The Responsibility of the States Regarding Bill Gates

Published in Le Temps
(Switzerland) on 4 May 2021
by Stéphane Bussard (link to originallink to original)
Translated from by Peyton Reynolds. Edited by Elizabeth Cosgriff.
Melinda and Bill Gates’ divorce is testing Geneva International, which is massively financing three major global health institutions. If the financial support of these two philanthropists is welcomed, this poses some questions about independence, notably of the World Health Organization.

It’s divorces that count. And the Melinda and Bill Gates divorce is one of those. It resounds clearly at the heart of Geneva International. The American billionaire and his wife are major silent partners in the ecosystem of global health on the edge of Lake Geneva. A change in the Gates family could consequently have repercussions for the financing of the World Health Organization, Gavi, the Vaccine Alliance, and the Global Fund to Fight AIDS, Tuberculosis and Malaria — all generously funded by these philanthropists.

Beyond undoubtedly exaggerated worries, the situation raises a fundamental question in the middle of the COVID-19 pandemic that has killed more than 3 million people: How do you finance global health? The WHO remains an incredibly under-equipped organization that is very vulnerable to the pressures of the member states. This was seen with China and Italy in the context of COVID-19. Despite Angela Merkel’s request to the World Health Assembly in Geneva in 2015, where she asked for more substantial financing for the WHO, the member states shied away from their responsibility. Year after year. At the 74th World Health Assembly, to be held from May 24 through June 1, they will, however, need to face the facts: Without a stronger financial base, the WHO will not be able to manage future pandemics.

Faced with such irresponsibility by the states, the generosity of philanthropists Melinda and Bill Gates is worth accepting. It makes up for what is missing. But this does not come without some questions.

Since the H1N1 pandemic, during which the identity of the WHO’s silent partners caused doubt regarding its independence, it reinforced its safeguards. But there is no doubt that Bill Gates has a real influence on the organization and the programs that he favors. And that’s without the democratic duty of answering to the citizens of this world who contribute, through their governments, to developing a quality health institution.

The dependence of the WHO on a billionaire reveals a great vulnerability. All this rich contributor has to do is change strategies or pass away and the WHO would be destabilized. This situation raises more questions about the private-public partnership of which Geneva is now the herald. In redefining multilateralism, this partnership seems necessary not just to mitigate the United Nations’ bureaucratic breakdown, but also to make up for the lack of funding from the states. But it must also be consistent with it. The private-public partnership cannot be a veneer destined to maintain hackneyed models like the inflexible one that Gates is defending regarding intellectual property rights relative to the vaccines.



Le divorce du couple Melinda et Bill Gates interroge la Genève internationale, où ce dernier finance massivement trois institutions majeures de la santé globale. Si l’apport financier de ces deux philanthropes est bienvenu, il pose aussi des questions d’indépendance, notamment de l’OMS.

Il est des divorces qui comptent. Celui de Melinda et Bill Gates est de ceux-là. Il résonne fortement au sein de la Genève internationale. Le milliardaire américain et son épouse sont un bailleur de fonds majeur de l’écosystème de santé globale au bout du Léman. Un changement au sein de la famille Gates peut dès lors avoir des répercussions sur le financement de l’OMS, de GAVI, l’Alliance du vaccin et du Fonds mondial de lutte contre le sida, la tuberculose et le paludisme généreusement financés par ces philanthropes.

Au-delà de ces inquiétudes sans doute exagérées, l’événement soulève une question qui reste fondamentale au cœur d’une pandémie de Covid-19 qui a tué plus de trois millions de personnes. Comment financer la santé globale? L’OMS demeure une organisation tellement sous-dotée qu’elle est très vulnérable aux pressions des Etats membres. On l’a vu avec la Chine et l’Italie dans le cadre du Covid-19. Malgré l’appel d’Angela Merkel lancé devant l’Assemblée mondiale de la santé en 2015 à Genève à financer plus substantiellement l’OMS, les Etats membres se dérobent à leur responsabilité. Année après année. A la 74e Assemblée mondiale de la santé qui se tient à Genève du 24 mai au 1er juin, ils devront pourtant se rendre à l’évidence: sans assise financière plus forte, l’OMS sera incapable de bien gérer les pandémies à venir.

Face à cette irresponsabilité des Etats, la générosité des philanthropes Melinda et Bill Gates est du coup bonne à prendre. Elle comble un vide. Mais elle ne va pas sans poser quelques questions.

Depuis l’épidémie de H1N1, durant laquelle l’identité de ses bailleurs de fonds mettait en doute son indépendance, l’OMS a renforcé ses garde-fous. Mais nul ne doute que Bill Gates exerce sur l’organisation une vraie influence sur les programmes qu’il privilégie. Et cela sans le devoir démocratique de rendre des comptes aux citoyens de ce monde qui contribuent, à travers leurs gouvernements, à développer une institution sanitaire de qualité.

La dépendance de l’OMS à un milliardaire révèle aussi une grande fragilité. Il suffit que ce riche contributeur change de stratégie ou décède pour que l’OMS soit déstabilisée. Cette situation interroge plus largement sur le partenariat privé-public dont Genève se fait désormais le héraut. Dans une redéfinition du multilatéralisme, ce partenariat paraît nécessaire tant pour pallier les dérives bureaucratiques onusiennes que pour combler le manque de financement des Etats. Mais il doit lui aussi être cadré. Le partenariat privé-public ne peut être un paravent destiné à maintenir des modèles éculés, comme celui, inflexible, que défend Bill Gates en matière de propriété intellectuelle relative aux vaccins.
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