What accountability means to Wellcome

Philanthropic foundations aren't answerable to taxpayers, shareholders or politicians. So what is their social value? For the past 18 months, we have been thinking about Wellcome's social value – and what it means for our purpose and mission.

Photography display in the windows of Wellcome's HQ in London
Wellcome's HQ in London, UK: the social value of philanthropic foundations like Wellcome is increasingly being called into question.
Credit: Thomas SG Farnetti / Wellcome

Those of us who work for philanthropic foundations often assume that our organisations do good. The funding we provide supports all manner of worthy causes. Wellcome has steered the development of the Ebola vaccine now saving lives in the Democratic Republic of Congo, and research that established today’s front-line malaria drugs. It’s easy to take our social value for granted.

Yet that social value is increasingly being called into question. A cluster of recent books from Rob Reich, Anand Giridharadas, Linsey McGoey and David Callahan has highlighted a challenge at the heart of philanthropy. The billions of dollars available to Gates, Rockefeller and Wellcome might be spent with benevolent intent, but they confer extensive power. A power without much accountability. 

Foundations aren’t answerable to shareholders, taxpayers or elected politicians. They don’t have customers or donors to please. They receive tax breaks and can have dominant influence in their fields. But if you object to the effects of that influence, there’s little you can do. You can’t vote their boards out. You can’t boycott their products. As Reich puts it: "This is something that fits uneasily, at best, in democratic societies that enshrine the value of political equality."

Over the past 18 months, Wellcome has been thinking deeply about this challenge, and about what it means for our purpose and mission.

Wellcome was established in 1936 in the will of Sir Henry Wellcome, the pharmaceutical pioneer who left his drug company to a charitable trust dedicated to advancing health, principally through supporting research. We sold the company two decades ago, and the endowment established with the proceeds has doubled to more than $30 billion (over £25 million) in the past 10 years. We spend about $1.2 billion each year on our mission – more than any of our peers, bar the Bill & Melinda Gates Foundation. 

As we’ve grown, we’ve become more active in taking on big health challenges of our time – drug-resistant infections and epidemics, mental health and climate change. As we’ve come to appreciate that our influence can be as important to achieving our mission as the research we fund, we’ve been asking ourselves big questions about our social licence to operate. 

  • What does it mean to be a charitable foundation?
  • In whose interests should we be trying to act?
  • To whom are we accountable, and how?
  • And what do we have to do to earn legitimacy?

We’ve elected to answer these questions through a statement of accountability, which we’re now applying to our decision-making. It states that "Wellcome is accountable to society, for delivering our mission, while using our independence for public benefit."

We expect it to help us to think more clearly about the right and wrong ways for us to contribute to society, with significant implications for the way we deliver our mission.

Wellcome is accountable to society

The first part of the statement clarifies to whom we consider ourselves accountable. As our mission is improving health on a global scale, we felt obliged to frame that extremely broadly. It would be too easy to consider ourselves accountable to the people we fund to do great research. We have responsibilities toward these important partners in our mission, but we don’t exist to serve their interests. Our true accountability is to our ultimate beneficiaries, which means the people whose health is improved by our work. We should have their interests in mind whenever we make decisions and be ready to give them an account of what we are doing and why.

An accountability this broad is difficult to exercise. We can’t give 7 billion people a direct say in our decisions. We think there are two things we can do instead.

First, we’re giving guidance to our board of governors and staff to think very deliberately about how our actions benefit society.

Second, we think we should be very open about the objectives we’ve set, why we’ve set them, how we’ve decided to pursue them, and how well we think we are doing.

To that end, we are soon to publish the first iteration of the Wellcome Success Framework [PDF 500KB], which will report on nine big ambitions, and our progress toward achieving them. We want this to be an invitation to constructive criticism and challenge. 

Wellcome is accountable for delivering its charitable mission

The second part of the statement is the most straightforward: We’re accountable for delivering our charitable mission. It should go without saying – but in any organisation, it’s worth reminding yourself constantly of what you’re in business to do.

At Wellcome, this matters particularly, because our mission – improving health – is so expansive. There are so many things we could do to deliver it that we couldn’t possibly do them all. We need to be clear with ourselves about which parts of the mission we will take on, and which we will leave to others. A strategy review is examining this right now. 

Wellcome is obliged to use its independence

This revised strategy will also draw heavily on the final part of the accountability statement, which is the most interesting and far-reaching. It challenges us to embrace the limited accountability of foundations not as a bug, but as a feature. We should feel obliged to make active use of the independence it affords us as a tool for creating public benefit. 

Why, we asked ourselves, does society intend there to be foundations? What value could there be in legislating the existence of bodies that lack democratic or market accountability? The only answer that made sense was that there’s advantage in having institutions that aren’t too beholden to shareholders, voters or customers. With less accountability comes the freedom to make choices that are harder for more accountable organisations to make. 

We’ve been given the independence to think long-term, to take risks, to venture into controversial or unfashionable territory. If we’re to have a legitimate social licence, we’re obliged to use it. We should be careful not to replicate what public funders, or business, or fundraising charities are doing already. We should look to the challenges these other actors can’t or won’t take on. 

Since completing our work, we’ve been encouraged that Rob Reich has developed a similar view of the social purpose of foundations. In his book Just Giving, Reich argues that foundations have two particularly valuable and legitimate functions. First, they should create diversity. In science, we do not know what funding approach will best generate the greatest social benefit; it’s thus valuable to have funders like Wellcome that can take a different approach to the US National Institutes of Health or the UK Medical Research Council. 

Reich also points to the special role that foundations can play in what he calls 'discovery' – investment in high-risk or long-term projects that test promising ideas too exploratory for public- or private-sector actors to justify taking on. If the concept checks out, another more accountable organisation could then take it to scale. Do what only you can do, is the argument – and know when it is time to stop and let others take over.

At Wellcome, we’re now using these sentiments in our decision-making. While it’s early days, the influence can already be seen in two new initiatives. We are putting £250 million into a new charitable entity called the Wellcome Leap Fund, which aims to accelerate discovery and innovation by funding explicitly high-risk projects with highly ambitious goals. We know that some of the projects it supports will fail – but we recognise and embrace that.

We’ve also embarked on a comprehensive review of the science that Wellcome supports. How can we best support research that works in the best interests of society? Which elements of our mission should we prioritize? How can we use our independence to create the most social value?

Wellcome might be the second-highest spending foundation, yet we can provide only a fraction of the resources needed to advance our founder’s vision of a healthier world. We must choose where we can make the biggest difference. Thinking actively about our purpose and accountability, and engaging with the challenges raised by philanthropy’s critics, will help us to do that.

This article was originally published on Inside Philanthropy

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