22 Global Governance 349 (2016)
The Bill and Melinda Gates Foundation and Legitimacy in Global Health Governance

handle is hein.journals/glogo22 and id is 357 raw text is: 

Global Governance 22 (2016), 349-368


    The Bill and Melinda Gates Foundation
                      and Legitimacy in
               Global Health Governance


                          Sophie Harman


    The Bill and Melinda Gates Foundation brings to light the legitimacy prob-
    lem with global philanthropy. The legitimacy problem here is twofold:
    first, with regard to the criteria used to assess the presence or absence of
    legitimacy in global governance; and, second, how analysis of legitimacy
    does not fully account for how we understand the legitimate basis of rule
    drawn from private wealth. This article begins to address this lacuna by an-
    alyzing the legitimacy of an actor that wields considerable authority in the
    field of global health politics and has growing prominence in contempo-
    rary global governance, the Bill and Melinda Gates Foundation. Key-
    words:  Bill and Melinda Gates Foundation, legitimacy, philanthropy,
    global health, Beetham.


PHILANTHROPY   IS NOTHING  NEW  TO  GLOBAL  GOVERNANCE.   IT HAS  A LONG
history of establishing international organizations, developing some of the
first international welfare programs, and acting as a tool of US hegemony in
the world.1 The Bill and Melinda Gates Foundation (BMGF)   is an extension
of the legacies left by US philanthropists such as John D. Rockefeller and An-
drew  Carnegie. However, the BMGF   exists in a postglobalization world that
encompasses  global-policy-making goals, public-private partnerships, global
information exchanges, prominent nonstate for-profit and not-for-profit actors,
the cult of celebrity, and a myriad of new and old international institutions.
This postglobalization world is best typified by global health governance, the
central domain in which the BMGF   positions its international affairs. Global
health governance  is an ever expanding field of governance that refers to
trans-border agreements or initiatives between states and/or non-state actors to
the control of public health and infectious disease and the protection of people
from  health risks or threats.2 It involves specialized public-private partner-
ships, multilateral and bilateral institutions, epistemic communities, private
companies,  celebrities, ex-politicians, and a variety of civil society organiza-
tions, and is underpinned by questions of equality, rights, and the efficacy of
development  assistance. Since the launch of the foundation in 2000, Bill and
Melinda  Gates have shaken up interest in global health by capturing the atten-
tion of policyrnakers and the general public through the foundation's Global


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