As the Gates Foundation's Budget Balloons, More U.S. Grantmaking Should Be On the Table

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The Bill & Melinda Gates Foundation announced its largest budget ever last week. It’ll spend $8.6 billion in 2024, a staggering sum that puts it well within striking distance of its goal to bump up its annual outlay to $9 billion by 2026.

The Gates Foundation is, of course, the most significant global health philanthropy by a long shot, with its influence in that arena rivaling and even surpassing that of major nations. Citing “stalling” contributions to health in the world’s lowest-income countries, the foundation continues to position its rising budget as a remedy. “We’re committed to spending down our endowment after our founders’ deaths because we’re focused on solving urgent problems now and helping set up systems that will outlive us,” wrote CEO Mark Suzman in the foundation’s latest annual letter.

While its global work predominates, Gates has also long devoted a fraction of its spend to education and economic opportunity in the United States. It’s a small fraction, but this is the Gates Foundation we’re talking about. In 2022, expenditures for Gates’ U.S. Program totaled $669 million

That alone gives Gates a prime place in what we’ve called the billionaire war on poverty in the U.S., alongside names like Bloomberg, Ballmer and Scott. To put Gates’ stateside funding in perspective, the Robert Wood Johnson Foundation’s total actual grantmaking in 2022 stood at roughly $610 million. The Ford Foundation’s total was $713 million.

But despite ongoing stateside commitments dwarfing what most other large U.S. funders bring to the table, Gates’ U.S. support has always felt like something of an afterthought. Indeed, as one page on the foundation’s website puts it, “Our work in the United States and Canada — research, innovation, policy and advocacy, and program investments in education, economic mobility, and global health and development — supports the foundation’s work across the globe.”

U.S. concerns will likely always play second fiddle at the world’s largest grantmaker, and maybe that’s how it should be. But that doesn’t mean the Gates Foundation shouldn’t consider ramping up and diversifying its funding in the United States, even as it sustains and grows its global portfolio.

It certainly doesn’t lack the resources. Nine billion dollars a year, after all, is just a starting point for the completely unprecedented level of grantmaking the foundation must undertake if it wants to spend down within 25 years. And even if the timeline ends up extending beyond that, Gates seems committed to the notion of sunsetting. Its newest annual letter, after all, heavily centers the late Chuck Feeney, still pretty much the only billionaire donor to succeed in fully spending down while alive.

Following an infusion of $20 billion from Bill Gates about a year ago, the foundation’s assets now top $67 billion. But if Bill intends to give away the bulk of his fortune through the foundation, as he has indicated, that’ll mean spending down something like $180 billion — which is still a conservative figure that doesn’t even account for what might pass to the foundation when Warren Buffett dies.

Last year, my colleague Michael Kavate ran the numbers for the $180 billion in 25 years scenario with the help of John Seitz of FoundationMark. They arrived at a figure not of $9 billion, but of $14.2 billion a year if the foundation wants to spend down within that timeframe. And again, that’s based on a relatively conservative starting point.

In other words, it should be more than possible for the Gates Foundation not only to continue growing its global funding by leaps and bounds, but also to level up the already sizable sum it’s devoting to U.S. work.

We’ve written at length about problems that have defied philanthropy and areas where philanthropy’s missing in action in the U.S., many of which are very much in sync with Gates’ institutional focus on public health. But to date, the foundation hasn’t committed significant resources toward most of these problems, even where what might seem a small investment to Gates could really change the state of the field. 

Consider the opioid crisis, an area where U.S. funders in general have very much failed to step up. There’s also obesity, mental health issues and suicide, gun violence and more — all of which impact the ability of lower-income Americans to get ahead and complicate their access to the kinds of educational and economic opportunities Gates has sought to back.

We haven’t always given Mike Bloomberg top marks when it comes to his U.S. philanthropy, but as one of Gates’ closest megadonor peers in terms of sheer dollars (if you can call Bloomberg Philanthropies’ $1.7 billion in 2022 “close” to Gates’ $7 billion!), Bloomberg hasn’t been shy about pairing domestic with global funding across a wide array of underfunded public health categories — among them guns, opioid overdoses, healthy food, road safety and more. Imagine what it would look like if the Gates Foundation moved just a portion of its far larger budget into some of those problems. 

If that alone isn’t sufficient reason, what about the capacity of such U.S. investments to inform the foundation’s wider global work? The problems ailing the U.S. are hardly specific to the U.S., and the maladies of the “developed” world are now being felt across a wider and wider portion of the planet. COVID showed just how little a country’s relative wealth can do to shield its citizens — marginalized people in particular — from at least some global health threats.

Institutional knowledge and the ability to foster it has been a big part of the Gates Foundation’s value proposition. And Bill Gates positions himself as all about anticipating and learning how to solve global health problems. With that in mind, isn’t some more diverse U.S. spending a worthy investment — if nothing else, as a way to learn lessons that Gates and others can one day apply more broadly?

Of course, the Gates Foundation has plenty of critics who’ll balk at the idea of a ramped-up U.S. portfolio. Gates’ U.S. education funding already has its share of naysayers, and calls have been mounting to hold the behemoth grantmaker accountable for what some characterize as “colonialist” practices abroad. 

You don’t need to believe the conspiracy theories to be leery of the influence wielded by this true heavyweight among grantmakers. And Gates isn’t alone — add all these existing and emergent megadonors together, and we’re looking at a vastly changed philanthropic landscape in which leading funders should absolutely be scrutinized, not least because the numbers involved are just so much bigger than they were 10, even five years ago. 

But in the end, the unprecedented project that is Gates philanthropy will go on. And more even than most megadonors, Gates is in a position to embrace a “both-and” giving philosophy. Under pressure to get ever more staggering sums out the door, why shouldn’t more causes closer to home be on the table?