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Vol. LXVI, No. 2
January 17, 2014

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Champion of Global Health
Gates Discusses R&D Efforts to Improve Health in Developing Countries

Bill Gates gives Barmes Lecture at NIH, Dec. 2.

Bill Gates gives Barmes Lecture at NIH, Dec. 2.

Entrepreneur and philanthropist Bill Gates delivered the annual David E. Barmes Global Health lecture on Dec. 2. More than 1,000 people lined up to attend the talk, filling 500-seat Masur Auditorium and overflow in Lipsett Amphitheater and FAES conference rooms. Another 4,000 people watched the lecture live via webcast.

Gates, who is co-chair of the Bill and Melinda Gates Foundation and co-founder and chairman of Microsoft Corp., recounted how he entered the global health field. While he and his wife Melinda were deliberating over what causes to support, they came across an article on a diarrheal disease caused by rotavirus that was killing hundreds of thousands of children in developing countries. At the time, the vaccine was only available in wealthy nations. The story inspired them to champion the cause of infant and child health in poorer countries.

Since its launch in 2000, the Bill and Melinda Gates Foundation has contributed more than $28 billion toward research and delivery of vaccines, other global health and development priorities around the world and education initiatives in the United States.

Gates said, “Over time, the cost of making most vaccines will get down to 20 to 25 cents per child treated and yet it can give you lifelong protection.”

One of the Gates Foundation’s first endeavors was investing in the Global Alliance for Vaccines and Immunization (GAVI), a public-private partnership that distributes vaccines to children in the world’s poorest countries. By buying vaccines in bulk from manufacturers, GAVI makes them available at low cost, which so far has benefited more than 400 million disadvantaged children globally.

“Anything that helps vaccines—understanding adjuvants, manufacture, making them at lower cost—those are things that really have a huge effect on global health,” Gates said.

The Gates Foundation is working with GAVI and other partners on several key vaccination initiatives. An urgent priority is the Global Polio Eradication Initiative led by the World Health Organization, which aims to eradicate polio globally by 2018. Gates noted distribution hurdles in Pakistan, Afghanistan and Nigeria, but technology such as satellite maps and GPS tracking are helping aid workers find remote villages in need.

Gates also said most children worldwide receive a pentavalent vaccine, a single shot containing 5 vaccines: diphtheria-tetanus-pertussis, hepatitis B and Haemophilus influenzae type B. GAVI is also expanding coverage of rotavirus and pneumococcus vaccines. During the remainder of this decade, Gates estimated these 2 vaccines will save more than 2.3 million lives.

“It’s the basic science work that you do that’s made this all possible,” said Gates. He paid homage to decades of NIH research that has enabled such advances in vaccinology and other interventions to promote global health.

Over the past half-century, biomedical innovation has decreased the mortality rate of children younger than 5, from 25 percent down to 5 percent. But with more than 6 million children still dying annually, there’s much more work to be done, he said. “I believe with the right kind of research that all of you are involved in and the right type of delivery activities,” said Gates, “we can get this number down below 3 million in the next 15 years.”

Gates (l) and NIH director Dr. Francis Collins engage in a dialogue on the Masur Auditorium stage during the second half of the annual Barmes Lecture.

Gates (l) and NIH director Dr. Francis Collins engage in a dialogue on the Masur Auditorium stage during the second half of the annual Barmes Lecture.

Photos: Bill Branson, Ernie Branson

Together, NIH and the Gates Foundation fund more than half of all global health R&D. Gates expressed hope that others will recognize the magnitude of this task and help support the cause.

“Investing in research has huge paybacks,” he said, “paybacks in improving the human condition, paybacks in reducing health costs as you get new tools…Innovation is the solution to make sure medical costs don’t expand.”

There’s been a surprising but positive correlation between vaccinations and population growth. Gates noted as vaccines become more widely available and child health is improving in developing countries, families are choosing to have fewer children. This trend has had a stabilizing social and political impact in these countries, he said, from nutrition to education to employment.

Gates reiterated the need for more research on vaccines, better nutrition and fewer preterm births to help further decrease infant and child mortality. He spoke optimistically about the prospect for an HIV vaccine and of medical and technological advances to come. During Q&A he said, “The promise of the new tools we’ll get over this next decade are pretty phenomenal.”

During his NIH visit, Gates toured a TB lab in Bldg. 33, met with institute directors and spoke to members of the press. Following the lecture, Gates, NIH director Dr. Francis Collins and NIAID director Dr. Anthony Fauci headed to the White House for an event to mark World AIDS Day.

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