In this era of global rise in charity spending, and dependence on donor aid particularly in the spheres of global health by developing nations, It is interesting to see how wealthy philanthropists gain an incredible amount of influence, and basically purchase soft power through mega donations that sometimes even supersede the place of domestic governments. A case in point is the Bill and Melinda Gates Foundation; a powerhouse that plays an incredibly solid role in structuring and governing policies at top levels of international decision-making in the spheres of global health. One cannot help but wonder how a privately owned organization attained such magnitude of power that allows it actually dabble into the affairs of global health governance.
As crucial as donor aids are, they are not without problems as no one holds philanthropists who dole out huge sums of capital and resources accountable. Consequently, the personal principles and ideologies of a few mega donors end up structuring and shaping societies to which they donate, a proof that power lies in the potential to attractively influence the inclinations of others.
Philanthrocapitalism threatens health sovereignty in my opinion. The use of donor aid to structure public institutions often results in directly or indirectly ceding parts of a nations health sovereignty rights to mega donors. For instance, in my experience as a physician providing primary care for People Living with HIV/AIDS in Nigeria, we are faced with evidences of wealthy philanthropists micromanaging global health affairs that should be prerogatives of the government. I argue that these are some of the reasons for extensive zones of abandonment and its resultant health effects particularly among people living with HIV/AIDS in Nigeria. This is as a result of poor coordination by folks with inadequate knowledge of local norms and traditions, and not to mention the issue of internal brain drain.
Philanthropy in my opinion weakens political commitment, and I dare say, the extremes of Philanthrocapitalism indirectly reduce receiving governments to mere placeholders. Corruption, unwillingness to research new grounds, and reluctance to step out of comfort zones are some of the major barriers to thriving governmental sectors in many developing nations. Revitalizing credible governments is a task that developing nations must not take for granted. These nations must work hard to create functional and effective national health care, which I argue, is the building block for establishing health sovereignty and a means to achieving sustained social welfare, and less dependence on donor aid. In conclusion, I wish to reflect on what the stand of wealthy philanthropists would be assuming developing nations move towards achieving total health sovereignty. Will the mega donors be allies to this “movement”?
Dr. Henrietta Ezegbe is a physician and public health practitioner. A fresh graduate from the Simon Fraser University Master of Public Health Program in the Global Health concentration, Henrietta is interested in HIV/AIDS research specifically among underserved population in high and lower middle-income settings.