Burkina Faso was one of Bill Gates biggest donation spots and it's had an endless series of unstable leaderships, insurgencies and coups in the last decade. This scares away both foreign investment and foreign aid. Countries like that have made lots of economic progress but seem to be stuck in this endless cycle of instability which is the bigger issue if the solution is to develop proper industry and proper modern housing sealed from insects.
Just because Bill Gates didn't solve all issues in Burkina Faso doesn't mean the donations were meaningless. Burkina Faso's GDP per capita has quadrupled since Bill Gates started donating, in addition to a lot of lifestyle indicators like child health and child mortality and so on. You certainly can't say his intervention made things worse.