Gates Foundation Accused by U.N. Official of Creating Scientific ‘Cartel’

As America’s wealthiest philanthropy, the Bill & Melinda Gates Foundation is no stranger to criticism.

But a senior official at the World Health Organization has raised eyebrows recently for his harshly worded critique of the large grant maker.

The official, Arata Kochi, who leads global antimalaria efforts for the United Nations health agency, charged the Gates foundation with making decisions behind closed doors and creating a scientific “cartel” that has hampered the fight against malaria.

Tadataka Yamada, executive director of global health at the Gates foundation, called the accusations baseless.

But Dr. Kochi’s opinion echoes others who have said the grant maker’s growing influence due to its unprecedented wealth — $38-billion and climbing — may inadvertently hurt the humanitarian causes it supports.

In an eight-page memo to the health organization’s leadership, a copy of which was obtained by The Chronicle, Dr. Kochi writes that Gates has provided desperately needed funds to combat malaria, which kills one million people a year. From 1997 to 2004, he said, the foundation helped annual malaria spending by governments and nonprofit groups grow from $84-million to almost $300-million.

But the health leader worries that the influx of so much money from one source could have “far-reaching, largely unintended consequences.”

With Gates’s “monopoly,” he writes, a scientist is less likely to question the fund’s approach or the research of other Gates grant recipients for fear of upsetting the foundation.

The situation makes “obtaining an independent review of scientific evidenceincreasingly difficult because leading scientists are now compromised by the risk of being deprived of research funding.”

With such power, he said, Gates should be more public about how it picks grant beneficiaries and approaches scientific inquiry, but the fund’s decision making “is a closed internal process, and as far as can be seen, accountable to none other than itself.”

Dr. Kochi was unavailable for further comment.

Outside Reviews

The Gates foundation’s Dr. Yamada countered that the foundation has multiple ways in which it receives feedback.

“We have consultants that review our grant applications, we’ve got a program advisory panel of outside experts that broadly looks at the Gates foundation’s investments in global health,” he said. “Input is exactly what we seek.”

For instance, he said, the fund meets regularly with the World Health Organization, other United Nations agencies, the World Bank, and other major players in global health to discuss strategies.

“This is not something we work on behind close doors in a smoke-filled room and decide ourself,” he said.

At the World Health Organization, a spokeswoman said Dr. Kochi’s memo did not reflect the views of the Geneva-based group or its director general, Margaret Chan.

“The document in question was developed by one department,” said Emma Thompson, a spokeswoman for the agency.

Other organizations that work with the Gates foundation voiced their approval of the grant maker.

“We’ve never felt that the Gates foundation acted like a cartel,” said Peter Costiglio, a spokesman for the Rockefeller Foundation, in New York, which works with the Gates fund on improving agriculture in Africa.

Dr. Kochi’s memo was first reported on by The New York Times, which said it was distributed to senior directors at the health agency with a note asking whether they have faced similar concerns about the Gates fund.

‘Continuous Pressure’

With an annual budget of $4-billion, the World Health Organization helps evaluate and recommend health policies for poor nations.

But Dr. Kochi’s memo suggests its role may now be threatened by the Gates foundation, which awards close to $3-billion a year to global health, education, and antipoverty efforts. In the next five years alone, it will spend $1-billion on antimalaria projects.

In his critique, Dr. Kochi writes that the foundation and a consortium of Gates-supported scientists have put “continuous pressure” on his office to back an experimental approach to preventing malaria, known as intermittent preventive treatment for infants.

He writes that the foundation ignores the treatment’s potential health risks because it has a “vested interest to seeing the data it helped generate taken to policy.”

Dr. Yamada said the philanthropy has never pressured Dr. Kochi or his staff members to make a specific policy recommendation on this matter and that an independent panel of health experts at the National Academy of Sciences will review the results of the treatment project; that panel’s conclusions will set the next step for the infant-malaria program.

And while Dr. Kochi is concerned about the foundation’s influence, Dr. Yamada said he continues to have a “very good working relationship” with other World Health Organization officials.

“I don’t think this is a turf battle at all,” he said.