No idea if that's true or not, but who cares? It's saving lives.

Most billionaires just hoard a few more islands for themselves.

I'd be more fearful of corruption in those countries. This is where so much foreign aid falls apart, it's siezed by the government, distributed to their favored constituents, and never makes it to the people who really need it.

Bill gates talks about corruption in his 2014 annual letter (1). Search for the word "corruption" if you don't want to the read the whole letter. TLDR: Its manageable.

(1)[http://www.gatesfoundation.org/Who-We-Are/Resources-and-Medi...]

See: United States.

> I wonder how much of this particular philanthropy is just giving back money that those countries spent? I.e. Microsoft licences, or balance of trade with the donor countries?

I mean, that's literally how capitalism works. You earn money selling a product or services to people, and use that money to purchase products or services from people.

I've seen too many pirated unactivated copies of Windows Server running large businesses (that could afford the licensing easily) in many of those countries to subscribe to that theory.