Al Truism

Earlier today my Facebook feed was filled with items about Bill Gates, stemming from this piece in the NY Times Magazine, about the plan to zero-out the Gates Foundation endowment in the next 20 years rather than to try and have the Gates Foundation operate in perpetuity. Most of the piece is an interview by David-Wallace Wells with Gates, to try and shed some light on Gates' perspective as to what the Foundation should be funding and why. 

Gates is very into problems of pubic health, particularly as they manifest in developing countries.  He talked a lot about Africa, mortality rates of children and their mothers while giving birth, and disease that should be imminently eradicated, certainly before the Gates Foundation goes out of business.  He also talked a lot about future technology, both for pharmaceuticals yet to be developed fully and for artificial intelligence, which might very well deliver medical care as well as serve as teachers of children, especially when the human alternative is in short supply.  I would call all of this forward looking.

(These days I prefer to read a sans-serif font, as it offers less clutter for my eyes.  But looking at the title of my post, one flaw with a sans-serif font is that the symbol for a lower case "L" is the same symbol as that for an upper case "I" and in some contexts, one might not be able to tell which was intended.  While I was going for a pun with my title, I wasn't looking for this ambiguity.  I meant the lower case "L" though the reader is free to make his or her own interpretation.)

But I wondered whether the interview missed on some points, particularly this one.  Given the U.S. government has cut its public health services internationally, for example PEPFAR and especially USAID funding of healthcare, should the Gates Foundation step in to partially fill the void?  It seemed implicitly as if the answer to that question is no, but the reason why that's the answer wasn't provided.  I would have liked to see this spelled out.  

A second question I have, one related to the first one, is whether some coordination across foundations is needed for filling the void.  With each foundation acting independently, and the others with smaller endowments than the Gates Foundation, they too can say no because the hole to fill is just too big for them.  Would that no longer be true if they acted in concert?  

Let me close on this note.  I'm comfortable financially but not wealthy.  I find similar dilemmas in my own charitable giving.  The bulk goes to the volunteer work I'm engaged in with Universal Love Alliance, but I also give locally to the public schools and the food bank.  Each has needs.  The approach I take to balancing them is completely ad hoc.  Can one do better than that?  I wish I knew.