Bill and Melinda Gates
Ahead of this year’s United Nations General Assembly, (UNGA) featuring world leaders from presidents, prime and foreign ministers to chief executives of non-governmental organisations and sundry global governance players, the Bill and Melinda Gates Foundation is stepping up its intervention in global poverty and health governance with Goalkeeper, a mining and synthesis of data on the key areas of the Social Development Goals, (SDG). This is in spite of the fear of estimated pervasiveness of private actors across all the domains in global health governance, for instance. The Bill and Melinda Gates Foundation is currently one of such most pervasive actors with particular reference to financing. In the latest move, however, the foundation is prioritising a reporting system beginning this year and every other year till 2030 focusing on diagnosis of the urgent problems, identification of promising solutions, measurement and interpretation of key results and spreading best practices.
The report explains how the data would be complemented with the stories behind the numbers: the leadership, the innovations and the policies that made the difference in countries where progress are adjudged most significant.
The Gates Foundation fears that unless there is reaffirmation of the commitments that led to the accomplishments in the past few decades, the ambition behind the Sustainable Development Goals adopted in 2015 by member states of the United Nations might not be achieved. It is particularly expecting leaders across the world to take action now as the guarantee of the set targets, pointing out how the report is coming out at a time of what it calls unusual doubt about the world’s commitment to development. Citing considerations in Congress in the USA, for instance, on big cuts to foreign aid in the president’s budget proposals and “a similar mood of retrenchment” that is believed to have taken hold in other donor countries, the foundation said this was happening when most developing countries needed to do more to prioritize the welfare of their poorest citizens.
Taking child mortality where the number of number of child deaths is said to have gone down drastically every year in the last 15 years, Gates, however, puts on the front burner how “close to half of the almost 5 million children who will die next year will die in the first 28 days of their lives. Most of them could be saved by a few simple interventions: for example, simple resuscitation if they can’t breathe, antiseptics that cost pennies to prevent infection, and breastfeeding to strengthen their immune systems”. He puts similar cuts on the front burner in HIV and family planning. That of HIV is captured as follows: By 2030, there will be more than 280 million Africans at the age when people are most at risk of contracting HIV. Compare that to 94 million people in 1990. If we only do as well as we’ve been doing on prevention, the absolute number of people getting HIV will go up even beyond its previous peak. So we have to do better. Part of that is more funding, not less”.
The sizzling nature of Gates Foundation’s articulation of the dynamics of global health and the massive amount of financial resources from the foundation have left critics and admirers in a quandary over how best to respond to what international lawyer, David Fidler calls the “unstructured plurality” that is unique to global health governance out of the about nine or so domains that constitute transnational or new security challenges viz climate change, terrorism, the internet, migration, etc. The World Health Organisation, (WHO) which is supposed to lead has somehow been displaced by richer actors, a situation which is difficult to reverse. That is because, even though everyone is saying ‘where is the House that WHO built’, everyone is also conscious of the question ‘who needs leadership or architecture with the success that has been achieved in global health governance in spite of architecture?’ It is, far, far ahead of any other of the domains of global governance, a process to which private actors have been pivotal even as critics fear they come with all manner baggage.
