by Jacob Levich
May 2014
from
RUPE Website
Jacob Levich, jlevich@earthlink.net,
has written on imperialist military strategy for Aspects No. 42.
He lives in New York City and tweets as @cordeliers. |
"You're trying to find the places where the money will have the
most leverage, how you can save the most lives for the dollar,
so to speak," Pelley remarked.
"Right. And transform the
societies," Gates replied.1
In 2009 the self-designated "Good Club" - a
gathering of the world's wealthiest people whose collective net worth then
totaled some $125 billion - met behind closed doors in New York City to
discuss a coordinated response to threats posed by the global financial
crisis.
Led by
Bill Gates, Warren Buffett, and
David Rockefeller, the group resolved
to find new ways of addressing sources of discontent in the developing
world, in particular "overpopulation" and infectious diseases.2
The billionaires in attendance committed to
massive spending in areas of interest to themselves, heedless of the
priorities of national governments and existing aid organizations.3
Details of the secret summit were leaked to the press and hailed as a
turning point for Big Philanthropy.
Traditional bureaucratic foundations like Ford,
Rockefeller, and Carnegie were said to be giving way to "philanthrocapitalism,"
a muscular new approach to charity in which the presumed entrepreneurial
skills of billionaires would be applied directly to the world's most
pressing challenges:
Today's philanthrocapitalists see a world
full of big problems that they, and perhaps only they, can and must put
right...
Their philanthropy is "strategic," "market
conscious," "impact oriented," "knowledge based," often "high
engagement," and always driven by the goal of maximizing the "leverage"
of the donor's money...
[P]hilanthrocapitalists are increasingly
trying to find ways of harnessing the profit motive to achieve social
good.4
Wielding "huge power that could reshape nations
according to their will," 5 billionaire donors would now
openly embrace not only the market-based theory, but also the practices and
organizational norms, of corporate capitalism.
Yet the overall thrust of their charitable
interventions would remain consistent with longstanding traditions of Big
Philanthropy, as discussed below:
I. The World's Largest Private Foundation
"A new form of multilateral organization"
The most prominent of the philanthrocapitalists is Bill Gates, co-founder of
Microsoft Corp. and as of this writing the richest man in the world.
(Despite the carefully cultivated impression
that Gates is "giving away" his fortune to charity, his estimated net worth
has increased every year since 2009 and now amounts to $72 billion.)
6
Gates owes his fortune not to making
technological contributions but to acquiring and enforcing a fabulously
lucrative monopoly in computer operating systems:
Microsoft's greatest strength has always
been its monopoly position in the PC chain. Its exclusionary licensing
agreement with PC manufacturers mandated a payment for an MS-DOS license
whether or not a Microsoft operating system was used...
By the time the company settled with the
Justice Department in 1994 over this illegal arrangement, Microsoft had
garnered a dominant market share of all operating systems sold.7
Microsoft employs the standard repertoire of
business strategies in defense of its monopoly power - preferential pricing,
lawsuits, acquisitions of competitors, lobbying for patent protection - but
relies ultimately, like other US-based monopolies, on the dominant position
of the US worldwide.
As former US Secretary of Defense William
Cohen observed in 1999,
"the prosperity that companies like
Microsoft now enjoy could not occur without having the strong military
that we have." 8
Gates remains chairman of Microsoft but now
devotes the bulk of his time to running
The Bill and Melinda Gates Foundation
(BMGF), the largest private foundation in the world and easily the most
powerful.
With an endowment of $38 billion, BMGF dwarfs
once-dominant players such as Ford ($10 billion), Rockefeller ($3 billion),
and Carnegie ($2.7 billion).9
These elite charitable funds are attractive to
the super-rich not only as alternative channels of influencing policy, but
also as a legal means of tax avoidance. Under US law, investments in
charitable foundations are tax-free; moreover, investors are not required to
sell their stock positions and may continue to vote their shares without
restriction.10
By sheltering foundations, the US Treasury
effectively co-finances the activities of BMGF and its investors, supplying
a substantial part of the "leverage" lauded above.
Even in a field dominated by the world's richest, the Gates Foundation has
acquired a reputation for exceptional high-handedness.
It is,
"driven by the interests and passions of the
Gates family," evasive about its financials, and accountable to no one
except its founder, who "shapes and approves foundation strategies,
advocates for the foundation's issues, and sets the organization's
overall direction."11
Gates' approach to charity is presumably rooted
in his attitude toward democracy:
The closer you get to [Government] and see
how the sausage is made, the more you go, oh my God! These guys don't
even actually know the budget...
The idea that all these people are going to
vote and have an opinion about subjects that are increasingly complex -
where what seems, you might think… the easy answer [is] not the real
answer. It's a very interesting problem.
Do democracies faced with these current
problems do these things well? 12
The Gates charitable empire is vast and growing.
Within the US, BMGF focuses primarily on "education reform," providing
support for efforts to privatize public schools and subordinate teachers'
unions.
Its much larger international divisions target
the developing world and are geared toward infectious diseases, agricultural
policy, reproductive health, and population control. In 2009 alone, BMGF
spent more than $1.8 billion on global health projects.13
The Gates Foundation exercises power not only via its own spending, but more
broadly through an elaborate network of "partner organizations" including
non-profits, government agencies, and private corporations.
As the third largest donor to the UN's
World Health Organization (WHO), it is a
dominant player in the formation of global health policy.14
It orchestrates vast elaborate public-private
partnerships - charitable salmagundis that tend to blur distinctions between
states, which are at least theoretically accountable to citizens, and
profit-seeking businesses that are accountable only to their shareholders.
For example, a 2012 initiative aimed at
combating neglected tropical diseases listed among its affiliates,
...and a consortium of 13 drug firms comprising
the most notorious powers
in Big Pharma, including,
-
Merck
-
GlaxoSmithKline
-
Pfizer 15
BMGF is the prime mover behind prominent
"multi-stakeholder initiatives" such as the Global Fund to Fight AIDS,
Tuberculosis and Malaria, and the GAVI Alliance (a "public-private
partnership" between the World Health Organization and
the vaccine industry).
Such arrangements allow BMGF to leverage its
stake in allied enterprises, much as private businesses enhance power and
profits through strategic investment schemes. The Foundation also intervenes
directly in the agendas and activities of national governments, ranging from
its financing of the development of municipal infrastructure in Uganda,16
to its recently announced collaboration with the Indian Ministry of Science
to "Reinvent the Toilet."17
At the same time the Foundation supports NGOs
that lobby governments to increase spending on the initiatives it sponsors.18
The Gates operation resembles nothing so much as a massive, vertically
integrated multinational corporation (MNC), controlling every step in
a supply chain that reaches from its Seattle-based boardroom, through
various stages of procurement, production, and distribution, to millions of
nameless, impoverished "end-users" in the villages of Africa and South Asia.
Emulating his own strategies for cornering the
software market, Gates has created a virtual monopoly in the field of
public health.
In the words of one NGO official,
"[y]ou can't cough, scratch your head or
sneeze in health without coming to the Gates Foundation."19
The Foundation's global influence is now so
great that former CEO Jeff Raikes was obliged to declare:
"We are not replacing the UN. But some
people would say we're a new form of multilateral organization."20
II. Foundations and Imperialism
When those who have aggressively established and maintained monopolies in
order to accumulate vast capital turn to charitable activities, we need not
assume their motives are humanitarian.21
Indeed, on occasion these 'philanthropists'
define their aims more bluntly as making the world safe for their kind. In a
letter published on the Foundation's website, Bill Gates invokes,
"the rich world's enlightened self-interest"
and warns that "[i]f societies can't provide for people's basic health,
if they can't feed and educate people, then their populations and
problems will grow and the world will be a less stable place."
22
The pattern of such 'philanthropic' activities
was set in the US about a century ago, when industrial barons such as
Rockefeller and Carnegie set up the foundations that bear their names, to be
followed in 1936 by Ford.
As Joan Roelofs has argued,23
during the past century large-scale private philanthropy has played a
critical worldwide role in ensuring the hegemony of neoliberal institutions
while reinforcing the ideology of the Western ruling class.
Interlocking networks of foundations,
foundation-sponsored NGOs, and US government institutions like
the National Endowment for Democracy (NED)
- notorious as a "pass-through" for CIA funds - work hand-in-hand with
imperialism, subverting people-friendly states and social movements by
co-opting institutions deemed helpful to US global strategy. In extreme but
not infrequent cases, foundations have actively collaborated in regime
change ops managed by US intelligence.24
The role of Big Philanthropy, however, is broader.
Even seemingly benign endeavors by foundations,
such as the fight against infectious diseases, can best be understood when
located in their specific historical and social contexts.
Recall that schools of tropical medicine were
established in and the US in the late 19th Century with
the explicit goal of increasing the productivity of colonized laborers while
insuring the safety of their white overseers.
As a journalist wrote in 1907:
Disease still decimates native populations
and sends men home from the tropics prematurely old and broken down.
Until the white man has the key to the problem, this blot must remain.
To bring large tracts of the globe under the
white man's rule has a grandiloquent ring; but unless we have the means
of improving the conditions of the inhabitants, it is scarcely more than
an empty boast.25
Precisely this reasoning underlay the formation
of the Rockefeller Foundation, which was incorporated in 1913 with the
initial goal of eradicating hookworm, malaria, and yellow fever.26
In the colonized world public health measures
encouraged by Rockefeller's International Health Commission yielded
increases in profit extraction, as each worker could now be paid less per
unit of work,
"but with increased strength was able to
work harder and longer and received more money in his pay envelope."27
In addition to enhanced labour efficiency -
which was not necessarily a critical challenge to capital in regions where
vast pools of underemployed labour were available for exploitation -
Rockefeller's research programs promised greater scope for future US
military adventures in the Global South, where occupying armies had often
been hamstrung by tropical diseases.28
As Rockefeller expanded its international health programs in concert with US
agencies and other organizations, additional advantages to the imperial core
were realized.
Modern medicine advertised the benefits of
capitalism to "backward" people, undermining their resistance to domination
by imperialist powers while creating a native professional class
increasingly receptive to neocolonialism and dependent on foreign largesse.
Rockefeller's president observed in 1916:
"[F]or purposes of placating primitive and
suspicious peoples medicines have some advantages over machine guns."29
In the aftermath of World War II, public health
philanthropy became closely aligned with US foreign policy as neocolonialism
embraced the rhetoric, if not always the substance, of "development."
Foundations collaborated with the US Agency
for International Development (USAID) in support of interventions aimed
at increasing production of raw materials while creating new markets for
Western manufactured goods.
A section of the US ruling class, represented
most prominently by Secretary of State George Marshall, argued that,
"increases in the productivity of tropical
labor would require investments in social and economic infrastructure
including greater investments in public health."30
Meanwhile, the seminal Gaither Report,
commissioned in 1949 by the Ford Foundation, had charged Big Philanthropy
with advancing "human welfare" in order to resist the,
"tide of Communism… in Asia and Europe."
31
By 1956, a report to the US president by the
International Development Administration Board openly framed public health
assistance as a tactic in aid of Western military aggression in Indochina:
[A]reas rendered inaccessible at night by
Viet Minh activity, during the day welcomed DDT-residual spray teams
combating malaria...
In the Philippines, similar programs make
possible colonization of many previously uninhabited areas, and
contribute greatly to the conversion of Huk terrorists to peaceful
landowners.32
For a time, therefore, Western philanthropy
worked to shape public health systems in poor countries, sometimes
condescending to relinquish control of infrastructure and trained personnel
to national health ministries.33
Although actual investment in Third World
healthcare was meager by comparison with the extravagant promises of Cold
War rhetoric, some response to health crises in poor countries was deemed
necessary in the context of the postwar struggle for "hearts and minds."
The fall of the Soviet Union ushered in the present phase of public health
philanthropy, characterized by the Western demand for "global health
governance" - purportedly as a response to the spread of communicable
diseases accelerated by globalization.
Health has been redefined as a security concern;
the developing world is portrayed as a teeming petri dish of SARS,
AIDS, and tropical infections, spreading "disease and death" across the
globe 34 and requiring Western powers to establish
centralized health systems designed to,
"overcome the constraints of state
sovereignty."35
Imperial interventions in the health field are
justified in the same terms as recent "humanitarian" military interventions:
"[N]ational interests now mandate that
countries engage internationally as a responsibility to protect against
imported health threats or to help stabilize conflicts abroad so that
they do not disrupt global security or commerce."36
Providing support for national healthcare
operations is no longer on the agenda; to the contrary - in keeping with
structural adjustment programs that have required ruinous disinvestment in
public health throughout the developing world 37 - health
ministries are routinely bypassed or compromised via "public-private
partnerships" and similar schemes.
As national health systems are hollowed out,
health spending by donor countries and private foundations has risen
dramatically.38
Indeed, the US-based
Council on Foreign Relations envisions a withering away of
state-sponsored healthcare delivery, to be replaced by a supranational
regime of,
"new legal frameworks, public-private
partnerships, national programs, innovative financing mechanisms, and
greater engagement by nongovernmental organizations, philanthropic
foundations, and multinational corporations."39
The exemplar of philanthropy in the era of
global health governance is the Gates Foundation.
Vastly endowed, essentially unaccountable,
unencumbered by respect for democracy or national sovereignty, floating
freely between the public and private spheres, it is ideally positioned to
intervene swiftly and decisively on behalf of the interests it represents.
As Bill Gates remarked,
"I'm not going to get voted out of office."40
Close working relationships with UN, US and EU
institutions, as well as powerful multinational corporations, give BMGF an
extraordinary capability to harmonize complex overlapping agendas, ensuring
that corporate and US ambitions are simultaneously advanced.
To better understand how BMGF operates and in
whose interests, it is worth looking closely at the Foundation's global
vaccine programs, where until recently the bulk of its money and muscle was
brought to bear.
III. Gates and Big Pharma
"Guinea pigs for the drugmakers"
Despite annual revenues approaching $1 trillion, the global pharmaceutical
industry has lately experienced a critical decline in the rate of profit,
for which it lays most of the blame on regulatory requirements.
A US think tank has estimated the cost of new
drug development at $5.8 billion per drug, of which 90 per cent is incurred
in Phase III clinical trials mandated by the US Food and Drug Administration
and similar agencies in Europe.41
(These are tests administered to large groups of
human subjects in order to confirm the effectiveness and monitor the side
effects of new vaccines and other medicines.)
The international business consulting firm
McKinsey & Company called the situation "dramatic" and urged
Big Pharma
executives to "envision responses that go well beyond simply tinkering with
the cost base" - primarily the relocation of clinical trials to emerging
markets, where drug safety testing is seen as relatively cheap, speedy, and
lax.42
It is in this specific context that BMGF's intervention in the distribution
of certain vaccines and contraceptives must be seen.
Heavily invested in Big Pharma,43
the Foundation is well positioned to facilitate pharmaceutical R&D
strategies tailored to the realities of the developing world, where,
"[t]o speed the translation of scientific
discovery into implementable solutions, we seek better ways to evaluate
and refine potential interventions - such as vaccine candidates - before
they enter costly and time-consuming clinical trials."44
In plain language, BMGF promises to assist Big
Pharma in its efforts to circumvent Western regulatory regimes by sponsoring
cut-rate drug trials in the periphery.
The instruments of this assistance are Gates-controlled institutions like,
-
the GAVI Alliance
-
the Global Health Innovative Technology
Fund
-
the Program for Appropriate Technology
in Health (PATH),
...public-private partnerships purportedly
devoted to saving Third World lives.
Notionally independent but so heavily funded by
Gates as to function as virtual arms of the Foundation, these organizations
began to conduct large-scale clinical trials in Africa and South Asia in the
mid-2000s.45
Africa soon experienced an "unprecedented increase in health research
involving humans" who were typically "poverty-stricken and poorly educated";46
the results were predictably lethal.
In 2010 the Gates Foundation funded a Phase III
trial of a malaria vaccine developed by GlaxoSmithKline (GSK), administering
the experimental treatment to thousands of infants across seven African
countries. Eager to secure the WHO approval necessary to license the vaccine
for global distribution, GSK and BMGF declared the trials a smashing
success, and the popular press uncritically reproduced the publicity.47
Few bothered to look closely at the study's fine
print, which revealed that the trials resulted in 151 deaths and caused
"serious adverse effects" (e.g., paralysis, seizures, febrile convulsions)
in 1048 of 5949 children aged 5-17 months.48
Similar stories emerged in the wake of the
Gates-funded MenAfriVac campaign in Chad, where unconfirmed reports alleged
that 50 of 500 children forcibly vaccinated for meningitis later developed
paralysis.49
Citing additional abuses, a South African
newspaper declared:
"We are guinea pigs for the drugmakers."50
It was in India, however, that the implications
of BMGF's collaboration with Big Pharma first rose to widespread public
attention.
In 2010 seven adolescent tribal girls in Gujarat
and Andhra Pradesh died after receiving injections of HPV (Human Papilloma
Virus) vaccines as part of a large-scale "demonstrational study" funded by
the Gates Foundation and administered by PATH.51
The vaccines, developed by GSK and Merck, were
given to approximately 23,000 girls between 10 and 14 years of age,
ostensibly to guard against cervical cancers they might develop in old age.
Extrapolating from trial data, Indian physicians later estimated that at
least 1,200 girls experienced severe side effects or developed auto-immune
disorders as a result of the injections.52
No follow-up examinations or medical care were
offered to the victims. Further investigations revealed pervasive violations
of ethical norms: vulnerable village girls were virtually press-ganged into
the trials, their parents bullied into signing consent forms they could not
read by PATH representatives who made false claims about the safety and
efficacy of the drugs. In many cases signatures were simply forged.53
An Indian Parliamentary Committee determined that the Gates-funded vaccine
campaign was in fact a large-scale clinical trial conducted on behalf of the
pharmaceutical firms and disguised as an "observational study" in order to
outflank statutory requirements.54
The Committee found that PATH had,
"violated all laws and regulations laid down
for clinical trials by the government" in a "clear-cut violation of
human rights and a case of child abuse."55
The Gates Foundation did not trouble to respond
to the findings but issued an annual letter calling for still more
health-related R&D in poor countries and reaffirming its belief in "the
value of every human life." 56
Making markets
By thrusting the HPV vaccine on India, The Gates Foundation was not merely
facilitating low-cost clinical trials but was also assisting in the creation
of new markets for a dubious and underperforming product.
Merck's version of the
vaccine, called Gardasil, was introduced in
2006 in conjunction with a high-powered marketing campaign that generated
$1.5 billion in annual sales57; the vaccine was named "brand of the year" by
Pharmaceutical Executive for "building a market out of thin air."58
Aided by enthusiastic endorsements from the
medical establishment, Merck at first persuaded Americans that Gardasil
could protect their daughters from cervical cancer.
In fact the vaccine was of questionable
efficacy:
The relationship between [HPV] infection at
a young age and development of cancer 20 to 40 years later is not
known... The virus does not appear to be very harmful because almost all
HPV infections are cleared by the immune system.
[S]ome women may develop precancerous
cervical lesions and eventually cervical cancer. It is currently
impossible to predict in which women this will occur and why.59
The prestigious Journal of the American
Medical Association in 2009 openly questioned whether the vaccine's
risks outweighed the potential benefits.60
As word of Gardasil's defects emerged, American
and European women began to decline the vaccine, and by 2010 Fortune
Magazine declared Gardasil a "marketplace dud" as year-over-year sales fell
by 18 percent.61
GSK's copycat HPV vaccine, Cervarix, experienced
a comparable sales trough.
Billions in profits and capitalization were at stake. At this stage the
Gates Foundation stepped in. Its principal tool was the GAVI Alliance,
launched by BMGF in 2000 with the "explicit goal to shape vaccine markets."62
GAVI was charged with co-financing vaccine
purchases with Third World public health ministries, meanwhile,
"finding the type of large-scale funding
needed to sustain long-term immunization programs" and "laying the
foundations that will allow governments to continue immunization
programs long after GAVI support ends."63
In essence, BMGF would buy up stockpiled drugs
that had failed to create sufficient demand in the West, press them on the
periphery at a discount, and lock in long-term purchase agreements with
Third World governments.
In 2011 GAVI held a highly publicized board meeting in Dhaka where, with the
enthusiastic endorsement of UN Secretary General Ban ki-Moon, it announced a
worldwide campaign to introduce HPV vaccines to developing countries:
"If [developing] countries can demonstrate
their ability to deliver the vaccines, up to two million women and girls
in nine countries could be protected from cervical cancer by 2015."64
GSK adopted a "Global Vaccine Availability
Model" involving tiered pricing to permit,
"transition[ing] into poorer countries with
the help of 'partners' such as UNICEF, the World Health Organization,
and the Global Alliance for Vaccines and Immunization."65
Meanwhile PATH was rushing to complete a
large-scale, five-year long project,
"to generate and disseminate evidence for
informed public sector introduction of HPV vaccines" in India, Uganda,
Peru and Vietnam.
An Indian Parliamentary report observed:
"all these countries have state-funded
national vaccine immunization programs, which if expanded to include
Gardasil, would mean tremendous financial benefit to the… manufacturer."66
By FYE 2012, Merck was able to report a 35
percent jump in worldwide Gardasil sales, reflecting inter alia,
"favorable performance in Japan and the
emerging markets," where "sales growth is being driven by vaccines."67
Evidently, a drug rightly deemed suspect by
Americans would be good enough for women in the developing world.
Other dangerous drugs that failed to gain a toehold in Western markets have
received similar attention from the Gates Foundation. Norplant, a
subcutaneous contraceptive implant that effectively sterilizes women for as
long as five years, was pulled from the US market after 36,000 women filed
suit over severe side effects undisclosed by the manufacturer, including
excessive menstrual bleeding, headaches, nausea, dizziness and depression.68
Slightly modified and rebranded as Jadelle, the
same drug is now being heavily promoted in Africa by USAID, the Gates
Foundation, and its affiliates.
A recent article on the Gates-sponsored website
Impatient Optimists elides its dangers and disingenuously states that the
drug "never gained traction" in the US because inserting and removing the
device was "cumbersome."
With Gates Foundation support, however, Jadelle
"has played a pivotal role in bringing implants to the developing world" and
is soon to be complemented by a second Norplant clone, Merck's Implanon.69
An equally risky contraceptive, Pfizer's Depo-Provera, recently received the
Gates Foundation imprimatur for distribution to poor women worldwide.
In the US and India feminists fought against
approval of the injectable drug for decades due to its alarming list of side
effects, including,
"infertility, irregular bleeding, decreased
libido, depression, high blood pressure, excessive weight gain, breast
tenderness, vaginal infections, hair loss, stomach pains, blurred
vision, joint pain, growth of facial hair, acne, cramps, diarrhea, skin
rash, tiredness, and swelling of limbs" 70 as well as
potentially irreversible osteoporosis.71
After the US Food and Drug Administration
succumbed to industry pressure and granted approval in 1992, studies found a
marked racial disparity in Depo-Provera prescriptions between white and
African American women, leading to charges that,
"this form of long-acting
provider-controlled birth control is routinely given to women of color
in order to deny them the ability to control their own reproduction."
72
White American and European women, by contrast,
receive the drug only rarely and typically as a treatment for endometriosis,
greatly limiting its commercial potential in the West.
Hence Pfizer stands to benefit enormously from a Gates-sponsored program,
announced with much fanfare at the 2012 London Summit on Family Planning, to
distribute the drug to millions of women in South Asia and sub-Saharan
Africa by 2016:73
[Y]ou do the numbers: If 120 million new
women users chose Depo-Provera, at an estimated average cost between
$120-$300 per woman annually, that works out to $15 billion to $36
billion in new sales annually, a nice payoff from leveraging $4 billion
in research money.74
Foundation publicity suggests that its
aggressive backing of a discredited drug is merely a response to appeals
from poor women.
"Many [African] women want to use injectable
contraceptives but simply cannot get access to them," claimed PATH
President and CEO Steve Davis.75
Reproductive rights activist Kwame Fasu
disagrees:
"No African woman would agree to being
injected if she had full knowledge of the contraceptives' dangerous side
effects."76
IV. A Broader Agenda
Behind BMGF's coordinated interventions in pharmaceuticals, agriculture,
population control, and other putatively philanthropic concerns lies a
broader agenda.
In a recent interview Bill Gates briefly
strayed off-message to warn of,
"huge population growth in places where we
don't want it, like Yemen and Pakistan and parts of Africa."77
His use of the majestic plural here is
revealing: in spite of much rhetoric about "empowering poor people," the
Foundation is fundamentally concerned with reshaping societies in the
context of ruling-class imperatives.
The central thrust of current imperialist strategy involves increasingly
direct intervention in the developing countries/Third World, ranging from
internal destabilization to regime change to outright military occupation.
This is evidenced by recent
wars of conquest in Iraq and Libya,
multiple programs of destabilization and proxy warfare
throughout the Middle East and North Africa, and the integration
of African Union military forces into the framework of AFRICOM.
Military aggression undergirds a redoubled
effort to seize control of raw materials in developing countries, in
particular oil and strategic mineral resources in the African continent.
Big Philanthropy's more aggressive interventions
in the public health systems of the Third World reflect and complement this
strategy.
Meanwhile, the capitalist core is pursuing an energetic program of what
David Harvey has called "accumulation by dispossession," leading to,
"a rapid and large movement of foreign
capital taking control over huge tracts of land - mainly in Africa,
Southeast Asia, and Latin America - by either outright purchase or by
long-term leases and removal of peasant farmers from the land."78
This process is facilitated in multiple ways by
the activities of the Gates Foundation. What follows is an attempt to
summarize the Gates agenda in a few broad strokes.
"Land mobility" not land reform
Hunger, claims the Gates Foundation website, is rooted in "population
growth, rising incomes, dwindling natural resources, and a changing
climate," and is best addressed by enhancing agricultural productivity.79
Unmentioned is the fact that per capita food
production has been trending upward for decades and remains at historic
highs,80 meaning that hunger is an issue of unequal
distribution rather than inadequate productivity. Extensive scholarship
shows also that food insecurity has been greatly exacerbated over recent
decades by massive dispossession of small farmers, depriving millions of
their livelihoods.81
Contra Gates, the food crisis is not one of
"rising incomes" but of vanishing incomes.
Although Foundation publicity pays lip service to the idea of sustainable
smallholder agriculture, in fact its initiatives are uniformly directed
toward high-tech, high-yield farming methods - much like the "Green
Revolution" technologies that proved ultimately ruinous for rural
peasantries beginning in the 1960s.82
Gates works closely with agribusiness giant
Monsanto through organizations like the Alliance for a Green Revolution
in Africa (AGRA), which steers billions in grant money primarily to
biotech and GMO research.83
The Foundation has also thrown its weight behind
a revival of Grameen-style microbanking schemes, which transpired during the
2000s to be a debt trap leading to dispossession of rural families.84
Far from empowering small farmers, BMGF's efforts envision the exit of
"inefficient" small farmers from their land - a process euphemistically
termed "land mobility" - as revealed by an internal memo leaked to the press
in 2008:
In order to transition agriculture from the
current situation of low investment, low productivity and low returns to
a market-oriented, highly-productive system, it is essential that supply
(productivity) and demand (market access) expand together… [this]
involves market-oriented farmers operating profitable farms that
generate enough income to sustain their rise out of poverty.
Over time, this will require some degree of
land mobility and a lower percentage of total employment involved in
direct agricultural production.85
The impact of these policies on small farmers
and their families is disastrous.
As Fred Magdoff recently explained,
"the world capitalist economy is [no longer]
able to provide productive employment for the huge numbers of people
losing their lands. Thus the fate of those migrating to cities or other
countries is commonly to live in slums and to exist precariously within
the 'informal' economy." 86
Indeed, the Foundation's agricultural policy
strikingly resembles what Samir Amin describes as the logical outcome
of subjecting agriculture to the same market principles as any other branch
of production:
20 million industrial farmers producing the
world's food supply in place of today's three billion peasants.87
As Amin observes:
The conditions for the success of such an
alternative would include:
-
the transfer of important pieces of
good land to the new capitalist farmers (and these lands would
have to be taken out of the hands of present peasant
populations)
-
capital (to buy supplies and
equipment)
-
access to the consumer markets. Such
farmers would indeed compete successfully with the billions of
present peasants.
But what would happen to those billions of
people? 88
Amin's analysis chimes with the Gates Foundation
memo quoted above, and there is reason to believe that BMGF is already
contemplating strategies for coping with the "surplus" population that the
processes of accumulation and dispossession are generating.
Population control not redistribution
In a 2012 Newsweek profile, Melinda Gates announced her intention to get
"family planning" back on the global agenda and made the dubious claim that
African women were literally clamoring for Depo-Provera as a way of hiding
contraceptive use from "unsupportive husbands."89
Boasting that a decision "likely to change lives
all over the world" had been hers alone, she announced that the Foundation
would invest $4 billion in an effort to supply injectable contraceptives to
120 million women - presumably women of color - by 2020. It was a program so
ambitious that some critics warned of a return to the era of eugenics and
coercive sterilization.90
Bill Gates, at one time an avowed Malthusian "at least in the developing
countries" 91 is now careful to repudiate Malthus in
public.
Yet it is striking that Foundation publicity
justifies not only contraception, but every major initiative in the language
of population control,
-
from
vaccination ("When children survive
in greater numbers, parents decide to have smaller families")
92
-
to primary
education ("[G]irls who complete
seven years of schooling will marry four years later and have 2.2
fewer children than girls who do not complete primary school")
93
In a 2010 public lecture, Bill Gates attributed
global warming to "overpopulation" and touted zero population growth as a
solution achievable,
"[i]f we do a really great job on new
vaccines, health care, and reproductive health services."94
The argument is disingenuous:
As Gates certainly knows, the poor people
who are the targets of his campaigns are responsible for no more than a
tiny percentage of the environmental damage that underlies climate
change.
The economist Utsa Patnaik has
demonstrated that when population figures are adjusted to account for actual
per capita demand on resources, e.g., fossil fuels and food, the greatest
"real population pressure" emanates not from India or Africa, but from the
advanced countries.95
The Gates Foundation is well aware of this
imbalance and works not to redress it but to preserve it - by blaming
poverty not on imperialism but on unrestrained sexual reproduction "in
places where we don't want it."
From Malthus to the present day, the myth of overpopulation has
supplied reliable ideological cover for the ruling class as it appropriates
ever greater shares of the people's labor and the planet's wealth.
As argued in Aspects No. 55,
"Malthus's heirs continue to wish us to
believe that people are responsible for their own misery; that there is
simply not enough to go around; and to ameliorate that state of
wretchedness we must not attempt to alter the ownership of social wealth
and redistribute the social product, but instead focus on
reducing the number of people."
96
In recent years BMGF's publicity apparatus,
exploiting Western alarm about "climate change," has helped create a
resurgence of the overpopulation hysteria last experienced during the 1970s
in the wake of Paul Erlich's bestseller The Population Bomb.97
Yet the sheer scale of BMGF's investment in "family planning" suggests that
its ambitions reach beyond mere propaganda. In addition to the multibillion
dollar contraception distribution program discussed previously, BMGF
provides research support for the development of new high-tech, long-lasting
contraceptives (e.g., an ultrasound sterilization procedure for men as well
as "non-surgical female sterilization").
Meanwhile the Foundation aggressively lobbies
Third World governments to spend more on birth control and supporting
infrastructure 98 while subsidizing steep cuts in the
price of subcutaneous contraceptives.99
These initiatives lie squarely within the traditions of Big Philanthropy.
The Rockefeller Foundation organized the
Population Council in 1953, predicting a "Malthusian crisis" in the
developing world and financing extensive experiments in population control.
These interventions were enthusiastically
embraced by US government policymakers, who agreed that,
"the demographic problems of the developing
countries, especially in areas of non-Western culture, make these
nations more vulnerable to Communism."100
Foundation research culminated in an era of
"unrestrained enthusiasm for government-sponsored family planning" by the
1970s.101
Less discussed but amply documented is the
consistent support
for eugenics research by US-based
foundations, dating from the 1920s,
-
when
Rockefeller helped found the
German eugenics program that undergirded Nazi racial theories,102
through the 1970s
-
when Ford Foundation research helped
prepare the intellectual ground for a brutal forced sterilization
campaign in India 103
Why have foundations invested so persistently in
actual technologies and campaigns for population reduction?
In the absence of a definitive explanation, two
possibilities are worth pondering:
-
Gates and his billionaire associates may
well share Dean Acheson's view - famously ridiculed by Mao Zedong -
that population growth engenders revolutions by "creating unbearable
pressure on the land."104
A more recent expression of this idea,
contained in the report of the US Vice President's Task Force on
Combating Terrorism, is that "population pressures create a volatile
mixture of youthful aspirations that when coupled with economic and
political frustrations help form a large pool of potential
terrorists."105
Thus BMGF likely sees population control
as a security imperative, in keeping with its fear of a "less
stable" world and reflecting the philosophy of global health
governance.106
-
Population control is, in another sense,
one of the instruments of social control. It extends ruling-class
jurisdiction more directly to the personal sphere, aiming at
"full-spectrum dominance" of the developing world.
Like laws regulating marriage and sexual
behavior, such interventions in the reproduction of labor power are
not essential to capitalists but remain desirable as a means of
exercising ruling class hegemony over every aspect of the lives of
the working people.
Whereas the ideology of population
control is intended to turn attention away from the existing
distribution of wealth and income that causes widespread want,
population control as such directly targets the bodies and dignity
of poor people, conditioning them to believe that life's most
intimate decisions are outside of their competence and control.107
The relationship between bourgeois ideology and
imperialist practice is dynamic and mutually supportive.
As David Harvey has observed:
"Whenever a theory of overpopulation seizes
hold in a society dominated by an elite, then the non-elite invariably
experience some form of political, economic, and social repression."108
Seen in this light, BMGF's promotion of
population control is doubly pernicious because it is cloaked in the
language of environmentalism, popular empowerment, and feminism.
Melinda Gates may evoke "choice" in
support of her family planning initiatives, but in reality it is not poor
women, but a handful of the world's wealthiest people who have presumed to
choose which methods of contraception will be delivered, and to whom.
Dependency not democracy
Speaking off the record, public health officials are scathing about the
imperiousness of the Gates Foundation.
It is said to be "domineering" and
"controlling," contemptuous of advice from experts, seeking to "divide and
conquer" the institutions of global health via "stealth-like monopolization
of communications and advocacy.109
But the high-handedness of the Foundation goes
far beyond office politics in Geneva.
In general it,
"has not been interested in health systems
strengthening and has rather competed with existing health services."110
It routinely subverts the health ministries of
sovereign nations, either coercing their cooperation or outmaneuvering them
via NGO-sponsored field operations that bypass existing infrastructure and
personnel.
In particular, the Foundation's emphasis on single-issue, vertically
organized interventions tends to undermine community-based primary care,
endorsed by the
Alma Ata Declaration of 1978 as the model
for Third World public health programs.
Based implicitly on the "barefoot doctor"
program that revolutionized public health in the People's Republic of China,
the philosophy of primary care proposed that the people,
"have a right and duty to participate
individually and collectively in the planning and implementation of
their health care."111
In theory, the goal was not only improvement of
health as such, but also popular empowerment and genuine democracy at the
local level. People would be encouraged to believe that health care was not
a gift from Western benefactors, but belonged to them as of right.
Although the Chinese model could never be properly implemented in
non-socialist countries, Alma Ata inspired various community-based health
initiatives in developing countries, achieving some success in lowering
infant mortality and raising life expectancy.112
Today, however, primary care programs worldwide
are on the decline due both to the imperatives of structural adjustment
programs and to the meddling of US-based foundations.113
The Gates Foundation, for its part, invariably
acts to steer resources away from community-based holistic doctoring and
toward single-disease crash programs, controlled by Western NGOs in
collaboration with health-related MNCs. Its approach to diarrhea, which
kills upwards of one million infants annually, is a case in point.
The procedures necessary to control diarrhea are not mysterious: clean water
and adequate sanitation are essential to prevention, while treatment
consists of administering oral rehydration salts (ORS) and zinc
supplements to afflicted infants.
Chinese "barefoot doctors" achieved steep
declines in diarrhea mortality from the 1950s through the 1980s by
distributing ORS supplies at the village level and educating families on
their importance and proper use.114
Yet while shepherding governments away from
investing in the sanitation infrastructure and primary care that have been
proven to save lives, BMGF funds and promotes vaccine research, marketing
programs administered by NGOs, and,
"work[ing] with manufacturers and
distributors to make ORS and zinc products more attractive to consumers
- by improving flavors and repackaging products."115
Perhaps Bill Gates, who became rich through the
expert marketing of inferior software, really believes that poor mothers
can't be relied upon to take an interest in saving their children's lives
unless medicines are advertised
like Coca-Cola.
But BMGF's overall stance toward diarrhea, as
toward public health in general, reminds us that the attenuation of Third
World democracy is far from unwelcome to the rulers.
As the educational theorist Robert Arnove
has observed, foundations are at bottom a corrosive influence on a
democratic society; they represent relatively unregulated and unaccountable
concentrations of power and wealth which buy talent, promote causes, and in
effect, establish an agenda of what merits society's attention.
They serve as 'cooling-out' agencies, delaying
and preventing more radical, structural change. They help maintain an
economic and political order, international in scope, which benefits the
ruling-class interests of philanthropists.116
Charitable activities that undermine democracy and state sovereignty are
immensely useful to the ruling class.
Robust, effective social programs in developing
countries are an impediment to the current imperial agenda of worldwide
expropriation; healthy people, in control of their own destinies and
invested in the social well-being of their communities, are better equipped
to defend their claim to the wealth they possess and produce.
Far better, from the point of view of the
Good Club philanthrocapitalists, if the world's poorest billions remain
wholly dependent on a largesse that may be granted or withdrawn at pleasure.
A facelift for the rulers
In the wake of the
2007-08 financial crisis and the subsequent
implementation of "austerity" programs worldwide, the super-rich experienced
popular anger more directly than at any time since the Great Depression.
-
The masses took to the streets worldwide
-
The avowedly anti-capitalist Occupy Wall
Street movement received extensive and largely favorable press
coverage
-
Newspaper columnists openly wondered
whether reforms might be needed to save capitalism from itself
-
Capital and The Communist Manifesto
returned to bestseller lists
Particularly worrisome to the mega-rich was the
extent to which they themselves, rather than vague complaints about "the
system," became the focus of discontent.
Even relatively well-to-do Americans questioned
the power and disproportionate wealth controlled by elites, now commonly
identified as "the 1 per cent" or the "1 per cent of the 1 per cent."
Confronting widespread hostile scrutiny, the
ruling class was in need of a facelift. BMGF's publicity operation was quick
to respond.
The Foundation exploited "multiple messaging
avenues for influencing the public narrative" including the creation of
"strategic media partners" - ostensibly independent news organizations whose
cooperation was ensured via the distribution of $25 million in annual grant
money.117
Bill Gates, said to be socially awkward and
formerly shy of media attention, was suddenly ubiquitous in
the mainstream press.
In every interview Gates worked from the same
talking points:
-
he had resolved to dedicate "the rest of
his life" to assisting the world's poor
-
to that end he intended to give away his
entire fortune
-
his uncompromising intelligence and
business acumen made him uniquely qualified to wring "more bang for
the buck" from philanthropic endeavors
-
he is nevertheless kindhearted and
deeply moved by personal encounters with sick and impoverished
children
...etc...
Invariably he told the suspiciously apposite
story of his mother's deathbed adjuration:
"From those to whom much is given, much is
expected."118
At the same time BMGF expanded its online
operations, using Twitter and Facebook to disseminate pseudoscientific
apercus and heartwarming images to millions of "followers" worldwide.119
Gates' willingness to carry the torch for the world's billionaires reflected
an understanding that his Foundation plays an important ideological role
within the global capitalist system. Apart from the promotion of specific
corporate interests and imperialist strategic aims, BMGF's expertly
publicized activities have the effect of laundering the enormous
concentration of wealth in the hands of a few supremely powerful oligarchs.
Through stories of Gates' philanthropy we are
assured that our rulers are benevolent, compassionate, and eager to "give
back" to the less fortunate; moreover, by leveraging their superior
intelligence and technocratic expertise, they are able to transcend the
bureaucratic fumblings of state institutions, finding "strategic,
market-based solutions" to problems that confound mere democracies.
This apotheosis of Western wealth and knowhow
works hand-in-hand with an implicit contempt for the sovereignty and
competence of poor nations, justifying ever more aggressive imperialist
interventions. 120
Thus the Gates Foundation, like the MNCs (multinational corporations) it so
closely resembles, seeks to manufacture consent for its activities through
the manipulation of public opinion.
Happily, not everyone is fooled: popular
resistance to the designs of Big Philanthropy is mounting.
The struggle is broad-based, ranging from the
women activists who exposed the criminal activities
of PATH in India, to the anti-sterilization
activities of African-American groups like The Rebecca Project, to the
anti-vaccine agitations in Pakistan following the revelation that
the CIA
had used immunization programs as cover for DNA collection.121
Surely a worldwide campaign to eradicate the
toxic philanthropy and infectious propaganda of the Gates Foundation would
be in the best traditions of public health.
Notes
1. "The Gates Foundation: Giving Away a
Fortune," CBS 60 Minutes, Sept. 30, 2010, http://www.cbsnews.com/news/the-gates-foundation-giving-away-a-fortune/3/.
2. Paul Harris, "They're Called The Good Club - And They Want to Save
the World," Guardian, May 30, 2009, http://www.theguardian.com/world/2009/may/31/new-york-billionaire-philanthropists.
3. Andrew Clark, "US Billionaires Club Together," Guardian, Aug. 4,
2010, http://www.theguardian.com/technology/2010/aug/04/us-billionaires-half-fortune-gates.
4. Matthew Bishop and Michael Green, Philanthrocapitalism: How Giving
Can Save the World (2008), pp. 3, 6.
5. Harris, op cit.
6. "Bill Gates," Forbes.com, Sept. 2013,
http://www.forbes.com/profile/bill-gates/.
7. Barry Ritholtz, "What's Behind Microsoft's Fall from Dominance,"
Washington Post, Sept. 26, 2013, http://www.washingtonpost.com/business/whats-behind-microsofts-fall-from-dominance/2013/09/05/b0e5e91e-157b-11e3-804b-d3a1a3a18f2c_story_1.html.
8. Quoted in Michael Perelman, "The Political Economy of Intellectual
Property," Monthly Review, vol. 54, no. 8, January, 2003, http://monthlyreview.org/2003/01/01/the-political-economy-of-intellectual-property.
9. The Foundation Center, Top Funders, http://foundationcenter.org/findfunders/topfunders/top100assets.html.
10. Sheldon Drobny, "The Gates and Buffett Foundation Shell Game,"
CommonDreams.org, April 26, 2006, http://www.commondreams.org/views06/0823-26.htm.
11. BMGF website, http://www.gatesfoundation.org/Who-We-Are/General-Information/Leadership/Management-Committee.
12. Richard Waters, "An exclusive interview with Bill Gates," Financial
Times, Nov. 1, 2013, http://www.ft.com/intl/cms/s/2/dacd1f84-41bf-11e3-b064-00144feabdc0.html#axzz2q0sgejl.
13. Noel Salazar, "Top 10 philanthropic foundations: A primer," Devex,
Aug. 1, 2011, https://www.devex.com/en/news/top-10-philanthropic-foundations-what-you-need-to/75508.
14. Global Health Watch, Global Health Watch 2: An Alternative World
Health Report, 2008, p. 250, http://www.ghwatch.org/sites/www.ghwatch.org/files/ghw2.pdf.
In a 2008 memo leaked to the press, Arata Kochi, chief of the malaria
program at the World Health Organization, charged that "the growing
dominance of malaria research by the Bill and Melinda Gates Foundation
risks stifling a diversity of views among scientists and wiping out the
health agency's policy-making function." Donald G. McNeil Jr., "WHO
official complains about Gates Foundation's dominance in malaria fight,"
NY Times, Nov. 7, 2008, http://www.nytimes.com/2008/02/17/world/americas/17iht-gates.4.10120087.html.
15. "Private and Public Partners Unite to Combat 10 Neglected Tropical
Diseases by 2020," BMGF press release, Jan. 2012, http://www.gatesfoundation.org/media-center/press-releases/2012/01/private-and-public-partners-unite-to-combat-10-neglected-tropical-diseases-by-2020.
16. Grant to Ministry of Lands, Housing and Urban Development;
Government of Uganda, July, 2012, http://www.gatesfoundation.org/How-We-Work/Quick-Links/Grants-Database/Grants/2012/07/OPP1053920
.
17. "The Next Grand Challenge in India: Reinvent the Toilet," BMGF press
release, Oct. 2013, http://www.gatesfoundation.org/Media-Center/Press-Releases/2013/10/The-Next-Grand-Challenge-in-India.
The Foundation also feels free to "sit down with the Pakistan
government" to demand security measures in support of its operations.
See Neil Tweedie, "Bill Gates Interview: I Have No Use for Money. This
is God's Work," The Telegraph, Jan. 18, 2013, http://www.telegraph.co.uk/technology/bill-gates/9812672/Bill-Gates-interview-I-have-no-use-for-money.-This-is-Gods-work.html.
18. Global Health Watch, op. cit., p. 251.
19. Ibid.
20. Gabrielle Pickard, "Will Gates Foundation Replace the UN?" UN Post,
2010, http://www.unpost.org/will-gates-foundation-replace-the-un/#ixzz2pjv08DJr.
21. The Gates Foundation's occasional
pretensions to selfless charity are belied by the policies of its Trust,
which invests heavily in "companies that contribute to the human
suffering in health, housing and social welfare that the foundation is
trying to alleviate." Andy Beckett, "Inside the Bill and Melinda Gates
Foundation," Guardian, July 12, 2010, http://www.theguardian.com/world/2010/jul/12/bill-and-melinda-gates-foundation.
22. Bill Gates, Annual Letter 2011, http://www.gatesfoundation.org/Who-We-Are/Resources-and-Media/Annual-Letters-List/Annual-Letter-2011.
23. Foundations and Public Policy: The Mask of Pluralism (SUNY Series in
Radical Social and Political Theory 2003); see also "New Study on the
Role of US Foundations," Aspects of India's Economy No. 38, Dec., 2004,
http://rupe-india.org/38/foundations.html.
24. E.g. "[i]n Indonesia the Ford Foundation-sponsored knowledge
networks worked to undermine the neutralist Sukarno government that
challenged U.S. hegemony. At the same time, Ford trained economists
(both at University of Indonesia and in U.S. universities) for a future
regime supportive of capitalist imperialism." Roelofs, "Foundations and
American Power," Counterpunch, April 20-22, 2012, http://www.counterpunch.org/2012/04/20/foundations-and-american-power/.
25. Quoted in E. Richard Brown, "Public Health in Imperialism: Early
Rockefeller Programs at Home and Abroad," Am J Public Health, 1976
September; 66(9): 897–903, 897.
26. From its earliest days Rockefeller's philanthropy hid a domestic
agenda as well. The Foundation was forced to retreat from sponsorship of
research into labor relations after the 1916 Walsh Commission Report
found it was "corrupt[ing] sources of public information" in an effort
to whitewash predatory business practices and industrial violence.
Jeffrey Brison, Rockefeller, Carnegie, and Canada, Montreal:
McGill-Queen's University Press, 2005, p. 35.
27. E. Richard Brown, op. cit., p. 900.
28. David Killingray, "Colonial Warfare in West Africa 1870-1914,"
reprinted in J. A. de Moor & H.L. Wesseling, eds., Imperialism and War,
Leiden : E.J. Brill : Universitaire pers Leiden, 1989, pp. 150-151.
29. E. Richard Brown, op. cit., p. 900.
30. Randall Packard, "Visions of Postwar Health and Development and
Their Impact on Public Health Interventions in the Developing World," re
41. Avik S.A. Roy, Stifling New Cures: The
True Cost of Lengthy Clinical Drug Trials, Manhattan Institute, April,
2012, http://www.manhattan-institute.org/html/fda_05.htm.
42. Vivan Hunt et al., A Wake-Up Call for Big Pharma, McKinsey & Co,
Dec. 2011, http://www.mckinsey.com/insights/health_systems_and_services/a_wake-up_call_for_big_pharma;
Michael Edwards, R&D in Emerging Markets: A New Approach for a New Era,
McKinsey & Co., Feb. 2012, http://www.mckinsey.com/insights/winning_in_emerging_markets/r_and_38d_in_emerging_markets_a_new
_approach_for_a_new_era .
43. In 2002 the Gates Foundation invested $205 million in pharmaceutical
companies, including Merck & Co., Pfizer Inc., Johnson & Johnson, and
GlaxoSmithKline. Ruben Rosenberg Colorni, "Bill Gates, Big Pharma, Bogus
Philanthropy," News Junkie Post, June 7, 2013, http://newsjunkiepost.com/2013/06/07/bill-gates-big-pharma-bogus-philanthropy/
.
44. Discovery and Translational Sciences Strategy Overview, BMGF
website, http://www.gatesfoundation.org/What-We-Do/Global-Health/Discovery-and-Translational-Sciences.
45. Gates-funded public-private consortia typically subcontract with
local Contract Research Organizations (CROs) to conduct trials in the
field, allowing the Foundation to maintain arms-length distance from the
realities of recruiting and injecting human subjects, which frequently
involves deception and coercion. The global CRO industry is projected to
reach over $32 billion by 2015. See WEMOS, The Clinical Trials Industry
in South Africa: Ethics, Rules and Realities, July 2012, pp. 11-13,
http://www.wemos.nl/files/Documenten%20Informatief/Bestanden%20voor%20'Medicijnen'/Clinical_Trials_Industry_South_Africa_2013_v3.pdf.
46. A. Nyika et al., "Composition, training needs and independence of
ethics review committees across Africa: are the gate-keepers rising to
the emerging challenges?," J Med Ethics, 2009 March; 35(3): 189–193.
47. E.g., "Malaria vaccine could save millions of children's lives,"
Guardian, Oct. 18, 2011, http://www.theguardian.com/society/2011/oct/18/malaria-vaccine-save-millions-children.
48. "First Results of Phase 3 Trial of RTS,S/AS01 Malaria Vaccine in
African Children ," N Engl J Med 365;20, November 17, 2011. Though some
of the deaths would have been expected due to high infant mortality
rates in Africa, children who received the vaccine died at more than
twice the rate of children in the control group. Ibid., p. 1869.
49. "Minimum of 40 Children Paralyzed after New Meningitis Vaccine,"
VacTruth.com, Jan. 6, 2013, http://vactruth.com/2013/01/06/paralyzed-after-meningitis-vaccine/.
The report relied on the Chadian daily La Voix.
50. Johannesburg Times, July 25, 2013, http://www.timeslive.co.za/news/2013/07/25/we-are-guinea-pigs-for-the-drugmakers.
51. Sandhya Srinivasan, "A Vaccine for Every Ailment," Infochange,
April, 2010, http://infochangeindia.org/public-health/healthcare-markets-and-you/a-vaccine-for-every-ailment.html.
PATH maintained that the dead girls had been bitten by snakes or fallen
down wells. Ibid.
52. Kalpana Mehta, Nalini Bhanot & V. Rukmini Rao, Supreme Court Pulls
Up Government Of India Over Licensing And Trials With "Cervical Cancer"
Vaccines, Countercurrents.org, Jan. 7, 2013, http://www.countercurrents.org/mehta070113.htm.
53. Aarthi Dhar, "It's a PATH of violations, all the way to vaccine
trials: House panel," The Hindu, Sept. 2, 2013, http://www.thehindu.com/news/national/its-a-path-of-violations-all-the-way-to-vaccine-trials-house-panel/article5083151.ece.
54. Parliament of India, 72nd Report on Alleged Irregularities in the
Conduct of Studies Using Human Papilloma Virus (HPV) Vaccine by PATH in
India, Aug. 29, 2013, sec. II, http://www.elsevierbi.com/~/media/Supporting%20Documents/Pharmasia%20News/2013/September/HPV%20Vaccines%20Parliameetnary%20Report%20%20Aug%2031%202013.pdf.
55. Quoted in Aarthi Dhar, op. cit.
56. Bill and Melinda Gates, 2014 Gates Annual Letter, Jan. 2014, http://annualletter.gatesfoundation.org/.
57. Merck, 2007 Annual Report, http://www.merck.com/finance/annualreport/ar2007/vaccines.html.
58. Zosia Chustecka, "HPV Vaccine: Debate Over Benefits, Marketing, and
New Adverse Event Data," Medscape, Aug. 18, 2009, http://www.medscape.com/viewarticle/707634.
59. Charlotte Haug M.D., "The Risks and benefits of HPV Vaccination,"
Journal of the American Medical Association, Aug. 19, 2009, p. 795,
http://jama.jamanetwork.com/article.aspx?articleid=184404.
60. Ibid.
61. Shelley DuBois, "What Went Wrong With Gardasil," Fortune, Sept. 7,
2012, http://money.cnn.com/2010/09/06/news/companies/merck_Gardasill_problems.fortune/
.
62. GAVI Alliance, "Vaccine supply and procurement," http://www.gavialliance.org/about/gavis-business-model/vaccine-supply-and-procurement/.
As of July 2013, GAVI had received $1.5 billion in support from the
Gates Foundation. Bill & Melinda Gates Foundation, Foundation Fact
Sheet, 2013, http://www.gatesfoundation.org/who-we-are/general-information/foundation-factsheet.
63. GAVI Alliance, "The Business Model," http://www.gavialliance.org/about/gavis-business-model/the-business-model/.
64. "GAVI takes first steps to introduce vaccines against cervical
cancer and rubella," GAVI press release, Nov. 17, 2011, http://www.gavialliance.org/library/news/press-releases/2011/gavi-takes-first-steps-to-introduce-vaccines-against-cervical-cancer-and-rubella/#sthash.czf4Hmry.dpuf.
65. Renee Twombly, "U.S. Girls To Receive HPV Vaccine but Picture
Unclear on Potential Worldwide Use, Acceptance," J Natl Cancer Inst,
vol. 98, no. 15, Aug., 2006, pp. 1030-32.
66. Parliament of India, 72nd Report, sec. 1.11.
67. "Merck Announces Full-Year and Fourth-Quarter 2012 Financial
Results," Business Wire, Feb. 1, 2013, http://www.businesswire.com/news/home/20130201005282/en/Merck-Announces-Full-Year-Fourth-Quarter-2012-Financial-Results.
68. Morrow, David J. "Maker of Norplant offers a settlement in suit over
effects," New York Times, Aug. 27, 1999, p. A1, http://www.nytimes.com/1999/08/27/us/maker-of-norplant-offers-a-settlement-in-suit-over-effects.html.
69. Dorfliner et al., "The Evolution of Implants," Impatient Optimists,
Feb. 20, 2013, http://www.impatientoptimists.org/Posts/2013/02/The-Evolution-of-Implants.
70. Amy Goodman, "The Case Against Depo Provera: Problems in the U.S.,"
Multinational Monitor, Feb./March, 1985, http://multinationalmonitor.org/hyper/issues/1985/02/problems-us.html.
See also N. B. Sarojini & Laxmi Murthy, "Why women's groups oppose
injectable contraceptives," Indian Journal of Medical Ethics, vol. 2,
no. 1, 2005, http://216.12.194.36/~ijmein/index.php/ijme/article/view/702/1715.
71. US Food & Drug Administration, "Black Box Warning Added Concerning
Long-Term Use of the Depo-Provera Contraceptive Injection," FDA Talk
Paper, Nov. 17, 2004, http://web.archive.org/web/20051221195621/http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01325.html.
72. Thomas W. Volscho, "Racism and Disparities in Women's Use of the
Depo-Provera Injection in the Contemporary USA," Crit Sociol 2011 37:
673, June 3, 2011, http://crs.sagepub.com/content/37/5/673.refs.
73. Innovative Partnership to Deliver Convenient Contraceptives to up to
Three Million Women," BMGF press release, July 11, 2012, http://www.gatesfoundation.org/Media-Center/Press-Releases/2012/07/Innovative-Partnership-to-Deliver-Convenient-Contraceptives-to-up-to-Three-Million-Women.
It is presumably a coincidence that the London Summit on Family Planning
was timed to take place on the 100th anniversary of the First
International Eugenics Congress.
74. Paul B. Farrell, "Gates' $4 Billion Foray in Global Family
Planning," MarketWatch, May 15, 2012, http://www.marketwatch.com/story/gatess-4-billion-foray-in-global-family-planning-2012-05-15.
75. Ibid.
76. Quoted in Lisa Correnti and Rebecca Oas, "Black Leaders, Rights
Experts Denounce Gates' New Contraceptive that May Increase HIV Risk,"
Catholic Family and Human Rights Institute, Oct. 18, 2013, http://c-fam.org/en/issues/global-health/7574-black-leaders-rights-experts-denounce-gates-new-contraceptive-that-may-increase-hiv-risk.
77. Ezra Klein, "Bill Gates: 'Capitalism Did
Not Eradicate Smallpox'," Washington Post, Jan. 21, 2014, http://www.washingtonpost.com/blogs/wonkblog/wp/2014/01/21/bill-gates-capitalism-did-not-eradicate-smallpox/
78. Fred Magdoff, "Twenty-First Century Land Grabs," Monthly Review,
vol. 65, no. 6, Nov., 2013, http://monthlyreview.org/2013/11/01/twenty-first-century-land-grabs.
79. Agricultural Development Strategy Overview, BMGF website, http://www.gatesfoundation.org/What-We-Do/Global-Development/Agricultural-Development.
80. Keith Fuglie and Alejandro Nin-Pratt, "A Changing Global Harvest,"
2012 Global Food Policy Report, International Food Policy Research
Institute, http://www.ifpri.org/gfpr/2012/agricultural-productivity.
81. See. e.g., Raj Patel et al., "Ending Africa's Hunger," The Nation,
Sept. 21, 2009, http://www.thenation.com/article/ending-africas-hunger;
Utsa Patnaik, The Republic of Hunger and Other Essays, London: Merlin
Press, 2007; Rahul Goswami, "From District to Town: The movement of food
and food providers alike," Macroscan, Jan. 8, 2013, http://www.macroscan.org/pol/jan13/pol08012013Rahul_Goswami.htm.
82. See generally John H. Perkins, Geopolitics and the Green Revolution:
Wheat, Genes, and the Cold War, Oxford University Press, 1997. See also
Deborah Fahy Bryceson, "Sub-Saharan Africa's Vanishing Peasantries and
the Spectre of a Global Food Crisis," Monthly Review, vol. 61, no. 3,
July-Aug., 2009, http://monthlyreview.org/2009/07/01/sub-saharan-africas-vanishing-peasantries-and-the-specter-of-a-global-food-crisis.
83. Raj Patel et al., op. cit.
84. Aasha Khosa, "Grameen Bank Can't Reduce Poverty: Economist,"
Business Standard, April 2, 2007, http://www.business-standard.com/article/economy-policy/grameen-bank-can-t-reduce-poverty-economist-107040201126_1.html;
Financial Services for the Poor Strategy Overview, BMGF website, http://www.gatesfoundation.org/What-We-Do/Global-Development/Financial-Services-for-the-Poor.
85. Quoted in Community Alliance for Global Justice, "Footloose
Farmers," AGRA Watch, Aug. 19, 2011, https://agrawatch.wordpress.com/tag/land-mobility/
(emphasis added).
86. Magdoff, op. cit.
87. Samir Amin, "World Poverty, Pauperization, and Capital
Accumulation," Monthly Review vol. 55, no. 5, Oct. 2003, http://monthlyreview.org/2003/10/01/world-poverty-pauperization-capital-accumulation.
88. Ibid.
89. Michelle Goldberg, "Melinda Gates' New Crusade: Investing Billions
in Women's Health," Newsweek, May 7, 2012, http://www.newsweek.com/melinda-gates-new-crusade-investing-billions-womens-health-64965.
90. The Rebecca Project for Human Rights, Depo-Provera: Deadly
Reproductive Violence Against Women, June 25, 2013,
http://www.1037thebeat.com/wp-content/uploads/2013/06/DEPO-PROVERA-DEADLY-REPRODUCTIVE-VIOLENCE-Rebecca-Project-for-Human-Rights-June-2013-2.pdf.
91. Interview with Bill Gates, NOW with Bill Moyers, May 9, 2003,
transcript of television interview, http://www.pbs.org/now/transcript/transcript_gates.html.
In this interview Gates also discloses his admiration for the notorious
Club of Rome report, Limits to Growth, a 1972 polemic that became
central to a postwar revival of Malthusian thought.
92. Bill and Melinda Gates, 2014 Gates Annual Letter.
93. Dr. Denise Dunning, "Girls: The World's Return on Greatest
Investment," Impatient Optimists website, http://m.impatientoptimists.org/?task=get&url=http%3A%2F%2Fwww.impatientoptimists.org%2FPosts%2F2014%2F02%2FThe-Worlds-Greatest-Return-on-Investment.
94. Hendershott, op. cit.
95. Patnaik, Republic of Hunger, pp. 10 et seq.
96. Manali Chakrabarti, "Are There Just Too Many of Us?," Aspects of
India's Economy no. 55, March, 2014, http://www.rupe-india.org/55/toomany.html.
97. The tone and implications of Erlich's influential tract, which has
sold more than two million copies, can be judged from its set-piece
opening describing a "stinking hot night in Delhi" experienced by the
author and his companions: "The streets seemed alive with people. People
eating, people washing, people sleeping... People thrusting their hands
through the taxi window, begging. People defecating and urinating...
People. People, people... Would we ever get to our hotel?" Paul Erlich,
The Population Bomb, Cutchogue, NY: Buccaneer Books, 1968, p. 1.
98. Anne Hendershott, "The Ambitions of Bill and Melinda Gates:
Controlling Population and Public Education," Crisis, March 25, 2013,
http://www.crisismagazine.com/2013/the-ambitions-of-bill-and-melinda-gates-controlling-population-and-public-education;
Family Planning Strategy Overview, BMGF website, http://www.gatesfoundation.org/What-We-Do/Global-Development/Family-Planning..
99. "Innovative Partnership Reduces Cost of Bayer's Long-Acting
Reversible Contraceptive Implant By More Than 50 Percent," BMGF press
release, Feb. 27, 2013, http://www.gatesfoundation.org/Media-Center/Press-Releases/2013/02/Partnership-Reduces-Cost-Of-Bayers-Reversible-Contraceptive-Implant.
100. Kingsley Davis, quoted in Donald T. Critchlow, ed., The Politics of
Abortion and Birth Control in Historical Perspective, University Park,
Penn.: Pennsylvania State University Press, 1995, p. 85.
101. Ibid., p. 87.
102. Edwin Black, "Eugenics: the California connection to Nazi
policies," San Francisco Chronicle, Nov. 10, 2003, http://www.sfgate.com/opinion/article/Eugenics-and-the-Nazis-the-California-2549771.php.
See generally Allan Chase, The Legacy of Malthus, Champaign, Ill.: Univ.
of Illinois Press, 1980.
103. Mark Hemingway, "Ford Ahead: The Foundation Tightens Its Belt,"
Wall Street Journal, June 26, 2009, http://online.wsj.com/news/articles/SB124598045813858017.
104. Quoted in Mao Zedong, The Bankruptcy of the Idealist Conception of
History, Sept. 16, 1949, http://www.marxists.org/reference/archive/mao/selected-works/volume-4/mswv4_70.htm.
105. Public Report of the Vice President's Task Force on Combatting
Terrorism, Feb. 1986, p. 1, http://www.population-security.org/bush_and_terror.pdf.
106. Hence BMGF literature lays special emphasis on population control
in urban sub-Saharan Africa and South Asia - putative hotbeds of
"terrorism" and precisely areas to which peasants dispossessed via
Gates-sponsored agricultural policies may be expected to relocate.
107. Population control is also potentially a weapon of ruling class
terror, as when India used coercive mass sterilization during the
1975-77 'Emergency'. In such a scenario, whether or not population
control measures succeed in substantially reducing the numbers of
people, they are effective in instilling and deepening among the common
people a dread of the State and its power to intervene in their lives.
(It is tempting to speculate that ultrasound and other high-tech
sterilization methods funded by BMGF are appealing because they could
facilitate coercive sterilization campaigns while avoiding the gory
surgical botches that might draw unfavourable publicity.)
108. David Harvey, "Population, Resources, and the Ideology of Science,"
Economic Geography, vol. 50, no. 3, July 1974, p. 273.
109. Global Health Watch, op. cit., p. 251.
110. Ibid, p. 253.
111. Declaration of Alma-Ata, International Conference on Primary Health
Care, Alma-Ata, USSR, September 6-12, 1978, http://www.who.int/publications/almaata_declaration_en.pdf?ua=1.
112. Mala Rao & Eva Pilot, "The Missing Link: The Role of Primary Care
in Global Health," Global Health Action, Jan. 1, 2014, p. 2.
113 .John Walley et al., "Primary Care: Making Alma-Ata a Reality,"
Lancet 2008; 372: 1001-1007.
114. Carl E. Taylor and Xu Zhao Yu, "Oral Rehydration in China," Am J
Public Health 1986; 76:187-189.
115. BMGF, Enteric and Diarrheal Diseases Strategy Overview, Gates
Foundation website, http://www.gatesfoundation.org/What-We-Do/Global-Health/Enteric-and-Diarrheal-Diseases.
116. Robert Arnove, ed., Philanthropy and Cultural Imperialism, Boston:
G.K. Hall, 1980, p. 1.
117. Tom Paulson, "Behind the scenes with the Gates Foundation's
'strategic media partners'," Humanosphere, Feb. 14, 2013, http://www.humanosphere.org/2013/02/a-personal-view-behind-the-scenes-with-the-gates-foundations-media-partners/.
For example, NPR's "Global Health Beat" and The Guardian's Global
Development page are underwritten by the Gates Foundation. Ibid.
118. See, for example, Caroline Graham, "This Is Not The Way I'd
Imagined Bill Gates," Daily Mail, June 9, 2011, http://www.dailymail.co.uk/home/moslive/article-2001697/Microsofts-Bill-Gates-A-rare-remarkable-interview-worlds-second-richest-man.html.
119. As of this writing Bill Gates' Twitter account boasts 15.8 million
followers. Social media is prized by corporate marketers as a low-cost,
unmediated, seemingly "organic" method of distributing publicity.
120. At the same time, the ideology promoted by BMGF fosters the
involvement of the corporate sector within 'philanthropic'
interventions, legitimizing the exploitation of public needs for private
profit. This opens the door for private corporations to annex still more
sectors of state activity, justifying the high cost of their services by
invoking illusory "efficiencies." BMGF's assistance to the ongoing
privatization of US public education via the "charter schools movement"
is a case in point.
121. "Yes, Vaccinations Are a CIA Plot," Economist, July 20, 2011,
http://www.economist.com/blogs/democracyinamerica/2011/07/bin-laden-vaccine.