As Trump dismantles global health, Gates's complicity draws outrage
Foundation insiders I interviewed decry Gates's cowardly capitulation--another example of the billionaire class bending the knee to Trump.
In Donald Trump’s brief time in office this year, he has moved to slash billions of dollars in federal spending aimed at advancing public health in poor nations, demanding cuts to the World Health Organization, USAID, PEPFAR and other projects.
The news media has widely reported on how Trump’s funding cuts (and frozen funding), if successfully enacted, will result in untold human suffering around the world. That’s because many poor nations today depend on foreign aid from the United States, and have organized their public health systems around this money.
What the news media has entirely missed is that Trump’s funding cuts will also cause acute suffering to one of the world’s richest people, Bill Gates.
As I wrote last November, Gates has built his philanthropic career through subsidies from the US government—in the form of foreign aid. He has spent much of the last two decades flying around the world in his private jet, pressuring government leaders to keep the tens of billions of taxpayer dollars flowing into his philanthropic projects. For years, Gates has given interviews and written op-eds forcefully lobbying for expanded foreign aid. When Zambian economist Dambisa Moyo wrote a high-profile critique of foreign aid, titled “Dead Aid,” Gates was so incensed that he publicly attacked the book as “evil.”
Given Gates’s history of passionate, high-profile advocacy on this issue, and given that his legacy as a philanthropist depends heavily on continued foreign aid funding, one would expect him to bring the full weight of his bully pulpit to challenge Trump, decrying his funding cuts as “evil.” But he’s not doing that. He’s mostly keeping his head down, spending almost all of his time promoting his self-aggrandizing memoir.
In the same way that Jeff Bezos and Mark Zuckerberg have cravenly re-organized their interests—-in the Washington Post and Meta—-to avoid conflict with the new president, so, too, has Gates carefully sought to avoid confronting Trump on foreign aid. If anything, Gates’s complicity and cowardice might be seen as far more odious than that of other billionaires because of the life-or-death consequences of the Gates Foundation’s work in public health.
In recent weeks, numerous insiders and public health experts have contacted me with a mix of confusion and horror, all of them asking the same question: why in the world is Gates sitting on the sidelines and refusing to step up to the plate?
As one former staffer told me, “If Bill actually had principles on this they’d already be stepping up to support PEPFAR and make sure ARTs [antiretroviral therapy for HIV] got delivered on schedule right now…A lot of these programs do time sensitive things and suddenly pausing them will do massive damage in global health, not just short term to the people they’re helping but long term to things like ART-resistance. Gates is one of the few people/institutions in the world that could possibly stem the bleeding…He should be going on Fox News and talking about how many people are going to die as a result of these decisions.”
A former Gates Foundation grantee echoed the sentiment: “It is exactly now that we need leadership on global health. And on vaccines. Where is the leadership? Or was global health always just about reputation, influence, and power. If it were really about saving lives and treating all lives as equal, now would be the time to speak up.”
[The Gates Foundation’s motto is “all lives have equal value.']
Gates has actually been very explicit about his decision not to speak up. In several recent media appearances promoting his memoir, he’s been asked about Trump. In an interview with the New Yorker, Gates was unamiguous that his foundation will not “oppose” Trump in any way.
“Trump will be making a lot of very key decisions, and the idea that people in the Gates Foundation will be trying to help them make those decisions well—that part I’ll have to stick up for. We are not going into opposition. We are continuing the partnership we’ve had with every administration.”
In some interviews Gates has gone further, openly endorsing Trump and gushing about how “impressed” he is with the billionaire president.
The effect of these public statements is to normalize and legitimize the Trump administration—at a time when many people, inside and outside public health, see a dire need to challenge Trump’s presidency as a slide into oligarchy, if not fascism.
The Gates Foundation’s website also shows no signs of resistance. The best the foundation can offer are extremely brief, meek and mealy-mouthed statements—which avoid mentioning Trump—often voiced through the foundation’s virtually unknown CEO, Mark Suzman.
Most foundation staff have also kept a low profile. To the extent that they are speaking out, they, too, seem be issuing carefully crafted commentary.
As one former staffer told me, “It’s actually been really hard to see the posts from current foundation employees on social media. It has added to the feelings of helplessness caused by what Trump is doing...Longstanding senior-level staff have the internal capital and the budgetary authority to advocate for action by the foundation or to actually allocate funding for things that they are instead simply choosing to complain about.”
These critiques raise the other obvious remedy that Gates could pursue; even if Bill Gates isn’t going to stand up to Donald Trump on principles, what is stopping him from filling in the funding gaps? Why not open the vault and start plugging holes?
Even I’ve been surprised that Gates has yet to embrace the savior routine, if only because it would deliver to him a massive PR boost. Through another lens we could ask, doesn’t Gates have a moral responsibility to take action? Given the ways that Gates has forcefully sought to compel the global poor to depend on a fragile, unjust and inefficient model of foreign aid and philanthropy, doesn’t he have to respond to the funding crisis? Doesn’t he have the resources to do so? If millions of lives are suddenly at stake, and Gates is uniquely positioned to help and doesn’t do so——doesn’t he have blood on his hands?
The Gates Foundation boasts a $76 billion endowment—which, notably, generated $11 billion in investment income in 2023. And Bill Gates also controls a personal fortune estimated at as much as $169 billion——money he has always said will be given away through philanthropy. What this shows is that Gates could single-handedly replace all of USAID’s public-health spending during Trump’s four-year presidency—and still have billions of dollars left in his bank account.
In a recent, long, friendly interview on PBS, (organized around his new memoir), Gates was finally asked directly whether he would do that. He was also asked how many lives were at stake. When pressed, Gates acknowledged the millions of lives that could be lost by Trump’s funding cuts, but also said there was no possible way he or his foundation would consider making up the shortfalls. He almost seemed to suggest that he couldn’t afford to do so. “We may step up in a very minor way, but…no, if this [federal] money goes away, there will be dramatic consequences,” Gates said.
How do we explain Gates’s response, or non-response—outside of words like ‘miser’ and ‘coward?’ And how do we square this behavior with the way that journalists right now are shamefully, bizarrely presenting Gates as a democracy-forward alternative to all the other billionaire sychophants capitulating to Trump?
The answer is that the New York Times, the New Yorker and most other news outlets are trading in misinformation. Bill Gates is not our good billionaire. He is not a man of principles, values or ethics. And he’s not a selfless philanthropist. He’s a self-interested oligarch obsessed with power and money. Faced with a politically unfriendly landscape for the first time in his political career (as a philanthropist), Gates is showing his true colors. He has made the decision to keep his head down and try to get through Trump’s presidency as unscathed as possible, hopefully leaving his Nobel-Peace-Prize candidacy intact. If millions of lives have to be lost, Gates’s sentiment seems to be: so be it.
If there is a glimmer of hope in this dark story it is that Gates, the world’s most ferocious defender of the status quo and the most incorrigible obstacle to progressive reforms, is finally being forced to lower his voice—and finally being exposed as a rank hypocrite.
How widely we recognize and debate this remains to be seen; the thousands of people and organizations around the world that remain on the Gates Foundation’s payroll (or that hope to join it), including a great many news outlets, are highly incentivized to perpetuate the myth of the good billionaire.
My own view is that we are reaching a tipping point with the way that extreme wealth corrupts democracy. And unless and until we can interrogate and challenge extreme wealth in all of its forms, we are doomed to a world increasingly run by oligarchs.
Oligarchs stick together. We’re witnessing the iron law of oligarchy in full effect.