Tireless efforts to cure world's poorest

Bill Gates speaks while his wife Melinda looks on during an interview in New York. File photo: Shannon Stapleton

Bill Gates speaks while his wife Melinda looks on during an interview in New York. File photo: Shannon Stapleton

Published May 24, 2016

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For more than 15 years, the Gates Foundation has been imagining what’s possible, writes chief executive Sue Desmond-Hellmann.

One question unites those of us who work at the Gates Foundation: What if?

What if infectious diseases could no longer wreak havoc on poor communities? What if women and girls everywhere were empowered to transform their lives? What if all children - especially the poorest - had an equal opportunity to reach their full potential?

For more than 15 years, the Gates Foundation has been imagining what’s possible. Our belief that all lives have equal value guides everything we do to eradicate poverty, and increase opportunity for the people we serve.

I joined the Gates Foundation as its chief executive two years ago. I’ve been here long enough to reflect, but I still think of myself as a relative newcomer. There are aspects of who we are, what we do and how we do it that aren’t as clear as they should be.

Bill and Melinda guide our vision, and bring crucial priorities to the global stage. I focus my expertise and passion on leading the foundation and boosting our ability to have impact in order to realise our vision. As a foundation, we align ourselves and our strategies to shared global goals. Equally, we push ourselves to adapt to a changing world and confront emerging challenges.

Pandemics like the Zika virus, for example, demand that we work quickly with partners in the face of urgency. Above all, everything we do depends on partnership, and we all need to play to our strengths. More and more, the Gates Foundation’s strength manifests as the ability to bring people together.

As someone who spent a significant portion of my career as a physician and cancer researcher, tobacco control really resonates with me. More than a billion people use tobacco products worldwide. When used as directed, they are the only consumer products that will kill half of all users. Nearly six million people die of tobacco-related diseases each year, including more than 600 000 non-smokers who are exposed to second-hand smoke. If current trends persist, the tobacco epidemic could kill more than 8 million people each year by 2030 - 80 percent of them in developing countries.

Since 2008, the Gates Foundation has committed over $225 million (R3.5 billion) to partners who are working to address the tobacco epidemic in more than 30 countries in Africa and Asia.

We have a team of two at the foundation who work on tobacco control. Two people. As CEO, I’m excited that we have a nimble team making and managing a portfolio of grants. But I’m even more excited by the fact that this means we’re truly leveraging the knowledge and expertise of our partners and the countries we support.

One incredible example of country-led tobacco control is happening in the Philippines. In 2013, the Philippine government stood strong in the face of intense tobacco industry opposition and enacted the landmark Sin Tax Law, which increased taxes on tobacco by up to 820 percent.

After just one year, the government earned $980m in new tobacco tax revenue - far exceeding projections. Cigarette prices also increased, leading to an overall decline in smoking in the Philippines, with the largest reductions among young adults (18 to 24-year-olds) and the very poor.

Revenue from the sin tax nearly doubled the Philippine department of health budget, and financed the extension of fully subsidised health insurance for more than 43 million poor Filipinos - nearly tripling the amount of poor families enrolled in the National Health Insurance Program. This is the kind of health intervention that gets me really excited.

One of our core missions is to combat infectious diseases, particularly those that affect the poorest. We focus a large part of our health work on diseases such as polio, malaria, HIV/Aids, diarrhoeal diseases, pneumonia and tuberculosis - diseases that take a huge toll on people living in poverty.

We also prioritise what are called neglected tropical diseases (NTDs), which historically have attracted little donor funding or attention. Yet, more than a billion people in developing countries suffer from one or more NTDs, making joint efforts to combat NTDs the largest medical intervention in history, and at the same time the most unknown. But progress against one tropical disease caught me by surprise: Human African trypanosomiasis or HAT, also known as sleeping sickness.

HAT is a parasitic infection spread through tsetse flies. It endangers millions in sub-Saharan Africa, and is nearly 100 percent fatal if left untreated. Here’s the surprising part: we have what it takes to eliminate sleeping sickness, a disease the world doesn’t pay attention to, and it can happen sooner than you might think.

Progress in Uganda already shows what’s possible. In 2007, there were nearly 300 cases. By 2013, that number had dropped to 10. This year, we’ve seen only four.

This is exactly why the Gates Foundation invests in innovation. There are now new diagnostic technologies, new drugs in clinical trials, new products to reduce insect populations, and - borrowing a chapter from the polio eradication playbook - state-of-the-art mapping and micro-planning can guide our efforts with greater precision.

We need people to believe - as we do - that a world without sleeping sickness is possible. This means asking: Can we set our goals higher? The answer to that is a resounding yes.

One reason we’re optimistic is because we increasingly see private sector partners stepping up with resources and expertise outside the norm for global health and development. Each prong of HAT elimination - insect control, diagnostics and treatment - has a commercial partner involved.

Private sector partners are involved in sleeping sickness programmes for a simple reason: it’s the right thing to do. This has been a challenging lesson for us to absorb, but we take it to heart.

The mission of improving education in America is both vast and complicated, and the Gates Foundation doesn’t have all the answers.

Finally, let me tell you about Haliru Usman. Mr Usman is an environmental health officer in Nigeria, who collects sewage samples so that they can be tested for the polio virus. I met him while visiting Kaduna state to learn about disease surveillance, one of the critical innovations necessary for the global goal of eradicating polio.

Usman took pride in doing his work because he knew it would help save lives and prevent suffering. He was right. Nigeria reached the milestone of a year without polio one month after my visit. For the first time in recorded history, the entire African continent went a full year without a child paralysed by wild polio virus.

This progress is the result of decades of hard work by the Global Polio Eradication Initiative (GPEI). Well before the Gates Foundation got involved, GPEI’s members were at the vanguard, working to bring a halt to the disease. Today, progress against polio is simply a thing of beauty.

As the world focuses on the last frontiers of polio eradication, Pakistan and Afghanistan, we, again, find ourselves asking: What if?

What if we channel the best science and technology, leverage global partnerships, and mobilise heroes and health workers like Usman to realise a vision decades in the making?

Eradicating polio will mean that we have wiped out one of humanity’s oldest scourges. But it will also mean that the world has built upon the groundwork of possibility to end other diseases that disproportionately affect the poor.

* Desmond-Hellmann is chief executive of the Bill & Melinda Gates Foundation.

Cape Times

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