The size of the Gates Foundation is only impressive if you believe public policy should be disproportionately influenced by the whims of a few rich individuals. Philanthropists may not be motivated by profit like lobbyists, but that doesn't mean they understand the needs of the people any better. For issues related to relatively concrete sciences like medicine this matters less. But in areas such as education for example, the role of the Gates foundation has been disastrous.
https://theintercept.com/2015/11/25/how-the-gates-foundation...