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Philanthrocapitalism, Past and Present: the Rockefeller © 2014 Anne-Emanuelle Birn REVIEW 1 / 27 Please cite this article as: University of Toronto Received: 2013/04/07; Accepted: 2014/08/18; Posted online: 2014/11/1 Correspondence: [email protected] Anne-Emanuelle Birn, Philanthrocapitalism, past and present: The Rockefeller © 2014 Anne-Emanuelle Birn. This is an Open Access Foundation, the Gates Foundation, and the setting(s) of the international/ article distributed by Hypothesis under the terms of the global health agenda. Hypothesis 2014, 12(1): e8, doi:10.5779/hypothesis. Creative Commons Attribution License (http://creative- commons.org/licenses/by/3.0/), which permits unrestric- v12i1.229. ted use, distribution, and reproduction in any medium, provided the original work is properly cited. Philanthrocapitalism, past and present: The Rockefeller Foundation, the Gates Foundation, and the setting(s) of the international/global health agenda Anne-Emanuelle Birn exigencies, and reach of global health INTRODUCTION International health Each of these two über-powerful foun- challenges the leadership and capacity philanthropy, comparing the goals, para- philanthropy, American-style, is back. dations emerged at a critical juncture in of public multilateral agencies, pushing digms, principles, modus operandi, and Almost exactly a century after the the history of international/global health. ahead an overlapping global health gov- agenda-setting roles of the Rockefeller Rockefeller Foundation began to use Each was started by the richest, most ernance arrangement with a huge role and Gates Foundations in their historical John D. Rockefeller’s colossal oil profits ruthless and innovative capitalist of his allotted for the private sector10. Both contexts. It proposes that the Rockefeller to stake a preeminent role in shaping day1,2. Rockefeller and Gates alike fended foundations (and their founders) were/ Foundation’s early 20th century initia- the institutions, ideologies, and practices off public opprobrium for their cutthroat are deeply political animals, all the while tives had a greater bearing on interna- of international health (as well as medi- monopolistic business practices3,4, and claiming the technical and purportedly tional health when the field was wide cine, education, social sciences, agri- both have been subject to uneven doses neutral scientific bases of their efforts11,12. open—in a world order characterized of adulation (for example on the cover culture, and science), the Bill and Given the confluence of largesse and by forceful European and ascendant of magazine) and skepticism re- Melinda Gates Foundation has emerged Time leadership at distinct historical moments, U.S. imperialism—than do the Gates garding their philanthropic motives5-8. as the current era’s most influential various questions come to the fore: How ABSTRACT In recent years the Bill and Foundation’s current global health efforts Both foundations have focused on gen- global health (and education, develop- and why have U.S. philanthropies played Melinda Gates Foundation has emerged amidst neoliberal globalization and fad- erating and applying new knowledge. ment, and agriculture) agenda-setter. such an important role in the produc- as this era’s most renowned, and argu- ing U.S. hegemony. It concludes that the One appeared when the international The high profile of its eponymous soft- tion and shaping of international/global ably its most influential, global health Gates Foundation’s pervasive influence health field was in gestation; the other ware magnate founder and his wife, cou- health knowledge, organizations, and player. A century ago, the Rockefeller is nonetheless of grave concern both to as it faced midlife crisis. One sought to pled with the Foundation’s big-stakes ap- strategies? What are the ideological, Foundation—likewise founded by the democratic global health governance establish health cooperation as a legiti- proach to grant-making and “partnering,” institutional, and human welfare implica- richest, most ruthless and innovative and to scientific independence—and mate sphere for (inter)governmental ac- has made it a de facto leader in the global tions? Have these foundations marked capitalist of his day—was an even more urges scientists to play a role in contest- tion, creating, largely from scratch, the health field. a singular, unimpeachable path in this powerful international health actor. This ing and identifying alternatives to global principles, practices, and key institutions field or are there meaningful alternative article reflects critically on the roots, health philanthrocapitalism. of the international health field9; the other approaches towards achieving global Illustration : Bechara Saab HYPOTHESIS Vol.12, No.1 | 2014 | hypothesisjournal.com Philanthrocapitalism, past and present: The Rockefeller Foundation, the Gates Foundation, and the setting(s) of the international/global health agenda REVIEW 2 / 27 Birn health equity? What are the continuities from tax deductions (both individual and its limits and the ways in which it might (later Pan American Sanitary Bureau the concept of international health, it and what has changed in the philanthro- corporate donations are tax-deductible15, be contested. [PASB]) in December 1902, based in was the major influence upon the field’s pists’ prerogatives? a practice that itself removes billions from THE BIRTH OF MODERN INTERNATIONAL Washington D.C. under the aegis of the 20th century agenda, approaches, and the public coffers). Up to a third or more, U.S. Public Health Service20. In their early actions22,23. Such questions are particularly salient HEALTH The rise of modern international depending on the tax rate, of the endow- decades, both the OIHP and PASB in an era in which “philanthrocapitalism” health is typically traced to the first Rockefeller’s efforts were part of a new ment monies of private philanthropies remained focused on establishing and has been cited not as a venal endeavor— International Sanitary Conference held American movement—“scientific phi- are thus subsidized by the public, which monitoring sanitary conventions and col- through which profits amassed via in Paris in 1851, viewed as the begin- lanthropy.” Launched by Scottish-born, has no role in how priorities are set or lecting disease statistics. Another early the exploitation of workers and natural ning of steady progress in international rags-to-riches steel magnate Andrew how monies are spent. agency was the International Committee resources are then harnessed through surveillance and infectious disease re- Carnegie in an 1889 essay, “The Gospel of the Red Cross, founded in Geneva in the very same exploitative business This article compares the goals, para- porting in the name of epidemic secu- of Wealth,” published in The North 1863 to provide aid to the victims of war. approaches in the name of improving digms, principles, modus operandi, and rity16,17. But the (mostly European) par- American Review, this approach called These organizations joined longstanding human welfare—but hailed unabashedly agenda-setting roles of the Rockefeller ties were so suspicious of one another for the wealthy to channel their fortunes intra-imperial health activities carried out as a means to “save the world”13 accord- and Gates Foundations in their historical that it took 11 conferences and over 50 to the societal good by supporting sys- by colonial administrators, military forces, ing to “big business-style strategies”14. contexts (albeit in the case of the Gates years to set up a full-time agency—the tematic social investments rather than and missionaries, all with the aim of pro- Foundation bound by events that are Office International d’Hygiène Publique haphazard forms of charity24-26. The re- Of note, over recent decades, business tecting troops, high-yielding colonial pro- still unfolding). It proposes that the (OIHP)—established in Paris in 1907. nowned Carnegie left a legacy of thou- models have proliferated in the (global) duction and trade, and colonial settlers, Rockefeller Foundation’s early 20th cen- The political and economic rivalries sands of public libraries and bathhouses public health field, with Gates Foundation at the same time as staving off unrest tury initiatives had a greater bearing on among the participants delayed the sign- along with donations to higher education, efforts emblematic of an overall trend to- among the colonized21. international health when the field was ing of accords, limited their enforcement, the arts, and peace studies, an example wards for-profit style management, lead- wide open—in a world order charac- and resulted in a contentious “Britain ver- heeded by various fellow millionaires. ership training, and goal-setting, as ENTER THE ROCKEFELLER FOUNDA- terized by vigorous European and as- sus France and everybody else” stance Just as these institutions were well as the privatizing of public health TION Notwithstanding the benign fashion with cendant U.S. imperialism—than do the at most of the meetings18. being created, a new player emerged activities. which this early philanthropy is now re- Gates Foundation’s current global health on the scene, one that would go be- Meanwhile, some countries, notably the garded, the philanthropist-“robber bar- At the outset it is crucial to stress that un- efforts in today’s age of neoliberal global- yond political and economic self- United States and Mexico, developed ons” of the day were reviled for the prov- like government entities, which are sub- ization and fading U.S. hegemony. And interest, war relief,
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