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On 25 September, Indian Prime Minister Narendra Modi was felicitated with the Global Goalkeeper Award by the Bill and Melinda Gates Foundation (BMGF). On the surface, it was recognition for the PM’s Swacch Bharat Abhiyan scheme—a programme that sought to eliminate the practice of open defecation. But there was a lot more riding on this award. It was the culmination of a years-long effort to make an ally of a man seen as critical to BMGF’s continued success in the region.

Instituted by BMGF in 2017, the Global Goals Awards are meant to recognise champions of United Nation General Assembly’s sustainable development goals (SDGs). Enshrined in 2015, these serve as a blueprint for a sustainable future without poverty, hunger and preventable child deaths. For Seattle-based BMGF, which has worked towards preventing child mortality since its inception in 2000, the SDGs are something of a north star.

This sort of focus made India a key proving ground for the Foundation. In fact, with the country accounting for just under 1 million child deaths a year—a fifth of the global child mortality burden—BMGF set up an office in India in 2003, just a few years after the charity’s conception. 

Since entering India, BMGF has also learned of three situations unique to the country. First, unlike countries in, say, Africa, where the Foundation is particularly active, the Indian government can afford to provide a decent standard of public health but doesn’t. For a developing country with a growing GDP, India is one of the lowest per capita spenders on health—with only around 1% of GDP spent on healthcare compared to the global average of 6%.

Big spender

With $47.9 billion in assets, BMGF spends about $5 billion annually across the developed and developing world. It is also the single largest donor to the World Health Organisation

Second, India’s massive population blunts the impact of direct grants. Although BMGF spent more on India—$282.5 million—in 2017 as compared to any other country, the per person spending came to 21 cents (Rs 15). In Uganda, where it spent only $34.9 million, the per person spending was closer to 85 cents (Rs 59).

Lastly, it has understood that it can’t just foster innovation, affordability and access. It needs the Indian government to adopt whatever it sets in motion and take things forward.

All of this made it clear to the Foundation that there was only so far it could go without having the Indian government decidedly onside. So, for the first iteration of the Global Goals Awards, the leadership of BMGF was sold on the idea of Narendra Modi being one of its inaugural awardees.


Ruhi Kandhari

Ruhi writes on the impact of healthcare policies, trends in the healthcare sector and developments on the implementation of Electronic Health Records in India. She has an M. Sc. in Development Studies from the London School of Economics.

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