When talking about actors in development, NGOs are usually the first thing people think about. They are seen as a ‘development alternative’ (Banks and Hulme, 2012 p.8) to official development actors due to their ability to work independently of the state and work from a grassroots level. But how effective is the work of NGOs? And how accountable are they to the people they aim to help?
Bill Gates is one of the world’s richest men. In 2000 he founded the Bill and Melinda Gates Foundation (Gates Foundation) to use his wealth to help people in developing and developed countries. The endowment of the Foundation is greater than the GDP of most sub-Saharan nations and it bestows more foreign aid than medium-sized countries (Turner, 2012). With all that money, surely the Gates Foundation should be able to do some good?
However, the Foundation has had many criticisms. A programme funded by the Foundation, the Global Fund, pays for salary increases for doctors and nurses providing antiretroviral drug therapy for HIV/AIDS (Piller and Smith, 2007). This has caused large numbers of healthcare workers in developing countries to move into AIDS care, creating a lack of clinicians working in basic care. By targeting only high profile diseases such as HIV/AIDS, the Foundation is ignoring the basic needs of people such as lack of food. For example, many patients are given drugs as AIDS treatment but don’t have enough food so find themselves unable to take the treatment (Piller and Smith, 2007). The Gates Foundation has also been criticised for its choices of firms to invest in. It has invested more than $400 million in oil firms in the Niger Delta which are responsible for pollution that many blame for respiratory problems among the local population (Democracy Now, 2007). The Foundation also has investments in sixty-nine of the worst polluting companies in the United States and Canada (Democracy Now, 2007). This shows that although the Foundation may be investing lots of money in health in developing countries, it may be inadvertently making things worse.
This raises the question of accountability and highlights the difference between the Gates Foundation and more conventional NGOs such as Oxfam or Save the Children. By acting as a philanthro-capitalist – using money from business to help people – the Foundation can choose exactly where to invest money. Conventional NGOs have a high dependency on donors (Banks and Hulme, 2012) who can have some say in where the money goes and potentially stop money being given to organisations which are causing harm. However, this dependency on donors has skewed accountability away from beneficiaries (Banks and Hulme, 2012). With a lack of dependency on the wishes of donors, the Gates Foundation may be able to focus more on what people in developing countries want.
Overall, I think that while the Gates Foundation is clearly going to help lots of people with the money it has available, it needs to be more careful about some of the companies it has investments in. I also believe it should not only focus on high profile diseases such as HIV/AIDS and instead focus on overall health. In my opinion, NGOs are a very important development actor as the high profile they can have is important in raising awareness, and they are able to take a more grassroots approach to development than other development actors.
Banks, N. and Hulme, D. (2012), The role of NGOs and civil society in development and poverty reduction. Brooks World Poverty Institute, University of Manchester
Bill and Melinda Gates Foundation. Available from: http://www.gatesfoundation.org/Pages/home.aspx (accessed 29/11/2012)
Democracy Now (2007), Report: Gates Foundation Causing Harm With the Same Money It Uses to Do Good. Available from: http://www.democracynow.org/2007/1/9/report_gates_foundation_causing_harm_with (accessed 29/11/2012)
Piller, C. and Smith, D. (2007), Unintended victims of Gates Foundation generosity. Available from: http://www.latimes.com/news/nationworld/nation/la-na-gates16dec16,1,7781791.story (accessed 29/11/2012)
Turner, J. (2012) ‘Is Melinda Gates the world’s most influential woman?’, The Times Magazine, 13/10/2012, pp. 28-34