Director-General Tedros and other senior officials at WHO have today been retweeting an interview from the Financial Times in which Bill Gates announces that the Bill and Melinda Gates Foundation is refocusing all of its efforts on the COVID-19 response: “We’ve taken an organisation that was focused on HIV and malaria and polio eradication, and almost entirely shifted it to work on this [COVID-19] … This has the foundation’s total attention.”

Tedros tweeted: “Really impressive that @gatesfoundation will focus all of its efforts on fighting #COVID19 at this critical time for the world. Thank you @billgates, @melindagates & the foundation colleagues for your commitment to science, global health & equitable access”. This was retweeted by Assistant Director-General Michèle Boccoz and Andrew Ball, Senior Adviser to ADG for UHC, as well as possibly other WHO staffers whose names I didn’t recognise in a quick scan of the list of retweeters.

Ren Minghui, Assistant Director-General for Universal Health Coverage/NCDs, also retweeted the FT article, saying “This is the incredible commitment to the fight against #COVID-19! Thank you!”

The Gates Foundation is a major WHO donor (by far the largest private donor), so the praise is politically understandable. It’s also understandable that people retweet their boss. But – if the FT story is to be believed – it is more than a little surprising that WHO officials aren’t much more hesitant than they appear to be about the downsides of this move by the Gates Foundation.

Of course many more resources are needed to bring the COVID-19 pandemic to an end. But the wider consequences of this move by the Gates Foundation seem so obvious as to scarcely need pointing out. Ongoing issues such as HIV, polio and malaria are not going away during the COVID crisis – indeed they are being made even more difficult to tackle. Taking resources away from them at this moment seems problematic, to say the least. Sophie Harman called it reckless, and I’m inclined to agree. 

Gates clearly recognises the downsides – indeed is explicit about recognising them in the interview. So what’s going on? Why is Gates doing this? And why are senior WHO officials publicly endorsing it?

Perhaps they think it will encourage governments to step up to the plate at the forthcoming COVID pledging conference, to be hosted by the EU on May 4^th, at which it is hoped $8 billion can be raised for COVID vaccine development?

Perhaps Gates is attracted by the prospect of being a global saviour at a time of crisis – something he is keen to deny at the end of the interview? As for WHO officials, under financial and political pressure from the Trump administration, perhaps they think Gates is the closest thing they have to a friend in the US?

Perhaps they all think that the Gates Foundation has unique skills and capabilities in this space that others can’t offer?

Whatever the reason, this episode surely reveals many of the problems of the philanthropic model as a way of fulfilling the right to health: too unaccountable, too narrowly targeted, too subject to rapidly changing priorities at the whim of the donor.

What’s more, if the aim is to encourage governments to give more, I have serious reservations about this as a strategy. Surely governments are far more likely to provide money for the COVID emergency response than they are to backfill the work on HIV, malaria and polio that Gates is moving away from? 

We need more resources for COVID-19. But don’t take them from health! Take them from military spending. Raise taxes on the rich. Do almost anything except de-fund HIV, polio and malaria.