38 The Bill & Melinda Gates Foundation's Grant-Making Programme for Global Health

David McCoy, Gayatri Kembhavi, Jinesh Patel, and Akish Luintel

Introduction

The Bill & Melinda Gates Foundation (henceforth referred to as the Gates Foundation) is the largest private grant-making foundation in the world. It has three main programmes: a US programme that focuses on secondary and post-secondary education; a global development programme 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.

Although there is a long history of private philanthropic 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), and was substantially more than the total grant spending of the Rockefeller Foundation across all programmatic areas in the same year ($0.17 billion). The Gates Foundation's effect on global health is evident in malaria research. In the late 1990s, only $84 million was spent on malaria research yearly; since 2000, the Gates Foundation has helped to roughly treble this amount. However, there have been concerns about the role, ...

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