Gates CEO Mark Suzman takes on foundation's critics in annual letter

Bill & Melinda Gates Foundation CEO Mark Suzman is hitting back at critics who believe the foundation’s wealth gives it undue influence over global health and development priorities, along with multilateral institutions such as the World Health Organization. Suzman took an unusually deep and reflective approach in his latest annual letter by focusing on the scale of the foundation — which has a record $8.3 billion budget this year — and the role of “unelected billionaires” and philanthropic capital in meeting global challenges. “It’s true that between our dollars, voice, and convening power, we have access and influence that many others do not,” Suzman wrote in the letter published Tuesday. “It’s also true that we are able to act in ways that others cannot. Because of this, we can call attention to and help find solutions for problems that otherwise might be neglected.” The letter is meant to come off as “proactive” rather than defensive, Suzman told Devex in an interview. The letter comes at a time when the foundation is facing harsh scrutiny, particularly regarding its leadership role in the global COVID-19 response despite a perceived lack of accountability. And while the foundation has always faced criticism, in recent years the critiques have grown more “extreme,” Suzman said, specifically mentioning the false conspiracy theories about foundation co-chair Bill Gates putting microchips into COVID-19 vaccines. Of course, some criticism is “appropriate” given the foundation’s size and scope, Suzman told Devex. It’s important to be “open” and accountable because that “makes us better and sharper,” he said. It was the foundation’s board — which formed last year and of which Suzman is a member — that encouraged him to address the criticism head-on, he told Devex. “It’s more of an approach that I feel and that the board has actually encouraged me to take, that we should just be proactive about explaining who we are, what we do, and why we do it,” he said. In the letter, Suzman also responded to criticisms of the foundation’s mission and methods for addressing global poverty and nutrition, among other areas. The Gates Foundation spends more than most other global nonprofits and more on global health than do some governments. Its plan to increase its annual budget to $8.3 billion this year represents about 15% more than what it spent last year, according to Suzman’s letter. The foundation’s forecasted payout for 2022 was just over $7 billion, “though that figure is still being finalized,” a spokesperson told Devex. With the additional spending, the foundation also will be “in the privileged position of being able to give away more money than any other philanthropy,” Suzman wrote. And that “raises an important question we hear often: Does our spending, along with the doors that it opens, give us too much power and influence?” he said in the letter. Wielding clout Some experts have said the foundation used its “clout” with WHO — for whom it is the second-largest donor — and other global health organizations to shape the global COVID-19 response, including conversations about vaccine distribution and whether to waive the intellectual property rights of vaccine manufacturers. It’s concerning that money is allowing the foundation and its partners to dictate policy and gain preferential access to global health agencies, they told POLITICO last year. “What makes Bill Gates qualified to be giving advice and advising the U.S. government on where they should be putting the tremendous resources?” said Kate Elder, senior vaccines policy adviser for the Médecins Sans Frontières’ access campaign. Agriculture in Africa also is a priority for the foundation. Some experts, including African farmers groups, also have criticized its approach to agricultural development on the continent, which they say promotes an industrial model that relies on environmentally harmful pesticides and fertilizers. Suzman tackled some of those critiques in an interview with Devex. When asked about the Gates Foundation’s role in decisions about the global response to COVID-19, he noted that while the foundation is WHO’s second-largest funder, “we don’t actually have any formal role in their governance.” In regard to health organizations where the foundation is part of decision-making, such as Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria, “we are trying, as always, to be transparent and collaborative” and “fully open about both our motivations and our methods,” he said. Gavi publishes governance information, including audits and investigations of its programs. The Global Fund has an office of the inspector general that “reports on all its activities in the interests of transparency and accountability,” according to its website. Still, Suzman said he also found it to be “outrageous” that the foundation’s contributions to WHO are greater than those of most countries. Governments should be giving more to the organization, he said. “We should be a much smaller funder of the World Health Organization,” he said. Further, while the foundation is increasing funding “where it can” it doesn’t match the scale of funding that governments can provide, Suzman said. The fact that the governments have not met the Group of 20 major economies’ call to provide $10 billion per year for pandemic preparedness “is a core example of neglect,” he said. Agenda setting Nevertheless, the foundation will not “stop using our influence, along with our monetary commitments, to find solutions” on issues ranging from ending malaria to improving U.S. math education, according to Suzman’s letter. He also signaled to Devex that the foundation did not intend to make any great course changes to its approach to agricultural development. In the letter, he outlined plans to work with smallholder farmers in sub-Saharan Africa, South Asia, and other regions greatly affected by climate change. The foundation particularly wants to help women farmers as part of its effort to help create more gender equity in the sector. The foundation committed to investing $1.4 billion to help smallholder farmers adapt to climate change late last year. “We’ve focused on agricultural development for 16 years, because it’s one of the most effective ways to help large numbers of people lift themselves out of poverty,” he wrote. And the foundation is not setting agricultural priorities and goals on its own, Suzman said. Instead, it works with national governments, regional bodies, such as the African Union, and organizations, such as CGIAR, a network or research centers, to determine where best to direct funding and resources, he said. “We feel, again, it’s an area where our work is responding to real needs and priorities set by the governments and the leaders and actually the farmers and stakeholders themselves where we work,” Suzman told Devex. The letter published Tuesday is the second annual letter from Suzman, who kicked off the tradition last year with a slightly more run-of-the-mill announcement about the formation of the board of trustees to provide additional oversight of the foundation’s operations in the wake of a governance shake-up. The board has since expanded to include two more members bringing its total to eight members. Bill Gates similarly defended the foundation’s mission in an end-of-year memo in December, saying that it has not changed over its more than 20-year existence. The foundation’s “top global priority” is to “help people in poor countries who shouldn’t die,” especially children, he said. Gates also said he believes the legacy of the foundation, which is slated to wind down after the deaths of both Gates and Melinda French Gates, will not be the billions of dollars it has spent, but rather “the teams of experts who developed strategies, partnerships, and innovations to reduce inequity.” Next steps The foundation plans to increase its annual payout by 50% to $9 billion by 2026 to advance its work in existing focus areas such as global health and education amid what it has referred to as the “compounding global crises” of the COVID-19 pandemic, rising inflation, climate change, and Russia’s war in Ukraine. In addition to agricultural adaptation, Suzman highlighted another global development area in his letter where the foundation was boosting its spending: global malaria eradication efforts. Last year, the foundation pledged $912 million to the Global Fund, which was its largest-ever commitment to the fund. The foundation also plans to prioritize funding for math education in the United States, Suzman wrote. Prior to announcing the new spending plan last year, the foundation paid out around $6 billion annually. The spending increase follows a pledge Gates and ex-wife Melinda French Gates made in 2021 to contribute an additional $15 billion to the foundation’s endowment, which currently stands at $53.3 billion. Gates, who is currently listed as the fifth wealthiest person in the world with an estimated net worth of $111 billion, helped fulfill that pledge with a $20 billion gift in July.