How Bill Gates and I met through bioethics and why I think philanthrocapitalism is a bioethical issue
Ivica Kelam
Faculty of Education/Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek
Abstract: This paper critically examines the Gates Foundation’s influence on global health and agriculture. While promoting technological solutions, its philanthrocapitalist model raises bioethical concerns regarding power imbalances, lack of democratic accountability, the promotion of GMO-based agricultural reforms, and the privatisation of public health systems. I argue that such practices reshape global health policy and food systems, often marginalising local knowledge and community participation.
Keywords: Philanthrocapitalism, global health policy, Bill Gates, bioethics, GMOS, agriculture
https://doi.org/10.63154/CETR2025.1-7
Introduction
In the 21st century, philanthropy has been replaced by so-called „philanthropic capitalism”, which has significantly changed how global health policies are shaped and international development projects are implemented to improve the health and living conditions of the poorest people on the planet. This new „philanthropic capitalism” model implies that ultra-wealthy individuals, led by Bill Gates, use their wealth, often acquired through neoliberal, ethically questionable market practices, to operate in humanitarian or scientific-medical fields, while applying market logic and success metrics. The most prominent representative and promoter of „philanthropic capitalism” is Bill Gates, whose activities through the Bill and Melinda Gates Foundation have become a global actor in shaping global health policies. However, while the Gates Foundation invests billions of dollars in vaccine research, the fight against infectious diseases, and agricultural biotechnology (including GMO crops) in developing countries, there are growing critics (myself included) who question the ethics and long-term consequences of these actions. Although this type of philanthropy appears well-intentioned at first glance, it increasingly resembles neocolonialism disguised as aid when analysed more closely. Below, we will briefly list and explain the main ethical issues associated with the practice of philanthrocapitalism.
Undemocratic power and lack of accountability
The Bill & Melinda Gates Foundation is the largest private funder of global health policies and the second-largest funder of the World Health Organisation (WHO), with several billion dollars in annual expenditures. The result of this type of financing is a direct influence on the priorities of the World Health Organisation, GAVI, CEPI and similar bodies. However, unlike national governments that must adhere to democratic procedures, the Gates Foundation operates independently of the political will of citizens; that is, Bill Gates is politically and morally accountable to the public for his actions. Consequently, such an absolute lack of accountability poses a serious bioethical problem because it allows the concentration of power without the possibility of critical scrutiny, audit or sanctions. Citizens of developing countries, scientists, and local health systems often have no meaningful opportunity to influence projects promoted by Gates and his foundation that directly affect their lives.
Technical solutions and conflicts of interest
Bill Gates often favours technological solutions such as vaccines, genetically modified crops, and the digitalisation of healthcare systems. While these tools have value, this reductionist approach ignores the complexity of social and cultural contexts. Health is not merely a matter of technology but also of economic, social, and political conditions. It is important to note that the Gates Foundation invests in shares of pharmaceutical and biotechnology companies whose products it simultaneously promotes, as was evident during the COVID-19 pandemic, with Bill Gates’s firm insistence on protecting the patent rights of large pharmaceutical corporations on coronavirus vaccines having a particularly negative public resonance. Such a conflict of interest undermines the ethical credibility of the foundation and raises the question of benefit: for whom are the projects intended – for patients or corporate shareholders?
Colonial patterns and cultural paternalism
Programs funded by the Gates Foundation often do not align with local priorities or cultural values. In India, Ethiopia, Nigeria, and Pakistan, vaccination programs and food packages were implemented without sufficient participation from local experts and communities. This kind of paternalism is reminiscent of colonial governance models in which „scientific” progress is imposed on local populations without their consent. In the long term, this can lead to refusal of medical interventions, erosion of trust in institutions, and the creation of additional health inequalities.
Conclusion
The philanthropy of Bill Gates is as dangerous as it is powerful. While bioethicists such as Peter Singer may regard his work as historically significant, a deeper analysis reveals a functional failure of the „techno-fix” model. As highlighted in my previous research, 18 years of AGRA (Alliance for a Green Revolution in Africa) have not only failed to meet their promises but have coincided with a 30 per cent increase in the level of undernourished people in the target countries (Kelam, 2024). These stark data underscore that Gates’s model is not merely ineffective; it is fundamentally anti-democratic. By prioritising the expertise and local seeds of African farmers over top-down agribusiness, the Gates Foundation effectively undermines local autonomy. As Jan Urhahn poignantly argues, this model has failed to relieve the hunger crisis and instead serves to „undercut Africans’ ability to solve their own problems, free of do-gooder philanthropists” (Urhahn, 2023). This highlights the necessity of bioethics as a science that must problematize the power relationships and non-democratic practices inherent in such global charity. Ultimately, the bioethical concern is the preservation of the status quo. Philanthrocapitalism, by its very nature, avoids addressing the root causes of inequality—namely, the neoliberal capitalist system—to ensure that the benefactors remain at the peak of the global power pyramid. As Tim Schwab (2023) reminds us, a charitable gift should collapse power asymmetries rather than magnify them. In this light, Gates’s disregard for the dignity and rights of low-income people speaks to a colonial lens. We will conclude with a word from Tim Schwab: humanitarianism, which aims at real human progress, equality, justice, and freedom, requires us to „challenge unaccountable power and illegitimate leaders, not worship them” (Schwab, 2023). In this bioethical framework, Bill Gates is clearly identified as the problem rather than the solution.