April 2011 - Centre for Civil Society - University of KwaZulu-Natal

donor to the World Health Organisation (WHO). This can be seen both
ways: donor money has infused life into a nearly bankrupt entity, but it is
also causing much consternation.
Effects of the structural changes being pushed by the new interests will be
seen years or decades down the line.
"The very mandate and constitution of the WHO is being undermined," says
KM Gopakumar, legal advisor and senior researcher of the Third World
Network in India.
Speaking to the media in Bangalore this week, Warren Buffett, who has
committed most of his $50 billion wealth to the Gates Foundation,
admitted it takes a long time to see the full results of philanthropic work.
While it is conceded that it would be downright impudent to look a gift
horse in the mouth, the concentration of power in the hands of new
philanthro-capitalists is causing alarm; especially on issues around equity
and social justice, on the accountability of donors and its impact, maybe
unintended, on global institutions and processes.
"The rapid demise of public sector policy-making in key areas of public
health, and the reliance on the Gates family and its staff, is impoverishing
debate over public health priorities," says James Love, director,
Knowledge Economy International (KEI), a US-based not-for-profit that
seeks better outcomes to the management of knowledge resources. It is
borne out by occasional outbursts from people within the system.
Concentration of Power
Some time ago, the head of WHO's malaria research revealed that the
increasing dominance of the Gates Foundation was stifling diversity of
views among scientists and that it could seriously impede the policymaking
function of the world body. He was dismayed by the foundation's
decision-making process: "A closed, internal process, accountable to none
other than itself".
More recently, in January 2011, the Peoples Health Movement, a grassroots
campaign for health for all, wrote to members of the WHO's executive
board, calling attention to a number of issues. This included innovation,
intellectual property rights (IPR), millennium development goals, and also
the future of financing WHO, especially the unhealthy trend of donor
money increasing in proportion to that of contributions from member
states.
WHO's recent over-reliance on medicines, diagnostics and other
technological fixes is being criticised. "Allocations to the social
determinants of health have shrunk greatly," says Mira Shiva. "Water, food,
sanitation and other social circumstances have a greater play on the health
of the poor." Shiva has been an ardent proponent for the rational use of
medicines.
In contrast, a humungous push on vaccines is underway. The Gates
Foundation, for example, has allocated $10 billion to this field and
describes this as the decade of vaccines. However, the GAVI Alliance, and
some of the mechanisms it has fostered, is now under fire.
One such mechanism is the Advance Market Commitments (AMC), inspired
and supported by the Gates Foundation. The AMC seeks to provide pharma
companies a captive market for 10 years, provided they agree to develop
and supply vaccines to developing countries, in millions of doses, at a deep