Disfunction comes from the very top, and creates a lot of fear, toxicity, inefficiencies, and wasted resources. Although large in staff size and endowment, Gates is a family foundation with active benefactors and has never (successfully) reckoned with the fact that family values, perspectives, and ways of engaging with staff might be fundamentally at odds with the "data-driven, impact-oriented, feminist (ha!)" institution that BMGF spins itself as. The generosity of the Gates Family is (obviously) worthy of celebration and respect, but they often treat their staff with disrespect and create a culture where fear of being wrong (or, gasp, just acknowledging we don't have all the answers) gets in the way of any genuine learning, sharing, and progress.
There is also a culture of constant complaining and negativity that gets old immediately. The lack of humility (and, to be frank, connection to reality) is truly astounding; it's an institution and culture that celebrates and seems to incentivize grandstanding amongst all levels of staff.
I had a decent boss, autonomy with my work, and loved making grants, but the culture and leadership was uninspiring on the best days and painful the rest of the time. I've worked at a variety of academic, public, and private institutions over the past several decades and have never had a workplace where people crying (yes, crying) was a regular occurrence. Leaving felt incredibly freeing, and I have been much, much happier at another global health institution.
