A new group of Western development donors has emerged as increasingly influential actors in global social policy. Big philanthropies have begun implementing social protection projects on a vast scale across the Global South and have become integrated within global governance structures. It is essential to examine whether their approach to social policy in the South is effective, legitimate and desirable for the substantive agendas and programmes in these countries and for analysis of social policy in a development context. This study investigates contemporary big philanthropies through a qualitative case-study of the Bill and Melinda Gates Foundation and its role in the health sector in Tanzania. It examines the ways in which big philanthropies engage and seek to influence policy on the ground, directly exploring the views and experiences of local stakeholders. The study finds that big philanthropies have distinctive features and mechanisms as global social policy entrepreneurs. In contrast to the vertical and linear processes associated with traditional policy transfer, a more messy and complex set of mechanisms are observed. The study also indicates that despite considerable resources and authority, philanthropic donors may not be effective in securing policy reform within aid-receiving countries due to a lack of transparency and embeddedness.
