The Foundation is the second largest donor to the World Health Organization (WHO) at $638.2 million, following the United States ($678.4 million) and nearly quintupling contributions from countries like Germany ($129.9 million) and the UK ($108.1 million). This position has allowed Gates to directly influence policy on vaccine patents in a way that has negatively affected mRNA vaccine manufacturing in low- and middle-income countries (LMICs).

For example, as reported on by The New Republic, the “Gates-directed tech-transfer mechanism without meaningful input from WHO members states […] would be a "body blow" to [the COVID-19 Technology Access Pool] and similar future initiatives that promote open licensing and knowledge sharing to maximize production and access.”

https://www.bioprocessintl.com/global-markets/gates-foundation-impact-on-global-health-and-biologics-manufacturing-to-increase

After weeks of immense pressure, the Biden administration came out in support of waiving intellectual property rights to coronavirus vaccines. Shortly after the Biden announcement earlier this month, the Bill and Melinda Gates Foundation also reversed course and endorsed the patent waiver. But Bill Gates himself, subject to revived scrutiny around sexual misconduct and perhaps the most powerful person in global health, hasn’t budged.

https://www.wired.com/story/opinion-the-world-loses-under-bill-gates-vaccine-colonialism/

Civil society organizations active in poorer nations, including Doctors Without Borders, expressed discomfort with the notion that Western-dominated groups, staffed by elite teams of experts, would be helping guide life-and-death decisions affecting people in poorer nations. Those tensions only increased when the Gates Foundation opposed efforts to waive intellectual property rights, a move that critics saw as protecting the interests of pharmaceutical giants over people living poorer nations.

“What makes Bill Gates qualified to be giving advice and advising the U.S. government on where they should be putting the tremendous resources?” asked Kate Elder, senior vaccines policy adviser for the Doctors Without Borders’ Access Campaign.

https://www.politico.com/news/2022/09/14/global-covid-pandemic-response-bill-gates-partners-00053969

Ask anyone with a passing interest in global health what the Gates Foundation means to them and you'll likely get just one answer: money. In a field long fatigued by the perpetual struggle for cash, the foundation's eagerness to finance projects neglected by many other donors raised high hopes among campaigners that its impact on health would be swift and great. And with the commitment last June by America's second richest man, Warren Buffet, to effectively double the foundation's $30bn (£15bn; €22bn) endowment,1 hopes of substantial health achievements grew higher still.

But despite Bill Gates's prediction at a press conference to mark Buffet's pledge that there was now “No reason why we can't cure the top 20 diseases”2 observers are starting to question whether all this money is reaping sufficient rewards. For although the foundation has given a huge boost to research and development into technologies against some of the world's most devastating and neglected diseases, critics suggest that its reluctance to embrace research, demonstration, and capacity building in health delivery systems is worsening the gap between what technology can do and what is actually happening to health in poor communities.

https://pmc.ncbi.nlm.nih.gov/articles/PMC1857776/

Over the past decade, the world’s richest man has become the World Health Organization’s second biggest donor, second only to the United States and just above the United Kingdom. This largesse gives him outsized influence over its agenda, one that could grow as the U.S. and the U.K. threaten to cut funding if the agency doesn’t make a better investment case.

The result, say his critics, is that Gates’ priorities have become the WHO’s. Rather than focusing on strengthening health care in poor countries — that would help, in their view, to contain future outbreaks like the Ebola epidemic — the agency spends a disproportionate amount of its resources on projects with the measurable outcomes Gates prefers, such as the effort to eradicate polio.

https://www.politico.eu/article/bill-gates-who-most-powerful-doctor/

So it’s surprising to wade into academic journals and find that many political scientists and development scholars are actually quite skeptical about the Gates Foundation’s outsize impact on global health. In numerous papers over the past decade, researchers have raised concerns about the foundation’s lack of transparency, its veto power over other global health institutions, and its spending priorities. Some experts worry that the Gateses’ health philanthropy has become too big to scrutinize.

https://www.vox.com/2015/6/10/8760199/gates-foundation-criticism

At the same time, strong evidence suggests that the Gates Foundation functions as a trojan horse for Western corporations, which of course have no goal greater than an increased bottom line.

Consider the revolving door between the Gates Foundation and Big Pharma.

Former director of vaccine development at the foundation and current CEO of the Bill & Melinda Gates Medical Research Institute, Penny Heaton, hails from drug kingpins Merck and Novartis.

The foundation’s president of global health, Trevor Mundel, served in leadership positions at both Novartis and Pfizer. His predecessor, Tachi Yamada, was previously a top executive at GlaxoSmithKline (GSK). Kate James, worked at GSK for almost 10 years, then became the foundation’s chief communications officer. The examples are almost endless.

https://grain.org/en/article/6511-why-the-bill-gates-global-health-empire-promises-more-empire-and-less-public-health

In the book, No Such Thing as a Free Gift: The Gates Foundation and the Price of Philanthropy, the sociologist Linsey McGoey traces the evolution of private philanthropy’s ‘father knows best’ approach to giving. As McGoey explains, foundations used to have a hands off approach to their grantees, with the understanding that those working closely on social issues best understood how to affect change. Now, most foundations are intimately involved in trying to shape their grantees’ methods, including the Gates Foundation. “The question is whether the practices associated with the new philanthropy – such as tighter control of grantee decision-making; a demand for swifter indicators of project success – might be stifling ingenuity and progress rather than engendering it.”

https://africasacountry.com/2015/12/does-the-gates-foundation-do-more-harm-than-good

The idea that Gates was a defender of the rights and the entitlements of people who are most disenfranchised by circulations of global capital is simply a ludicrous proposition. So when it came to the general public, my criticisms of Mr. Gates might have been surprising, but in some of the left-wing circles that I hung out in that I had been involved in for over a decade before I began to research the Gates Foundation more directly, my criticism was not that surprising. It was a bit outlandish to assume that Mr. Gates, chief monopolist, was somehow going to be a defender of the rights of the poor, and someone who could close the global inequality gaps. In reality, he was really at the forefront of helping to perpetuate inequality through his approach to labor contracts and through his approach to patent protections.

https://www.currentaffairs.org/news/2022/07/how-bill-gates-makes-the-world-worse-off