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India, AIDS and Microsoft

A look at the aggressive nature of charity
In November 2002, Bill Gates made a historic visit to India. It was historic because of the amount of money that Gates pledged to the Indian government. Half a billion dollars-$400 million for high-tech investment and development, $100 million for AIDS education and research. The high-tech investment included $100 million for Microsoft's software development center in Hyderabad, a burgeoning high-tech city. But it wasn't the $400 million that was precedent setting-Gates reportedly dropped 3/4 of a billion on China a few years back. It was the $100 million for AIDS research and education, pledged through the Bill and Melinda Gates Foundation, that was unique.

That was the largest sum to date that the Gates Foundation had pledged to a single country. In October 2003, the pledge was doubled to $200 million, making India by far the leading recipient of Gates Foundation charity.

The money is for AIDS education and research, NOT for care of AIDS patients.

As the Seattle Post-Intelligencer reported on December 8, 2003, "Bill Gates isn't much interested in paying for AIDS treatment or care." The article goes on, "...Gates is primarily focused on disease prevention because it is so woefully underfunded, and because the foundation believes treatment is the government's responsibility."

The problem is that India's government also hasn't been much interested in paying for AIDS treatment or care. Recognizing that there was a problem was a major step forward, and slow progress is being made as the government confronts the issue. The number of AIDS cases in India is estimated at 4.6 million, in a country of 1.2 billion. This is second only to South Africa, with an estimated 4.7 million cases, in a population of 42 million.

In contrast to the $200 million pledged to India by the Gates Foundation, South Africa has received little in direct pledges. From what I saw on the Gates Foundation website, South Africa has received $32 million for a campaign called Lovelife to reduce HIV infection among young South Africans, and $445,000 to reduce suffering in AIDS patients.

That's just under $32.5 million for South Africa, and $200 million for India, and the two countries have roughly the same amount of AIDS patients.

In southern India, two states have received more in AIDS prevention grants from the Gates Foundation than the country of South Africa. They are Andhra Pradesh and Karnataka, both associated with India's high-tech boom, and both also receiving alot of money from Microsoft for investment and development projects. Andhra Pradesh has Hyderabad, a burgeoning high-tech city where Microsoft has a large presence, Karnataka has Bangalore, a more well-established high-tech mecca.

Between these two states, Gates Foundation pledged $34 million just last December, more than for South Africa in the last four years.

These numbers don't take into account several factors, such as that South Africa's government has been skeptical of the science behind AIDS vaccines, and has been reluctant to admit that HIV leads to AIDS. South Africa is also more modernized than most AIDS-devastated countries, and would be in a better position to deal with the problem. Also, South Africa benefits from the more general pledges the Gates Foundation has made to researching and fighting global AIDS. India benefits too from the general pledges, on top of the $200 million in direct pledges.

Botswana and Nigeria, two countries devastated by AIDS, have received large grants, but nothing comparing to India's.

So why is India receiving so much attention? Bill Gates and others claim that the AIDS epidemic in India has the potential to spiral out of control, perhaps even getting as bad as sub-Saharan Africa. That's why preemptive action is necessary. When Gates went to India in 2002, he took with him a report by the National Intelligence Council, which reports directly to the Director of Central Intelligence (CIA). The report identified India along with Russia and China as countries that pose international threats by spreading the AIDS epidemic. This makes the AIDS epidemic a US national security issue. The NIC report projected the number of people with HIV in India as being twice the number reported by the Indian government.

Many people weren't happy about that.

Purushottaman Mulloli, a human rights activist and spokesman for a group called Joint Action Council, said there appeared to be a clear link between Gates visit and the release of the CIA [sic] report with its exaggerated and unsubstantiated projections that suggested India would have between 20 and 25 million people with HIV by the end of the decade.

Mulloli and others, including India's Health Minister Shatrugan Sinha, viewed the projections as alarmist and accused Gates of spreading an unnecessary panic.

Gates was not perturbed however. It's no secret that his Gates Foundation operates in an aggressive, business-like fashion, and that it demands results from governments if they expect further funding. This is perhaps why South Africa has received little funding in comparison to its need.

Again, the Seattle PI: "The battleground is disease prevention, not treatment. The tactics are businesslike performance, not traditional charitable giving...In effect, the Microsoft co-founder has become the director of his own world health organization."

The Gates Foundation may use the business world as a model for its practices, but in India those practices may actually be good for business.

If the Gates Foundation gives $200 million for AIDS prevention and education, that's $200 million the Indian government doesn't have to pay with its own resources. In other words, they don't have to shift resources away from other things, such as the highly state-subsidized higher education program. They can continue the high level of funding for higher education, which turns out a huge number of highly skilled IT workers, who in turn will be paid 1/6 the amount of money they would get in the US, by corporations like Microsoft who are increasingly outsourcing their labor to India.

On a more sinister note, if those already HIV positive are not given adequate care, they will die off at a faster rate, thereby reducing both the number of people who need care, and the risk to the general population. There would be fewer AIDS patients, and the population would be less likely to contract the disease due to the many prevention programs. This would also free up money for the government for higher education, and also for big loans to multinationals who are interested in setting up shop in India.

Nobody is saying that that's the plan of either the Indian government or the Gates Foundation. It is just the actual reality of the situation.

useful links:

Bill Gates in India

India's high-tech bounty

Gates Global Health Vision (an ongoing series in the Seattle PI)


Bill Gates visit stirs up trouble:
India has cheap and excellent coders 29.Mar.2004 12:17


Gates want to be able to tap that resource to lower Microsoft's
R&D costs. And of course preventing the coders from being
targeted by murderous "AIDS-drugs".

another possiblity 29.Mar.2004 12:32


can't help but wonder what the implications will be for future intellectual property rights negotiations regarding both software and drugs, especially with a microsoft foot in the door/ financial dependence of politicos. Maybe i'm just being paranoid, though.

Correction 31.Mar.2004 11:09


It has come to my attention that in April 2003 Bill Gates pledged or donated $28 million to South Africa for an initiative to provide women with latex diaphragms, in order to reduce the spread of HIV/AIDS. This must not have been on the Gates Foundation website.

Add that to the $32 million for the Lovelife campaign and another $445,000, and that's $60 million, 445,000 in the last four years. It still pales in comparison to what's being done in India.