Critics say the Gates Foundation needs to focus on health delivery

Malaria Vaccine Initiative/Marc de Semir

The Bill and Melinda Gates Foundation is changing the face of global health research, but not everyone agrees the money is doing as much good as it could, writes Hannah Brown in this BMJ article.

The foundation has injected crucial funds into global health projects ― a total of US$6 billion, with almost half of all the money awarded so far. Observers generally agree it has stabilised research, especially in neglected areas.

But critics worry that the new technologies funded by the foundation won't get to those in need, because the systems needed to deliver them are not being developed concurrently. This is a particular problem for the fragile health systems of some developing countries.

The foundation's focus on disease-specific funding may even be undermining comprehensive ― and ultimately more sustainable ― health initiatives in developing countries.

It has also come under fire for awarding grants primarily to northern institutions, and for not being suitably accountable for its grant-giving by virtue of its private status. 

Observers say that the foundation should use its influence to compel other donors to improve economic conditions in developing countries, and extend its funding toward assisting these countries with policy choices.