It baffles me that you chose to share this comment on, of all things, a post about the eradication of Polio, which was primarily funded by the Bill and Melinda Gates Foundation in a _clear_ example of a "philanthropic approach" working quite well. If I had to identify one organization that has contributed the _most_ to positive changes in public health infrastructure in the last decade it would be them, above any governments, churches, or other non-billionare organizations.
Reaching back further, many/most top universities have billionaires to thank for their existence (Stanford, Carnegie Mellon, etc.), the widespread existence of public libraries is mostly due to Andrew Carnegie, and a lot of tech/science innovation comes from for-profit companies primarily controlled by or funded by billionaires.
I won't deny that billionaire philanthropy _sometimes_ doesn't work, but that's true for any system of building infrastructure that I can imagine, and is a far cry from your claim that philanthropy is demonstrably an ineffective way to solve public infrastructure problems.
I'm curious if there are other processes you see as being historically more effective, either overall or per-dollar, at producing effective public health outcomes than philanthropic organizations? If so, I'd definitely like to find ways to give them more resources.