Content area
Full Text
The Bill & Melinda Gates Foundation is a major contributor to global health; its influence on international health policy and the design of global health programmes and initiatives is profound. Although the foundation's contribution to global health generally receives acclaim, fairly little is known about its grant-making programme. We undertook an analysis of 1094 global health grants awarded between January, 1998, and December, 2007. We found that the total value of these grants was US$8.95 billion, of which $5.82 billion (65%) was shared by only 20 organisations. Nevertheless, a wide range of global health organisations, such as WHO, the GAVI Alliance, the World Bank, the Global Fund to Fight AIDS, Tuberculosis and Malaria, prominent universities, and non-governmental organisations received grants. $3.62 billion (40% of all funding) was given to supranational organisations. Of the remaining amount, 82% went to recipients based in the USA. Just over a third ($3.27 billion) of funding was allocated to research and development (mainly for vaccines and microbicides), or to basic science research. The findings of this report raise several questions about the foundation's global health grant-making programme, which needs further research and assessment.
Introduction
The Bill & Melinda Gates Foundation (henceforth referred to as the Gates Foundation) is the largest private grant-making foundation in the world.1 It has three main programmes: a US programme that focuses on secondary and post-secondary education; a global development pro gramme that focuses on hunger and poverty (with an emphasis on small farmers and financial services for the poor); and a global health programme. The total amount paid out by the foundation for all grants in 2007 was US$2.01 billion, of which $1.22 billion (61%) was for global health.2
Although there is a long history of private philan thropic funding in global health-notably by the Rockefeller Foundation and the Ford Foundation-the influence of the Gates Foundation is of a different order. In 2007, the amount spent by the Gates Foundation on global health was almost as much as WHO's annual budget (approximately $1.65 billion),3 and was substantially more than the total grant spending of the Rockefeller Foundation across all programmatic areas in the same year ($0.17 billion).4 The Gates Foundation's effect on global health is evident in malaria research. In the late 1990s, only...