Great Gifts of Health From U.S. Donors
For generations, deadly epidemics were a regular occurrence in America. The disease feared perhaps more than any other was yellow fever. Every few years, outbreaks would explode across seaboard regions, killing thousands at random. People were so frightened that a third or more of the residents of major cities like Philadelphia would flee to the countryside at the first hint of infection.
No one had any accurate idea what caused the fever. Not until 1900 did researchers understand that it was caused by a virus (the first human virus ever identified) and transmitted from person to person by mosquito bites. Even after that discovery, efforts to quench yellow fever foundered. Then, in 1915 the Rockefeller Foundation declared war on the illness — dangerous work that killed six of the foundation’s lead researchers over a period of years.
In 1931, Rockefeller Institute scientist Bruce Wilson volunteered to be injected with an experimental vaccine, and he developed immunity to the illness. In the first seven years the vaccine was available, the Rockefeller Foundation gave out 28 million doses. One of the world’s most frightening scourges was finally brought under control, and lead Rockefeller researcher Max Theiler was awarded the Nobel Prize in Medicine.
A second virus that terrorized Americans was polio. Each summer there would be alarms in various parts of the U.S. — complete with social distancing, quarantines, and families temporarily moving to rural areas. Right up to the 1960s, the illness ended lives without warning every year, and left hundreds of thousands of children and adults clamped into iron lung machines, wheelchairs, and permanent leg braces and crutches.
In response, millions of individuals made donations to the National Foundation for Infantile Paralysis (known as the March of Dimes because of its reliance on small gifts). By the mid-1950s the charity’s annual budget was almost $500 million in today’s dollars, and it provided 25 times more funding for polio research than the U.S. National Institutes of Health. Its money went to fellowships in virology, lab studies, support for stricken families, and public-information efforts.
Voluntary gifts eventually disabled the polio virus. It was a $35,000 grant from the Sarah Scaife Foundation that allowed Dr. Jonas Salk to equip a modern research laboratory. Scaife offered follow-up grants, and Salk also received support from small donors through the March of Dimes. In a few years the doctor created an experimental polio vaccine and immunized himself and his family with it. Thanks to rapid field trials paid for by the March of Dimes, the Salk vaccine was soon deemed safe. It went into production in 1955 and was widely administered around the world as the world’s first polio blocker.
By 2019 there were barely 100 polio cases anywhere on the globe, and a set of philanthropies were collaborating to drive the virus to final extinction: The Rotary International Foundation donated $2 billion collected from its 35,000 local chapters, and the Bill & Melinda Gates Foundation put up billions more. At the end of 2019, donors pledged an additional $2.6 billion with the aim of turning one of history’s most wounding viruses into a cold memory.
The epic triumphs over polio and yellow fever were part of a long philanthropic history. To avoid a repeat of the 1918 influenza pandemic that killed as many as 50 million people worldwide, donors funded investigations that opened the door to lifesaving flu vaccinations. When the AIDS virus started killing millions, the family of a New York real-estate developer created the Aaron Diamond AIDS Research Center, which developed anti-retroviral “cocktails” that eventually brought that epidemic under control, and stopped transmission of HIV from mothers to babies.
Philanthropic campaigns also put a crimp in tuberculosis. That malady accounted for 11% of all U.S. deaths in the early 20th century, sparking an army to fight back. A new National Association for the Study and Prevention of Tuberculosis collected coins from the public, and soon grew to command multimillion-dollar annual budgets. (It eventually became the American Lung Association.) This “people’s philanthropy” became a model for subsequent popular crusades against cancer, heart disease, and other ailments.
Boosts from the Rockefeller Foundation were crucial to discovering penicillin and learning to produce it in large quantities. That sparked miraculous progress in breaking the back of diphtheria, meningitis, rheumatic fever, pneumonia, syphilis, gonorrhea, and other communicable diseases.
Starting in the 1970s, philanthropists played essential roles in bringing modern medicine to people in poor countries, and launching new attacks on neglected tropical diseases. Private givers cut the malaria death rate in half, and prevented an estimated 13 million deaths among children by providing vaccinations in developing countries. Donors have several times played crucial roles in suppressing the horrifying Ebola virus.
In addition to battling specific afflictions, donors created much of America’s world-leading medical backbone. They created our first hospitals, and financed today’s unsurpassed facilities like the Mayo Clinic, Johns Hopkins, Cleveland Clinic, Sloan Kettering, New York-Presbyterian, Houston Methodist, M.D. Anderson, NYU-Langone, Sanford, Huntsman, and Cedars-Sinai.
It was philanthropists who founded America’s medical schools, modernized them against much resistance, and made them the best in the world by endowing professorships and labs. Our schools of public health were first created by John Rockefeller, and deepened by other donors like Michael Bloomberg and Gerald Chan. Philanthropists established landmark research institutes and top fellowships for star scientists. Generous benefactors drove the recent explosion of specialized hospitals for children.
Today’s vital mechanisms of trauma response, 911 calls, EMT training, ambulance and ER coordination were instigated by the Robert Wood Johnson Foundation in the 1970s. Electronic health records, patient surveys, protocols to prevent released patients from relapsing, hospice care at the end of life — these and many other innovations were initiated or hurried along by voluntary givers. The John Hartford Foundation brought lifesaving kidney dialysis and transplants to the public, and played a large role in building up the emerging field of geriatric medicine. The Carnegie Corporation saved hundreds of thousands of lives by speeding insulin-replacement therapy to patients. Uncas Whitaker poured more than $700 million into developing biomedical engineering as a thriving independent discipline, overcoming strong government and academic inertia to hasten modern miracles like joint replacement, laser surgery, lab-grown organs, and bionic limbs.
A vast portion of America’s infrastructure for battling cancer has been donor initiated. And today’s newest medical branches — including genomic medicine, systems biology, advanced brain and neurological institutes, modern mental-health research, and immunotherapy — are racing ahead thanks to charitable giving. Because it tends to be flexible, risk-tolerant, and offered without either the onerous red tape of government grants or the short time horizon of corporate research, medical charity continues to be extraordinarily important in medical innovation.
And now donors are attacking the new coronavirus. At the opening of the pandemic, an immediate surge of more than $11 billion in gifts was directed into medical research, tests of vaccines and therapeutics, reinforcement of health infrastructure, and various social and economic supports. One of the most dramatic philanthropic actions was the overnight pivot of the Gates foundation. Within weeks it had directed more than $355 million into new anti-COVID spending, and the foundation’s mobilization is even larger than that because so many existing projects and so much of its standing expertise have been retargeted at the coronavirus. “We’ve taken an organization that was focused on HIV and malaria and polio eradication and almost entirely shifted it to work on this,” explained Bill Gates at the end of April.
These Gates contributions put the lie to critics who caricature philanthropists as unqualified meddlers and rank amateurs. Just before the coronavirus contagion, Twitter sniper Dan Riffle argued it is “ludicrous” that some “guy who has expertise in software and taking maximum advantage of patent laws” would “be out there curing malaria.” Contrary to that barb, though, Bill Gates isn’t just a retired electronics peddler. He, like the best philanthropists throughout history, has made himself into a formidable authority on his philanthropic passions. He studied, gathered networks of experts, and used his rare engineering and organizational skills to become one of today’s most effective solvers of public-health problems. For years, Gates has been warning government authorities they were unprepared for a pandemic. It was public “experts” at agencies like the WHO and CDC who lacked understanding and failed to act promptly.
Our neighborly generosity in support of healing extends back hundreds of years, and continues to be a high priority for millions of our citizens. The collective effect of these gifts is vast. More than any other factor, it is philanthropy that has distinguished America in understanding threats to human health, and then fending them off.
This short preview of the lead feature article in the forthcoming Summer 2020 issue of Philanthropy magazine was published at RealClearPolitics on June 23.