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India is burning.

Even as some sense of normalcy returns to the United States, the pandemic, globally, is as dire as it ever has been. And into this frightening situation Bill Gates this week decided to toss an opinion about whether Covid vaccine patents should be broken in order to expand access in poor countries, as many Indians (and others) are asking:

Directly asked during an interview with Sky News if he thought it "would be helpful" to have vaccine recipes be shared, Gates quickly answered: "No."

Asked to explain why not, Gates — whose massive fortune as founder of Microsoft relies largely on intellectual property laws that turned his software innovations into tens of billions of dollars in personal wealth — said: "Well, there's only so many vaccine factories in the world and people are very serious about the safety of vaccines. And so moving something that had never been done — moving a vaccine, say, from a [Johnson & Johnson] factory into a factory in India — it's novel — it's only because of our grants and expertise that that can happen at all."

“Who appointed this billionaire head of global health?” Nick Dearden, executive director of Global Justice Now, which advocates for patent waivers, asked in light of Gates’ comments. “Oh yeah, he did.”

Afterward, I reached out to my friend Megan Tompkins-Stange, a brilliant scholar of philanthropy at the University of Michigan, and an expert on the philanthropic and other activities of Bill Gates, most notably in her important book, “Policy Patrons: Philanthropy, Education Reform, and the Politics of Influence.”

Our conversation is below. As always, consider subscribing if you enjoy getting these. Your support makes this experiment in independent media possible.

“His ‘thoughts’ should have the same role as yours or mine”: a conversation with Megan Tompkins-Stange

ANAND: So there's this guy named Bill Gates who apparently has done very well for himself and now has a lot of opinions about vaccines, whether or not we should break patents to immunize the developing world, and more. You wrote a book called “Policy Patrons,” about how Gates are other rich guys try to elbow their way into public questions like this one. What should we make of Gates having thoughts about our collective vaccination?

MEGAN: Gates is the benefactor of a private philanthropic foundation. He is not an infectious-disease specialist, nor is he an elected official or an appointed representative to a transnational health organization.

He is not accountable to official oversight bodies or stakeholders — and, as such, his "thoughts" should have the same role as yours or mine: advisory, without the formal power to develop or change public-health policies.

In “Policy Patrons,” I write about how wealthy philanthropists' opinions are amplified by virtue of their wealth and embeddedness in elite networks, and how this challenges the fundamental principles of a liberal democracy.

What's important to understand here is that, in order to influence public policy on a wider scale — beyond backstage — Gates has to obtain something called "democratic legitimacy” — whether or not a person or organization is viewed as a valid, acceptable political actor, which is often determined by the extent to which they achieve desirable policy outcomes. In other words, a philanthropist like Gates can essentially "purchase" democratic legitimacy by producing results that are seen as creating public value, even without being held accountable to the public.

To date, Gates' philanthropy on global public health has been credited with achieving such results (a broad generalization, as a significant body of critical literature contests this assertion), his funding of initiatives like GAVI and the Global Fund to Fight AIDS, Tuberculosis, and Malaria have improved outcomes for child infectious-disease transmission and treatment, especially the research on drug development and delivery.

This is not true, however, for his philanthropy in the U.S. education system, which has pursued a number of high-profile interventions that have not delivered on their goals, often at great expense to historically marginalized communities, and Gates is no longer broadly accepted as a legitimate political actor in K-12 education.

The bottom line? Gates has a loudspeaker in the vaccination debate because he's banked credibility from his past philanthropic efforts. However, that credibility is highly dependent on the extent to which he's viewed as producing results that add value.

And his recent statements against sharing intellectual property for global vaccination — which are morally abhorrent, in my opinion — may begin to compromise that perception. Public reverence for philanthropy is fickle and can turn on a dime — especially in our current age of skepticism, perhaps even rejection, of the accumulation of private wealth at the expense of equity. 

ANAND: Why would someone like Gates advocate for patents instead of against them? This is something that boggles many people's minds.

MEGAN: As the former CEO and largest shareholder of Microsoft, you might think that Bill Gates is a capitalist, but that's not exactly the case. In the classical definition of capitalism, private actors accumulate and exchange assets through the free market, at prices determined by supply and demand. Gates' version of capitalism would better be called monopolistic. He has consistently sought to distort free markets in order to advance his own corporation's accumulation of wealth, power, and preeminence.

Microsoft achieved its dominance by using intellectual property laws to prevent its competitors' products from running on its Windows operating system, creating a proprietary monopoly in the software industry. Gates' wealth is a direct result of the patents that codified Microsoft's intellectual property.

As such, it isn't surprising that one of Gates' core beliefs is that intellectual property needs to be protected at all costs — and that eliminating patent restrictions for vaccines violates this guiding principle.

Your question implies that, even though Gates sanctifies intellectual property rights, surely he would be willing to override this view in order to protect poor countries from Covid. Indeed, given that his foundation prominently proclaims that "all lives have equal value," one might expect this — even more so given that Gates is a self-identified utilitarian, someone whose moral values elevate the ends (saving lives) over the means (compromising a principle).

But this is where it gets more complicated. As a philanthropist, Gates is a founding member of a cohort of benefactors who believe that pursuing profit is not incompatible with social good. This philosophy has been on the rise at least since 1970, when Milton Friedman famously argued that “the social responsibility of business is to increase its profits,” and is now best described as "MarketWorld," as you coined in “Winners Take All,” or "doing well by doing good."

MarketWorld marinates prosocial values in market-based flavors, preferring "social impact" to "charity" and "investments" to "grants." Gates' alignment with this cohort means that he is far more likely to advocate for patents, even in a crisis like Covid.

ANAND: If Bill Gates were reading this newsletter, what would you say to him directly?

MEGAN: You've invested two decades of your life to advance the health and welfare of people in poverty around the world. You've given billions and billions of dollars to prevent and treat deadly diseases. You've partnered with countries to support innovation in vaccine research and development, and you've had a significant influence on efforts to lower prices on drugs that radically improve life outcomes.

But even if you add all of these actions up, they still pale in comparison to the global impact that making Covid vaccines accessible would have.

Economic theory dictates that removing patent protections will discourage innovation. But what if we challenged this tenet, and gambled on the idea that firms can be motivated by values other than economic benefit? Would pharmaceutical companies really refuse to develop vaccines for a worldwide pandemic if they knew they might reap less of a financial windfall in doing so?

A cynic might think so. But I believe that the commons still exists. I believe that people have humanity, and that they want to take responsibility for easing others' suffering beyond their own self-interest — especially when millions of people are dying, and when their deaths could so easily be prevented.

And I believe that disrupting the political economy of the pandemic, in order to save the lives of millions, is the greatest legacy that you, Bill Gates, could have.

Megan Tompkins-Stange teaches public policy at the Gerald R. Ford School of Public Policy at the University of Michigan (Go Blue!). She is the author of “Policy Patrons: Philanthropy, Education Reform, and the Politics of Influence.”