October 6, 2003
Prepared remarks by William H. Gates Sr., co-chair
On behalf of Bill and Melinda, I’m honored to accept the Bishop John T. Walker Humanitarian Service Award. It means a great deal to us – given the path-breaking work of the people giving the award.
Leaders from Bishop Walker, to C. Payne Lucas, to Julius Coles set a trend for the nation – and demonstrated a personal commitment to action.
C. Payne Lucas, as a young man, went to Togo in 1961 as one of the earliest members of the Peace Corps. Some years later, the President of Niger came to him and pressed upon him the idea of starting an organization like Africare.
It says something of your character when a Head of State sees in you the capacity to start a movement. And C. Payne Lucas helped start the movement -- and made the strategic decision to put the U.S. headquarters of Africare in his basement. He could get no money from rich people, until he first raised it from poor people – then the rich took notice. What a leader he has been! Thank you Mr. Lucas.
And what a worthy successor we have in Africare’s new leader President Julius Coles. Back in 1961, Julius Coles convinced 800 students at Morehouse College to give him one dollar each so he could travel to Africa and come back and tell them about it. He’s been talking up Africa ever since. That’s got to be the best return anyone ever got for the investment of a dollar. Thank you Mr. Coles.
When Africare was created more than thirty years ago, it was responding to an emergency of drought and famine – and quickly embraced the cause of agricultural development. Africare’s work in agriculture – in HIV/AIDS, and in everything you do – reminds me of the story of a farmer who brought the pastor of his church home one Sunday afternoon to show off his crops.
The pastor was impressed and said: “Look what the Lord and you have done with this corn.” And “Look what the Lord and you have done with this wheat.” And “Look what the Lord and you have done with these tomatoes.” The farmer, who was feeling a little slighted, finally blurted out: “Pastor, you should have seen it when the Lord was working this land by himself.”
The founders of Africare were in many ways working the land by themselves. They embraced Africa before others acknowledged the need or the duty. In those early years, no American president had ever visited sub-Saharan Africa. Now three of the last five presidents have done so.
In those early years, American foundations were not interested in the cause of Africa. You’ve got our attention today. We at the Gates Foundation thank you for your leadership, and we are proud to work with you to fight disease and ease suffering in Africa.
There has been a fair amount written about Bill and Melinda and the birth of their foundation. I mark the start from an event that occurred several years ago. Bill and Melinda had been receiving a rising number of requests for funding. But they had not yet established an organization or settled on a vision for their giving.
Then one day they read an article about the millions of children who were dying every year in poor countries from diseases that we had long ago eliminated in this country. Bill clipped that article and sent it to me with a note that said: “Dad, maybe we can do something about this.”
Bill and Melinda believe with their hearts and souls that every human life has equal worth. That’s the founding ideal of our philanthropy. Melinda captures it best. She has said “The death of a child in Africa is every bit as tragic as the death of a child in America.”
If you believe that every human life has equal worth, then you can’t keep your heart from breaking when you see the world’s inequities. We believe that the world’s greatest inequity – that does the gravest damage – is the inequity in global health care.
Poor health aggravates poverty, poverty deepens disease, and families trapped in that spiral can never escape unless we help. That’s why we have made global health the top priority of the foundation. We’re working to improve women’s reproductive health. We’re working to find more effective tools to fight diseases like TB and malaria. We’re trying to distribute vaccines worldwide so children stop dying from diseases we’ve already cured. And we are dedicating the greatest share of our resources to stopping the global transmission of HIV/AIDS. As the focus of this event is on HIV/AIDS, and because HIV/AIDS is also the focus of so much of our work, I am going to center my remarks on that subject tonight.
Many people make the case that AIDS is an economic issue or a national security issue. That’s alright with me. If we have to make that argument to get the public funds we need to fight disease, we should do it.
But to me, this is not primarily an economic issue or a national security issue; this is a humanitarian issue. People are dying, and we can save them; and that ought to be enough.
People suffering from AIDS are human beings. They are not national security assets. They are not markets for our exports. They are not allies in the war against terrorism.
They are human beings who have infinite worth in their own right without any reference to us. They have mothers who love them and children who need them and friends who cherish them, and we ought to help them.
The question is how? No foundation can do this alone. If we can fix a problem with philanthropic dollars alone, it can’t be that big of a problem…
The fact is – foundations control only a tiny slice of the world’s wealth. So we have to work with great leverage. Our special role is to find new approaches, prove they work, and then get business and government to step in and help sustain them.
That’s why we are investing a lot of money in vaccine research. It’s the high-risk/high-reward approach that is tailor-made for our type of philanthropy. Prevention and treatment can win battles, but a vaccine wins the war.
In Kenyatta National Hospital in Nairobi, the Kenyan AIDS Vaccine Initiative is conducting the first-ever human trials of a vaccine designed specifically for a strain of HIV common in Africa. The Kenyan doctor running the trials, a man by the name of Job J. Bwayo, said: “this is a marathon, not a sprint, and Kenyans are good at the marathon.”
We’re proud to be funding this research, and I can’t tell you how excited we are that the vaccine could come out of Africa – developed by Africans.
I met with the Kenyan researchers a year ago last March, when President Jimmy Carter and I went to Africa to help get more action against AIDS. What hit me hardest during my visit is that the millions of people living with HIV are in the prime of life – the age that bears burdens for the old and the young. These are the people who enforce the laws, harvest the food, heal the sick, teach the students, and raise the children. Without farmers and teachers and mothers and fathers, things fall apart.
We saw some situations that were desperately bleak. President Carter talked about “the dismal scene of a mother slowly wasting away with four children sitting hopelessly by her bed.”
I couldn’t shake from my head the image of a hospice for infants, run by a woman I met in Kenya. There may be nothing worse than burying a child, unless it’s to bury your mother when still a child.
But suffering is not all I saw in Africa. I saw heroes and reason for hope. And I saw in the midst of this great struggle so many more happy faces than I ever could have imagined. I can’t explain it. But I saw it. There were happy moments – even joyous moments – in the midst of the most painful circumstances.
Let me tell you about one memorable moment. You remember the picture of the three old men with little babies they put up on the screen earlier? Well, the photo caption should read: “not all men are created equal.” What you saw there were two Nobel peace-prize winning, world-class politicians – and a lawyer from Seattle.
As soon as we arrived at the clinic, those two went straight for the babies. Then one mother, seeing me empty-handed, thrust her baby at me. The Mandela and Carter babies were peaceful, but the Gates baby started screaming. When the mother came forward with a bottle, I thought: “thank God, I’m outta this.” And I’m sure the baby was thinking the same thing.
But when I went to give her the baby, she handed me the bottle. So there I was feeding a baby for the first time in 40 years. The baby I was holding – we were confident – was born without HIV because the doctor there was administering nevirapine. Nevirapine is an inexpensive drug that can prevent, by up to 50 percent, the transmission of the virus from an infected mother to her newborn. And he was doing it in violation of South African government policy. That man was a hero, and that day was happy and hopeful.
In Nigeria, President Carter and I met with commercial sex workers in a slum outside Abuja. Most had the same tragic story – they fell into sex work after they were orphaned at a young age, and had to find a way to feed themselves, their brothers and sisters.
Each one had to serve more than 1,000 clients a year to scrape out a living – and to avoid dying. They belonged to an NGO group of “peer educators” who teach sex workers how to negotiate condom use with their clients.
Yet there are immense obstacles. And I’ll never forget one of them telling me that clients usually pay 5 Nigerian dollars. But many clients will offer 15 dollars – if they don’t have to use a condom. Some of these poor women multiply their risk of death for a little more money. Could there be any more vivid evidence that AIDS discriminates against the poor?
We were told – because of the twin taboos against sex work and AIDS – that we should not invite the health minister to the meeting with the sex workers.
We ignored the advice, invited the health minister, and he heard this story for the first time. Right there he committed to providing the NGO all the condoms they needed, which these women previously had to buy themselves. The peer educators are heroes, and so is the health minister.
Between Nigeria and Kenya, we stopped to refuel in the Central African Republic – a landlocked country the size of Texas with few roads, no railroads and a per capita income of $300 a year. We visited an AIDS hospice near the airport at Bangui. It was one of the bleakest things I’ve ever seen. Every bed was occupied. And we counted more than 200 people in line – mostly women – waiting for some form of treatment.
Yet there probably wasn’t an anti-retroviral drug within 1,000 miles. When we asked a wife of one of the officials about HIV-prevention efforts, it was clear she didn’t know what a condom was.
Yet, a Japanese woman, supported by a Japanese relief agency named “Friends of Africa,” has been running this hospice in the middle of Africa for more than 10 years.
As long as there are people around the world willing to devote their lives to this work, how can any of us not have hope? We are glad she is comforting the dying, but we want to help her protect the living. Earlier this month, we gave her organization a grant to do HIV/AIDS education in the Central African Republic.
As you all know from the video, Bill and Melinda traveled to Africa late last month – visiting Botswana, South Africa, and Mozambique to learn more about the impact of malaria and AIDS and to draw more attention to the need to address Africa’s health problems. I’ve had a chance to talk to them, and they came back very excited about the increased awareness and cutting-edge research happening on the ground in Africa.
They said a highlight of the trip was joining Nelson Mandela in a group discussion with South African teenagers about preventing the spread of HIV, which is exacting such a devastating toll on their generation. President Mandela urged the teenagers to launch a social revolution in the fight against AIDS in the same way the earlier generation fought apartheid. Bill and Melinda were very inspired by that.
I personally have no doubt about the final outcome of AIDS. The human response has attained such momentum that there is no question: AIDS will yield. It is only a matter of time. But the more time it takes, the more lives it will take. We have to end it sooner rather than later.
Everybody in this room is doing something to fight AIDS. And everyone in this room can do something more. You have honored Bill and Melinda. But the end of AIDS will not come from the commitment of one large foundation or even one large government. AIDS will fall to the relentless, persistent attack of millions of people – rich and poor – who decide the time has come for AIDS to go.
Let me close with a story that I imagine must have been close to the heart of Bishop Walker. It’s the story of Jesus going to the temple treasury and watching people make their donations.
The Bible says: “Many that were rich cast in much. And then there came a certain poor widow, and she threw in two mites, which make a farthing.” And Jesus called his disciples and said: “This poor widow has put more into the treasury than all the others. They all gave out of their wealth; but she, out of her poverty, cast in all that she had, even all her living.”
We at the Gates Foundation are not heroes. But our work is inspired by heroes. They motivate us to find more effective tools so that they can save even more lives. I want to close in tribute to them.
The Japanese woman running a hospice in the Central African Republic.
The South African doctor treating mothers with nevirapine against government policy.
The Kenyan doctor seeking a vaccine for AIDS for Africans.
The women who train sex workers to demand condom use from their clients.
And – finally – the poor people of northeast and southeast Washington who came with their bags of pennies to help start Africare more than 30 years ago. Those earliest donors didn’t have enough money to buy fine clothes and come here tonight. They had just enough money to become philanthropists. And they “put more into the treasury than all the others.” When we end the scourge of AIDS, and we will, it will be because of people like these. Let us never forget their example.