The bill gates problem, p.34
The Bill Gates Problem, page 34
If the Gates Foundation’s generous donations have allowed it to play by a different set of rules at the University of Washington, there are other checks and balances in scientific enterprise that should come to bear on the IHME. The currency of science is, to a great extent, the studies that researchers publish in scientific journals. It’s here where they describe, debate, and debunk findings. And, before publication, studies first undergo a gauntlet of scrutiny by editors and peer reviewers, who rigorously assess the merits of the researchers’ work.
In this world of academic publishing, the IHME is a heavyweight champion, putting out some of the most widely cited studies in the world, many of which are published in The Lancet, one of the world’s leading medical journals. While most scholars are lucky to publish one research article in The Lancet during a decades-long career, Chris Murray has published more than one hundred. He has made The Lancet home to most of the IHME’s biggest studies, which lay out the “global burden of disease” that other researchers look to for health metrics. When scientists publish their own research on a given disease, they commonly cite IHME numbers on mortalities and infections. And each time a researcher cites IHME’s studies in The Lancet, this increases the journal’s “impact factor,” a measure of its relative importance in the scientific literature. This can translate into prestige and influence for the journal, if not also raise subscription rates and advertising revenue for The Lancet’s for-profit owner, Elsevier.
Some scholars see perverse incentives driving this relationship, alleging that the benefits The Lancet derives from publishing IHME research have biased the journal’s editorial oversight. Multiple sources I interviewed criticize The Lancet’s peer-review process, for example, which puts impossibly short deadlines on extremely complex IHME studies, leading to superficial reviews. “At the end of the day, [the peer-review process] pretends to be a validation of something it is not,” Patrick Gerland, a demographer in the United Nations Population Division, told me.
“You can’t go through the five thousand pages of tables and figures for The Lancet and say, ‘I’ve noticed a mistake on page three thousand five hundred fifty-six, line twenty-five,’” said Peter Byass. “That’s just not going to happen.” Nevertheless, The Lancet publishes five-thousand-page appendices that are labeled as having been peer-reviewed. Scholars also question The Lancet’s editorial decision to allow the IHME to publish studies with hundreds of different authors. “You could sign on as a collaborator to IHME, and they’ll send out draft papers to you,” Colin Mathers explained. “You may or may not read them, you may or may not comment on them, but your name gets to be [included as] an author in the end, and IHME can then claim there are twelve hundred people from [various] countries who have reviewed all the results. I don’t know how The Lancet squares that … with the standard scientific authorship requirements.”
David Resnik, a bioethicist at the National Institutes of Health, elaborated on the importance of ethical rules around authorship for me: “When you have this many people, and their roles are ill-defined, you’re losing the accountability and responsibility for it. It’s not really telling [you] who did what or who did more.”
Many feel that the IHME leans on so many authors as political gamesmanship. By offering international researchers the opportunity to coauthor a study in The Lancet—a feather in any researcher’s cap—the IHME can present its research as far more robust and collaborative than it really is. The institute can also count on coauthors to serve as allies, apologists, and defenders—to deflect criticism of its “data imperialism” or challenge the allegation that the institute is a tightly run monopoly in Seattle.
The IHME insisted to me that it complies with proper authorship guidelines, but days before offering this defense—and shortly after I raised questions—it issued an internal memo announcing new guidelines around authorship and a strict new auditing process.
Perhaps the most striking irregularity in The Lancet’s relationship with the IHME concerns the institute’s awarding a one-hundred-thousand-dollar prize to the journal’s editor, Richard Horton, in 2019. Even inside the IHME, alarms went off. “I would like to understand what the long term thought process was in awarding Horton the prize,” one IHME employee said in an internal email, “and how we are expected to defend that decision as staff when criticized for buying our way into the Lancet rather than being published based on the merit of our work?”
In a phone interview in 2019, Horton denied all allegations of impropriety, arguing—oddly—that because the award, called the Roux Prize, had come from the IHME’s board of directors, it should be viewed as independent of the institute. “I see it as completely separate, personally,” Horton said, noting that IHME board member Dave Roux, a cofounder of the private equity firm Silver Lake, funded the award.
The institute offered its own parsing, saying that the “IHME does not award the Roux Prize; it is the custodian of the prize. Moreover, it is quite implausible that there was any expectation of benefit to the Institute’s Board—either collectively or to any individual member—by awarding Dr. Richard Horton the prize in 2019, given his terminal cancer diagnosis.”
Years later, Horton continues to edit The Lancet—and continues to put the full weight of his journal into elevating the IHME’s research. Horton does acknowledge the “very special relationship” his journal has with the IHME, but he defends it as good science. He notes that The Lancet publishes estimates from other research institutes, saying this helps create a robust debate that has historically been missing in global health, including during the WHO’s reign as the leading purveyor of estimates. “The reason why it’s very important to publish these papers in our journal is because it holds IHME accountable,” he said in an interview. “If you publish a paper in The Lancet … scientists can look at that paper and say, ‘Okay, do I think this is high-quality science? Do I agree with what they said? And do I agree with their interpretation?’ And they can write letters to us, and they can say, ‘Actually, we strongly disagree with X, Y, and Z,’ and we will publish those letters, and that holds Chris Murray and IHME accountable for their work,” Horton said. “This is the way the science is done. It’s self-corrective.… You publish the best work you can, then you see who, over time, falls out of view.”
Horton’s vision of a functioning, incrementalist system of knowledge creation, rich with debate and competition, however, is, in the eyes of many scholars, an alternate reality. What the IHME represents to the wider scientific community is a broken system of science that privileges wealth and power over independence and integrity. “It’s a bit like the agenda in many developed countries over the last twenty, thirty years to privatize all sorts of functions that I had thought should properly be in the public domain with checks and balances and so on,” Colin Mathers told me. “Gates, just because he charged us all too much for Windows for so long, is now in a position to decide—to change the global health landscape and the numbers, with little ability of others to push back.”
13
Agriculture
Among the most storied corporate villains over the last thirty years, Monsanto ranks as perhaps even more notorious than Microsoft. To be sure, if Bill Gates had decided to put his energy into agriculture instead of computers, the company he would have made would look an awful lot like the seed and agrochemical giant from St. Louis. (Bayer acquired Monsanto in 2018.)
Monsanto’s hard-earned reputation for controversy stems in part from the monopoly power it wields over our food system, seeking to control the genetic code of life itself. Over the last two decades, much of the corn and soy grown in the United States has contained genetic traits owned by Monsanto, the most well-known of which is being “Roundup Ready,” which refers to the crops’ immunity to the herbicide Roundup. That means farmers can spray their fields indiscriminately with weed-killing chemicals, eliminating weeds, while their crops survive thanks to their genetic modification. This presents a major benefit to farmers in terms of labor, as they are spared the hard work of pulling weeds by hand or trying to carefully spray individual weeds. Yet, the expanded use of agrochemicals has drawn concerns related to the environment and human health, which is one reason most nations, including much of Europe, don’t grow GMOs (genetically modified organisms).
The GMO model is also expensive, and for it to make financial sense, it is generally used on the largest-scale farms. Growers plant vast acreages of monoculture corn or soy, apply synthetic fertilizer, and then hire crop dusters to blanket the fields with Roundup, the use of which has skyrocketed with the advent of GMOs. All this has been good business for Monsanto, which sells not only Roundup Ready GMO seeds but also the Roundup herbicides used with them.
Monsanto’s market power has also reached onto farms in other ways. When farmers buy GMO seeds, they sign technology agreements that restrict how they can use them. And Monsanto isn’t shy about verifying that farmers respect the terms and conditions of these agreements. As Vanity Fair reported in 2008:
As interviews and reams of court documents reveal, Monsanto relies on a shadowy army of private investigators and agents in the American heartland to strike fear into farm country. They fan out into fields and farm towns, where they secretly videotape and photograph farmers, store owners, and co-ops; infiltrate community meetings; and gather information from informants about farming activities. Farmers say that some Monsanto agents pretend to be surveyors. Others confront farmers on their land and try to pressure them to sign papers giving Monsanto access to their private records. Farmers call them the “seed police” and use words such as “Gestapo” and “Mafia” to describe their tactics. When asked about these practices, Monsanto declined to comment specifically, other than to say that the company is simply protecting its patents.… Some compare Monsanto’s hard-line approach to Microsoft’s zealous efforts to protect its software from pirates. At least with Microsoft the buyer of a program can use it over and over again. But farmers who buy Monsanto’s seeds can’t even do that.
Monsanto has also generated controversy around its influence in the scientific enterprise. The University of California, San Francisco has an online library of documents detailing some of this influence, adjacent to its trove of documents examining Big Tobacco’s industry playbook. As one of legion examples, in 2013 Monsanto contacted a number of academic scientists, suggesting that they produce policy papers based on talking points that the company furnished—which some professors did without disclosing Monsanto’s role in the papers. One academic caught up in this scandal was Harvard economist Calestous Juma, who had also partnered on agricultural work with the Gates Foundation.
Gates funded some of Juma’s academic research—and even created a fellowship to honor him after he died. And when Juma engaged in political advocacy activities, like a 2015 letter to the Food and Drug Administration in support of GMOs, he trumpeted his affiliation with the Gates Foundation but, naturally, made no disclosures about his close work with Monsanto. As with many of the areas where Gates works, the foundation has become a valuable front for industry ambitions, a charitable face for a corporate agenda.
The reason the Gates Foundation and Monsanto both worked so closely with Juma was what he represented for them: an African scholar—he was from Kenya—housed at a prestigious university in the West who could help promote Gates and Monsanto’s shared goal of introducing GMOs to Africa. “The biggest area of arable land in the world that is underutilized at this point is in Africa,” Monsanto executive Mark Edge noted in a 2016 news story that discussed the company’s philanthropic partnership with the Gates Foundation. “There’s a real business argument to be made.… Your choice is can you go in now, and you know that you’re not going to make much money in it but can you lay those foundations for 10 or 15 years from now where it’s going to be?”
Bill Gates spins the narrative differently, leaning on humanitarian arguments: “It’s fine for people from rich, well-fed nations with productive farms to decline the use of GMOs. But they should not be allowed to impose their preferences on Africa.”
At the same time, Gates doesn’t appear to have much compunction about imposing his own preferences. As a self-described technologist, he is a true believer in GMOs, even as many experts question whether this technology can really benefit the smallholder farmers in sub-Saharan Africa whom the foundation targets. Asked in an interview with the Verge in 2015 whether poor nations had the necessary regulatory capacity to ensure that GMOs were safely tested and cultivated—and whether the foundation might step in to provide “quasi-regulatory oversight”—Bill Gates didn’t blink:
We can fund training, so that they can have scientists who can staff their safety commission. We can make sure the [scientific] studies, they’re done and done well. We can incent the companies that are making these great seeds for rich countries—we can work with them to make sure that it’s at least available—actually at a lower price because that tiered price where poor countries get a better price has worked so well in medicines—that same type of thing we can make sure happens with these crops. But at the end of the day, they get to decide—which vaccines, which drugs, which seeds are okay. That’s their country. But their expertise is developing, so I feel like they will make a good choice.
Gates’s candor is remarkable as he, essentially, explains how his foundation seeks to control the entire approval process—except for the rubber stamp at the very end. He’s training the African scientists who will regulate GMOs. He’s creating the scientific studies they review. He’s even intervening in private markets to make sure GMOs are available. And he isn’t exaggerating.
Bill Gates has become one of the most powerful voices in African agriculture, a vastly underfunded sector where Gates Foundation donations have translated into far-reaching influence over public policy. The foundation has spent $6.5 billion on all agricultural projects, including lead funding to some of the most prominent agricultural organizations operating on the continent—organizations that look and feel African and often have the name “Africa” in their title. These surrogates—like the Alliance for a Green Revolution in Africa and the African Agricultural Technology Foundation, seem to function the same way Monsanto’s corporate front groups once did: advancing their sponsor’s agenda while claiming to be independent, or science-based, or farmer-forward, or African-led.
Gates’s ambition to introduce GMOs is just one agenda item in a larger effort to industrialize African agriculture, making more productive, higher-yielding farms through expanded use of what are called “inputs”—chemicals, fertilizers, new seeds, and irrigation. It’s a project that Gates has undertaken in close partnership with the multinational companies that sell these inputs, companies that have long eyed Africa as an untapped market. For the foundation, the goal is not profits but yields: “the need to find solutions so farmers—especially those in the poorest countries—have better tools and knowledge so they can grow enough food to feed their families.”
Gates’s interventions, however, have failed to deliver the “revolution” the foundation promised. Despite decades of political lobbying by vested interests, only one African nation grows any significant quantities of GMO food crops—South Africa. Likewise, we haven’t seen the major decreases in hunger or increases in crop yields and farmers’ incomes that Bill Gates promised his agricultural agenda would deliver.
The failures, however, don’t mean the Gates Foundation isn’t having an impact. “In so many ways, they are very much successful because they sold a narrative,” Million Belay, head of the Alliance for Food Sovereignty in Africa, told me in an interview. “The narrative is African seeds are tired. The land of Africans is not fertile. The knowledge that Africans have is archaic. In order to produce more food, you need hybrid variety seeds. The soil is very tired, so you have to target it with lots of chemicals. Also, this is market-based agriculture, part of the neoliberal ideology.”
The premise of the Gates Foundation’s work is that African nations don’t have the expertise or capacity or tools to manage their own food systems—that they need professionals and experts from the Global North to help them. The foundation does this by working with politicians and policy makers to change the governing laws in the African countries where it works, effectively acting as a lobbyist, placing its technical experts inside government agencies and even helping to create, fund, and staff entirely new agencies, like the Agricultural Transformation Agency (ATA) in Belay’s home country of Ethiopia.
This new body—an “independent unit to support the Ministry of Agriculture to accelerate agricultural growth and augment the Ministry’s work”—has benefited from at least $27 million from the Gates Foundation. In 2010, Ethiopian legislators codified the new agency, and a year later, a Gates Foundation senior program officer, Khalid Bomba, left the foundation to become the head of the ATA. A year after that, the foundation announced “the appointment of its first official representative in Ethiopia … [who] will serve as the foundation’s liaison to the federal government of Ethiopia and the African Union.” A rapid revolving door of staff between Gates and the Ethiopian agency followed in the years ahead. One group of researchers cited the ATA as being instrumental in fostering greater private-sector engagement in Ethiopian farming, including opening up new markets for seed and agrochemical giant DuPont.
As another example, the Gates-funded Alliance for a Green Revolution in Africa (AGRA) describes having worked on, over a recent four-year period, sixty-eight different policy reforms in Burkina Faso, Ethiopia, Ghana, Nigeria, Tanzania, Rwanda, and the East African Community (an intergovernmental body)—on everything from trade policy to seed laws to pesticides to regulations over fertilizer markets. “A combination of AGRA’s policy and advocacy approach reduces the normal timetable to get agricultural policy reforms completed throughout the administrative and legislative processes,” the group reports on its website. “All of this is aimed at strengthening effective and functional seed, fertilizer and market systems.”
