The Gates Foundation’s strategic relationship with Europe has involved both territorial and bureaucratic expansion over the past fifteen years, including in the United Kingdom, Germany, and France, which the Foundation describes as “highly engaged multilateral partners” [50]. This reflects the fact that they are major donors and partners with the Gates Foundation in initiatives like Gavi and The Global Fund, and also that they convene broader policy networks, diplomatic initiatives and innovation processes with which the Foundation seeks to engage.

The Foundation opened its first European office in the UK in 2010 to support its expanding activities in Europe, as well as the Middle East, and East Asia [51]. According to Joe Cerrell, who set up and still manages the London office, “We established the London office…because of the UK’s long-standing reputation and influence in international development” [52]. The Foundation also points to the UK’s role as an active partner and funder across most of the Foundation’s focus areas, its major role in global health and development, science and diplomacy [52], and that London regularly hosts “major global summits to secure political commitment and funding for urgent issues,” such as vaccine delivery, nutrition, family planning, and malaria control [51].

Following the UK’s vote to withdraw from the European Union, the Foundation opened a Berlin office in 2018, underscoring Germany's rising leadership in global health and the Foundation's longstanding collaboration with both the German Federal Government and civil society [53]. Like the UK, Germany was seen as an attractive partner due to its role as a major donor to international health and development programs (the second largest after the United States). The choice of Germany as a location also reflected Berlin’s emergence as a regional global health and development hub.Footnote 2 As former Gates Foundation CEO Sue Desmond-Helland explained at the Berlin office’s launch, “By establishing an office here, we hope to grow the Gates Foundation’s network across Germany and continental Europe” [53]. The Foundation also expected the new office to “allow us to tap into Germany’s thriving life sciences sector” [53].

Besides these two offices, the Gates Foundation maintains a network of representatives across the continent, who are either fully employed by the Foundation or working on a consultancy basis. This includes France, which the Foundation views France as strategically important because “it wields considerable influence over the global health and development priorities of the Group of 7 (G7) and Group of 20 (G20) nations and the European Union” [50], all actors the Foundation seeks to influence. Having a representative in Brussels is also important for engaging with the European Union, while a representative in Stockholm covers relations with the Nordic countries, which have been co-founders and among the largest donors of the Gates Foundation’s flagship initiatives, notably Gavi.

Organizationally, the “Europe team” and offices are part of the Foundation’s Global Policy and Advocacy division and are led by senior Foundation staff with high-level leadership experience from government and strategy consulting and training in political science or economics, according to their profiles on the website and on LinkedIn. London office manager Joe Cerrell has been with the Foundation since 2001, holding senior roles at the headquarters in Seattle, including as Director for Donor Government Relations and Director of Global Health Policy and Advocacy. He also set up Goalkeepers in 2017 and currently serves on the board of directors for the ONE Campaign and Global Citizen in Europe, which are both heavily supported by the Foundation. Before joining the Foundation, he served in a variety of senior roles in government and strategy consulting practices, including positions in the Clinton White House. Anja Langenbucher, who manages the Berlin office, has worked at the Foundation since 2011 and has previous experience from Boston Consulting Group (which works with the Foundation on many of its activities in Germany (e.g. [54]), and senior roles in the European Bank for Reconstruction and Development (EBRD), the IFC/World Bank, and the European Commission. Beatrice Nere, who heads the Gates Foundation’s Southern Europe, G7 & G20 relations from Paris, has worked at the Foundation since 2008, initially within the Global Health and Advocacy team in Seattle, and has experience as a Public Relations officer working on the implementation of EU legislation at the national level [55].

These executives lead Europe-based policy, advocacy and communications staff whose role is variously described as “building relationships with program partners,” “government relations,” “working to sustain European donor support for international development,” [56] “building donor support and mobilising resources” [57], and “fostering commitment to advancing global health and development goals” [53]. Specifically, the London office is described as working with “grantees and partners” to support a “constructive and well-informed political and public debate around the importance of the UK’s role in international development,” and to “advocate for the best use of the UK’s collective funding resources and its diplomatic influence in service of global health and development” [52]. Similarly, the Berlin office builds “strategic relationships with various stakeholders across Europe including governments, civil society institutions, and media” [53].

In the next section, we move beyond these broad self-descriptions and analyse what “government relations” means in practice.

The Gates Foundation’s European offices engage in a wide range of efforts aimed at developing and strengthening partnerships with the governments of France, Germany and the UK (as well as other key European countries and the EU), in some cases with the direct involvement of the Seattle headquarters. This is done through a range of activities including regular meetings between the Foundation’s staff and key government officials; the signing of Memoranda of Understanding (MoUs) to formalise areas of joint work; and appearances by Foundation staff (often by Bill Gates himself) at key global health and development summits, occasions which provide opportunities both for formal meetings and more informal engagements.

Foundation representatives hold regular high-level meetings with ministers and other key officials as well as routine lower-level interactions over a wide range of health and development issues. In the UK case, over four years (2020–2023), at least 37 meetings were held at Ministerial/Permanent Secretary level with Foundation representatives across four key ministries: The Foreign, Commonwealth and Development Office (FDCO) incorporating the former Department for International Development (DFID), the Department for Health and Social Care, Her Majesty's Treasury, and the Cabinet OfficeFootnote 3 (see Supplementary File 1 for full details). These included eight meetings with the incumbent Prime Minister and two with the Chancellor of the Exchequer. Most often, the Foundation met with Ministers at DFID/FCDO (20 of the 37 meetings). Yet these high-level meetings are clearly only the tip of the iceberg. In 2011, Jeff Raikes, then CEO of the Gates Foundation, told the House of Commons International Development Committee that “We have a good relationship with DFID. It is a regular relationship, with regular interaction. Many of our staff will be in contact as regularly as weekly” [58].

In France, Bill and Melinda Gates met with a succession of Presidents and Ministers of Foreign Affairs and Development, totalling at least 16 times between 2010 and 2023 (see Supplementary File 1). In addition, the French lobby register specifies that the Foundation targets the President’s advisers and government officials from three ministries: Health, Foreign Affairs and International Development, and Economy and Finance. The interactions include “informal discussion,” “regular correspondence,” “events, meetings or promotional activities”, and sharing “information and expertise with an advocacy objective” [59].

Foundation staff and German officials also regularly interact [60]. Although meeting records are not available for Germany, the Gates Foundation declared having spent €4.1 million in 2023 for the representation of its interests in Germany and accredited 26 staff from both its Berlin office and headquarters in Seattle to interact with German politicians [61]. It advised the government on its global health strategy, both by sitting on the Federal Ministry of Health's International Advisory Board on Global Health in 2018 [62] and contributing with Charité and Boston Consulting to a 2019 report on Germany's leadership in global health [54]. The Foundation also co-hosts events with the German government, such as the 2018 Grand Challenges meeting in Berlin [63] and the annual World Health Summit. In 2024, Bill Gates spoke alongside, German Chancellor Olaf Scholz, WHO’s Director General Tedros Adhanom Ghebreyesus, and others at the World Health Summit’s “signature event” which aimed to support WHO’s fundraising efforts [64].

Beyond its interactions with British, French and German officials, the Foundation conducted 98 meetings with European Commission members between 2015 and June 2024, averaging ten annually. These meetings aimed to engage the Commission on a wide range of issues including health, climate, and food security, among others [65]. The Gates Foundation has also formalised its partnerships with the European governments across a range of global health and development-related areas. In the UK, the Foundation signed a 2011 ‘Strategic Partnership’ on agricultural development [66], and a ‘Collaboration Framework’ with DFID for a ‘Strategic Research Partnership’ that set out a framework through which “the Parties intend to work together more strategically on issues of common interest, and to streamline their current working relationships” [67, p1]. These are in addition to a variety of other ongoing collaborations. The 2019–20 DFID Annual Report highlighted three specific partnerships with the Foundation during that year: on reducing the costs of next-generation mosquito nets, coordinating technical working groups for the Tokyo Nutrition for Growth Summit, and launching the Ed Tech Hub [68].

A MoU with Germany’s Federal Ministry for Economic Cooperation and Development in 2017 aimed to “strengthen…collaboration on multilateral and bilateral projects under the overarching objective of significantly reducing poverty and transforming the lives of those most in need” [53]. This was built on an earlier 2011 agreement in which the Foundation pledged to match the increase in Germany’s donation to Gavi [69]. Similarly, in 2016, the Foundation signed a MoU with AFD, the French development agency, “to work together on a range of issues and across a number of regions, including collaborating on maternal, newborn, child nutrition & health and water and sanitation in West Africa” [70]. This was followed by a 2023 agreement outlining a strategic partnership on gender equality and human development across Africa and South Asia (Ibid).

Finally, the Gates Foundation actively engages with European governments through its participation in global summits and high-level international political events, such as the World Economic Forum, the Munich Security Conference, the G7, and the G20. Notably, prior to the 2011 Cannes Summit, former French President Sarkozy asked Bill Gates to prepare a report on financing for development [71]. Despite being a private actor, the Gates Foundation frequently occupies a presence and is ‘in the room’ alongside state representatives at many key global events and has long been treated by others as akin to a government, particularly at high-profile conferences addressing international aid. As Laurie Lee, then Deputy Director of the Gates Foundation, said in giving evidence to the UK House of Commons International Development Committee in 2011:

We had staff at the meeting in Paris to discuss the Paris Declaration [on Aid Effectiveness] and at that time it was not suggested that foundations - us or others - would sign it. But we were there for the discussions. We also attended the conference in 2008 in Accra [Agenda for Action] and were part of those discussions. We will be sending staff to Busan [Partnership for effective development co-operation] this month, as well. So we are very much part of discussing this [58].

The previous sections examined how the Gates Foundation has developed a bureaucratic infrastructure and institutionalised its cooperation with governments in its European focus countries over the past fifteen years. In this section, we investigate how the Gates Foundation funds other societal actors within France, Germany, and the UK in ways that contribute to shaping national and international policy environments and public discourse.

From 1997Footnote 4 to 2024, British organisations received over $3.5 billion in funding from the Gates Foundation, positioning the UK as the second largest recipient of overseas funding from the foundation. This is surpassed only by Switzerland, where most of the funding is directed towards the numerous multilateral and global organisations headquartered there. Organizations based in France and Germany were awarded $627 million and $577 million in grants, respectively, ranking them as the 9th and 10th largest grant recipients outside of the US (Table 1. See also supplementary material 2).

A closer examination of the list of grantees in each of the three countries highlights the wide breadth of actors supported, but also the importance of the Foundation’s spending in specific sectors (Figs. 1 and 2).

Gates Foundation’s funding to different categories of recipients in the UK, France, and Germany (USD millions)

Share of the Gates Foundation’s support to different types of grantees in the UK, France and Germany

First, the Gates Foundation supports public agencies headquartered in these countries. Roughly a third of the Gates Foundation’s funding directed to France and Germany was channelled into their official Development Cooperation Agencies, making them the countries’ largest grantees. In the UK, FCDO (and formerly DFID) has not received direct funding from the Gates Foundation, although there is a significant amount of co-funding of projects between Gates and the British government. However, eleven other British public agencies, including museums, research councils, Public Health England, and the Medicines and Healthcare Products Regulatory Agency, have received over $62 million in Gates grants. Moreover, the Gates Foundation has channelled close to $700 million to multilateral organisations headquartered in France and the UK, notably to the UK-based global public–private partnerships Global Alliance for Livestock Veterinary Medicines ($189 million) and the Innovative Vector Control Consortium ($186 million) and the France-based CGIAR system organisation ($101 million), which works on agricultural innovation.

Second, the Gates Foundation has awarded large-scale grant funding to British and German innovation and research ecosystems, notably universities and research institutes. More than half of its funding to the UK ($1.9 billion) has gone to 63 British universities and research institutes. The three largest grantees, with close to $330 million each, are Imperial College London, the London School of Hygiene and Tropical Medicine, and the University of Oxford—all dominant institutions for research on global health and development. Overall, 24 British universities and research institutes have received grants totalling over $10 million. Six universities in Germany and one research institute in France have received grants of this magnitude. The Foundation has also directed some of its grants to commercial companies working on R&D and technological innovation, notably pharmaceutical and agricultural biotech companies. These grants represent a fifth of the Foundation’s funding to Germany, which is proportionally three times more than in the UK (7%) and France (6%). The largest recipients were funded to develop new diagnostics and to advance drug discovery. In addition to grants, the Foundation makes “strategic investments” in companies and other organizations “to create incentives to harness the power of private enterprise to create change for those who need it most,” which we have not analysed here [10].

Finally, the Gates Foundation has allocated over $1.16 billion to organisations based in France, Germany, and the UK working on, or promoting, development issues broadly defined. In this category, the UK stands out due to the scale of funding ($878 million) and its distribution across 159 recipients. Notably, the non-government organizations (NGOs) MSI Reproductive Choice, Save the Children, BBC Media Action and Sightsavers have received more than $50 million each, and nine other NGOs have received more than $10 million each. Some of the largest recipients are highly professionalised and international NGOs, including some who act as advocates on behalf of Gates-funded initiatives [39]. In addition, media outlets such as The Guardian and the BBC, major British policy think tanks and private research institutes working on development issues have also received substantial grants. This includes ODI ($35 million); the International Institute for Environment and Development ($33 million); the Tony Blair Institute for Global Change ($27 million); CGD Europe ($24 million); the Institute of Development Studies ($16 million); ITAD ($7 million); and Chatham House ($3 million).

A significant portion of the grants allocated to organizations focused on development issues falls under the “advocacy and policy” category as designated by the Gates Foundation. We conducted an in-depth analysis of 261 such grants allocated to its three European focus countries between 2007 and 2024 totalling over $400 million, of which the UK received the majority ($267 million), significantly surpassing Germany and France, which received $81 million and France $33 million, respectively.

The Gates Foundation began systematically investing in policy and advocacy support in the UK shortly after establishing its London office in 2010, notably by tripling its advocacy grant funding in 2012. This level of support has been maintained consistently since then. In Germany, the Gates Foundation significantly increased its advocacy grants in 2011, coinciding with the signing of its first MoU with German authorities. New commitments for advocacy support rose from $7 million in 2011 to $10 million in 2013, and to $15.5 million in 2016. A year later, a new, revised MoU was signed. French organisations did not receive substantial resources for policy and advocacy until 2018 but has since then received several grants totalling more than $24 million.

The Gates Foundation appears to support one main local NGO partner in each country through advocacy and policy grants that are both larger and longer (up to four years) than average. In the UK, this is Save the Children, which has received $59 million since 2011 to support its advocacy efforts. Save the Children employs over 140 staff in its policy and advocacy division and received $3.2 million from Gates in 2021 and 2022, corresponding to roughly one third of the division’s budget [72, p34]. In Germany, the main recipient of advocacy and policy grants is Deutsche Stiftung Weltbevoelkerung (DSW, the German Foundation for World Population), an international nonprofit foundation that supports sexual and reproductive rights and population dynamics. DSW has received a total of $46 million (between $2.4 and $3.4 million annually) for policy and advocacy since 2009. In 2021, the Gates Foundation provided more than a quarter of DSW’s total annual budget [73, p37]. Moreover, the director of the Gates Foundation’s Berlin office, Anja Langenbucher, sits on DSW’s board of trustees [73, p38]. In France, Focus 2030 is the main recipient of advocacy and policy grants. Focus 2030 was launched in 2017 as a non-profit organisation promoting the achievement of the UN’s Sustainable Development Goals by 2030, with a $833,000 Gates grant for its first four months of operation. Since 2018, Focus 2030 has received at least $1 million per year for its policy and advocacy efforts, which corresponds to more than 90% of its total annual budget [74, p30].

Although the Gates Foundation appears to have selected one main advocacy partner in each of its European focus countries, its advocacy and policy grants have been allocated to a wide range of recipients — 114 individual organisations — including NGOs, policy think tanks, media outlets, consulting groups, PR companies and universities. The largest media companies that have benefitted from a combined total of $35 million of Gates Funding for reporting on development and global health issues are The Guardian ($12 million between 2011–2023), followed by Le Monde ($6 million), The Daily Telegraph ($5.8 million) and Der Spiegel ($5.5 million), while the BBC, The Bureau of Investigative Journalism, The Financial Times, and The Economist have also received advocacy and policy grants. Numerous policy think tanks, consultancies and universities obtained policy and advocacy grants to bring together key stakeholders and organise events or develop reports and data that can be used for advocacy and set the agendas of major events.

The purpose of most of the policy and advocacy grants is formulated in broad terms, such as “to increase support for official development assistance” or “raise awareness for global health and development issues” among policymakers, media, civil society, and the general public. However, some grants are also formulated in more specific terms. ODI, for instance, received two grants worth a total of $12 million “to generate compelling and well substantiated development success stories” and “identify untold stories of sustained, macro-level development progress”.Footnote 5 Some grants were also earmarked to support a specific policy agenda, such as “to advance the innovative development finance agenda”,Footnote 6 “develop case studies on digital public finance”Footnote 7 or “inform discussion around calls for a data revolution”.Footnote 8 In some cases, the grants funded advocacy and policy linked to particular policy events, notably the World Health Summit in Berlin, the Paris Peace Forum, and the Munich Security Conference; the replenishment campaigns of the Global Fund, Gavi and the Global Financing Facility; or explicitly aimed to shape the agenda of international summits such as the G7 or G20 (see Supplementary material 2).

Although some of the activities and grants we identified can be described as political advocacy or lobbying, they comply with the Foundation’s guidelines and US law on lobbying. Private foundations registered in the US are prevented by law from lobbying the US government on specific legislation. However, there are many exceptions to this. According to the Gates Foundation own guidelines on lobbying, these exceptions include: 1) Written technical advice or assistance in response to a written invitation, 2) Nonpartisan analysis, study or research; 3) Issue advocacy addressing broad concerns; 4) Specific legislative proposals regarding matters related to jointly-funded programs (such as global partnerships); and 5) Specific legislative proposals that impact the powers, duties or tax-exempt status of the foundation (‘self-defence’ clause) [75].