The foundation’s aggressive goals for our health and development work are only realistic because of the basic scientific advances that have been made recently and continue to be made. Investments in research and development by large governments and private companies drive this rapid increase in understanding of medicine and agriculture. The U.S. National Institutes of Health spend about $30 billion per year on biological research. American pharmaceutical, biotech, and crop science companies spend an additional $60 billion. Genome sequencing is a great example of how research by the private and public sectors can benefit the very poor. Scientists, including many funded by the foundation, are using the data from genomic sequencing to design new drugs and vaccines. Our role as a foundation is to help make sure the new science is applied to the needs of the poor, because the marketplace doesn’t respond when buyers have almost no money.
Polio is another good example of what can happen when you take innovations that benefit the rich world and apply them in the poor world. The book Polio: An American Story, by David Oshinsky, tells the story of how Franklin Delano Roosevelt’s polio raised public awareness of the disease and made it possible to raise money for research into a vaccine. The vaccine work was done in the United States in the 1950s, supported by the March of Dimes. Polio was eliminated from the United States in 1979.
Because of that success, in 1988 the world adopted a goal of making polio the second disease to be eliminated, after smallpox. The United Nations Fund for Children and the World Health Organization led the charge. Rotary International has been a primary supporter of the work, and we wouldn’t be anywhere on this without their efforts.
Many people probably think polio has already been eradicated, because it gets so little press coverage, especially in rich countries. But there is still a significant amount of polio in four countries, with most of the cases coming from India and Nigeria. Eliminating it will require continued investment. Many people had hoped that it would be eradicated by now, but it has proven more difficult than expected. Researchers have learned that in some parts of India kids need to receive more than eight doses of the vaccine before they are protected. The government of India has done a very good job distributing it, but with the limited power of the vaccine they will have to add some new tactics and keep up the effort for several more years. Given all of their health priorities this is not easy. I met with the Indian prime minister and health minister this past November and feel sure they will do their part. The picture below shows a beautiful and happy 9-month-old girl named Hashmin, whom I met last year in a slum in New Delhi. She had recently gotten polio. It was tragic to see the muscles in her legs wasting away. Now she will never be able to walk normally. When you meet children like Hashmin, you are reminded why eliminating polio is so important.
The most difficult place to achieve success will be northern Nigeria, where the vaccine is still not being given to enough children. In order to convince enough families to participate in the polio campaign, you need not only dedicated teams that track down all the children but also a clear message from political, tribal, and religious leaders that the vaccine is safe and should be taken. An intense effort is being applied to get all these factors to come together in northern Nigeria. I’m making a visit there next month. With a few more years of investment and hard work the world will have a success with polio, which will invigorate the whole field of global health.
Polio is a good example of why the foundation needs to be flexible in our strategies and budgets. Last year, Melinda and I met with our polio team to get an update on progress against the disease. The team was asking us to approve the same amount of money we had been spending for years, but they kept talking about the many challenges of eradicating polio. Melinda and I probed to understand if they were saying that the world needed to spend more, and whether our leading by example could help make it happen. They said yes, and within a month they had put together a more aggressive plan that involved us spending hundreds of millions more and getting other donors to step up as well. We approved the plan. Rotary International and other donors are doing a great job so far coming up with the extra resources that are needed. Just this month I went to a Rotary meeting and helped announce more than $600 million in new money from various sources that will go toward eradicating polio. But none of this would have been possible if we didn’t keep flexibility in our budget and stay open to changing our approach.