In 2018, the Bill & Melinda Gates Foundation announced a partnership with the European Union to strengthen diagnostic health services in Africa. Aside from this high profile partnership, the Gates Foundation is widely known to engage in a number of philanthropic ventures – from the mosquito eradication project, to education reform, to various disease eradication projects across the continent of Africa.
According to the foundation’s website, the aims of the foundation’s Global Health Division is as follows:
Our Global Health Division aims to harness advances in science and technology to save lives in developing countries. We work with partners to deliver proven tools—including vaccines, drugs, and diagnostics—as well as discover pathbreaking new solutions that are affordable and reliable. Equally important is innovation in how we bring health interventions to those who need them most. We invest heavily in vaccine to prevent infectious diseases and support the development of integrated health solutions for family planning, nutrition, and maternal and child health.
The Bill & Melinda Gates Foundation is able to carry out such large scale, global projects due to the massive wealth of its founder, Bill Gates. Recently, polls have suggested a decline in support for capitalism among youth – only 19% of youth in America identify as “capitalists”, and only 42% support the economic system. Still, a large proportion of media coverage concerning billionaires has been positive, with tech entrepreneurs in particular being celebrated for “spurring innovation”, “uplifting economically poor communities”, and the biggest one, large scale venture philanthropy.
According to supporters, billionaires with large amounts of money who engage in venture philanthropy are doing an objective good for the people under their purview. In fact, it does not particularly matter how the billionaires acquired this money, so long as it is being used for some form of good. Some may even support this as a form of effective altruism: get rich, and use your money for the good of others.
Such a view can be linked to Rawls’s notion of Natural Aristocracy – namely, a system where both social and natural contingencies are allowed to create inequality insofar as the inequality creates positive outcomes for the worst off. In simpler terms, a Natural Aristocracy allows for social inequality, as well as inequality in talent amongst people, to create unequal distributions of resources in society. However, this inequality is to be restrained by the difference principle – namely, that inequality occur only so far as it results in positive outcomes for the worst off. Rawls does not believe that a Natural Aristocracy is just, and discounts it on the grounds that it is unstable (meaning that it allows for morally arbitrary social inequality to dictate distributions of resources, which is unjust). He instead argues for a system where social contingencies are eliminated and differences in natural ability are allowed to create inequality only insofar as they adhere to the difference principle (this is also known as Democratic Equality).
Matthew Clayton, in his paper Rawls and Natural Aristocracy, argues for the view that Natural Aristocracy is in principle compatible with a Rawlsian theory of justice. Clayton’s view is that Natural Aristocracy acknowledges both social contingencies and natural endowments as morally arbitrary, and responds to such arbitrariness by allowing for both under the assumption that such inequalities lead to the benefit of the least advantaged members of society. This view is summarized aptly by the following quote: “Natural Aristocracy abandons egalitarianism in favor of a thoroughgoing prioritarianism: both natural and social potential causes of inequality can legitimately produce inequalities if such inequality benefits the worse-off.”
Clayton claims that a system of Natural Aristocracy, in contrast to Democratic Equality, avoids the challenge of having to offer a moral criterion on which to distinguish and account for social contingencies versus natural endowments. There is weight behind this quality: there is significant debate surrounding policies that try to equalize social inequality in the sense that Democratic Equality requires; controversy around affirmative action and minority quota policies in particular is abound. Natural Aristocracy avoids such debates entirely, by allowing for all forms of inequality subject to the difference principle. Avoiding such controversy in practice is quite attractive for reasons of parsimony and efficiency, and so Natural Aristocracy presents an attractive option if Clayton’s arguments are sound.
The implication of such arguments, therefore, is that inequality in all forms can be good for society when it produces charitable outcomes; for example, today’s billionaires may have exploited labor or social inequality in order to acquire their wealth, but such wealth is now being put to use for the good of the people, and is therefore justified. Therefore, we can intuitively see that the arguments for Natural Aristocracy mirror the ones for foundations such as the Bill and Melinda Gates Foundation, and venture philanthropy at large: let people with talents and resources get rich so that they can solve global hunger, disease, and economic downturn. Underlying this intuition also is the idea that success in economic markets is indicative of the ability to create efficient value in the charity space, and this idea underlies the “effective altruism” movement as well.
Notice, however, that Clayton is very amiable to abandoning principles of equality, whereas Rawls isn’t. Taking a look at the Bill & Melinda Gates Foundation, it is easy to see that the foundation could not exist without severe inequality between average citizens and William H. Gates III. And for Rawls, there is something about this inequality, resultant of many social contingencies of course, that is morally arbitrary, and therefore unjust. In this article, I will develop an argument from the case of the Bill & Melinda Gates Foundation for why Natural Aristocracy in practice is an unjust system.
My primary objection to Gates’s philanthropy and its various justifications is that Natural Aristocracy’s allowance of social contingencies to create inequality results in a severe consolidation of political power amongst the wealthiest and most privileged members of our society. Specifically, there are three avenues through which the Gates Foundation has and continues to consolidate political power with regard to global healthcare governance.
First, the anticompetitive practices engaged by Bill Gates in the establishment of his company Microsoft’s tech monopoly allowed him to create and bestow significant political powers on the Gates Foundation, which is now the largest private foundation in the US. Second, the arbitrary ways in which the Foundation selects grant recipients from informal personal networks creates a positive bias towards US based health institutions. The foundation’s grant making process is managed mainly through personal networks and relationships, rather than scientifically peer reviewed projects designed for maximum impact. This not only allows the foundation to have sway over international institutions for global health, but also a significant amount of leeway in choosing which specific projects get the prestigious funding of the Gates Foundation. This presents as a bias toward providing grants for US-based NGOs, think tanks, universities, etc., which then perform their projects outside of their borders in countries in Africa, for example. Third, the Gates Foundation’s agenda setting power chokes out other global agendas due to the Gates Foundation’s massive worldwide influence. The Gates foundation continually invests billions of dollars into international intergovernmental institutions, effectively buying the power to set agendas within these institutions and within the global healthcare space.
All of this is to say that the Gates Foundation holds a very significant amount of political power in healthcare governance, and the Foundation limits outsider voices in agenda setting, projects, etc. through its wide influence. I argue further that this consolidation of political power and restriction of outsider opinions necessarily leads to an inadequate contestation of judgments regarding the foundation’s philanthropic projects, which reduces the efficacy and value of Gates’s charity for the worst off.
For example, Gates’s focus on technological solutions, particularly capitalist ones, crowds out other potentially more effective projects for global healthcare development. According to Sophie Harman, the Gates foundation pours large amounts of investment into researching illnesses such as malaria and HIV, which redirects the focus of global healthcare institutions toward curing major illnesses from the top-down and away from building horizontal systems of basic healthcare. Therefore, the Gates Foundation brings with it a focus on vaccines and technologically advanced solutions that are not always effective for the long term development of healthcare systems globally.
More than that, it is worth considering whether privileged tech entrepreneurs from the United States are really best suited to find solutions to the healthcare concerns of local citizens in Africa. Assuming the best of their intentions, it is still unlikely that the limited set of decision makers in the Gates foundation are able to approximate the lived experience of the individuals they are trying to help, and this gap is another significant negative aspect of the consolidation of power described earlier.
All of this is to say that there is something is Rawls’s original system that is worth implementing in modern visions of philanthropy. Namely, a commitment to egalitarianism that is equal to our commitment to the difference principle, as there is something about a greater equality that is as important to respecting individuals and enacting just policies as the commitment to uplifting the worst off itself.
Clayton, Matthew (2001). Rawls and Natural Aristocracy. Croatian Journal of Philosophy 1 (3):239-259.
Rawls, John, 1921-2002. (1971). A theory of justice. Cambridge, Mass. :Belknap Press of Harvard University Press,
McCoy, David et al. (2009) The Bill & Melinda Gates Foundation’s grant-making programme for global health. The Lancet , Volume 373 , Issue 9675 , 1645 – 1653
Sophie Harman (2016) The Bill and Melinda Gates Foundation and Legitimacy in Global Health Governance. Global Governance: A Review of Multilateralism and International Organizations: July-September 2016, Vol. 22, No. 3, pp. 349-368.
 Rawls (1971), p. 64.
 Clayton (2001), p. 246
 Clayton (2001), p. 248
 Clayton (2001), p. 248
 McCoy et al. (2009), p. 1650
 Harman (2016), p. 353, p. 1649
 McCoy et al. (2009), p. 1649, Harman (2016), p. 353
 Harman (2016), p. 355
 See https://www.psychologytoday.com/us/blog/under-the-influence/201208/how-the-rich-are-different-the-poor-ii-empathy