The Failure of Philanthropy

After 10 years and an investment of $1 billion, none of the projects funded under the Gates Foundation’s  Grand Challenges program has yet made a significant contribution to saving lives and improving health in the developing world, according to thisarticle in the Seattle Times.

Launched with fanfare a decade ago, the original Grand Challenges program mobilized leading scientists to tackle some of the toughest problems in global health. Gates handed out nearly half a billion dollars in grants to 45 “dream teams” of researchers working on everything from tuberculosis drugs and new vaccine strategies to advanced mosquito repellents and bananas genetically engineered to boost nutrition. Not only did he underestimate some of the scientific hurdles, Gates said. He and his team also failed to adequately consider what it would take to implement new technologies in countries where millions of people lack access to basic necessities such as clean water and medical care.

So in 2008 he introduced a program of small, highly focused grants called Grand Challenges Explorations. With headline-grabbing goals like condoms that feel good and waste-to-energy toilets, the explorations initiative has probably garnered more media attention than anything else the giant philanthropy has undertaken. But none of those projects has yet borne fruit, either.

“Was the program actually a success?” asked Nobel Prize-winning biologist Harold Varmus, who served on the founding board. “We don’t know.”

Among Bill Gates’ favorite projects is an effort to eliminate Dengue fever by infecting mosquitoes with bacteria that block disease transmission. Another is a spinoff biotech working on a probiotic to cure cholera. But critics say projects like those demonstrate the foundation’s continuing emphasis on technological fixes, rather than on the social and political roots of poverty and disease.

Dr. David McCoy, a public-health expert at Queen Mary University, London, said “It’s in looking constantly for new solutions, rather than tackling the barriers to existing solutions.” The toll of many diseases could be lowered simply by strengthening health systems in developing countries, he said. Instead, programs like Grand Challenges — heavily promoted by the Gates Foundation’s PR machine — divert the global community’s attention from such needs, McCoy argues.

There exits a disconnect between laboratory science and the field. An effort to develop vaccines that don’t need refrigeration yielded good ideas, but it didn’t make sense to commercialize the technology because the entire vaccine-distribution system in Africa is built around the use of refrigeration.

Several Gates-funded, high-tech toilets were installed in the Indian city of Raichur last year, at a cost of about $8,000 each, residents refused to use them. Many of the other toilet prototypes funded through Grand Challenges are so complex, with solar panels and combustion chambers, they would never prove practical. Jason Kass, founder of Toilets for People, a company that sells simple, composting toilets to nonprofits in the developing world, explained in the  New York Times that “Bill Gates Can’t Build a Toilet…If the many failed development projects of the past 60 years have taught us anything, it’s that complicated, imported solutions do not work. ”