How does the Bill & Melinda Gates Foundation operate in India?
- The Gates Foundation operates as a branch office of a foreign organization, with the permission of the Reserve Bank of India (RBI) under the Foreign Exchange Management Act (FEMA). We are compliant with audit and disclosure procedures as mandated by the Government of India and the U.S. government, and our tax returns and consolidated financial statements are available on our website.
- The Foundation is a charitable trust under the laws of the State of Washington, USA, and a tax-exempt private foundation as described in section 501(c)(3) of the United States Internal Revenue Code.
What rules and regulations govern the operations of the foundation in India?
- The foundation is a charitable trust under the laws of the State of Washington, USA, and a tax-exempt private foundation as described in sections 501(c)(3) and 509(a) of the United States Internal Revenue Code.
- The foundation disburses its grants directly from its Seattle office. As a US-based organization, the foundation is not subject to the Foreign Contribution Regulation Act (FCRA) of 2010, administered by the Ministry of Home Affairs of the Government of India; however, it obtains confirmation that all of its Indian grant recipients have the relevant approvals under the FCRA prior to receiving any payments from the foundation.
- All grants made by the foundation are visible through its website.
- The foundation also operates a branch office in India, with the permission of the Reserve Bank of India (RBI), under the Foreign Exchange Management Act (FEMA) of 2017. This office does not disburse any grants on behalf of the foundation nor does it receive any grants from the foundation’s Seattle office. The approval it has under FEMA allows it to bring foreign exchange into the country for meeting its direct expenses.
- The Gates Foundation is compliant with audit and disclosure procedures mandated by the Government of India and the U.S. government, and its tax returns and consolidated financial statements are available on its website.
Is the foundation compliant with the Foreign Contribution Regulation Act (FCRA)?
- Indian NGOs that receive foreign funds from the foundation are regulated by the Ministry of Home Affairs under the Foreign Contribution Regulation Act (FCRA) of 2010.
- The foundation confirms that all Indian grant recipients have the necessary FCRA approvals before it disburses funds from its Seattle office to them.
- The Gates Foundation branch office in India does not receive foreign contributions subject to FCRA.
- Since the Foundation is a US-based organization and not an Indian grant recipient, as is the case with other non-Indian donors it is not regulated by the FCRA.
What is the foundation’s operating model in India?
- Our approach is based on strategically aligned partnerships with community leaders, government officials, civil society leaders, and advocates. At every stage, our work is informed by a broad group of experts inside and outside the foundation.
- Our work is aligned with the priorities of the Government of India, as well as those of state governments, including Bihar and Uttar Pradesh, and is guided by their laws and regulations.
How do you work with the government in India?
- Our work with central and state governments and government entities is based on shared priorities. Our engagements with them are based on and include consultations with senior officials, written requests, and where appropriate, different types of memoranda of cooperation and understanding.
- To support the government’s goals, we work with a variety of partners across academia and the private and public sectors, which allows us to draw on their unique knowledge and resources to provide access to services for India’s most vulnerable populations.
Why does the foundation work with the private sector? How does this advance health outcomes?
- The problems affecting the world’s poorest people are complex, and solving them requires the collaboration of governments, NGOs, academic institutions, and private companies. The private sector, in particular, has access to innovations – for example, in science, medicine, and technology – that can save and improve lives. We can enable and incentivize the private sector to take on issues they ordinarily wouldn’t.
- Through partnerships with private sector companies, the foundation is placing bold bets on breakthroughs that have real potential to benefit the world’s poorest.
- India’s health/biotech sector is very innovative. The industry’s robust R&D has the potential to deliver even more novel solutions for accelerating India’s health and development outcomes.
What criteria does the foundation use when selecting partners? How do you ensure that foundation investments are used responsibly?
- As a foundation, our process begins by identifying where we can have the greatest impact to improve the lives of those most in need. Once we commit to an area of need, we define our major goals and identify a clear path to achieving them. We seek partners based on their ability to help achieve shared goals.
- We apply a rigorous approach to funding our partners, monitoring and evaluating the effectiveness of the work. We require all grantees to adhere to applicable laws.
- Our grantees must commit to global access; that is, that the knowledge and information generated by foundation funding will be promptly and broadly disseminated and any resulting products will be made available and accessible at an affordable price to people most in need.
- We will continue to work wherever we believe we can have the greatest impact on improving the lives of the world’s poorest people.
What is the Bill and Melinda Gates Foundation Trust? How is the different from the foundation itself?
- The endowment that funds the Gates Foundation is managed independently by a separate entity, the Bill & Melinda Gates Foundation Trust.
- Foundation staff have no influence on Trust investment decisions, and no visibility into the trust’s investment strategies or holdings, other than what is publicly available via required public disclosures, such as the annual tax return (Form 990).
Why is the foundation particularly focused on health as a priority?
- The foundation’s work is driven by the belief that all lives have equal value. Disease and malnutrition are among the fundamental drivers of global inequities that keep people from reaching their fullest potential.
What are the nutrition programs that you bring to India?
- Addressing malnutrition is a top priority for the Gates Foundation in India. Too many Indian children suffer from the dire effects of both physical and cognitive stunting.
- The foundation’s nutrition program is aligned with the priorities of the Government of India, as well as those of the Bihar and Uttar Pradesh state governments. We support the government around the National Nutrition Mission rollout. We also collaborate with partners across India to address childhood stunting; under-nutrition in pregnant women; and anaemia in women and girls.
What are the key tenets of the foundation’s vaccines work?
Vaccines are among the best investments the world can make to give every child a healthy start in life and build stronger communities and economies.
- Vaccines are among the most cost-effective health tools ever invented – every $1 spent on childhood immunization returns up to $44 in economic and social benefits. (1)
- By preventing illness and the need for subsequent treatment, vaccines reduce the financial burden of disease.
- When countries invest in routine immunization, they lay the foundation for resilient health systems that can withstand disease outbreaks and other emerging threats to global health security, such as antimicrobial resistance.
Thanks to vaccines, the world has saved millions of lives and made impressive strides in combating disease.
- Since 1990, largely thanks to the power of vaccines, the world has reduced the number of child deaths by more than half. Today, vaccines are estimated to save 2-3 million lives every year. (2, 3)
- Over the past few decades, vaccines have been responsible for the eradication of smallpox and the dramatic reduction of diseases including polio, meningitis and measles – some by nearly 90% – despite global population growth. (4)
- More children than ever before are being reached with life-saving vaccines. (5)
- Since its inception in 2000, Gavi, the Vaccine Alliance, has helped developing countries to prevent more than 10 million future deaths through its support of 10 vaccines: pentavalent, pneumococcal, rotavirus, yellow fever, meningitis A, Japanese encephalitis, measles second dose, measles-rubella and rubella. (6)
Despite vaccines’ life-saving potential, too many children do not have access to them.
- Globally, one in seven children are excluded from the benefits of vaccines.
Does the foundation manufacture and sell vaccines?
- The Gates Foundation does not manufacture or sell vaccines.
- The foundation – along with other global health organizations and governments around the world – supports NGOs and pharmaceutical and biotech firms with grants to enable them to pursue the research and development of lower-cost, safer and more effective drugs and vaccines. These drugs and vaccines save millions of lives today, and with further innovation they have the potential to save millions more.
- The foundation’s partnerships with the private sector aims to incentivize research into vaccines for diseases such as TB, HIV and malaria, which account for high levels of child and adult mortality in the poorest communities.
Why does the foundation support / invest in the HPV vaccine?
- HPV is the primary cause of cervical cancer, which is the leading cancer killer of women in India. The World Health Organization, the International Federation of Gynaecology and Obstetrics, and the Federation of Obstetric and Gynaecological Societies of India have all recommended vaccination as a proven and highly effective preventive measure for cervical cancer. HPV vaccine has been administered safely around the world to more than 100 million people, preventing countless cases of cervical cancer, illness and death.
- Cervical cancer disproportionately affects the poorest, most vulnerable women because they have limited access to prevention methods.
- Two HPV types (16 and 18) cause 70% of cervical cancers and precancerous cervical lesions. Thankfully, these two HPV types can be prevented through immunization and early screening and treatment of precancerous conditions.
- Vaccinating and screening — individually and in combination -- are safe, effective prevention strategies that have been successfully adopted in many countries.
What is the foundation’s stance on sanitation?
- Diarrheal diseases are the most common cause of childhood illness and the second-leading infectious killer of children under five worldwide, with over 1,400 deaths every day.
- Around 90 percent of childhood deaths from diarrheal disease occur in South Asia and sub-Saharan Africa, where access to safe water, sanitation, and urgent medical care can be limited.
- Access to sanitation is a critical health intervention. We are committed to working with the Indian government, multilateral organizations, community-based organizations and the private sector to help with the successful implementation of a national urban sanitation program.
- These efforts include initiatives that expand the reach and effectiveness of safe and hygienic sanitation services.
What are the foundation’s overall sanitation goals in India?
- The goal of the foundation’s sanitation work in India is to support the development of new sanitation technologies and operating models; and markets and regulatory frameworks for the adoption and scale-up of products and services that safely manage and treat human excreta.
- The Gates Foundation believes that in order to realize the vision of a Swachh Bharat, a clean India, it is imperative to not only focus on toilet construction and usage, but also to take a broader view of fecal sludge management (FSM); that is to say, how waste is transported, cleaned and stored, in addition to how it is captured.
What is the foundation’s role in working with the government to further its financial inclusion agenda?
- The Gates Foundation is a partner to India’s government in building digital platforms for financial inclusion. We believe that such innovations will help the poor lead healthier, more productive, more equitable lives.
- We believe that poverty and gender inequality are deeply intertwined, and that economic empowerment programs, including financial inclusion, have huge spill-over effects. Our Gender Equality strategy is aimed at giving more women and girls the economic opportunities they need to act and engage as equals in society.
- We provide technical support to state and national governments to help establish public-sector digital payment platforms. Together we have launched a range of financial inclusion data collection efforts; product design experiments; and pro-poor communications efforts to advance the use of digital financial services.
You’ve recently announced a strategic investment on gender that sounds like more of the work you’re already doing. What’s new?
- While gender has always been at the heart of what the Gates Foundation has prioritized – for example, in our family planning, health, and nutrition programs -- this is our first explicit gender-focused strategy.
- It is intentionally focused on targeting barriers women face simply because of their gender, and it centers around women’s economic empowerment.
- The foundation is investing $170 million over four years to tackle these barriers and shape new economic opportunities for the poorest women, including in India.
- India is one of the four geographies that the investment prioritizes. The others are Kenya, Tanzania, and Uganda.
What is the focus of your agricultural development program?
- We support innovations that help poor farmers boost production for a wide assortment of crops that provide more nutritious food for their families and communities. We invest in projects across the agriculture sector that supply these farmers with the best and most appropriate tools to meet their needs.
- We support policies to ensure that agricultural products are safe, effective, and accessible to people living in the poorest parts of the world.
- We partner with the public sector, private companies, and NGOs, to make sure we hear and address the needs of small farmers, and we invest in crops that poor Indian farmers and families depend on, including rice, wheat, and legumes.
- We support science and technology to develop solutions that can increase farmers’ yields, help them feed their families, strengthen their local economy, and combat the effects of a changing climate.
What percent of your agricultural development investments in India include transgenic crops?
- None of our technologies/investments in India are in transgenic/genetically modified crops.
(1) Ozawa, Sachiko, et al. "Return On Investment From Childhood Immunization In Low-And Middle-Income Countries, 2011–20." Health Affairs 35.2 (2016): 199-207.
(2) UNICEF, Levels and Trends in Child Mortality: Report 2015, http://www.unicef.org/publications/files/Child_Mortality_Report_2015_Web_9_Sept_15.pdf. accessed 29 September 2016
(3) WHO, Immunization Coverage Factsheet, September 2016. http://www.who.int/gho/immunization/en/
(5) WHO, Immunization Coverage Factsheet, September 2016. http://www.who.int/mediacentre/factsheets/fs378/en/