The Gates Foundation: No Controversy or No Complicity?

By Rebecca Oas, Ph.D. | August 23, 2021

INTRODUCTION

At the London Summit on Family Planning in 2012, the Bill and Melinda Gates Foundation made family planning one of its signature issues, using the slogan “No Controversy” to insist that contraception should not be politically divisive, and should be seen as separate from the highly controversial issue of abortion. Almost a decade later, looking at the partnerships supported by the Gates Foundation and their near-unanimous support for abortion, this Definitions examines the distinction between the desire to avoid controversy and how the Gates Foundation might have operated if it were committed to avoiding complicity in abortion, as opposed to merely controversy.

Melinda Gates: “No Controversy” and the London Summit

The London Family Planning Summit was held on July 11, 2012, and was co-hosted by the Gates Foundation, the United Nations Population Fund (UNFPA), and the government of the United Kingdom, led by prime minister David Cameron.  Donors, including national governments and private foundations, pledged $2.6 billion to achieve an ambitious goal: “120 million women and girls in the developing world will be given access to contraception.”

In April 2012, Melinda Gates delivered a talk at a TEDxChange event in Berlin about birth control, “something that should be a totally uncontroversial topic” that had unfortunately become “incredibly controversial.”

“Some people think that when we talk about contraception, that it’s code for abortion,” Gates said, “which it’s not.”  She added that the controversy associated with population control was a “side issue,” and the focus should be on couples deciding when they want to have a child, nothing more.  “There’s a global movement waiting to happen, and ready to get behind this totally uncontroversial idea.”

In reality, there was already a global family planning movement, with decades of advocacy behind it, that was willing to welcome Gates’ billions of dollars and the media attention she was able to harness, but far less willing to alter its ideological commitments to suit her preferences.  A handful of longtime abortion advocates openly criticized her stated desire to separate family planning from abortion, including professor Malcolm Potts of the University of California at Berkeley and Marge Berer, founding editor of Reproductive Health Matters.  Berer expressed hope that Gates would reconsider her “prejudices against abortion” because “it would make her a far more credible ambassador for this cause, which after all does not belong to her.”  Potts pragmatically acknowledged that Gates “could not have established the leadership she showed at the London Family Planning Summit if she had not set the abortion controversy aside.”

Shortly before the summit, a group of 21 “U.S.-based global organizations focused on advancing women’s sexual and reproductive health and rights” sent a letter to Melinda Gates and David Cameron insisting that women’s reproductive rights include not just access to contraceptives but also “safe, legal abortion.”  They argued that family planning providers “should be equipped to provide quality safe abortion services” and called for “close integration of family planning and safe abortion services.”

Nonetheless, for the most part, family planning organizations welcomed the funding and attention that Gates directed their way, and while they may have seen her squeamishness about abortion as naïve or misguided, it wasn’t as if she was insisting that they share it.  To the extent that their work included abortion advocacy or provision, they could continue doing so while benefiting from Gates Foundation support for their family planning projects.

Meanwhile, the abortion controversy was never truly “set aside.”  Pro-life organizations immediately raised concerns regarding the groups likely to receive the funding pledged at the summit, pointing out that many of those in attendance “have a sordid association with abortion and population control.”

Partner organizations included the International Planned Parenthood Federation (IPPF), Marie Stopes International (MSI), Ipas, the International Women’s Health Coalition, Population Action International, Pathfinder, the Population Council, and other leading providers and proponents of abortion worldwide.

The Gates Foundation continued to emphasize the “No Controversy” message, using the slogan to promote a Twitter hashtag and the website www.no-controversy.com that argued, “Surely, there is no controversy in raising your voice for millions of women and girls who want access to lifesaving contraceptives.”

Who reads the fine print?

Setting aside, for the moment, the extremely controversial linkages to abortion and organizations linked to coercive population control measures, other aspects of the Gates Foundation’s new flagship family planning enterprise were inconsistent or misleading.  The “No Controversy” website referred repeatedly to “contraceptives,” rather than the broader “family planning,” which includes such non-contraceptive methods as fertility awareness, including the use of CycleBeads.  In her TED talk, Melinda Gates had clearly displayed a picture of CycleBeads alongside other methods when discussing the importance of offering a range of different methods to women in developing countries.  Moreover, she emphasized her Catholic faith (including a mention of a Jesuit priest relative), and while her promotion of contraception clearly contradicts the Church’s teaching, the Church has not forbidden the use of fertility-awareness-based methods for delaying pregnancy for serious reasons.  Given the fact that many of the women her initiative aims to reach are practicing Catholics, in addition to her own Catholic affiliation, it would seem important to emphasize the inclusion of non-contraceptive methods of family planning.

As of 2019, FP2020 included some non-contraceptive methods under their definition of “modern,” such as the Standard Days Method, which uses CycleBeads as a visual tool.  However, it is by no means a method promoted by the major partners of the Gates’ initiative. In fact, it is shunned and even derided, despite several studies proving its comparable effectiveness to contraceptives when both are used properly, as well as its lack of side effects. And in any case, the use of “contraceptive” interchangeably with “family planning” continues to blur important distinctions.

The Gates Foundation’s insistence that over 200 million women lack access to family planning is also problematic.  While that number of women were defined at the time as having an “unmet need” for family planning, meaning they were not currently using a modern method despite a stated desire to avoid or postpone pregnancy, fewer than ten percent of them cited lack of access as their reason for non-use.  The “unmet need” concept has been criticized as a misleading policy construct designed to create the impression of unsatisfied demand, while simultaneously raising funds to market contraceptives to women who have chosen not to use them.

The global partnership launched at the London Summit, known as Family Planning 2020, or FP2020, set a goal of “expand[ing] access to family planning information, services, and supplies to an additional 120 million women and girls in 69 of the world’s poorest countries by 2020.”  This was defined as adding 120 million new users, which was later restated as “additional users” compared with 2012 levels when technical questions arose regarding whether a woman who discontinued use of family planning and later resumed it could be regarded as a “new user.”  The technical accuracy of equating access to family planning with its use, especially in light of the evidence that lack of access was not a major driver of non-use, was not subjected to similar scrutiny.

Success or failure

By 2015, FP2020 was reporting that its progress toward achieving its goal was slower than projected, and sounding the alarm: “If we continue at this rate, we risk missing our goal,” and 2018 saw their targets “way off track.” The following year, with 2020 fast approaching, FP2020 announced that 53 million women and girls—well short of the goal of 120 million—were now using modern contraceptives.

In the report announcing this underwhelming result, FP2020 took pains to stress that its original goal was “extremely ambitious,” and its executive director told Devex that “sometimes the goal itself can mask the levels of progress that are underneath it.”  They also pointed to funding as a “key obstacle.” An important component of family planning expenditures outlined in the progress report is “demand creation campaigns,” which would seem to be unnecessary if the millions of women characterized as having an “unmet need” also had a stated desire for family planning and complained of a lack of access to it.  Furthermore, blaming FP2020’s failure to come close to meeting its goal on the excessive ambition of the goal sidesteps the fact that the goal was created by FP2020 in the first place. 

In the end, FP2020 claimed that they had achieved half of the original goal—60 million new family planning users—and claimed that “more women and girls have access to family planning than ever before.”  In the months since the final report was issued, FP2020 has been transitioning to a new chapter: FP2030, which will operate in more countries and emphasize greater inclusiveness, showcasing people who identify as LGBTQ+ and persons with disabilities.  Where FP2020 led with its numerical target, FP2030 has directed its messaging in a qualitative rather than quantitative direction, perhaps having learned from experience the perils of being overly ambitious in setting targets.

Contamination by controversy—and complicity in abortion

Attempting to work in the field of international family planning while avoiding the stigma and controversy associated with abortion is no simple feat, primarily because the dominant discourse within the global family planning movement strongly opposes any attempt to separate the two issues.  The same is true of maternal health, as Canada discovered when it launched its Muskoka Initiative on Maternal, Newborn and Child Health in 2010 at the G8 Summit and faced sharp criticism for not spending more on contraception—and refusing to fund abortion at all. Indeed, according to one reporter, “The week’s main announcement, a global Muskoka Initiative aimed at reducing mother and infant mortality in the world’s poorest countries, carried a $7.3-billion price tag but received little coverage in Canada except as an example of [Prime Minister] Harper’s refusal to include funding for abortions in developing countries.”

In large part due to its divisive nature, abortion advocates have long championed a strategy of claiming that when it comes to women’s health or maternal health, you can’t do anything without doing everything, including abortion.  Both the Gates Foundation and the Canadian government under its previous conservative leadership argued that by slicing off the most contentious part—abortion—you could generate a much larger coalition to achieve maternal health or family planning goals.  In a 2014 joint interview between then-Prime Minister Stephen Harper of Canada and Melinda Gates, Harper told the Globe and Mail that he wanted to build international consensus for “saving the lives of mothers and babies.”  Regarding abortion, he said, “it’s not only divisive in our country and in other donor countries, it’s extremely divisive in recipient countries where it’s often illegal.”

In a way, the pioneer of the “no controversy” approach to aid funding was United States Senator Jesse Helms, who in 1973 proposed the provision to the U.S. foreign aid appropriations law that blocked funding for the promotion or provision of abortion:

I want to make it clear that my amendment touches only abortion; it does not affect AID [the United States Agency for International Development] programs of family planning which prevent conception.  For example, AID is the world’s largest purchaser and distributor of present oral contraceptives.  This program would not be affected by my amendment.

However, Helms made clear that his purpose was not merely to avoid controversy, but to prevent the U.S. from becoming “the world’s largest exporter of death.”

To this day, the Helms Amendment has been strongly denounced by abortion advocacy groups, despite having remained attached to U.S. foreign assistance, along with other pro-life provisions, for decades.  Perhaps it is unsurprising that U.S. taxpayers would balk at funding the export of abortion—an issue on which they are deeply divided in domestic policy as well.  But if the U.S. was the original proponent of “no controversy” family planning, it has also, more recently, become a global leader in proposing what might be termed a “no complicity” approach, which goes the further step of denying funding to foreign-based organizations that promote or provide abortions overseas, even with funding from other sources.

The Mexico City Policy was first introduced by President Ronald Reagan in 1984, and was rescinded by Democratic presidents and reinstated by Republican presidents in subsequent administrations.  In 2017, newly-elected President Donald Trump renamed the policy “Protecting Life in Global Health Assistance” and expanded it to cover not only family planning funding, but all global health assistance.  While the policy only applies to recipients based overseas, a large percentage of those deemed ineligible for U.S. funding under the policy were affiliates of international abortion giants—and FP2020 partners—IPPF and MSI.  Since taking office in 2021, President Joe Biden has rescinded the Mexico City Policy.

Known by the company they keep

If the Helms Amendment, the maternal health project launched by Stephen Harper’s Canadian government, and the Gates Foundation’s family planning investment were focused on segregating funding to avoid directly doing harm, the Mexico City Policy went one step further by cutting funding from—and ending partnerships with—the doers of harm.

This more stringent approach reflects a reality that has only become more obvious in the past few decades: money is fungible, and an affiliate of IPPF or MSI will always promote abortion, even if the major sources of their funding are for projects not directly related to it.  Additionally, whatever goodwill donor governments or foundations have earned by helping communities overseas will reflect on the organizations they fund and partner with.

If the Gates Foundation’s commitment to “setting the abortion controversy aside,” as professor Potts put it, was more than a cosmetic concern, the expanded Mexico City Policy under President Trump might have seemed a welcome development.  Not so: in a 2017 interview with The Guardian, Bill and Melinda Gates expressed concern. “The US is the No 1 donor in the work that we do. Government aid can’t be replaced by philanthropy,” said Bill Gates. “When government leaves an area like that, it can’t be offset, there isn’t a real alternative. This expansion of this policy, depending on how it’s implemented, could create a void that even a foundation like ours can’t fill.”

The Guardian article warned of “funding from the world’s biggest donor to family planning and women’s health programmes in the developing world being slashed,” despite the fact that the expanded Mexico City Policy included no funding cuts, and new grantees would be sought where existing ones were ineligible due to their unwillingness to agree to the policy’s terms.  In contrast to Bill Gates’ fears, most of the foreign organizations receiving health funding from the U.S. accepted the terms of the policy.  According to the United States Agency for International Development (USAID), in most cases where the funding was declined, it was transferred to another organization able to carry out the same activities while complying with the policy.

Because of two court rulings in the 1980s, the Mexico City Policy only applies to foreign organizations and the foreign sub-grantees of U.S.-based organizations when it is in effect.  However, as a private entity, the Gates Foundation could, if it chose, apply a similar standard to all its grantees, foreign or domestic.  Instead, it has consistently given grants in the millions of dollars to IPPF, MSI, and other leading international abortion providers such as Ipas, Population Action International, Population Services International, and others.

Money Talks

To take a closer look at Gates grantmaking, the foundation makes some of its financial documents, including its IRS Form 990s, available on its website.  Between 2012 and 2019, the most recent year for which records are available as of this writing, about 1400 grants were awarded for family planning alone, or for a combination of activities that included family planning.  These awards went to approximately 200 grantees, and had a combined worth of over $3.5 billion.  The largest share of these funds, 82%, went to U.S.-based nonprofits, with smaller portions going to foreign-based nonprofits, for-profit companies both foreign and domestic, foreign governments, and UN agencies (see Figure 1) The awards are not subdivided with regard to whether they will focus on international or domestic family planning, but the fact that a grantee is based in the U.S. does not preclude it from working predominantly abroad, as many of those receiving money from the Gates Foundation do.
  

FIGURE 1

Of the funds including family planning awarded to U.S.-based nonprofits, approximately 31% went to universities, but the majority (56%) went to nongovernmental organizations (NGOs) that explicitly promote and/or provide abortion.  The remaining recipient organizations are not necessarily pro-life, and very few have taken a public stance on the issue at all (See Figure 2).

 


FIGURE 2

As mentioned above, the leaders of 21 U.S.-based NGOs sent a letter prior to the 2012 London Summit urging that abortion should be included in its family planning work.  Between 2012 and 2019, the Gates Foundation gave grants to 13 (62%) of those organizations or their subsidiaries, with a combined value approaching $1.5 billion.

The grants awarded to those 13 organizations were not only for family planning, but included other health categories such as HIV, pneumonia, malaria, vaccine delivery, and enteric and diarrheal diseases.  They also included nutrition, water, sanitation, hygiene, and the empowerment of women.

It is useful to once again consider the Mexico City Policy as a point of comparison.  Former president Trump’s decision to expand the policy to cover all of global health funding was in response to the fact that stridently pro-abortion organizations, such as those who sent the letter to Gates, are not only family planning providers.  Rather, the abortion issue has metastasized to all parts of global health, and beyond, leading to pro-life calls for the Mexico City Policy to be further expanded to cover more funding areas.  The data from the Gates tax returns serves as a clear illustration of this issue.

It is also useful to consider the fact that in its effort to make global family planning one of its signature issues, the Gates Foundation chose to award the lion’s share of its grants for this purpose to U.S.-based organizations that work overseas, rather than foreign-based NGOs.  The Gates grantees that would be subject to the Mexico City Policy if they received U.S. government funding make up a relatively small share of the total (see Figure 1, the parts colored yellow).  While the U.S. currently faces legal barriers to applying the Mexico City Policy to domestic NGOs, as a private entity, the Gates Foundation could apply a similar standard, if it chose to do so.  Furthermore, if the Gates Foundation adopted such a standard, it could remain stable over time, unlike the Mexico City Policy, which has become a “political football” that moves back and forth based on whether Democrats or Republicans control the White House.

Conclusion

In 2021, Bill and Melinda Gates announced they were getting divorced, a process which was finalized in August.  For at least the next two years, they intend to continue operating their foundation jointly, assuming they are able to work together effectively.  As the process of the divorce was ongoing, the foundation announced its commitment of $2.1 billion dollars for women’s and girls’ empowerment at the UN’s Generation Equality Forum, of which $1.4 billion would go to promoting family planning.

In being critical of the Gates Foundation for funding abortion-promoting organizations, if not directly funding abortion itself, it is important to remember that other deep-pocketed philanthropists, such as the Buffets and the Packards, have taken a blatant and unapologetic position in favor of promoting abortion around the world.  Despite their position’s deficiencies, the Gates’ unwillingness to go that far is not nothing.

Nevertheless, it remains true that the Gates Foundation has given billions of dollars to pro-abortion organizations. Even if that funding is earmarked for other purposes, many of them entirely uncontroversial, it enables those organizations to establish a greater foothold in different countries, enhances their credibility, allows them to hire more employees, and enables them to build connections to foreign governments and lobby them to liberalize their abortion laws.

In her 2019 book The Moment of Lift, Melinda Gates laments the way the abortion issue has “blocked a clear and focused conversation on contraceptives.”  She writes:

Instead of acknowledging the role of contraceptives in reducing abortion, some opponents of contraception conflate it with abortion. The simple appeal of letting women choose whether or when to have children is so threatening that opponents strain to make it about something else. And trying to make the contraceptive debate about abortion is very effective in sabotaging the conversation.

This interpretation seems intentionally misleading, or at best, uninformed.  Certainly, there remains debate over whether the mode of action of some contraceptives could be in fact abortifacient rather than contraceptive—that is, whether it prevents sperm-egg fusion (conception) or blocks the implantation in the uterus of an existing embryo.  These are important distinctions, but very different from conflating contraception with abortion in a general sense.  

To the extent that pro-life advocates are “making the contraceptive debate about abortion,” it is far more about the issue of partnerships and funding, the same debate as surrounds the Mexico City Policy, the Helms Amendment, and much of the political maneuvering that has resulted from both of them.  For Gates to be ignorant of this seems implausible.  Nevertheless, to engage with it directly would be highly inconvenient, given the billions of dollars the Gates Foundation has spent to lend support and credibility to organizations that promote abortion.

Abortion and contraception are both condemned by the Catholic Church, in which Melinda Gates continues to claim membership, and presumably finds to be a source of valuable teaching in other areas.  But Catholics and other pro-life advocates are perfectly capable of distinguishing between abortion and contraception, while at the same time acknowledging that to give funding to global abortion lobbyists and providers such as IPPF and MSI for any reason is to support them in all they do: in other words, complicity.

If the Gates Foundation has revealed an unfortunate tolerance for complicity, it has also shown a desire to sidestep controversy.  Therefore, it is all the more important for pro-life individuals and organizations to ensure that giving funding to abortion proponents, both at home and abroad, remains controversial.

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