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2011 Rotary International Convention

Bill Gates challenges Rotary to make polio a disease of the past.

May 24, 2011
Prepared Remarks by Bill Gates, Co-chair and Trustee

Thank you. It’s a great honor to be here. And as you can tell from those clips, I’m a big fan of Rotary. Between myself and Penny LeGate, and of course, one of the great Rotary Clubs in the United States, Rotary 4, I’m glad to see Seattle so well-represented today. It’s an example of the incredible strength of Rotary—your ability to take local and regional action, to meet national and international goals. And to that end, I want to recognize another group that’s impressively represented here today. There are over three hundred Rotarians here from Nigeria.

Rotary’s work in Nigeria has been central in bringing new voices to the fight against polio. Like that of folksinger, Dan Maraya Jos. He’s been a visible presence, campaigning throughout the country, and recording radio announcements encouraging Nigerian parents to immunize their children. Their presence here today is an incredible show of strength and commitment.

I’m proud to be a partner in the work that Rotary has been doing to eradicate polio. I’m well aware that the reason we’re even able to have a discussion about how to eradicate polio, is because Rotary’s efforts have helped get us 99 percent of the way there.

Because of you, there are many places where polio’s thought of as a disease of the past. Now that’s both a blessing and a curse. The blessing is that, for it to be a disease of the past, means no child is being affected. The curse is that it makes it more difficult to raise awareness, that in some places, polio is still a disease of the present. And if we fail to help leaders around the world know this, polio will still be a disease in the future.

I describe myself as an impatient optimist. I have one simple statistic I like to use to explain my optimism. In 1960, of all the children in the world under the age of five, 20 million died of different diseases. Last year, that figure was down to 8.1 million. And so during that time, less than my lifetime, we’ve learned how to use life-saving tools, including vaccines, to save the lives of over 12 million children every year. As a whole, this has to be one of the great accomplishments of humanity over the past century. Now to build on this progress, and to get that number to be even lower, we need to get new vaccines for more diseases. We need to reach all the children. And we need to eradicate polio.

The question for all of us is, do we have what it takes?. Are donor countries willing to close next year’s $400 million funding gap, and see the job through to the very end? Are the countries where polio is still a threat willing to take extraordinary action to reach almost every single child with the vaccine? And are all of us ready to apply pressure to the leaders of these countries, when their answers to these questions are unsatisfactory? I challenge us all to do so.

Because if we fail, the disease will not stay at its current low level. It will spread back into the countries where it’s been eliminated, and it will kill and paralyze hundreds of thousands of children who used to be safe. Instead of energizing the field of global health with an amazing victory, we could lose decades of progress. We simply cannot allow that to happen. Failure in this fight is unacceptable.

And so that’s why I want to discuss with you today a frank and open discussion of the challenges of this final one percent. Now I personally made eradicating polio my top priority. I get to spend a lot of time with the great people, from Rotary and other organizations, working on this challenge. I get to meet with scientists; I get to look at the genetic maps of how the virus is changing. I know that one of the absolutely critical things it will take to win this fight is your voice, and your influence. You have the ability to keep the importance of polio eradication front and center in your home countries, and in the global conversation.

Now there are many polio success stories that show what we’re capable of, when we use all the tools at our disposal. I think, the best of all of them, is the progress that’s been made in India. Now there’s a lot of elements that make India a very hospitable place for polio. Not only does it have over a billion people, but every year there’s more than 24 million children born. That’s like adding another country the size of Venezuela to India every year. India also has many challenges, challenges of malnutrition, and diarrheal diseases and over infectious diseases. And so there’s a number of kids, particularly in the north, where the vaccine doesn’t have much effect, even after a number of doses.

So many people looked at India, its size, the difficulty of the vaccine not working in some kids, and saw it as the toughest part of the polio campaign. But in fact, because of the incredible work, India is approaching zero cases. The largest state in India, Uttar Pradesh, which was the most difficult location, and its most populous state, has gone a year with no cases. In Bihar, we’ve passed the eight-month mark. And one of the ways we test, to see if polio’s still around is we actually monitor sewage systems in a number of cities and so far, we have found none. In fact in India this year there’s only been one case.

So leaders, like Rotary’s incoming president, Kalyan Banerjee, and leaders of the PolioPlus Committee of India, like Deepak Kapur, and Ashok Mahajan, are setting the pace on the subcontinent, and will assure that Rotary stays the course. I want to take a moment, and recognize the huge commitment and dedication of the Rotary leadership in India.

And although India may have been the most difficult place to get the cases to such a level, it’s certainly not alone. In fact, in more than a hundred countries, the fight has been a success. Worldwide since the beginning of the campaign in 1988, the number of cases has gone down from 350,000 a year, to fewer than 1,300 last year.

As you know there are three types of polio, and it looks like one of those types has been eradicated, what we call type 2. The last type 2 wild virus was seen many years ago. We also have type 3 down to very small numbers, so far this year with only cases in Africa. Now none of this would have been achieved without Rotary International. We would not be where we are without you. Nor can we get to where we’re going without you. It is precisely because we’ve come so far and done so much, that we need to be frank with ourselves about the distance yet to travel.

The places that are easy to clear of polio were cleared early in the campaign. Many of the places that were hard to clear of polio have also been cleared, from remote villages to war zones. We’re on the threshold of eradication, but now is the toughest work of all. I think we’d all agree this has been harder than any of us expected. The progress we made in the northern part of India that I just discussed, for example, required intensification, a level of commitment and an investment, far beyond the original plan. And it’s a stark reminder to everyone involved in this effort, everywhere, that we need to be better— smarter, more innovative, and more vocal.

As you know, this is a disease you need to slam the door on. If it’s allowed to get its toe in the door, it will get its foot in the door, and it will kick the door open. And there are several places where polio is trying to get, or has already wedged its foot in the door.

An independent group appointed by the World Health Assembly to oversee the global polio program, recently met in Geneva. The report they generated stated our challenge plainly. If we want to reach eradication and I quote, “better implementation of the same strategies, is not the whole solution. The approaches, mind-sets and assumptions that so successfully eradicated 99 percent of polio, will not eradicate the last one percent.”

Part of the challenge is logistical. As you know to get eradication, we have to reach almost every child, over and over again year after year. It means reaching the 120 million children in India under the age of five. It’s not easy. And we need to constantly improve our ability to get this done.

Part of the challenge is scientific. We’ve done refinements to the polio vaccine, creating subsets that are targeted to the needs of specific areas. We’re creating diagnostic tools that allow us to track cases in a more rapid way, including— including things like the ability to do sewage monitoring. We’re doing overall modeling to look at how the disease is being passed down, and that’s informing all of our efforts.

But the best science and logistics in the world won’t matter, if we don’t have the will, and the funding, to put the tools to use to get rid of every last case. And that means we need to do even more to leverage the power of your 1.2 million members to keep polio front and center.

You’re the people who are capable of mobilizing others. You are the people that leaders listen and respond to. With your credibility, you are the world’s most important advocates for polio eradication. I’ve seen the incredible commitment you’ve brought to raising money-- charity bike rides, a charity swim, climbing mountains, projecting the “End Polio Now” message in many, many places.

These are amazing, inspirational efforts that raise both funds and awareness. They need to continue. They make a huge difference. But we also should recognize that even the most committed individuals and organizations, like Rotary, don’t have all the resources that governments have. And so we need to bring them along as well. We need to help ensure that governments are committed to polio eradication, until the end.

How can we do this? Many ways.

Use your relationships. Leaders are moved to action, when they’re approached by staff, friends, donors, lobbyists, or high-profile champions. In this room, we have many of those.

Tell your story. Leaders are moved when they feel a personal connection to a cause, are convinced of its need, its rightness, and its feasibility. Polio eradication is needed, it’s right, it’s urgent, and it’s possible. Leaders need to hear this repeatedly.

Finally, use the power of Rotary. Leaders respond to active groups of high-profile citizens. Rotarians banded together around the world have a key role to make sure this becomes a disease of the past.

A great example was up in Canada. Canada first donated to polio eradication in 1985, when PolioPlus was launched. The Canadian government has matched Rotarian contributions to PolioPlus in many of the years since. A few years ago, Canada’s government was considering cutting this funding. But then Rotarians reminded their leaders how important this is to them, through a massive nationwide letter-writing campaign. The success of that campaign became clear, when in 2008, Canada announced a $60 million contribution to help eradicate polio in Afghanistan, while the Rotary International convention was underway. I want to congratulate the Rotarians here from Canada, for refusing to let their government forget that this work is important, and it’s not yet done.

Here in the United States, Rotary has been very successful in getting a commitment of over $130 million a year from the US government for the fight to end polio. In the President’s 2012 budget, which is not yet approved by Congress, there’s an increase of another $18 million. These are tight budget times, and so it’s not guaranteed. But if this does pass, it would be a major achievement. Now at the same time, the funding needs of the program have increased even more. Total spending on the polio campaign now is about $1 billion a year. So even in these tight budgetary times, we’ll need to call on the United States governments, and all governments, to do more.

The United Kingdom provided an example for the world by intensifying its commitment. In January, British Prime Minister David Cameron announced that even in the face of an austerity budget that was cutting almost every item, the United Kingdom would double its investment in the eradication effort. They’re investing over 60 million pounds over the next two years.

The United Arab Emirates has also provided a strong example, with the crown prince making a $17 million commitment to the global polio program.

These are examples the world needs to follow. Donors that were once involved, that have fallen away—like Australia, Germany, and France—need to reengage. We hope Japan, despite its challenges, will continue to play a significant role in ending polio. And countries that have not yet been involved need to get involved. And you can help make that happen. Make sure that your politicians know about polio, and its urgency. Go and tell them about the need to finish. Invite them to your meetings. And when they visit, don’t let them leave without telling them you expect them to be champions in this fight, and that you’ll be holding them accountable for what they do.

There’s no doubt this is as important in the affected countries as it is in the donor countries. It takes a huge amount of political will to run campaigns that are comprehensive, and keep pushing for each to be more effective than the last. Because we have to reach almost every child to reach eradication.

You’ve helped so many people understand that we are “this close”. We need to help even more understand. There’s a great example in Pakistan, where Aziz Memon is a participant in meetings with the president, regional governors, and health advisors. Rotary’s in the room when decisions are made in Pakistan. And you’re capable of being in those same rooms in every other country in which you operate. Now we need to make polio front and center, beyond what we’ve done in the past. And we need to be more creative in our ways of keeping it there. I spend lots of time discussing with your leadership some of the ideas of how we can do that. With the redoubled effort of everyone in this room, and your fellow Rotarians around the world, we can succeed.

This redoubling is critical and that’s why my wife and I are so engaged in this, and telling everyone we can why it’s our top priority. It’s our top priority in terms of spending, it’s our top priority in terms of our voice, it’s our top priority in terms of our creativity. I get a chance to visit both donor countries and affected countries. Last year I was in both Nigeria and India, and I’ll be traveling to Africa in a few months to check on these campaigns.

Last week, there was a gathering of the world’s health ministers, and I got to have specific meetings with the ministers of health from Chad, the Democratic Republic of Congo, Angola, Pakistan, Afghanistan, and Nigeria. I told them that the world’s eyes are on their country, and that they need to do their part in eradicating polio as not only a noble goal, but an important proving ground. If they take action, and they’re held accountable, it will fuel the world’s commitment to working together, and to bringing more resources to the fight against other health challenges that they face.

These meetings are important. And every person can make a big impact. But one person does not move the agenda, nearly as effectively as 1.2 million. So Rotary will make a huge difference, going forward, in keeping this story front and center.

Now every year on Rotary’s anniversary, I mentioned you creatively illuminate different monuments around the world with this “End Polio Now” message. It’s powerful to see the message reminding people on the face of the Roman Coliseum, the New York Stock Exchange, the Houses of Parliament in London, Sydney’s Opera House, the Charminar in India, and the KPT Building in Pakistan. And we’ve even projected it on our new foundation building in Seattle.

Of course, the greatest monument, won’t be the ones we illuminate, it’ll be the one we create. The eradication of polio will ultimately be a monument, to scientific achievement, in developing a vaccine, and to the advances yet to come.

It’ll be a monument to organizational excellence in delivering that vaccine. It’ll be a monument to persistence, because persistence is so essential to tracking, cornering and ultimately ending polio. It will be a monument to humanity’s ability to come together, on behalf of those most vulnerable of humans. And it will be a monument, to one thing more. It will be a monument to the Rotarians of the world, who lived and gave life to the motto of “service above self.”

Your work has brought us so far. 99 percent of the way there. This last one percent will be the longest, hardest one percent. It’ll require more work and commitment than ever before. But I’m 100 percent convinced, that this fight is winnable. We’ve never stopped at 99 percent before.

We are “this close”. Rotary has written so many chapters in history of the fight against polio. Your work. Your voices. Your continuing commitment. These are the things that will allow us to end the story...and close the book.

Thank you.

On May 24, 2011, in a speech to 19,000 Rotarians, Bill Gates challenged the organization to make polio a disease of the present so it can become a disease of the past.  

Over 25 years, Rotary International has contributed more than $1B to eradicate polio, and has teamed with the foundation to raise $555 million and help stamp out “the final 1 percent.” At Rotary’s annual convention of Rotarians from 160 countries, Bill urged members to keep the issue alive globally and with their local government leaders.

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