Hold the Malaria Nets: Bloomberg’s Contrarian Vision for Global Health Funding

Smoking kills six times as many people worldwide as HIV/AIDS

The title of this post is misleading. It’s not that Michael Bloomberg—who is worth $48 billion and gave away over $600 million last year—wants global health philanthropists to abandon the fight against malaria, which kills nearly a half-million people annually and debilitates millions more. Rather, it’s that Bloomberg wants donors and governments to fixate less on a handful of notorious communicable diseases—a benefit concert list that also includes HIV/AIDS, polio and tuberculosis—and focus more on the biggest killers that stalk humanity.

That’s the dominant message of his annual letter for Bloomberg Philanthropies, released today. He writes: “For the first time in human history, more people around the world are dying from noncommunicable diseases, like heart disease and cancer, than communicable ones, like malaria and polio.” Every year, these NCDs kill some 40 million people—deaths that Bloomberg says are often premature and can be prevented through such efforts as reducing smoking and cutting obesity. Likewise, he says, the worldwide death toll from another major killer, traffic accidents—which claim 1.3 million lives annually—could be lowered by common sense policies.

Strangely, though, many global health funders aren’t much interested in going after this low-hanging fruit, even as poorer countries suffer the most from NCDs. Bloomberg writes that “despite making up 67 percent of deaths in these countries, only 1 percent of global health funding is aimed at preventing noncommunicable diseases.”

How can funding be so skewed? The temptation here might be to blame Bono and other celebrity figures, including Bill Clinton, who’ve turned a suite of dread diseases into fashionable causes among the global elite—ignoring bigger threats. Bloomberg doesn’t do that. Instead, he says that a “casual acceptance of NCDs” has led “society to tolerate them at tragically high levels.” A lack of awareness is one reason for this acceptance. Most people don’t know, for example, that smoking causes six times as many premature deaths globally every year as HIV/AIDS. (The annual toll from smoking, by the way, is projected to rise to 8 million deaths by 2030.)

Another reason people tolerate so many preventable deaths, Bloomberg says, it that we “tend to blame the victims’ personal negligence or genetics.” We also tend to see these deaths as an inevitable part of the human story.

And this is where Bloomberg takes a strong stand, offering up a counter-narrative on global health. He writes: "None of us can escape death, but it’s time to change our view of it. Most of us can live longer, healthier lives if we take simple steps and demand that our governments adopt basic, and often inexpensive, protections."

Again, it’s not that Bloomberg wants to pull the plug on funding for groups like Against Malaria. He thinks it’s great that the world has made progress in such areas and believes we can afford to keep up this work. That said, he wants to see a fundamental reordering of priorities among global health funders. “We must go where the data leads us—and it leads directly to noncommunicable diseases and injuries.”

This week, Bloomberg is blitzing the media with his message, hoping to draw attention to NCDs and other “overlooked killers.” He’s also accepted an invitation from the World Health Organization to become its first Global Ambassador for Noncommunicable Diseases.

Of course, none of this will be new or surprising to readers of Inside Philanthropy. We’ve extensively covered Bloomberg’s no-nonsense global health giving in recent years, including how he’s now given nearly $1 billion to reduce tobacco deaths and over $250 million to curb traffic fatalities. These efforts have already saved many lives. And if Bloomberg can achieve his biggest goal—bending the future mortality curve on tobacco-related deaths—he could save many millions more through his giving.

More than any other donor we follow, Michael Bloomberg embodies the promise of today’s big philanthropy. He’s driven by a compassionate vision, but also by data and results.

Better yet, he couldn’t seem to care less about what’s fashionable in the glitzier precincts of global philanthropy.

Will other top philanthropists learn to be like Mike? Let’s hope so.