Reaching the Last Mile Global Health Forum

Bill Gates
Abu Dhabi, United Arab Emirates
November 15, 2017
AS PREPARED

Thank you for that introduction. It’s great to be here today. I want to thank His Highness Sheikh Mohamed bin Zayed for his hospitality, and for his generosity and leadership in global health.

His Highness and I began working together in 2011 to support childhood immunization and polio eradication. Since then, I have traveled to the UAE a number of times for important global health events like the Global Vaccine Summit in 2013, and the Heroes of Polio Eradication Awards in 2015.

This isn’t surprising, since the UAE’s commitment to global health goes back decades. The UAE’s founding father, Sheikh Zayed, was among the first international leaders to join the global fight against Guinea worm disease.

Looking at the UAE now, it’s easy to forget this is still a relatively young country, where diseases like malaria were endemic not too long ago. Today, healthcare outcomes in the UAE are among the best in the world. In fact, maternal and infant mortality rates here are lower than in the United States.

So, it makes sense that the global health community is meeting in Abu Dhabi once again. You heard today from experts about the kinds of innovation and collaboration that are needed to end infectious diseases around the world.

I’d like to explain why I’m optimistic about the future.

One reason is the terrific progress we’ve already made. People don’t always realize just how much has been accomplished. But the most compelling indicator of progress is this: Since 1990, we’ve cut in half the number of children who die before their fifth birthday. This is a remarkable statistic, but it is also part of a larger story of advancement in global health.

More than half of all people living with HIV now have access to antiretroviral therapy. Between 2000 and 2015, malaria deaths dropped by 60 percent. Polio is on the verge of eradication. And the number of people at risk of NTDs fell by 20 percent in the last five years.

A couple of months ago, our foundation published a report called ‘Goalkeepers’ that highlighted much of this progress. But it also contained a warning: that future progress isn’t inevitable.

If we don’t double down on investments in innovation, more children will die needlessly and poor health will continue to hold back millions of people and limit the economic potential of many developing countries.

I’m confident that we can maintain a trajectory of progress. There’s a lot of exciting innovation happening and I’d like to share a few examples.

Take polio. So far, this year, there have been just 14 cases of wild poliovirus globally, and all of them were in just two countries: Pakistan and Afghanistan. This is remarkable. A quarter century ago, polio paralyzed more than 350,000 people every year.

It’s taken an amazing level of partnership to get to this point, including critical support from the UAE to help vaccinators get to children in hard-to-reach parts of Pakistan.

To eliminate the last vestiges of polio, we are using genetic sequencing to track the movement of polio in the few places where it is still endemic or where it occasionally resurfaces. By tracking strains of the virus, we can understand how long it has been circulating and trace its geographic movement. This tells us what kind of immunization response is needed to stamp out the virus. Conversely, if we haven’t seen a specific strain in the field for an extended period, that gives us a pretty good idea that it’s gone.

Like the eradication of smallpox, finishing the job on polio will prove that, together, we can succeed in ridding the world of epidemic diseases. What’s more, we can draw on the knowledge, systems, and resources used to end polio to make progress against other diseases, and to reduce the risk of future pandemics.

With malaria, one of the most urgent challenges is that the mosquitos that carry malaria are becoming resistant to current insecticides used in bed nets and for indoor spraying.

Without new insecticides, malaria deaths could surge. As a short-term measure, the WHO recently began recommending the use of bed nets that include a chemical agent that breaks down the mosquitoes’ resistance.

But we also need entirely new insecticides to stay ahead of resistance. The good news is that the WHO also has approved an entirely new insecticide for bed nets — the first in 30 years — and just a couple weeks ago prequalified a new insecticide for indoor residual spray as well. This is fantastic progress that will allow us to manage resistance and potentially save many thousands of lives.

You’ve heard a lot today about neglected tropical diseases. We are making good progress against these terrible diseases, thanks to a remarkable level of global commitment, including from pharmaceutical industry partners.

I’m particularly excited about the new triple-drug therapy for lymphatic filariasis. Field studies in four countries over the last year have shown that this new treatment is safe for widespread use and effective in suppressing transmission and curing infection in most people.

Thanks to the WHO’s streamlined review and recent recommendation, we will be able to treat tens of millions of people with LF more quickly and at less cost. We look forward to working with countries and partners to get this out to communities as soon as possible.

I also recently learned about a new way to monitor cases of LF using 3D infrared sensing technology. By quickly measuring the level of swelling in a patient’s limbs, this advance will allow health workers to quickly see if a patient’s symptoms are getting better or worse.

It’s an incredibly exciting time to be working in global health. We have the opportunity to end diseases that have plagued humanity for centuries, making life better for millions of people. But success isn’t guaranteed. And this is something that should concern all of us.

The world needs countries like the UAE and others to continue leading the way in supporting global health innovation. But the fight against infectious diseases isn’t only about money.

We also need high-quality data to understand the burden of disease. We need world-class experts working together on smart policies and great scientists to pursue new solutions. And we need dedicated advocates to ensure that improving health for all stays at the top of the global agenda.

With this need in mind, I am excited to announce today a new initiative in partnership with His Highness to establish a state-of the-art institute that will work with international partners to leverage Abu Dhabi’s unique talents and assets in the global effort to eliminate infectious diseases.

The institute will focus on translating research and data on the burden of disease into actionable policy across the wider region and around the world. This will serve as an exciting addition to the rapidly growing platform of global health expertise in the UAE.

As many of you know, 2018 will be the “Year of Zayed” in the UAE. What better time to build on Sheikh Zayed’s legacy of philanthropy? Imagine what is possible if we continue working together to give everyone the opportunity to live a healthy and productive life.

Thank you.