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The Market and the Social Sector

Review of Winners Take All by Anand Giridharadas

While public health is a discipline unto itself, more than that it convenes people from different disciplines to address public health problems. Embracing different sectors and approaches Is part of the logic of public health. “Winners Take All” reminds us that in some cases, we should do this with caution.

For a while, a lot of people were talking about getting “business thinking” into the social sector. For example, I think we can all remember when Melinda Gates famously questioned why Coca Cola could get their soft drink to every corner of the globe, while vaccine logistics was such a challenge.

This talk continues, and it’s still a proposition that we need to keep questioning, considering that business thinking created a lot of the world’s problems in the first place – including the epidemic of diseases such as diabetes and cardiovascular disease caused (in part) by Coca Cola’s global reach. What do I mean by business thinking? Creating short term profit.

I recently spoke once to an ex-McKinsey consultant who was working in health, asking “but didn’t your people create a lot of these problems?”. He didn’t miss a beat “yes, we created them and that’s why we understand them so well, now only we can solve them”. He was laughing, but still.

Nevertheless, business thinking has lept into the social sector– partly due to corporate types looking for a greater sense of purpose, and shifting their career focus. Sometimes business thinking comes into the social sector because business ‘titans’ are moving into philanthropy – often in an attempt to do some karmic laundry. In India, the companies law requirement that 2% of profits be donated to charity through corporate social responsibility efforts has also led to the active involvement of business-trained people into social problem-solving.

There is no doubt this has had many benefits. We can see our sector has many improved efficiencies – small NGOs know how to use Excel and create a budget thanks to groups like Dasra. We are much better at thinking about scale. We are definitely more innovative. Social enterprise has established itself as a more or less respectable business model thanks to organizations such as the Ashoka Foundation. But what are the costs?

Anand Giridharas’s book “Winners Take All” (just released in India, no known relationship to the ABBA song) explores the cost of business titans dodging paying tax and instead, giving their money away through corporate philanthropy. It means of course that they are not accountable to anyone in their charitable giving. More importantly, their charitable efforts typically focus on solutions that bolster the status-quo – ensuring the guillotine is kept at bay. Their solutions are positioned as “win-win” – making sure they never lose.

With such people positioning themselves as having all the answers, it’s unlikely that some of the most effective solutions – such as a sugar tax in the case of Coca Cola and non-communicable diseases – are even tabled.

He positions these CEOs-doing-philanthropy (a sector he called “MarketWorld”) as contrary to the democratic norms that govern our society – in terms of everyone having a voice, with checks and balances in place. Giridharadas suggests that we will never achieve social justice through “a system that perpetuates vast differences in privilege and then tasks the privileged with improving the system.” And of course, these billionaires are funded by us – through our work, our investments, their low taxes, our poor health care.

The arguments this book makes are not new or radical, but the scenarios he describes remind us to appreciate the biases and forces that shape the different players in our work context.

Thank you to Sanjeev Narrain, Christie Caldwell and Aastha Sharma for discussing ideas for this blogpost.

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