The grand impact of the Gates Foundation

Abstract

Sixty billion dollars and one famous person can affect the spending and research focus of public agenciesKirstin RW Matthews1 and Vivian Ho11James A. Baker III Institute of Public Policy, Rice University,Vivian Ho is also at the Department of Medicine, Baylor College of Medicine,Houston, TX, USA Houston, TX, USAIn an ideal world, scientific research would be free from constraints; the professional interests of the scientific community and individual scientists would determine research topics and directions, and funding would be limitless. In the real world, however, factors such as the economy, health and social interests also have an influence and eventually limited financial resources must be prioritized. Public agencies and private benefactors support research with the expectation that the results will translate into tangible benefits such as economic growth, health products, or solutions to social problems. Given that much of academic research is predominantly funded by public money, funding agencies frequently determine the direction of research.The foundation frequently stated that the goal was not only to solve global health challenges, but also to attract new scientists to the fieldIn the USA, the National Institutes of Health (NIH; Bethesda, MD, USA) has an annual budget of approximately US$30 billion and influences biomedical research extensively by setting funding priorities. Given that the NIH distributes taxpayers' money, it predominantly supports research that targets health problems affecting US citizens. However, more recently, the US Federal Government's funding allocations through the NIH have been influenced by private foundations, shifting their focus and resources towards addressing the problems of global health. Most notable of these foundations has been the Bill & Melinda Gates Foundation (BMGF; Seattle, WA, USA; www.gatesfoundation.org), which was set up by the couple in 2000.Here, we review the impact of the Grand Challenges for Global Health (GCGH) initiative that was started by the BMGF in 2003 and that managed to influence the NIH's funding priorities. We found that the NIH supplemented the GCGH with increased funding of approximately US$1 billion for global health issues at a time when the overall NIH budget experienced little growth. Interestingly, this redirection of …