It’s good that watchdogs are keeping their eye on the Gates Foundation and that thoughtful experts are monitoring the overall benefits of global health philanthropies, but Sunday’s LA Times story on the Gates Foundation was awfully sensational.
It basically says money the foundation is spending battling AIDS in Africa is distorting the continent’s already poor healthcare system, drawing resources and luring desparately needed healthcare workers to better-paying jobs funded by grants. It also questions priorities, noting that people are still dying of hunger — some are so hungry they throw up the AIDS medicine the foundation is funding.
These are interesting questions and there is great on-the-ground reporting, but the story uses a terrible anecdote of an infant’s death to make its point.
Here’s an excerpt from the story, headlined “Unintended victims of Gates Foundation generosity”:
There was no oxygen tube for Mankuebe. She asphyxiated for lack of a second valve. It would have cost $35.
The hospital, with no staff to move Mankuebe’s remains to the morgue, placed her body on a shelf near the delivery room while her father arranged for burial. The tiny corpse was swaddled in a baby blanket. A handwritten death notice was stuck to the blanket with a used hypodermic needle.
The Gates Foundation, endowed by the personal fortunes of the Microsoft Corp. chairman, his wife and Berkshire Hathaway Inc. Chairman Warren E. Buffett, has given $650 million to the Global Fund. But the oxygen valve fell outside the priorities of the fund’s grants to Lesotho.
Every day, nurses say, one or two babies at the hospital die as Mankuebe did — bypassed in a place where AIDS overshadows other concerns.
That’s a low blow, because it implies the foundation is responsible because it didn’t spend $35 for a valve.
The lack of a valve in a chronically underfunded African hospital isn’t a smoking gun. Maybe I missed something in the story, but it didn’t say the valve would have been there if not for the priority placed on AIDS work because of the Gates money. So how does that make Mankuebe an “unintended victim”?
The story actually says the foundation gave the child a chance to come into the world, because it had earlier saved the child’s mother, not to mention all the children saved by its work on malaria and other critical problems.
It does a good job showing that the AIDS work is stressing Africa’s healthcare system, and it’s a reminder that the foundation is still young and has issues to sort out, such as the side effects of its giant footprint.
It’s also good for the public to know about the foundation’s challenges and outcomes, intended and unintended. With all the money being spent, there’s going to be some dirt.
I’m glad there are newspapers with the resources to do this kind of reporting, but I wish the story had more context.
Also, if the goal is to pressure the foundation to spend more on basic healthcare delivery in places like Africa, I’m not sure the best route is to suggest Mankuebe died because of bad decisions made in Seattle.