Philanthrocapitalism, past and present: The Rockefeller Foundation, the Gates Foundation, and the setting(s) of the international/global health agenda

Abstract

In recent years the Bill and Melinda Gates Foundation has emerged as this era's most renowned, and arguably its most influential, global health player. A century ago, the Rockefeller Foundation-likewise founded by the richest, most ruthless and innovative capitalist of his day-was an even more powerful international health actor. This article reflects critically on the roots, exigencies, and reach of global health philanthropy, comparing the goals, paradigms, principles, modus operandi, and agenda-setting roles of the Rockefeller and Gates Foundations in their historical contexts. It proposes that the Rockefeller Foundation's early 20th century initiatives had a greater bearing on international health when the field was wide open-in a world order characterized by forceful European and ascendant U.S. imperialism-than do the Gates Foundation's current global health efforts amidst neoliberal globalization and fading U.S. hegemony. It concludes that the Gates Foundation's pervasive influence is nonetheless of grave concern both to democratic global health governance and to scientific independence-and urges scientists to play a role in contesting and identifying alternatives to global health philanthrocapitalism. D.C. under the aegis of the U.S. Public Health Service (20). In their early decades, both the OIHP and PASB remained focused on establishing and monitoring sanitary conventions and collecting disease statistics. Another early agency was the International Committee of the Red Cross, founded in Geneva in 1863 to provide aid to the victims of war. These organizations joined longstanding intra-imperial health activities carried out by colonial administrators, military forces, and missionaries, all with the aim of protecting troops, high-yielding colonial production and trade, and colonial settlers, at the same time as staving off unrest among the colonized (21). Enter the Rockefeller Foundation Just as these institutions were being created, a new player emerged on the scene, one that would go beyond political and economic self-interest, war relief, and information exchange to fundamentally transform the nascent international health field. The Rockefeller Foundation (RF) was established in 1913 by oil mogul-cum-philanthropist John D. Rockefeller-to promote the well-being of mankind throughout the world.‖ Not only did the RF virtually single-handedly popularize the concept of international health, it was the major influence upon the field's 20th century agenda, approaches, and actions (22,23). Rockefeller's efforts were part of a new American movement-scientific philanthropy.‖ Launched by Scottish-born, rags-to-riches steel magnate Andrew Carnegie in an 1889 essay,-The Gospel of Wealth,‖ published in The North American Review, this approach called for the wealthy to channel their fortunes to the societal good by supporting systematic social investments rather than haphazard forms of charity (24-26). The renowned Carnegie left a legacy of thousands of public libraries and bathhouses along with donations to higher ed...

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