The People v. Bill Gates

Bill and Melinda Gates have asked for privacy after their divorce announcement, but a storm of attention seems more likely. Interest in their marital arrangements isn’t merely prurient. They are public figures and their personal lives have political ramifications. The urgent question in global health circles is what will happen to their powerhouse foundation in the wake of their split. Large amounts of funding hang in the balance.

Even before the divorce, public opinion was shifting. A year ago, many people were sympathetic to Bill Gates, and even outraged on his behalf, when he became the target of conspiracy theories spread by QAnon and other groups, suggesting the pandemic was all part of a secret plan to implant microchips in people. More recently, though, as his opposition to waiving patents on vaccines has become better known, it isn’t only the conspiracists who are angry with him.

People are once again asking – as they did when he was at the helm of Microsoft during its anti-trust legal battles – whether it’s right for one private individual to wield so much economic and political power. For two decades the question seemed to have gone away: after all, how could anyone dislike the world’s most charitable man?

But as I argued a few years ago in No Such Thing As a Free Gift, Gates has long deserved more critical scrutiny than he has received, especially since a lot of the Gates Foundation’s money is channelled to western researchers and pharmaceutical companies, exacerbating inequality between the global north and global south. Gates has also long refused to concede that current patent protections on drugs and vaccines are unfair and biased against the interests of poor nations, making it legally difficult for them to respond to health emergencies even when they have the scientific knowhow.

Private philanthropy in general can be a threat to democratic accountability and a just society. Reverence for big donors implies that billions of underpaid and exploited people should be satisfied with philanthropic crumbs from a self-appointed aristocracy rather than entitled to economic justice. What’s really needed for a fairer, more equal society is not charity but justice, though Gates has long presumed otherwise.

From the worst years of the HIV crisis, when antiretroviral drugs were priced sky-high, through to today’s scandalously expensive diabetes and cancer treatments in the US and elsewhere, Gates has insisted that the patent system works just fine. His message to health activists who fight for lowered prices has essentially been: shut up and leave the business of health to the people who know business best, billionaires like me and our friends in the pharmaceutical industry.

It’s an illogical stance if you want a more equitable health system, but makes perfect sense if your fortune was built from strict patents on software and other technology. The surprise is not that Gates has consistently defended industry interests, but that it has taken people so long to realise that his efforts are undermining the health goals he purports to aim for.

In late April, Gates made his views on patent protections clear in an interview with Sophy Ridge on Sky news. Asked if he thought a proposal before the World Trade Organisation to waive patent restrictions on covid vaccines was a good idea, his answer was a firm no. What is ‘holding things back in this case is not intellectual property’, he insisted, but a lack of safe manufacturing facilities in poor nations.

This is not true, though he’s been making the same case for months. ‘At this point,’ he told Simon Allison of South Africa’s Mail & Guardian in January, ‘changing the rules wouldn’t make any additional vaccines available.’ But as Allison reports, experts at the World Health Organisation disagree. Although waiving patents is ‘no miracle fix’ on its own, it is an essential first step towards commissioning more factories to produce safe vaccines – factories that are currently sitting idle and have offered their services to help ramp up vaccine manufacturing.

In March, the head of the WHO, Tedros Adhanom Ghebreyesus, called for the patent waiver that Gates objects to, and the UNAIDS executive director, Winnie Byanyima, asked the World Bank to ‘align with us’ in supporting patent waivers. She pointed out that relaxing intellectual property protections had been a necessary step for HIV treatments to come down in price from $10,000 per person to $100 in many African nations.

The growing distrust of Gates may signal a shift in public attitudes to the dangers of so much wealth and power being concentrated in unelected hands. There may even be sound reasons why people subscribe to the wildest, untrue conspiracy theories about him. In the 1830s, merchants employed by the East Indian Company had carried cholera to the docklands of Liverpool and London. As the disease spread, rumours began to link it with the crimes committed in Edinburgh in 1828 by William Burke and William Hare, who murdered at least sixteen people and sold the corpses to the anatomist Robert Knox, a lecturer at the University of Edinburgh. They were eventually caught, Hare turned king’s evidence and Burke was sentenced to hanging. People suspected that Knox knew of or at least suspected the crimes but feigned ignorance. He was legally cleared of any involvement, but the public remained unconvinced.

A few years later, as cholera claimed more lives, the relatives of some of the dead rioted in the streets, demanding justice for loved ones they were convinced had died of a made-up disease, killed for their cadavers. It wasn’t true, of course, that hospitals were sites of systematic murder. But it was true that gruelling working conditions, weak public health infrastructure, and a classist, racist culture compounded the poor’s righteous mistrust of the rich. The cholera riots were politically incendiary, sparking activism that brought about improved sanitation and public health measures by the end of the 19th century.

The rioters were wrong about cholera, but understood all too well that the economic and political system was biased against them. The disease was brought to them by a corporation that had plundered India for the gain of aristocrats and the upper-middle classes, while labourers were paid crumbs to live and die in mills, mines and factories throughout the world. Today, Covid-19 disproportionately afflicts the poor, especially women and men of colour, while the rich have the means to barricade themselves against it.

Bill Gates, like William IV before him, sits at the apex of a global financial empire. The people who are angry with him, rightly or wrongly, shouldn’t be blamed for appreciating this reality. The blame lies with the billionaires like Gates who pretend the system works fine.