Last month, the government of India revoked the ability of the Public Health Foundation of India (PFHI) to receive funding from any foreign sources. Since its founding in 2006, PFHI has evolved to become a premier public health research and educational institution as well as a policy think tank. Until last month, it was the first choice for an Indian partner for non-Indian foundations, university researchers, health organizations, and even foreign governments who wanted to do work in India. Despite being a successful organization with a favourable international reputation, and a long history of working closely with national and state government officials, some significant issue or force motivated the move to severely constrain if not shut down PFHI. According to government officials, the reason for revoking the foreign funding permission was because PFHI had acted illegally by lobbying parliamentarians and the media about controlling tobacco. Money could be used for research on tobacco, but using foreign funding for lobbying breaks some fundament rules, argues the government. But, that reason is being understood by many within and outside India as a ruse.
The rise of mega-philanthropists in global health
Rather than being about tobacco, the supposedly real reason to constrain PFHI is to push back at the enormous influence that the Bill and Melinda Gates Foundation has been having on health policy and programmes in India, particularly through PFHI. In particular, the Gates Foundation’s efforts to increase the levels of childhood vaccinations around the world, particularly in large countries such as India, has been understood by some as being ‘pro-pharma’. Against the background scepticism of pharmaceutical companies, especially large multinational ones that conduct research in developing countries, the advocacy by the Gates Foundation for particular types of vaccines, made by particular companies, and to be implemented at enormous scale has raised numerous concerns by anti-globalisation activists and vaccine sceptics. Whatever might be the real reason(s) for constraining the work of PFHI, the consistent identification of the Gates Foundation as part of the story brings to the forefront questions about the future of the Gates Foundation in India, the rise of mega-philanthropists in global health, and ‘philanthrocapitalism’ more broadly.
Can run afoul governments
I and David Stuckler - members of the Lancet-University of Oslo Independent Panel on Global Governance for Health - are currently doing research on this phenomenon of philanthrocapitalism in order to identify its intellectual and economic underpinnings, and its strengths and weaknesses. As the situation in India shows, despite enormous contribution to saving lives, modern day mega-philanthropists and their organizations can run afoul governments or local social movements. And, importantly, many of the largest donations are in the area of health, in both rich and poor countries. Many of these mega-philanthropists are often self-made business people. As a result, they would like to see their philanthropy conducted in the same way as their businesses which have had significant success.
What are the principles of good practice?
As part of the research, we are also trying to identify some principles of good practice for ‘philanthrocapitalists’. Out intended audience is not just the handful of mega-philanthropists around the world, but also companies. This is because, in India, any company that has annual revenues more than 10 billion Rupees ($160 Million) must donate 2% of net profits to charity. This mandatory philanthropy by companies in India is truly philanthrocapitalism on a grand scale. And it could be used to significantly improve the health of the Indian population as well as securing global health. What principles of good practice would you recommend?
