Journalists around Africa sat down with Chief Executive Officer of the Bill and Melinda Gates Foundation (BMGF) Mark Suzman to discuss the Annual Letter where he called on more wealthy people to give to philanthropic causes that would save millions of lives. Seun Akioye was there.
In the Annual Letter, you make the case very eloquently for the benefits that philanthropy can achieve. But as you say, many billionaires hold their wealth close and continue to give very little of it away. Just wondering if you had one of them here on the call with us, what would you say to them right now to persuade them to give away more of their money?
MARK SUZMAN: Yeah, so it’s a very important question. And I don’t want to call out particular individuals, but I think there are a number of reasons why very wealthy people are often hesitant to give. Sometimes it’s as simple as just not wanting to fail. Often, these are very successful people in their fields, and giving smartly and effectively is actually quite difficult and challenging.
Warren Buffett, who gives very generously, a lot of his resources to us to spend, is famous for telling us, and instructing us and saying that he doesn’t want us to take his lessons from business, because in business, he feels very confident about his decisions and his investments. But the kind of issues that he wants us to tackle at the Foundation, HIV, poverty, malaria are incredibly difficult and have not had much traction in traditional resources. And so, we need to take bigger risks. And he uses a baseball metaphor, saying we need to swing and miss, and many of these wealthy people are not very comfortable swinging and missing.
And so, our message and the example of Bill, and Melinda and Warren, is that actually giving now, giving at scale, giving to human inequity can make a very big difference, can be hugely impactful. And we have a number of very concrete examples to demonstrate that, that the need is now greater. If you think you’re actually retaining your resources, because you might give later, I think given the current global trends, we think actually now is where the needs are critical.
And then there are actually, increasingly tools. I had mentioned in the letter, the growing thing of collaborative philanthropy, and often. that’s when philanthropists can group together. I mentioned Tsitsi Masiyiwa. She both chairs the END Fund, which is a collaborative fund that looks to end neglected tropical diseases around the world, and Co-Impact, which we all support, which helps focus on – pulls together a number of very wealthy people to focus on outcomes, like improving women’s leadership worldwide, and other tools.
There’s an African partner collective, which was set up during the pandemic, with a number of partners, which now has raised over $80 million, and has, I think, now 100 different partners. In South Africa, where you are, there was a solidarity fund created during COVID, which really brought together a number of major philanthropists and capitalized, I think, over $100 million in resources and know how.
And so, what we’re trying to do is make the positive case for why giving now, giving it scale, and giving to an equity actually is a highly impactful and very worthwhile thing to do. And if you see – I don’t know if we’ve shared a couple of the videos yet of some of the philanthropists, but if you look at the video we share that we’ll be launching with the letter that someone like Jeff Skoll, who speaks, or Azim Premji from India, they talk powerfully about how meaningful it is to them, as philanthropists, to invest their private sector fortunes in human development. And we think telling that positive story will hopefully encourage many more to step in.
You have noted issues such as geopolitical conflict as having an impact. And I’m wondering whether or not you’re getting a sense that the billionaires are not wanting to give because of the instability, or the sentiments that may come, whether you decide to give or not give. But also this year, I think across the world, there are going to be several elections that are going to be held.
And so, how much of an impact does political stability play in philanthropy work and people actually wanting to give, because you need to know what you’re actually contributing towards?
MARK SUZMAN: Yeah, so it’s a very important question. The biggest impact of the geopolitical instability has actually been on traditional governmental funding, rather than philanthropic funding at this stage, especially from countries like European countries, or the United States, where between conflicts in the Middle East and Ukraine, domestic priority issues around migration, the issues we’ve seen, net resources going into – as I mentioned, the aid to Africa dropped 8% in 2022. And so, it’s partly to engage with that gap.
Then I think for philanthropists coming in, there is often a question in terms of giving global – philanthropists from wealthy countries, high income countries often don’t have a very good understanding of what the challenges or opportunities are in the Global South. That’s something which we, at the Gates Foundation and with other partners, have been working to help demystify, because they worry, are there ways to spend money effectively? Can you actually have impact? When countries are unstable, what kind of impact can you see?
And I think we’ve proven over the last two decades that, for example, through initiatives like the GAVI vaccine alliance, or the Global Polio Eradication Initiative, to take a number in health, but also in agricultural development, where we support AGRA, which works across multiple African countries, we’ve shown that you can actually have very high impact in varying political situations that are affecting people. In the end, child immunization, kids need to be immunized, whether it’s an election year or not an election year.
And we can actually help provide some of the tools and structures, and drive down the prices of vaccines, and find new technologies and new tools. And those are the opportunities that we’ve been trying to demonstrate to other philanthropists. And many of them have responded.
For example, in polio, where we are our very significant funders, and it’s one of the areas where we’ve increased our budget, where it’s down to just 11 cases last year, wild polio virus, which was just in Pakistan and Afghanistan. Africa is free of wild polio virus, but still has vaccine-derived polio virus.
A number of other philanthropists have stepped up and helped support as governments have pulled back. Countries like the UK or Norway have provided less money even though we’re so close to eradicating the disease. And yet we’ve had philanthropists like Mike Bloomberg, or Larry Ellison, in the U.S., Ray Dalio, all responding and providing resources, supplementing what the Gates Foundation has been giving.
That’s one thing where I think we can show that regardless of the geopolitics, these are investments that can have a high impact on human development in different contexts.
And in terms of just the wider geopolitical issue, and then your point about elections, again, we like to say at the Gates Foundation, that we are kind of nonpartisan in any of the countries where we work in, because we feel that the issues we work on are ones that should be common cause among different sides of that work.
How do you improve healthcare? How do you improve opportunities for smallholder farmers? How do you improve access to credit for women entrepreneurs? I don’t think you’ll find many campaigners on either side of the political divide campaigning against such outcomes. They’re more debating about the best way to get to them. And we come in to provide a politically neutral technical resource around how to meet those goals.
From your assessment, how do you rate philanthropy, for example, in Africa in the past year? And which areas do you feel need much focus and attention moving forward? And do you feel you are getting enough support from the governments you are working with, in the philanthropy that you’re giving?
MARK SUZMAN: Yeah, so great. Yes, I mean, Africa, obviously has the world’s highest comparative poverty burden, but it also has a number of very wealthy individuals. And it has a strong tradition of philanthropy. I mentioned the Motsepes, the Masiyiwas.
There are other leaders like Mo Ibrahim, who gives on governance across the continent, Mo Dewji in Tanzania, Aliko Dangote in Nigeria, who we partner with and is a strong supporter of the fight against polio, and actually helped – Nigeria was the last country in Africa to have biopolio virus, and the Dangote Foundation was an incredibly important partner in that work.
And I mentioned the Africa Partner Collective. And I didn’t mention that there’s also the African Philanthropy Forum, which is an annual gathering that helps connect philanthropists across the continent.
And so, I think there’s growing momentum, and energy and understanding, and we want to connect those African philanthropists to global efforts. I mentioned some of the big collaboratives like Co-Impact. That crowds in funders from Africa, the U.S., Asia, and elsewhere, but a lot of their funding takes place on the African continent. And so, we’re both bringing in resources from outside the continent and philanthropic resources from inside the continent.
And so, clearly needs growing, but I think some of the models that came out of COVID, even if COVID had significant challenges, such as the Solidarity Fund in South Africa, such as that Africa Partner Collective, are really important models that we can build on and expand.
In terms of how governments have been receptive and what the role of philanthropy, vis a vis government is, that’s very important. And it’s because we like to say that our agenda really is the world’s agenda. It is set by the Sustainable Development Goals, which were set by every country on the planet at the UN as commitments to their own citizens. And they set out clear goals in areas like health or agricultural development, poverty reduction, financial inclusion, women’s empowerment and gender equality. And those are ones that we expect and hope governments to be prioritizing and taking the lead on.
And then our role is to come in and help support and show, here are methods in which you can do much more innovative primary healthcare or vaccine delivery, or here are new tools or treatments.
An example of something that we are starting to fund this year, which the trials will be on the African continent, is the first trials, Phase 3 trials, which are the last trials before something is proven, we hope, to be successful for a tuberculosis vaccine. Tuberculosis, there hasn’t been a new tuberculosis vaccine in over 100 years. And tuberculosis kills more people. It’s the infectious disease that kills more people than any other. It’s actually taken back over from COVID in the last year with 1.6 million deaths a year.
And so, that’s the kind of initiative that philanthropy can take. We’ll take the risk, and we’re being supported by the Wellcome Trust and other philanthropy to do those trials. And we’re working on new treatments in tuberculosis and malaria as well. But in the end, when those are developed, it has to be governments who take the lead, working with international organizations like the World Health Organization, or the Global Fund to fight AIDS, TB and malaria, to ensure that those reach the people who need them.
That’s not something philanthropy can do at scale. We can prove models, we can test models, but to actually provide impact at scale, that has to be government in the lead, and often, the private sector, driving some of the innovation and productivity, for example, in recent investments we made in Kenya and Rwanda to create the first big syringe manufacturers in Africa.
It’s the kind of thing that you don’t normally think of as a need. That’s something which will now have its own self-sustaining market. It’s enough syringes to cover the continent for vaccines domestically manufactured. But we were the catalytic funders, but the long-term sustainability comes from governmental and multilateral sources.
How do you ensure that the projects proposed by small organizations align with the needs and priorities of the communities they serve. How do you follow up when you give funding for certain causes to ensure that they are utilized well to meet the intended purposes.
MARK SUZMAN: It’s definitely true that historically, many global philanthropies, including ours, did not pay enough attention to developing long-term local partners in the countries and communities where we work. Often, we would work through big international organizations and NGOs. Many of them do excellent work, but the truth is, it’s clear if you want sustainable, long-term impact at scale, it has to be driven by the countries and communities themselves, both government-led priorities, but then within the communities, if it’s a health initiative, an education initiative, whatever it might be.
And so, we really, along with other partners, have been making a major effort to invest in organizations on the African continent, or in South Asia, or other parts of world where we work, to help develop that. And many of those might start smaller. This is where we talk about the smaller organizations, because all organizations have to start somewhere and grow. But then we’re talking to invest in them over many years.
And so, we have partners that I mentioned. AGRA is one we work closely with; Amref, many of you may be familiar with. We’ve got a range of examples of where we’ve been working with partners for them to grow and become stronger across the continent. And that’s something we’ll continue to do. I mean, that’s critical. We’re going to be working on the continent of Africa for the lifetime of the Foundation.
As I said in the letter, we do have a finite lifetime. Unlike other foundations, we will spend ourselves down. We will not exist within 20 years of the deaths of our founders, Bill and Melinda French Gates, because they believe very strongly that they want their resources to be used against today’s problems and today’s needs. And they hope and expect that future generations of philanthropists will tackle future problems. And so, that’s a very core principle behind the way we operate.
In terms of how we follow up, and monitor and measure, that’s a careful balance where, again, because we focus on human outcomes, nearly all the grants we give will have clear outcome measures that we agree with the partners on the ground, that we want to work towards.
If we’re working on developing drought resistant seeds, or drought resilient poultry, to take one concrete – a couple of concrete examples, we want to make sure they’re reaching a certain demographic of women farmers across the continent. And on the poultry, we work at Nigeria, Kenya, Ethiopia, Zimbabwe, a range of those countries. And so, we all want to measure. Did it reach those? Have those farmers increase their income? Are they able to expand? Do they have extra resources they can expand on their families, and support educational health needs?
And so, it’s those metrics that we will carefully follow up. And they’re customized around whatever the sector is. Are you meeting HIV treatments for HIV positive people in South Africa or Southern Africa broadly? Are we having a reach of new extension services support to smallholder farmers working on areas, whether it’s Nigeria or Ethiopia. In each of those, you’ll have a clear set of metrics, which we look at. We’ll adjust, we’ll examine every year.
And I know there’s sometimes debate about does that reporting mean you don’t fully trust or empower your partners. And we don’t think that’s true at all. These are sort of discussed closely with the partners. We agree the goals together. We monitor them together, we course correct together. But it is definitely true at the Gates Foundation that we want to make sure in the end, our success is measured not in how much money we spent, but in lives saved and opportunities provided for the poorest and most vulnerable. We do try to measure that.
According to the Forbes magazine, currently, we have four billionaires recorded in the Forbes, in Nigeria. Out of these four, just one is currently engaged in the kind of philanthropy you have mentioned. Do you want to speak directly to the other billionaires, and including those who are not recorded in the Forbes list? Do you want to talk directly to them and preach to them to join in the train to partner with the Foundation, and also get things going in Nigeria?
MARK SUZMAN: Yeah, so broadly, not just for Nigeria, but across the continent, the Giving Pledge is an initiative. There are now 240 people who have signed up to the Giving Pledge. That’s a commitment for billionaires to essentially give at least a minimum of 50% of their fortune to charity, to philanthropy. It can be done in the course of their lifetime. It can be done in their wills.
Obviously, part of my letter is encouraging those who do want to give, saying, actually, it’s better to give now than to hold on and wait, if you possibly can, both because of the need, the impact and how fulfilling it can be. And that is a message that not just the Gates Foundation and our co-chairs, Bill and Melinda French Gates, do give to other very wealthy people, but other philanthropists on the continent also give that message and share that message.
And people like Tsitsi Masiyiwa and her husband, Strive Masiyiwa, who actually sits on the Gates Foundation Board, are very good examples of that. They work through their own Higher Life Foundation, but they work in collaboratives across the continent. And they validate to other very wealthy Africans why this is so critically important.
In Nigeria specifically, again, I don’t want to get around particular names. But certainly, I’ve mentioned we have a strong and longstanding partnership with Aliko Dangote, who is the wealthiest man in Nigeria and the wealthiest person on the continent of Africa. And that’s been a really good model, and the Dangote Foundation does some excellent work. And particularly, we focused on polio and healthcare, especially in the north of Nigeria, where the needs are greatest.
And so, it’s demonstrating those kinds of models. I think there’s also been a sort of healthy ecosystem within Nigeria. They’re discussing philanthropy, but I certainly feel there is more opportunity for wealthy Nigerians, given there is a critical mass of significant wealth in that country, to help engage, to engage on local problems and local issues.
And so, certainly we are open and looking at ways we can do more. We have an office in Nigeria, as you know, in Abuja, and we are working across the country in multiple plays across health, financial inclusion, agriculture and other areas. And so, I hope we will see more engagement with more philanthropists, going forward.
What have been some of your biggest challenges and successes in your philanthropy efforts in Africa? The second one is how much of the annual budget is going to the fight against climate crisis in Africa, considering that the World Health Organization says that some of the health issues we are faced with today are exacerbated by climate change like cholera.
MARK SUZMAN: Yes, so what successes, I mean, there have been a huge number of successes. I mean the Foundation was started in 2000. And really, between 2002 and 2020, I think we had very similar, particularly in health, not just broader improvements in vaccination reductions in child mortality, but very specific ones. For example, the meningitis – well, meningitis A vaccine was one that was developed entirely by the Gates Foundation, working with partner called (Path) rolled out across Central and West Africa, the Sahel belt, where meningitis is a huge problem, and essentially has helped largely tackle the disease.
That’s a very nice concrete model, but we see it in other diseases. We see it in the improvements in malaria. Even if we don’t yet have an incredibly effective malaria vaccine, we have some malaria vaccines with limited effectiveness, which are helping. But we’ve seen the role of bed nets, of treatments have helped bring down mortality in malaria by nearly 50%. Unfortunately, we’ve seen a recent uptick, but the kinds of things that we can do successfully –
And again, the Gates Foundation has been the primary supporter of developing new mosquito-resistant bed nets. As mosquitoes have evolved to be become resistant themselves to the first generation of bed nets – the mosquito is a very wily enemy on malaria – we helped develop a new generation of bed nets, which are now being rolled out, which are dual insecticide, two different insecticides which protect against disease.
And so, each of those are kind of concrete examples, where philanthropy can come in and help support the particular innovation, the development of the vaccine, or the bed net, or the crop I was mentioning, the drought resilient floods and chickens. And then we can have that impact at scale.
The challenges are the broader challenges faced across much of the continent, that when you have big setbacks, like we’ve had with COVID, where you see resources being limited and budgets having to be cut in many cases, that’s a huge challenge, because you do need financial resources in order to meet these challenges. And over time, you need broader economic growth to be able to help drive longer-term progress. And some of the geopolitical instability in countries that was mentioned earlier can be challenging. In fragile states, it’s often more difficult to roll out programs and treatments, although we can and do operate, and have some successful interventions.
On the specific issue of climate, yes, that’s a really important one. And so, on climate, let me tackle it in three ways.
One, there’s the broader issue of climate mitigation, which is a global need of how you reduce greenhouse gas emissions and provide alternative forms of non-fossil fuel energy. And there, Bill Gates is a major investor, but uses his private capital, because he feels that is very important, that it shouldn’t be private capital being used, risk capital, because some of them will generate a return. There will be high returns for investments in alternative energy.
For the Foundation, we focus primarily on adaptation, because we see the greatest impact of climate change is affecting those who contributed the least, which is people living in the tropics, largely, who faced much greater weather fluctuations, droughts and floods than people in temperate zones, which is most of the Global North. And these are people who contributed the least. And the vast majority of them are still rural poor, who depend on smallholder farming.
We’ve made a very major focus of our agricultural development program. And I made a big announcement in COP two years ago, which Bill Gates reinforced at the most recent COP, where we’re investing billions of dollars in climate adaptation in these things, trying to develop more drought and flood resilient crops, particularly local.
No natural market is going to invest in drought resistant cassava. That’s the kind of – that cassava is a huge crop across the continent of Africa. And so, we make those investments to more productive and nutritious cassava that can survive in the current climate of climate change. You can have flood resistant rice that can stay submerged for much longer, which we’ve been developing, the draft resilient chickens that I’ve been talking about, poultry, which are very critical, especially for women farmers.
That’s the big part of our investment and the primary focus, because that’s where the primary need is.
In terms of the intersection between climate and health specifically, and it was important that the COP this year was the first ever Climate and Health Day, which we participated in, and Bill Gates was part of, it’s definitely the case that, for example, as temperature ranges change, you see shifts in the reach of vector borne diseases, like especially mosquito diseases like malaria, dengue, chikungunya, Zika, etcetera.
But unfortunately, Africa already has the highest disease burden for malaria. And that’s not going to be a massive change, although you have seen malaria appearing in cities like Nairobi, that there hasn’t been for many years. And so, we definitely do need to tackle and think about those dimensions.
But the biggest one is actually around nutrition, because of the big droughts and floods, that when you have big disruptions to food and crop cycles, then often, you aren’t able to fully feed, as we’ve just seen recently in the Horn of Africa, when they were their five consecutive drought years, which was a record, followed by floods. That leads to huge setbacks in nutrition.
And we know from our other research that when you don’t have adequate nutrition in the first six months of life or during pregnancy for a pregnant mother, then the risk is that children will never fully develop physically and mentally to their full potential. And so, making sure we’re also engaging very deeply in both nutritional supplements and tools that can help in the context of climate change for health, but also some of those more nutritious crops, and livestock, and tools like milk and eggs can help.
And so, it sounds quite nuts and bolts, but that really is, in many ways, the most important health intervention. And it’s a very big focus for us.