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William H. Gates Sr. - 2005 Gates Award for Global Health: African Medical and Research Foundation

June 2, 2005
Prepared remarks by William H. Gates Sr., co-chair

Good evening. Thank you for that warm welcome.

Tonight, as we honor the work of the African Medical and Research Foundation, I can’t help thinking about some of the warm welcomes extended to me by the people of Africa when I’ve visited there.

I remember one instance, in the Central African Republic where I traveled with President Carter some years ago, a welcome ceremony filled with songs, drums and whistles, and incredible dancing.

Then the music stopped.
And I was called upon to utter some suitably dignified response…when all the while what I was really thinking was:

“I wish I could dance like that!”

On my first visit to Africa, I attended a vaccination day in Mozambique. The first child to get a vaccination was a little baby girl who had survived a natural disaster—not unlike the tsunami of the recent past—and endured a lot of other hardships.

But she had survived it all. Her name in Portuguese was Esperanza which translated into English means “Hope.”
                       
I met many Africans on that and other visits to Africa—whose lives expressed hope and possibilities.

Their voices and stories remain alive in my mind tonight.

AMREF is an authentic voice of Africa.

After all, it was founded almost half a century ago. It’s the oldest international non-governmental health development organization based in Africa. And, 97 percent of its staff members are African.

AMREF is a voice for better health in Africa.

A voice from Africans, to Africans, and to the world.

They speak out especially on behalf of those who are most vulnerable—women and children, the sick and the poor.

Being a voice for Africa is a daunting assignment.

Take for example the case of the Commission on Africa launched by Tony Blair. The British went looking for a group that could ensure that all African countries including those in the east and in the Horn of Africa—would have a voice in the commission’s proceedings.

Well, all roads led to AMREF.

AMREF identified civil society leaders to represent and debate the themes set by the Commission for Africa at the meetings. The mission was to set up an action plan for Africa—a plan for rich countries to support. AMREF made sure that health and poverty stayed high on the agenda. And they say they will remain vigilant to see that the G8 takes seriously what it heard from Africans.

Being the voice of Africa is a challenge because Africa is many nations and many cultures. It is also sometimes difficult to overcome erroneous assumptions that exist about Africa—assumptions that underestimate the African people and their potential.

Of course, AMREF is more than a voice of Africa. It is deeds: acts of compassion, of intelligence, of purpose.

They’ve learned how to truly improve health in Africa by asking Africans what needs to be done, and how best to do it.

Theirs is an approach that involves people at all economic levels and that looks for answers and solutions that the people themselves implement.

The Gates Award Jury was strongly attracted to that.

The Gates Award for Global Health was established by the Bill & Melinda Gates Foundation to reward and exemplify organizations that have improved health with measurable results. Improving health around the world is one of the great moral challenges of the 21st Century.

The Award recognizes past achievements and the promise of continuing activity and improvement.

It’s not hard to see why AMREF is such a worthy recipient.

Working across 7 countries—with links to 14 others—they’re helping 10 million disadvantaged Africans improve their health so that they can escape poverty and build better lives for themselves.

They focus on Africa’s most critical health issues: HIV/AIDS tuberculosis, and sexually transmitted infections; malaria; family health; safe water and basic sanitation. 

They provide clinical outreach and train health professionals who provide care for the sick.

We’re very sensitive to the critical importance of training health workers, and AMREF has trained some 10,000 doctors over the years.

They also train nurses, and even offer a one-year, fulltime course that earns a diploma in community health. Plus, they offer various short courses in healthcare issues for medical facility managers.

As part of their training program AMREF is the largest publisher of health education books in Africa.

And it may not be a great surprise to learn that the name of one of their most popular titles is: Where There is No Doctor.

To minimize the need for that book and for medical interventions, AMREF also helps people learn how to stay well.

In addition, AMREF combines project work with a strong research and evaluation component. So their successes can be repeated, elsewhere.

For example, studies done in Mwanza, Tanzania, showed that improving treatment for other sexually transmitted infections reduced HIV incidence by 40 percent.

Now, many African countries are using that approach.

That research was part of the long-term AMREF project on HIV prevention conducted with the London School of Hygiene and Tropical Medicine. It has influenced health policy in countries all over the world. That’s because the practice has been endorsed, adopted and promoted by the World Health Organization.

There is so much more that I could say about AMREF.

But to truly understand what they do, one must listen to other voices.

One must listen to the singing voices of “the dramactors.”

These are women in Uganda who have heard the cries of their children in the night–when they are convulsed with malaria—a disease that kills one child every 30 seconds.
 
Some of those children’s cries were stilled by death and replaced by the wailing of their mothers.

But others were quieted by the small miracle of bed nets treated with insecticide.

And so these dramactors—these groups of women—sing and dance before crowds of up to a thousand people at a time, singing a message to other mothers to tell them that they must get bed nets for their children to sleep under, and that they should seek medicine at the first sign of fever. 

AMREF’s impact on malaria there was summarized by one of those singers: She said: “Our children were dying before they reached the hospital. We had no drugs in the village, no knowledge of treatments. But since AMREF came, we have gained knowledge plus home treatment packs with the drugs to keep us out of danger. Our children are still getting sick. But they are not dying.”

You know, it would be one thing if we didn’t know how to fight diseases like malaria, but the fact is: we know what it takes. The cures are there. We simply must marshal the political will and the resources that are needed to meet these challenges.

One must also listen to the voice of an impoverished mother of five say that it was at an AMREF clinic that she and her husband learned that their sick two-year-old was malnourished because she’d taken him off breast milk so she could feed his infant brother. It was there, with an AMREF counselor at hand, she found the courage to confront her husband on the issue of having more children and he agreed to let her take birth control pills.

One must see the pride in the face of the boy who has persuaded an AMREF worker to follow him home from school. He wants her to see how clean things are there since he taught his mother what he learned in school about hygiene.

And finally, one must go back to those Daegoaretti Street children—the ones you saw acting and dancing in that film—and follow their voices all the way to Rome. They’ve just starred there—for the second year in a row—in a performance called Black Pinocchio.

Black Pinocchio, which was actually re-written by these boys, tells the story of a boy who has lost his parents, his family and his hope, but who manages to find a new life and a new identity.

It is their own true-life story.

These kids are showing the world what the future of Africa really looks like. They are living proof of its potential.

I opened up this evening talking about some of the very colorful ceremonies Africans have used to welcome me to their home land.

I’d like to close with something I read about African greetings.

It’s been said that in certain parts of South Africa with Zulu roots, when one person greets another they do so with words that mean, “I see you.”

The other person answers with words that mean, “I am here.”

This reflects the belief that a person is not a person unless he or she is seen by other people.

So tonight I want to say:

Africa, we see you.

Africa, we hear you.

I’m pleased now to ask Dr. Miriam Were, Chairman of the Board of AMREF, to come up and accept the 2005 Gates Award for Global Health.

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