The Bill & Melinda Gates Foundation’s annual letter is out, crafted as a thank-you note to fellow billionaire and foundation donor Warren Buffett about the benefits and promise of foreign aid.
There are no big surprises in the 2017 Gates Foundation always optimistic annual letter, repeating many of the gains made in global health through expansion of child vaccinations, improvements in child and maternal mortality and the continuing global reduction in the most extreme forms of poverty.
What’s not said in the letter, or is only referred to somewhat obliquely, is perhaps of more significance.
“Our letter is being released amid dramatic political transitions in these countries, including new leadership in the United States and the United Kingdom. We hope this story will remind everyone why foreign aid should remain a priority—because by lifting up the poorest, we express the highest values of our nations,” say the Gates in the introduction. “One of the greatest of those values is the belief that the best investment any of us can ever make is in the lives of others.”
That is very hopeful indeed, since the new leadership in the U.S. and U.K. is arguably driven by isolationism and, to some extent, forms of nationalism hostile to foreign aid or any other forms of ‘investment’ in the poor overseas.
The world’s top philanthropists had not until recently joined the chorus of those who were directly challenging the Trump Administration on policies that appear to run counter to their philanthropic mission and values. Just after the election but before the inauguration, Bill Gates spoke by phone with Donald Trump and publicly said he was enthusiastic about the promise of a Trump presidency.
“But in the same way President Kennedy talked about the space mission and got the country behind that,” he said to CNBC in December, “I think whether it’s education or stopping epidemics … [or]in this energy space, there can be a very upbeat message that [Trump’s] administration [is]going to organize things, get rid of regulatory barriers, and have American leadership through innovation.”
Melinda Gates, asked at an event in Seattle last week what she thought of the stated aims and policies of the Trump Administration, said they plan to work with the Trump Administration to advance foreign aid.
Some saw that response, following on the heels of Gates’ comparison of Trump to JFK, as pretty weak tea – given the Trump Administration’s stated aims that many see as contradictory to the fundamental purpose of aid and development. But as this piece at Inside Philanthropy reported, the Gates Foundation hasn’t been unique within the aid/dev community in having trouble findings its voice amid the political turmoil caused by the Trump Adminstration’s now-on-hold travel ban, his talk of building walls and so on.
The Gates annual letter doesn’t talk about much of the new political landscape. Instead, it goes on at length to describe how the world is getting better thanks to aid and development. Buffett asked that this year’s letter reflect on the accomplishments and lessons learned over the course of the foundation’s work. He said it is “important” for the foundation that “will always be in the spotlight” to reach out to its global audience.
In response, the Gates tell Buffett that the work of the foundation follows the path towards a world without poverty.
“Polio will soon be history. In our lifetimes, malaria will end. No one will die from AIDS. Few people will get TB. Children everywhere will be well nourished. And the death of a child in the developing world will be just as rare as the death of a child in the rich world,” they write. “We can’t put a date on these events, and we don’t know the sequence, but we’re confident of one thing: The future will surprise the pessimists.”
That optimism is less present in recent public statements. The Gates make a narrow appeal in their promotional interviews and appearances – it is all about protecting foreign aid spending. They worry that the inward trend of political movements in donor countries could jeopardize the global anti-poverty effort.
“If people turn too inwards to look at their country and don’t continue to look at the world at large, we won’t have peace and security in the world,” said Melinda Gates, to Quartz.
Perhaps in part because they recognized the official letter may sound a little, well, lacking in context, Bill and Melinda granted interviews with select media to speak out against the Trump Administration’s reinstatement of the so-called ‘global gag rule’ prohibiting recipients of U.S. foreign aid money to promote or provide abortion services. The foundation and other philanthropies are unable to fill the family planning funding gap left by the rule.
“We’re concerned that this shift could impact millions of women and girls around the world,” said Melinda Gates, to the Guardian. “It’s likely to have a negative effect on a broad range of health programs that provide lifesaving treatment and prevention options to those most in need. This includes programs that prevent and treat HIV, TB and malaria, and provide healthcare to women and children around the world.”
The rule threatens the Melinda Gates-led Family Planning 2020 partnership that aimed to give 120 million more women access to contraceptives by 2020. Achieving that goal requires the rate of access to accelerate faster than the rate since the 2012 launch of the partnership.
(Gates Foundation)
Contraceptives need to reach nearly 100 million more women in 3 years – less than half of the 225 million women who want to avoid pregnancy but cannot access contraceptives. The return of the gag rule will make the task more difficult. Population Action International found that U.S. contraceptive shipments to 16 developing countries in Africa, Asia and the Middle East stopped by 2002, a year after President George W. Bush reinstated the rule.
An expanded reintroduction of the rule may harm other U.S. funded health programs. Bill Gates expressed concerns that President’s Emergency Plan for AIDS Relief (PEPFAR), to USA Today. It is one of the few government programs that enjoys strong bi-partisan support. Launched by Bush, PEPFAR is equally well-regarded in global health circles as it is in Washington D.C.
The letter acknowledges some of the challenges but manages to put a positive spin on everything. The Gates use data as the skeleton for the letter’s optimism. Facts like vaccine coverage in low-income countries increased from below 20 percent in 1980 to 80 percent in 2015. And concerning data such as the fact that more than 2.5 million babies died in their first month of life, last year. The information about how to reduce deaths and improve health access fill out the body of the letter.
“A lot of people feel the world is getting more fragmented, and we all can point to examples of that. But if you look along a timeline, the periods of fragmentation often come when society is digesting its new diversity. The larger historical trends are toward greater inclusion and caring,” says Melinda Gates.
“We definitely see it in global health. Governments are prioritizing it. Citizens are supporting it. And scientists are migrating to it.”
