Why should they give something seperate? Their charity is among the most effective. Should Bill be willing to let people die whom their foundation could have s

Why should they give something seperate? Their charity is among the most effective. Should Bill be willing to let people die whom their foundation could have saved just to please those who think it's self-serving? B&M Gates recognized most charities aren't particularly effective, and that there were few places they could convert their cash to QALY's. They created a foundation which effectively does that and now pour their money into it. I don't exactly understand what they should have done instead. Settle for a worse charity that would save fewer lives?