It’s my party and I’ll cry if I want to…

There’s an interesting “debate” going on the current issue (vol 365 no 9463) of The Lancet regarding the work of the Bill & Melinda Gates Foundation (Foundation).

The editors ask if Bill Gates is “a 21st century Robin Hood”, pointing to how he has given away over $28 billion USD to date. With an endowment of over $28.8 billion USD, the Gates Foundation is the world’s largest charity, having to give away at least 5% of its assets each year. That means the foundation must give away about $1.5 billion USD in 2005 alone! Okay, so far so good. The Foundation focuses on four main areas: global health, education, public libraries, and support for at-risk families in the Washington/Oregon area. Some of the good things the Foundation is doing include pushing global health research to the fore and providing immediate medicinal relief. The editors note that the Foundation isn’t perfect, but that Bill Gates is at least trying to make a difference by putting serious dollars to things that interest him.

On the other side, Prof. Anne-Emanuelle Birn provides an opposite viewpoint in her paper titled “Gates’s grandest challenge: Transcending technology as public health ideology”. Basically, Birn says that the goals of the Foundation are well intentioned by go about things in the wrong way. The criticism of the goals are quite sharp, and with merit. Birn’s strongest criticism is how the Foundation separates the public health issues from the socio-political landscape. After reading the paper, I must say that I would tend to agree with the critique. I mean, in Canada, we realized this back in 1974 with the release of the Lalonde report (A new perspective on the health of Canadians).

I think Birn is forgetting an important point – it’s Gates’s money and he can do what he wants with it. I know that this position may not sit well with everyone, but we (well, I assume *we*) in Western democracies that espouse personal liberties. He was successful in his business and should have the freedom to spend it as he lawfully chooses. Personally, I think quite highly of him to give so much of his personal wealth away. Sure, he’s still worth an estimated $48 billion USD as of 2005, but I don’t see any other billionaire supporting charities to such a large degree. I think the only other person that comes to mind is Ted Turner who gave away some $1 billion at one point. Sure Gates can probably do a better job, but at least he is trying to do something positive. It’s easy to complain, but maybe we should be going after the other industrialists and uber-rich to pony up and give back. Personally, I think Bill Gates is working on his legacy of trying to be his generation’s version of the Rockefellers or Carnegies.

So, it’s Bill’s party and he can cry if he wants to.



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