Gates Avoids Answering Questions About Philanthropy's Role in Abortions

Dr. Shani Horowitz-Rozen
4 min readAug 9, 2022


The reversal on abortions brings a new challenge to philanthropists who focus on health and social justice

Photo by Gayatri Malhotra on Unsplash

The reversal on abortions brings a new challenge to philanthropists who focus on health and social justice, like Bill Gates. Philanthropists, who strive to make society better, are faced with a moral question: What is their role as leaders in the social world when a new situation arises that worsens people's lives? Such is the reversal of abortions and the war in Ukraine. The answer for Gates, as a global leader, is clear. He should address the meaning of these situations to people's lives and well-being.

The reversal of abortion rights is and should be seen by elite philanthropists as a worsening health problem close to home. The daunting medical data is accumulating already. Almost overnight, doctors have become hesitant or even forbidden to initiate life-saving procedures, leading to more deadly infections and pain, trapping families in a limbo of grief and helplessness.

According to the World Health Organization, 23,000 women die from unsafe abortions each year, and tens of thousands more experience significant health complications. According to a recent study, banning abortion would increase the number of pregnancy-related deaths in the U.S. by 21% (33% among Black women). Increased deaths due to unsafe abortions or attempted abortions would be in addition to these estimates.

Gates frames the reversal on abortions under political divisiveness

Bill Gates recently announced that he would donate $20 billion to the charitable foundation he and his ex-wife Melinda French Gates run, to boost its annual distributions. Gates also explained that he plans to give virtually all of his wealth to the foundation, eventually moving off the list of the world's wealthiest people. This is an astronomical amount of money, and Gates has an immense part in saving lives and changing the world's health. At the same time, this is a necessary ramp-up message that aims to revive the narrative of philanthropy that Gates wishes to project.

In his article, Gates addressed the reversal on abortions within his paragraph on the political polarization in the U.S. He writes that the reversal is a massive setback for gender equality. This is not surprising because the supporters of the reversal generally are not looking to create gender equality. His choice to include his comments on abortions under the political paragraph frames the topic as a mere political matter and not as the moral, health, and human rights issue that it is.

Gates talks about facts: what kinds of medication are developed and distributed, along with decreasing death and disease rates. These are all admirable aspects of Gates' contribution. Gates also warns that the decision to revoke Roe v. Wade will harm women's health. Since this is already happening, Gates should also mention facts and numbers about abortions and discuss how to solve complications arising from lack of access to unsafe abortions.

It is not surprising that The Bill & Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health called abortion restrictions "a grave threat to public health, gender equality, and human rights." Similarly, Gates called the reversal of abortion rights in the U.S. a huge setback for gender equality, women's health, and overall human progress. He warns that the reversal will put lives at risk for women, people of color, and anyone living on the margins.

If Gates indeed believes that this is a setback for gender equality, the public will benefit from his explanations why. Using his voice and public image to promote understanding of what this reversal means would be an invaluable service for women and the public discourse. By doing that, he would be able to acknowledge the problem, address possible solutions, and steer the public discourse.

What should a philanthropist do when a new health problem arises?

Philanthropy's role in a democracy is complicated. The ability of donors to invest in think tanks and affect public opinion is a long-time debate. Yet affluent, conservative donors have been doing this for years. Whether we agree with it or not, wealthy people have the power to shape the political climate.

The central question that the public needs to ask, and philanthropists should answer, is when donors like Gates and Warren Buffett will act to prevent new moral, social, and health problems that contradict their worldviews and commit the charitable funds to solve them. Will either Gates or Buffett be among the first major donors to steer the political discussion about abortions?

It is time for Gates and other leading philanthropists to consider their moral red-lines and plan ahead. Similar to other negotiation situations, we should ask what will be the issue that will drive donors to act. Will it be the threats of rolling back gay rights, access to contraception, and even interracial marriage? Philanthropy must respond to these new problems the political division is creating that turn into critical moral, health, economic, and social problems.

Gates must stand up to rising threats to women and children, support abortion accessibility and pro-choice advocacy, and protect doctors in the same way he works towards eradicating diseases, fighting global warming, and saving lives. Otherwise, what value does philanthropy bring when avoiding problems that will challenge its donors?

Bill Gates and Melinda French Gates have created an invaluable positive change in the world. Their work has saved millions of lives and made the world a much better place. As their foundation focuses on health issues, they must address the reversal of abortions as such. As the U.S. Supreme Court decision worsens women's health and social welfare, they must address this issue with their entire public persona, highlight the implications of the reversal, and how the foundation will address it. Women's health is being directly targeted, and elite philanthropists, who have gained an extraordinary public status, must adjust their worldview and answer to the public.



Dr. Shani Horowitz-Rozen

Helping companies and executives tell their stories and focus their messages. Framing is everything