Linsey McGoey - No Such Thing as a Free Gift: The Gates Foundation and the Price of Philanthropy

T he year is 2012. John E. Mahama drinks a Star beer at a caf in East Legon, a wealthier area of central Accra populated by foreigners from the dozens of aid agencies operating in Ghana.

It is mid-April. Ghanas wet season is almost upon the country clouds gather and linger without breaking; the sky flits between clear and overcast. For a city with two million residents, the streets in richer boroughs such as Cantonments and East Legon are strikingly quiet in the early evening.

Theres a flat-screen TV inside the caf. In a short while, the football will be on: Chelsea are playing Barcelona. A pair of lanky, teenaged boys walk with a swagger to the patio of the caf. They pull up two chairs and position themselves close to the window, inches from the pane, prepped to watch the game from outside, peering through the glass. They know that venturing inside is bound to be costly: sandwiches at the caf are an eye-opening fifteen Ghanaian cedis, about five British pounds no cheaper than in central London.

Its the same with rental properties. One- or two-bedroom flats in Cantonments or East Legon rent for $1,500 to $2,000 a month, on a par with areas of London, New York, or Chicago. Many Ghanaians who work in Accra, Ghanas capital city, dont live there they cant afford to. Cleaners, nannies, and office personnel wake at 4.30 a.m. to arrive at work by 7.30 or 8.00 a.m., riding in cramped Tro-Tros rusted mini-vans that form a makeshift transport system, their insides stripped clean and crammed with benches holding eighteen to twenty passengers at a time. Locals blame the vibrant aid industry for driving up rental costs.

Seen for years as one of Sub-Saharan Africas golden economic performers, Ghana earned middle-income status in 2011. The World Bank determines a countrys ranking according to a decades-old (many say outdated) classificatory scheme based on gross national income per capita. Boosted by a commodities boom in gold, diamonds, and recently discovered oil deposits, many Ghanaians have grown wealthier in recent years. Inequality has widened dramatically.

While richer Ghanaians ready themselves for watching the football match, staff from the Ghana Health Service battle a recent outbreak of cholera in the capital. Eighteen people have died in Accra during the first days of April. More are dying as I sit across from John Mahama in the quiet shade of the caf patio.

Just about the same time last year there was also a cholera outbreak in Accra, Mahama says. Sanitation in Ghana is one of the worst in Africa. Only about 13 per cent of Ghanaians have access to approved latrines. He pauses, emphasizing his words: Only onethree per cent.

Mahama is young, polite, and more privileged than most. His calm demeanour is something of a performance. He is far angrier and more tired than hell admit. Until recently, he worked at the Ghana AIDS Commission, a job he took up after completing an MSc in International Health at University College, London. Before leaving for England, he hadnt appreciated just how isolated Ghanas academic community was from the latest scientific research into the health burdens affecting most Ghanaians.

His biography is almost a metaphor for the nation itself. A high-achiever, Ghanas vibrant private sector has helped the nation to climb the global economic indices, inviting more and more foreign investment. Yet many of the countrys poorest citizens watch from the peripheries, their lives unchanged by the proclamations of progress issued from Washington, DC or Geneva. Middle-income status means little to those who have no income at all.

Much like Mahamas clearer-eyed appreciation of Ghanas lack of academic resources after returning from his year abroad, the nations newfound wealth simply illuminates its frustratingly absent basic amenities: the lack of latrines; the dearth of safe water pumps. There are parts of Accra where ten or twelve family members sleep side by side in rambling, one-room shanties with corrugated iron roofs. Most of Jamestown, a cripplingly poor borough just fifteen minutes away from East Legon by car, has uncovered sewers and no latrines defecation and urination take place openly in the street.

We seem to be doing well on some fronts, says Mahama. The private sector in Ghana is quite huge now. Gold mining, for example. There are a lot of private companies in the extractive industry. Gold and quite recently oil and gas. If these organizations were interested in filling the infrastructure gap for water and sanitation, we would have come a long way by now.

On a separate continent, a century earlier, the accumulation of an unprecedented oil fortune raised similar questions to those asked by Mahama: who benefits the most from rises in national income? Whats the best way to make sure that the poor have a share in a countrys growing wealth: Regulation? Taxes? Philanthropy?

John D. Rockefeller was convinced that the best approach to combating poverty was less regulation and more philanthropy. He fought for years to secure a charter that would permit him to establish the Rockefeller Foundation. Time and again, the US Congress rejected his overtures, citing concern for the public welfare and objections over

Philanthropic foundations at this time were viewed as mere outposts of profit-seeking empires, only cosmetically different from the corporations that had spawned them, a convenient way for business magnates to extend their reach over domestic and foreign populaces. They were a scheme for perpetuating vast wealth, the US Attorney General George Wickersham said, one entirely inconsistent with the public interest.

But Rockefeller was determined to establish a trust that would help him scale up his philanthropic giving, something he embarked upon long before the Department of Justice launched its suit against Standard Oil. In 1901, partly at the urging of his son, he established the Rockefeller Institute for Medical Research, housed on a vast stretch of disused farmland bordering what came to be called York Avenue, on Manhattans Upper East Side, bought for $700,000. The Institute soon emerged as a global centre for medical excellence.