Thrilled to see @TheLancet publish our viewpoint “Global health partnerships for a post-2030 agenda”, co-written with @DrSophieHarman, @SimonRushton8 & @KStoreng . A thread 🧵

Our study is just a first step – more research is needed to investigate how the Foundation interacts with other donors (e.g. Gulf States, Singapore); better understand partners’ perspectives through in-depth research; how other private foundations seek to influence policy; etc.

d) If everyone becomes a partner of the Foundation, who remains to hold the Gates Foundation accountable?.

c) How can we ensure that policy alternatives may also emerge – including some that might challenge the “Gates approach” to global health and development – if everyone is aligned with the Gates Foundation?.

b) Is it appropriate for a foreign private actor to develop close diplomatic ties with governments, while in parallel, working with and funding other stakeholders to influence policy? Do we have regulations in place to ensure that interactions are transparent and accountable?.

a) The Gates Foundation’s network diplomacy gives it influence over public policy. Its links with and funding to a wide range of actors in the global health ecosystem represents a remarkable concentration of power in the hands of a private actor.

The concept of network diplomacy helps to make sense of the Gates Foundation’s direct and indirect engagement with European donor countries by highlighting its capacity to leverage its networks to advance its own policy objectives. 🙋❓Why does it matter?.

5. The Gates Foundation has some favorite European advocacy partners. Save the Children (UK), DSW (Germany) and Focus 2030 (France) get larger, longer and more frequent advocacy and policy grants than other NGOs.

4. The Gates Foundation funds actors across the entire global health and development ecosystem. Between 2007-2024, it awarded $400 million in policy and advocacy grants to a wide range of NGOs, think tanks, research institutes, universities and media organizations in 🇬🇧🇩🇪🇫🇷.

3. Foundation staff also frequently interact with bureaucrats. European governments also signed Memoranda of Understanding with the Gates Foundation formalizing cooperation by highlighting key areas of common interest.

2. The Foundation has developed close ties with European political leaders, including through many high-level meetings in the UK, Germany and France and with the European Commission (up to 10 annually). Bill Gates has met with every French president during the past 25 years.

1. The Gates Foundation set up an international bureaucracy to manage its relations with governments and multilateral organizations, including regional offices in London and Berlin. These resemble embassies and report to a “global policy & advocacy division” in the Seattle HQ.

We analyze how the Gates Foundation strategically works to align European donor countries with its global health and development priorities. Our key findings in this thread 🧵.

🚨 New paper 📑 “The Gates Foundation’s network diplomacy in European donor countries”, co-written with @KStoreng & @SimonRushton8 . 🔓

RT @DevTodayJournal: .@Gavi's dwindling path to $9b replenishment:.3 govts + Gates account for 65% of $30b in resources since 2000. US and….

Interested in the role of mega-philanthropic foundations & private actors in global health governance? . Come work with me, @KStoreng & team at @sum_uio, University of Oslo!. PhD position: Postdoc position: Deadline April 23.

g) In terms of market-shaping, will Gavi have more leeway to re-orient its purchase away from big US pharmaceutical companies? (We saw US pressures during covid to buy US).

f) In terms of governance, will the US loose its seat on the board – and how will this impact the different constituencies represented?.

e) Other questions include: Will the US also cut its support to the Global Polio Eradication Initiative? If so, Gavi might have to further cut (it budgeted 671 million for polio vaccines during the period 2026-2030).

d) The malaria vaccine is particularly interesting, because Gavi and the Global Fund planned to cooperate on its roll out. *If* the Global Fund retain US support but not Gavi, this might change the power-balance between the two organizations.

3) Go ahead in expanding its vaccine portfolio (cf Malaria vaccine), or re-focus on fewer, key vaccines?.