By Edward Liger Smith – Sep 15, 2022
Healthcare administration students in the United States have no choice but to learn about private vs public interests, and the power that private interests have in crafting the Nation’s healthcare policy. Essentials of Health Policy and Law is a fairly standard healthcare administration textbook that budding health policy experts are given to study in American universities. The text uses health policy decisions made in recent years by the Bill and Melinda Gates Foundation as an example of the way private interests control public health policy. According to the book, the Bill and Melinda Gates foundation “provides grants to develop crops that are high in essential vitamins and minerals to improve the nutrition of people in developing countries” (Wilensky, 2023). A very uncritical examination of the way investors like Gates use their wealth to make important decisions that affect millions.
The text is referring to the ‘Green Revolution’ initiative in Africa, which in the field of healthcare administration, is what’s considered a health policy decision. The initiative was launched by the Alliance for a Green Revolution in Africa (AGRA) , a philanthropic group led by Bill Gates and many other wealthy investors who have spent billions of dollars bringing fertilizer, seeds, and productive agricultural infrastructure to underdeveloped nations in Africa. An initiative which the investors promised would decrease poverty, malnutrition, and other metrics related to standard of living. However, a yearly progress report from the Gates Foundation itself has cast doubt on the effectiveness of the initiative, which critics argue is actually intended to maximize the profits of multinational agricultural companies selling commodities like seeds and fertilizer, rather than feed people in Africa.
An African farming summit was recently held in Rwanda where many African farmers and activists criticized the Green Revolution and requested that philanthropists discontinue their support for the initiative. Critics from Africa and elsewhere across the globe came together to argue that the Green Revolution has had the opposite of its intended effects. African Agricultural experts claimed that chemicals in Western fertilizers have led to decreased fertility in the African soil. Simultaneously, small African farmers have continually gone into debt from buying these fertilizers and other agricultural materials from Western multinationals.
Many at the summit also criticized how the initiative distributes funds, claiming that Green Revolution grants are not given to small African farmers for the purpose of developing infrastructure, but are diverted towards large companies who sell seeds and other agricultural products. When resources are given to farmers it is usually in the form of credit, meaning a bank loan that must be paid back with interest to Western banking institutions. Often giving farmers the money needed to purchase agricultural commodities from various multinationals, but leaving them trapped in a downward spiral of debt if they can’t pay back their loans. A system of resource allocation which has done much to increase the welfare of Western finance capital in Africa, but very little to increase the public welfare of African people. Gabriel Manyangadze of the Southern African Faith Communities suggested that the purpose of the Green Revolution was always to maximize the profits of wealthy philanthropists who never intended to decrease malnutrition. Manyangadze called for a new “Green Restoration” plan where grants are diverted towards small African farmers instead of large multinationals. The entire summit in Rwanda was summarized in a fantastic piece written by Nina Shapiro and published in The Seattle Times titled Gates Funded ‘green revolution’ in Africa has failed.
Perhaps in response to the Rwanda summit or the recent piece from Shapiro, Bill Gates decided to do an interview with the New York Times on September 13th just a few days after Shapiro’s article was published. Gates was mildly critical of the Green Revolution but pointed to climate change and the war in Ukraine as reasons why the initiative failed to meet its goals. Gates says “The Green Revolution was one of the greatest things ever. But then we lost track… Helping farmers has got to be the very top of the climate adaptation agenda… credit for fertilizer, cheap fertilizer, better seeds that we should be very intent on- funding those things and setting ambitious goals.” (Wallace-Wells, 2022). Admitting that the initiative has failed to fulfill any of its promises, but ignoring the specific criticisms repeatedly voiced by African policy analysts. Gates instead argues the opposite of those at the Rwanda Summit, pushing for more fertilizer sales and more credit for African farmers. Doing little to dispel the idea that the Green Revolution has always been an initiative that weaponizes philanthropy for the purpose of maximizing profits on Wall Street.
AGRA has made it clear that they are going to be ignoring the Rwanda summit and continuing to follow the strategy laid out by Gates in the New York Times. The organization recently announced they will be deepening their influence over African Health Policy with a new five-year initiative emphasizing environmentalism, launched with the help of $200 million from the Gates Foundation. Gates remains steadfast in his opinion that capitalistic market-based solutions are the key to improving African Agriculture, pointing to Kenya as a Green Revolution success story, which he attributes to a market-friendly economy that connects Kenya to larger global markets.
Kenyan agricultural activists were present at the summit in Rwanda including Celestine Otieno who said of the Green Revolution “I think it’s the second phase of colonization.” Similarly, at a news conference organized for the purpose of publicly criticizing AGRA, Anne Maina, national coordinator of the Biodiversity and Biosafety Association of Kenya, asked “When will you stop pushing for these Green Revolution models that have failed?” The New York Times interview with Gates makes no mention of these criticisms from Kenyan activists, and offers no critical analysis of his claim that AGRA succeeded in Kenya.
There is a striking contrast between the analysis of the Green Revolution given by Bill Gates and Western Healthcare Administration textbooks, vs the analysis given by health and agriculture policy experts in Africa. It serves as a prime example of the way private interests dominate global health policy decisions with little to no input from the masses of people who their decisions directly affect. Spokespeople for these private interests, such as Gates, often respond indignantly to any criticism of their philanthropic efforts, touting their initiatives as great successes, which can only be improved if we go further and do more! All the while deflecting blame to external factors like climate change in order to brush aside the failures of their initiatives. Private interests can then blast their messaging through a loudspeaker all across the country with the help of corporate friendly news outlets like the New York Times. Meanwhile events like the Summit of African leaders in Rwanda get very little coverage in the Western Press.
Though Bill Gates had access to the giant media platform that is the New York Times, he failed to make a convincing argument for the continuation or AGRA, and in doing so he failed to make a good argument for capitalistic market-based solutions in general. When asked about the role of commodity speculation, which has led to price hikes in food products and supply chain disruptions, Gates responded “the market actually works amazingly well” before later admitting that African farmers are being “priced out of the market” for agricultural supplies. His solution to this of course is more credit for farmers, so they can purchase more productive commodities, sell more food, and hopefully pay those loans back before spiraling into a debt trap.
The most interesting question posed to Gates by NYT interviewer David Wallace-Wells had to do with the poverty alleviation efforts in China.
I wanted to ask you about poverty. It has gotten an enormous amount of attention over the past couple of decades, and the progress has been really remarkable. But quite a lot of it reflects progress in China, Right? How much do you think we should expect the long-term trend to continue, given that China has sort of finished eradicating real poverty and progress would have to come now from elsewhere?
It’s rare these days to see anyone in Western media speaking highly of China, but it seems the country’s incredible poverty alleviation efforts can no longer be ignored. Gates himself admits that China has done a good job as part of his confused and jumbled answer. He goes on to say that there has also been some progress in other high population Asian countries, and he is optimistic that India will soon begin reducing poverty “in its own sort of up and down way.” However, Gates thinks poverty in Africa will be more difficult to address saying “we’re faced with the mind-blowing challenge of Africa, where population growth is still there.” It’s unclear what kind of connection Gates was trying to draw here between high population countries in Asia vs those in Africa, but his overall point seems to be that African countries will not be able to lift themselves out of poverty the same way China did, and one reason for this is that the African population is increasing. An argument reminiscent of the English economist Robert Thomas Malthus who argued that excess population growth created the Irish potato famine, rather than capitalism and colonialism (Berezow,2020). Similarly to Malthus, Gates never questions capitalism or the effectiveness of the Market, repeatedly saying it works very well, but with little evidence in support of his claim. The preeminence and supremacy of the capitalist market is always assumed.
If Mr. Gates looked a little closer at China’s poverty alleviation efforts; he may have some second thoughts about the efficiency of private markets. Though it’s unlikely that he would ever admit this given the incredible amount of wealth that he has accumulated through market transactions. However, for those of us who don’t make millions of dollars through global commodity markets each year it may be useful to take a closer look at what China has done to eradicate poverty. An intensive study of China’s poverty alleviation programs from the Tricontinental Institute contains many interviews with experts in Chinese economics including Justin Lin Yifu, former chief economist of the World Bank who now works as a professor at Peking University in China.
In contrast to the rest of the world, the Chinese government has played a crucial part. Poverty eradication would not have been achieved merely through the role of the market had the government not paid great attention to the issue of the poor people.”
The researchers from Tricontinental go on to summarize Lin’s analysis saying, “In other words, a combination of the ‘visible’ and ‘invisible hand,’together with the mobilization of broad sectors of society, was the hallmark of China’s poverty alleviation.” (Tricontinental,2021). When the researchers refer to the ‘invisible hand’ they mean the natural effects of undisturbed private market exchange which was first conceptualized by Adam Smith. The ‘Visible Hand,’ on the other hand, refers to centralized economic plans organized by the Chinese people and Government intended to do what the market can’t. Party cadres are assigned to various areas to make sure people’s basic needs are being met, social welfare programs and safety nets have been set up, largely funded by publicly owned companies like Baowu steel, one of the largest steel companies in the world. This is only possible of course because Baowu steel is owned by the Chinese Government rather than private investors, who would surely divert the company’s revenue into their own bank accounts rather than social welfare programs if given the chance.
Of course these kinds of ‘Visible Hand’ solutions are off limits for somebody like Mr. Gates because those markets must remain “free” for him to exploit. If AGRA investors took an honest look at poverty alleviation in China they would be forced to admit that the ‘invisible hand’ of the market will simply not solve all society’s problems, and in fact it is contributing to global issues like malnutrition in Africa. However, Mr. Gates and the other AGRA investors are not concerned with malnutrition in Africa and they never have been. They are exclusively concerned with their own bottom line. It is inconsequential to them whether or not people in Africa are lifted from poverty, so long as they are able to continue selling commodities in Africa. Do small African farmers not have enough money for our commodities? Give them predatory loans! Are the banks using the loans to make money off farmers and trap them in debt? They just need more fertilizer to make more crops and revenue! Is the fertilizer poisoning the soil? I really don’t care. Buy more Fertilizer! These are the only solutions we will ever get from private interests when it comes to poverty alleviation. They will never admit the market is not working. Because for them, the market is working! It’s allowing them to accumulate mass hoards of wealth and exploit entire continents.
One of the last people who tried to bring some ‘visible hand’ economics to Africa was Libyan leader Mummar Gaddafi, who had plans to create a publicly owned African central development bank. For his efforts, Gaddafi was murdered by NATO at the beheast of Western Finance capitalists. Libya had one of the highest living standards in Africa under Gadaffi. After the intervention overseen by Hillary Clinton, Libya now has an open air slave market and has been torn apart by civil war. That is what Bill Gates and his cronies do to anybody who makes a real attempt to alleviate poverty in Africa. They lobby for and cheerlead murderous interventions while portraying themselves as the saviors of Africa, who are so generously abolishing poverty through their philanthropy. If the invisible hand of the market and the philanthropic efforts of wealthy investors fail to alleviate poverty as they promised? It’s not because of capitalism or the market, it’s because the African population is too high and needs to be decreased!
This is what happens when you have a society where public health decisions are determined by markets, multinational corporations, and Bill Gates. Or more simply, when society is dominated by the capitalist class. Under capitalism millions of people go without having their most basic needs met and charitable giving becomes a tool of colonialism. As Marx said “all that is holy is profaned”
1- Wilensky, S. E., & Teitelbaum, J. B. (2023). Chapter 2. In Essentials of health policy and law (4th ed., pp. 12–12). essay, Jones & Bartlett Learning.
2- Shapiro, N. (2022, September 8). Gates-funded ‘green revolution’ in Africa has failed, critics say. The Seattle Times. Retrieved September 14, 2022, from https://www.seattletimes.com/seattle-news/gates-funded-green-revolution-in-africa-has-failed-critics-say/
3- Wallace-wells, D. (2022, September 13). Bill Gates: ‘we’re in a worse place than I expected’. The New York Times. Retrieved September 14, 2022, from https://www.nytimes.com/2022/09/13/opinion/environment/bill-gates-climate-change-report.html
4- Berezow, A. (2020, May 26). Irish Potato Famine: How belief in overpopulation leads to human evil. American Council on Science and Health. Retrieved September 15, 2022, from https://www.acsh.org/news/2020/05/14/irish-potato-famine-how-belief-overpopulation-leads-human-evil-14792
5- Tricontinental Institute for Social Research. (2021, July 23). Serve the people: The eradication of extreme poverty in China. Tricontinental. Retrieved September 15, 2022, from https://thetricontinental.org/studies-1-socialist-construction/#part3_poverty-alleviation-theory-and-practice
Edward Liger Smith is an American Political Scientist and specialist in anti-imperialist and socialist projects, especially Venezuela and China. He also has research interests in the role southern slavery played in the development of American and European capitalism. He is a co-founder and editor of Midwestern Marx and the Journal of American Socialist Studies. He is currently a health care administration graduate student and wrestling coach at the University of Wisconsin-Platteville.
Orinoco Tribune 2https://orinocotribune.com/author/yullma/September 28, 2023
Orinoco Tribune 2https://orinocotribune.com/author/yullma/
Orinoco Tribune 2https://orinocotribune.com/author/yullma/September 28, 2023
Orinoco Tribune 2https://orinocotribune.com/author/yullma/