Paper short abstract:

Over a short period, the Bill and Melinda Gates Foundation has become the largest private player in global health funding and governance, spending more annually on healthcare in developing regions than the World Health Organization (WHO), and providing 10 per cent of the WHO's overall budget. The Gates Foundation's growing influence is raising concerns about the foundation's transparency, accountability, grant disbursement decisions, and investment in corporations seen as exacerbating global health problems. Drawing on interviews with those inside the Gates Foundation and outside, this talk explores the relationship between philanthropic power and expert ignorance.

Paper long abstract:

In particular, I explore the ways that those most concerned with the Gates Foundation's dominance over decision-making are typically the same individuals least likely to voice concerns publicly, leading to hierarchies of silence where the most valuable knowledge is that which is rarely articulated. The Gates Foundation exemplifies the methodological difficulty of accessing the "truth" of organizations which tend to generate more strategic silence about their operations the more their own knowledge-base and scale of influence expands. This case illuminates an obvious and yet underappreciated truism: the more an organization knows, the less we're entitled to know about it, particularly when those with the most expertise about an institution are the least likely to speak 'truth to power.'