefeller, Carnegie, and Canada, Montreal: McGill-Queen’s University Press, 2005, p. 35. (back)

27. E. Richard Brown, op. cit., p. 900. (back)

28. David Killingray, “Colonial Warfare in West Africa 1870-1914,” reprinted in J. A. de Moor & H.L. Wesseling, eds., Imperialism and War, Leiden : E.J. Brill : Universitaire pers Leiden, 1989, pp. 150-151. (back)

29. E. Richard Brown, op. cit., p. 900. (back)

30. Randall Packard, “Visions of Postwar Health and Development and Their Impact on Public Health Interventions in the Developing World,” reprinted in Frederick Cooper & Randall Packard, International Development and the Social Sciences, Berkeley: Univ. of California Press, 1997, p. 97. In a 1948 address to the Fourth International Congress of Tropical Diseases and Malaria, Marshall, a leading architect of US policy during the early years of the Cold War, outlined a grandiose vision of healthcare under ‘enlightened’ capitalism: “Little imagination is required to visualize the great increase in the production of food and raw materials, the stimulus to world trade, and above all the improvement in living conditions, with consequent cultural and social advantages, that would result from the conquest of tropical diseases.” Ibid., p. 97. (back)

31. Report of the Study for the Ford Foundation on Policy and Program, Detroit: Ford Foundation, November, 1949, p. 26, (back)

32. Quoted in Packard, op. cit., p. 99. (back)

33. Wilbur G. Downs, M.D., “The Rockefeller Foundation Virus Program 1951-1971 with Update to 1981, Ann. Rev. Med. 1982 33:1-29, 8. (back)

34. Andrew F. Cooper and John J. Kirton, eds., Innovation in Global Health Governance: Critical Cases, Aldershot: Ashgate Publishing, 2009, ch. 1. (back)

35. Michael A. Stevenson & Andrew F. Cooper, “Overcoming Constraints of State Sovereignty: Global Health Governance in Asia, Third World Quarterly, vol. 30, no. 7, 3009, pp. 1379-1394. (back)

36. Thomas E Novotny et al., “Global health diplomacy– a bridge to innovative collaborative action,” Global Forum Update on Research for Health, vol. 5, 2008, p. 41. (Emphasis added.) (back)

37. See Ann-Louise Colgan, Hazardous to Health: The World Bank and IMF in Africa, Africa Action position paper, April 18, 2002, (back)

38. Global Health Watch, pp. 210-11. (back)

39. David P. Fidler, The Challenges of Global Health Governance, CFR Working Paper, May, 2010, (back)

40. Interview with Bill Gates, NOW with Bill Moyers, May 9, 2003, transcript of television interview, (back)



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