Leadership, however, is open to the Gates Foundation. It has unique power to move the debate, said Bauer, of Rockefeller Philanthropy Advisors. If Gates adopted mission-related investing, Bauer said in an interview, the shift in the world of philanthropy would be "seismic."
Life in 'Cancer Valley'
AT a clinic in Isipingo, a suburb of the South African port city of Durban where the HIV infection rate is as high as 40%, Thembeka Dube, 20, was getting a checkup.
Dube had volunteered for tests of a vaginal gel that researchers hope will be shown to protect against HIV. The tests are part of a study conducted by the New York-based Population Council, and funded by a $20-million grant from the Bill & Melinda Gates Foundation.
Dube's boyfriend won't use condoms. She hoped the tests would show she could use the microbicidal gel, called Carraguard, and stop worrying about AIDS.
Research into prophylactics such as Carraguard can fight AIDS by empowering women, Bill Gates told the International AIDS Conference in Toronto in August. "Whether the woman is a faithful married mother of small children, or a sex worker trying to scrape out a living in a slum " he said, "a woman should never need her partner's permission to save her own life."
Two days before Gates spoke, Kyrone Smith was born only a few kilometers from the Isipingo clinic. At the same time the Gates Foundation was trying to help Dube, it owned a stake in companies that appeared to be hurting Kyrone.
At six weeks, his lungs began to fail. Kyrone struggled to cry, but he was so weak that no sound came out — just husky, labored breaths.
His mother, Renee Smith, 26, rushed him to a hospital, where he was given oxygen. She feared it would be the first of many hospital visits. Smith knew from experience.
"My son Teiago was in and out of hospital since the age of 3," she said. "He couldn't breathe nicely . There are so many children in this area who have the same problems."
Two of the area's worst industrial polluters — a Mondi paper mill and a giant Sapref oil refinery — squat among the homes near Isipingo like sleepy grey dragons, exhaling chemical vapors day and night.
The Sapref plant, which has had two dozen significant spills, flares, pipeline ruptures and explosions since 1998, and the Mondi plant together pump thousands of tons of putrid-smelling chemicals into the air annually, according to their own monitoring.
In 2002, a study found that more than half of the children at a school in nearby Merebank suffered asthma — one of the highest rates in scientific literature. A second study, published last year, found serious respiratory problems throughout the region: More than half of children aged 2 to 5 had asthma, largely attributed to sulfur dioxide and other industrial pollutants. Much of it was produced by companies in which the Gates Foundation was invested.
Asthma was not the only danger. Isipingo is in what environmental activists call "Cancer Valley." Emissions of benzene, dioxins and other carcinogens were "among the highest levels found in any comparable location the world," said Stuart Batterman at the University of Michigan, a coauthor of both studies.
The Gates Foundation is a major shareholder in the companies that own both of the polluting plants. As of September, the foundation held $295 million worth of stock in BP, a co-owner of Sapref. As of 2005, it held $35 million worth of stock in Royal Dutch Shell, Sapref's other owner. The foundation also held a $39-million investment in Anglo American, which owns the Mondi paper mill.
The foundation has held large investments in all three companies since at least 2002. Since then, the worth of BP shares has shot up by about 83%, Royal Dutch Shell shares by 77% and Anglo American shares about 255%. Dividends have padded the foundation's assets by additional millions of dollars.
The foundation has gotten much more in financial gains from its investments in the polluters than it has given to the Durban microbicide study to fight AIDS.
Sapref said it had cut sulfur dioxide emissions by two-thirds since 1997 and spent more than $64 million over 11 years on environmental initiatives. It said lead in its gasoline and sulfur in its diesel fuel were reduced a year ago. Plant officials said: "Sapref does not accept any responsibility for any health issues in South Durban."