Is Gates Foundation, WHO’s Biggest Private Funder, Ineligible To Join WHO?

As the World Health Organization Board prepares to consider candidate institutions to be admitted into official relations with the UN agency, some health and public interest groups are raising alarm at what they see as a seeming lack of safeguard against conflicts of interest. Particular concern has been raised over admitting the Bill & Melinda Gates Foundation as an observer because of the Foundation trust’s investments in business ventures such as Coca-Cola, which they see as contrary to health goals. But the Gates Foundation, which is the biggest private donor of the WHO, said the trust is a separate entity from the foundation, and refutes any conflicts of interest.

The WHO Executive Board, meeting from 23 January to 1 February, is expected to consider [pdf] the following candidates: the Bill & Melinda Gates Foundation, Grand Challenges Canada, International Rescue Committee, Knowledge Ecology International and The Fred Hollows Foundation for admission into official relations with WHO.

In May 2016, the WHO adopted a Framework of Engagement with Non-State Actors (FENSA), which is aimed at reducing the risk of conflicts. Non-state actors are non-government organisations, private sector entities, philanthropic foundations, and academic institutions.

A number of public interest, health, and citizens’ groups sent a letter [pdf] to the Executive Board calling the attention of the Board to the weakness of conflict of interest safeguards to protect WHO from influence of industry.

In the letter, the groups detail the example of the Gates Foundation, which is seeking to be admitted as an external actor in “official relations” with the WHO and as a non-voting member of the World Health Assembly. The Gates Foundation is the largest non-governmental donor of the WHO.

According to the letter, citing the United States Government’s Securities and Exchange Commission, “the Bill and Melinda Gates Foundation Trust endowment—the source of revenue for the Foundation—is heavily invested in many of the food, alcohol, and physical inactivity related consumer products that cause or treat the current crisis of preventable heart disease, stroke, cancer, and diabetes.”

In particular, “Gates Foundation Trust direct investments include: Coca-Cola regional company that operates in the Americas south of the U.S. ($466 million), Walmart ($837 million), the largest food retailer in the U.S. and a leading retailer of pharmaceutical drugs and alcoholic beverages, Walgreen-Boots Alliance ($280 million), a large multinational pharmaceutical drug retailer, and two of the world’s largest TV companies (screen-time): Group Televisa ($433 million) and Liberty Global PLC ($221 million),” the letter said.

The signatories belong to institutions such as Alcohol Justice (USA), Baby Milk Action (United Kingdom), Centre for Health Science and Law (Canada), FIAN International (Germany), Foundation for Alcohol Research and Education (Australia), Health Innovation in Practice (Switzerland), International Baby Food Action Network (Brazil) People’s Health Movement (Global), and World Public Health Nutrition Association (United Kingdom).

The letter notes that what they see as conflicts of interest are not acknowledged in the WHO budget’s financial contributor database, and only partially noted in the WHO’s Register of Non-State Actors.

The signatories called for member states to fund the WHO more adequately so it does not have to rely on funding from major investors in food, drug, and alcohol companies, and compromises the independence of the WHO.

They asked the Executive Board this week to “defer the decision to accept the Gates Foundation and any other new and legacy applicants for Official Relations status for which there has been no conflict of interest safeguard review on the record for consideration” by member states of the EB.

Gates Foundation Clarifies Independence

Meanwhile, according to Chris Elias, president of Global Development at the Gates Foundation, “The Gates Foundation provides the World Health Organization with funding to help it achieve global health goals that have been approved by its member states. These include global polio eradication and ending preventable child deaths. Formalizing our relationship with WHO under the framework that it has adopted for working with NGOs creates clear norms and guidelines for our ongoing support.”

“In this and all our work, the foundation operates as a separate entity from the Bill & Melinda Gates Foundation Trust,” he told Intellectual Property Watch in an email.

“Foundation staff have no influence on the trust’s investment decisions and no visibility into its investment strategies or holdings, other than through what is publicly available. This two-entity structure ensures that the foundation’s work remains independent from the trust’s investments, and focused solely on fulfilling our mission to improve quality of life for the world’s poorest,” he said.

Other Candidates

Grand Challenges Canada is funded by the government of Canada and fund innovators in low- and middle-income countries and Canada.

The United States-based International Rescue Committee specialises in relief during humanitarian crisis.

The Fred Hollows Foundation based in Australia works to restore sight to people in developing countries.

US-based Knowledge Ecology International has a focus on social justice.

Draft Decision Calls for Postponing Review of Some, Dropping Others

The draft decision to the agenda item on non-state actors calls for the Board to approve maintaining official relations with 58 non-state actors whose names are listed in Annex 2 of the document. This includes the Drugs for Neglected Diseases initiative, International Baby Food Action Network, International Federation on Ageing, Medicines Patent Pool, Médecins Sans Frontières (MSF, Doctors Without Borders), and the International Society for Biomedical Research on Alcoholism.

The draft decision also asks to defer the review of relations with a number of non-state actors until the 142nd session of the EB in January 2018. The list includes the European Generic Medicines Association, the International Union for Health Promotion and Education, and the World Federation of the Deaf.

Among the institutions with which the WHO suggested discontinued relations are the Inter-African Committee on Traditional Practices affecting the Health of Women and Children, the International Centre for Trade and Sustainable Development, and the World Association for Sexual Health.

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