2005 UNICEF

June 23, 2005
Remarks by Patty Stonesifer, chief executive officer

Thank you, Chip, for that introduction. Thank you, too, for your leadership of the U.S. Fund for UNICEF. You are one of the world’s most effective advocates for children—not just in your leadership of the US Fund but in the leadership and wisdom you have shown working across the field.

And I’m looking forward to working closely with Ann Veneman, who has made it clear that she wants to use her unique role to do the most she can to help children everywhere.

I’m delighted to be here today to help celebrate the work of such an important organization. As you are well aware, since 1960, thanks largely to UNICEF’s efforts, the death rate among children under age 5 has been cut in half. UNICEF’s network of in-country health experts take the world’s best ideas and make them a reality on the ground, in the places where they’re needed the most. This could not happen without the support of all of you here today—and all of us at the Gates Foundation thank you.

But none of us would be here today if we thought this work was done. Today, war, disease and poverty still kill millions of children, and keep millions more from even having a real shot at healthy, productive lives.

We can help these children and their families.

Improving health is only one part of the equation—but it’s a crucial part, because when health improves, life improves, by every measure.

I’m here today to talk about our shared goal: how we can save millions of young children who die needlessly every year. Of course, UNICEF cannot do this alone. The United States government can’t do it alone. The Bill & Melinda Gates Foundation certainly can’t do it alone. That’s why I also want to talk about how we have to work together, through partnerships, to help these children.

Every year, 3 million children die before they’re a week old. Another million die in the first month of life. Nearly 11 million die before their fifth birthday. Virtually all of these deaths happen in the developing world.

These statistics are even more chilling when you realize most of these deaths are totally preventable. We know how to save millions of these children.

We are not failing these children because we don’t know what to do. We’re failing because the world simply hasn’t done enough. If we focus our efforts and work together, we can—and will—save millions of lives. It is what we must do.

Why am I so optimistic? I believe we’ll do this for several reasons.

First, we are more aware than ever of these problems. When I was a child growing up in Indianapolis, I had heard of UNICEF. But to be honest, it all seemed very exotic and very far away. My family cared about its neighbors and acted in their interests – but we defined those neighbors in terms of our city, our state, our neighborhood.

Today, with the flip of a television switch, those children are no longer a world away—they are our neighbors. We cannot ignore them and we cannot ignore the call of our own conscience to act.  

Yet it is not just private citizens who feel the call of conscience. We are seeing new political will among governments to address the huge inequities in global health.

Consider efforts such as the United States’ Emergency Plan for AIDS, the United Kingdom’s Commission on Africa, and the countries now supporting the Global Fund for AIDS, TB, and Malaria. And consider the run-up and enthusiasm for the agenda on Africa at the July meeting of the G-8.

This political will is unprecedented. Notice the kinds of folks who have joined forces: rock stars like Bono of U2 and the late Pope John Paul II. Talk about an odd couple…but these two individuals from such different worlds, were both moved to act…to do what they could to help, and to bring others with them.

But the desire to help means nothing without the capacity to help—and our capacity to help is increasing rapidly through the miracles of 21st century science.  

Recent advances in basic research, like the sequencing of the human genome, give us an unprecedented opportunity to make progress against all disease. In the past decades, vaccines have stopped or reduced the spread of polio, hepatitis B, yellow fever, and other killers. In the future, science will make even greater advances: new vaccines for malaria and better TB vaccines, but also great strides in “deliverability” such as vaccines that don’t need to be kept cold, rapid yet simple tests for diseases, and much cheaper and simpler drugs that can alleviate suffering. 

These vastly improved technologies, combined with growing awareness and commitment, create a powerful force that can make deadly diseases, conquerable.

But to make the most of this, it takes money. It takes coordination. It takes innovation.

And none of those things can happen unless we build great partnerships.

Partnerships are fundamental to how we think about our work at the Bill & Melinda Gates Foundation. Bill and Melinda started their foundation because they want to promote equity—to help make sure that all people, no matter where they’re born, have a chance to live a healthy, productive life. We believe that the world can do the most for equity in global health by focusing the powers of science and technology on the problems of its poorest people—and then making sure that advances in those areas reach the people who need them. Solutions need to be developed, and they need to be delivered.

All of this requires better coordination than ever before. Without it, we don’t stand a chance of making the most of what we already know, or what we’re going to learn, about saving kids’ lives.

That’s why, of the investments the Gates Foundation makes in global health, 90 percent of our dollars go to partnerships. Some of these are funding partnerships; others help plan or implement delivery; and others encourage new scientific research.

Let me tell you why. In the year 2005 and in the decades ahead—whether you’re in the public sector or in business: If you want maximum results, you must make partnerships work.  

Let me read you a few sentences from a recent article in the New Yorker by James Surowiecki…
“Firms that were once exemplars of going it alone have dedicated themselves to playing well with others. Procter & Gamble now gets more than thirty percent of its innovations from outside. Pharmaceutical companies rely more and more on partnerships with small biotechs to come up with new drugs… I.B.M. has made ‘strategic alliances’ a cornerstone of its business. Even Apple Computer – once the most imperially self-reliant of companies – has changed. Steve Jobs used to fantasize about controlling everything down to the sand in Apple's computer chips. Today, Apple works contentedly with companies like Motorola and Hewlett-Packard.”

Of course, partnerships weren’t invented in Silicon Valley. There's an old African proverb that says a lot about partnerships: “If you want to go fast, go alone. If you want to go far, go together.”

The first part of that proverb—“If you want to go fast, go alone”—is a polite way of saying: Partnerships can be a real pain. They’re hard to navigate. If you have to make a fast decision, your first thought probably isn’t to consult half a dozen people or form a steering committee!

Partnerships also cause friction. Informed, opinionated people won’t always agree on the best way to solve a problem.

And yet—friction has *enormous* benefits. It forces us to test our beliefs about our work and the results we’re getting. In business, you get friction from your competitors and your customers—it’s a constant feedback loop that tells you how you’re doing and where you need to improve.

In the nonprofit world, we don’t always get that same kind of feedback. It’s hard to measure the results of your work or to know if you’re following the right strategy. Partnerships can make us uncomfortable and help avoid complacency. In isolation, it is too easy to take pride in the kids you are serving. In an honest partnership, you are constantly reminded of the kids you are not serving.

They have other advantages too. In a strong partnership, no single institution has to solve every problem or do all the work. Each partner contributes its own particular expertise. Partnerships also make it easier to avoid overlapping investments. And they spread out risk.

All of this talk about partnerships may sound theoretical. It isn’t. If we’re going to make sure that low-cost health solutions reach everyone who needs them, we have to build partnerships at every step: for research and development; for delivery; and on the ground, in the countries that have the most to gain from them.

Let me give you a few examples.

We have an exciting model for R&D partnerships in the Global HIV Vaccine Enterprise.

As you are well aware, AIDS is absolutely devastating to families and children. It’s essential to provide treatment to the people who are suffering now. But the only way we will ultimately break the cycle of suffering is by creating an HIV vaccine.

Finding an HIV vaccine is one of the most challenging scientific problems of our time. It’s risky and expensive. And until recently, this work has not been well coordinated. Some of the world’s top scientific minds were working on this challenge, but in their own labs, without a common strategy, standardized tools to compare their results, or even a forum where they could identify priorities and share information. After two decades of work, only one vaccine candidate has made it into large-scale trials – and it didn’t work.

How do we solve this problem? Partnership.

Over the past two years, an alliance of researchers and funders has united under the Global HIV Vaccine Enterprise. Now they are working together—strategically and aggressively—to find a vaccine.

The enterprise has taken exciting first steps. Last year, it was endorsed by the G-8 countries, who will align their own national AIDS research with the goals of the Enterprise. Earlier this year it brought many of the world’s leading vaccine researchers together to develop a common research blueprint, which will help eliminate duplication and maximize the contributions of so many brilliant minds. 

The Vaccine Enterprise holds out great promise that the world will, eventually, develop a reliable way to stop AIDS. But even the most powerful vaccine means nothing if we don’t deliver it.

A fantastic example of a delivery partnership is GAVI, the Global Alliance for Vaccines and Immunization, which in just five short years has helped immunize tens of millions of children. UNICEF has been an absolutely critical partner in GAVI, and had a seat at the table—quite literally—from the very beginning.

GAVI got its start during a dinner at Bill and Melinda Gates’ house. A number of public health leaders were talking with us about how the world had lost momentum in the effort to immunize children. They said there too many independent actors were competing for attention, credit, and money. These problems were crippling the immunization movement.

At dinner that night, the idea came up to create a partnership to solve these problems. Bill told the experts: “Think big.”

And they did. They created GAVI. Carol Bellamy served on the first board, and later led it as chair. GAVI brought together multiple donors, including governments and private funders, as well as vaccine manufacturers. Since 2000, ten governments and the European Union have provided hundreds of millions of dollars to purchase and distribute vaccines—introducing new vaccines and getting basic vaccines out to children who would never have been reached. UNICEF has been involved every step of the way.

Since 2000, this work has helped save more than 700,000 lives.

It was not easy. There were egos—institutional and individual—and obstacles—institutional and individual—all of which needed to be set aside.

But the leaders of GAVI kept their eyes on the goal of reaching every child everywhere, they worked together—and now, immunization will never be the same.

But 27 million children still went without the basic package of vaccines last year. GAVI plans to change that.

That is the power of partnership.

There is another crucial link in this chain of delivery and development. To make sure that solutions for better health reach every person who needs them, we need partnerships on the ground, in the countries that are hit hardest by disease.

The Gates Foundation recently joined such a country partnership—one that will fight malaria in Zambia.

Malaria is practically unheard of in the industrialized world, but in the developing world it still kills more than a million children every year—one child every 30 seconds.

These children are dying even though we know about proven ways to control this disease—such as bed nets that are treated with insecticide, indoor mosquito control, and effective drugs.

That’s why the foundation helped start MACEPA –the Malaria Control and Evaluation Partnership in Africa. This is a new project designed to dramatically reduce the disease burden in Zambia, and to show that other countries in Africa can do the same.

Like all good alliances, MACEPA will rely on the special expertise of its partners. PATH is providing technical knowledge and experience. The Global Fund will provide much of the financing. And the Zambian government will coordinate the purchase and distribution of hundreds of thousands of bed nets, thousands of doses of medicine, and enough insecticide to spray the walls of every eligible home in Zambia—reaching 80 percent of the country’s population in three years.

If they reach this goal, they could cut the number of deaths due to malaria by 75 percent in Zambia—and in the process develop a model that could save lives in other African countries too.

That is the power of partnership.

I have talked about R&D partnerships, delivery partnerships, and on-the-ground partnerships. There is one more, very important type of partnership: funding and advocacy partnerships.

One particularly timely example of this is the campaign to eradicate polio.

Since 1988, immunization campaigns have led to a 99 percent reduction in polio cases throughout the world. In 2000 alone, 550 million children under age five were immunized against the disease. A wide range of partners helped with the funding and delivery, including WHO, the UN Foundation, and of course UNICEF. But looming large in this partnership is Rotary International and its chapters all over the world – which kept polio in the spotlight and have raised more than $600 million.

As you may know, difficult pockets of polio remain in South Asia and in Africa. But if we can finish the job—and we will—it will mean thousands of children saved from death or disability, and it will free up billions of dollars that can help solve other public health problems.

That is the power of partnership.

MACEPA, the HIV Vaccine Enterprise, GAVI, and other exciting projects give me real hope that we can do this. We can create a world where all children, no matter where they’re born, have a chance at a healthy life.

I am optimistic, but I’m not naive. This will not be easy.

None of this work can happen until we get the world’s scientific brainpower focused on these problems.

None of it can happen without leadership and technical expertise in delivery.

Absolutely none of it can happen without resources.

It takes reliable funding—now, and in the future. When you support UNICEF – and when you ask your government to do the same–you are saying: “I wouldn’t let millions of children die needlessly in my country. And I won’t let millions of children die needlessly in my world.”

Finally: not a single one of these things can happen without partnerships. The problems are just too big—and the need to change the status quo is too strong - to do it any other way.

So I want to conclude by expressing my deep gratitude to UNICEF for the partnerships that it has led so far—maternal neonatal tetanus, iodine deficiency, emergency relief in the tsunami affected areas, in Darfur, and GAVI, just to name a few. And I want to express my great hope for the partnerships UNICEF will lead in the future.

Remember, if you want to go fast, go alone.

We all are here, today, in this room supporting UNICEF because we want to go far.

Improving the health of the world’s poorest people—especially its children—is the great moral challenge of the 21st century.

Let us go together to meet that challenge

Thank you.