Nothing in this sentence gave you pause for a second thought? Would you replace Jonas Salk with a community garden?
The criticism of Altman is apt because he hasn't achieved anything of definitive social value. (Not in a way someone else wouldn't have on a similar timeline.) Equating anything he's done to the eradication of malaria is pure scope failure.
Let's "assume good faith" and "respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize" [1].
They may be a troll, or an idiot. Or they may be reflecting an increasingly-prevalent view that people should stick to their "own" territory, for various definitions of "own." (Whether this fuel anti-immigrant xenophobia, colonist/coloniser moral binaries, or the dismissal or a disease eradicator.)
edit: For with it's worth, "don't feed trolls" is also an HN guideline ("Don't feed egregious comments by replying").
From https://www.gatesfoundation.org/about/committed-grants it looks like Seattle is the city that they've given the most grants to - 3,609 so far.
https://lite.datasette.io/?csv=https://static.simonwillison....
They’ve also been deeply involved with various education reforms in the US. They’re definitely active here.
Their work in Africa has had unambiguously huge benefits.
[1]: https://globalhealth.washington.edu/news/2017/01/25/seattle-...
[2]: https://www.gatesfoundation.org/ideas/media-center/press-rel...
"The essential thing is to be good to the people with whom one lives. Abroad, the Spartan was ambitious, avaricious. iniquitous. But disinterestedness, equity, and concord reigned within his walls. Distrust those cosmopolitans who go to great length in their books to discover duties they do not deign to fulfill around them. A philosopher loves the Tartars so as to be spared having to love his neighbors."