Bill Gates' war on disease, poverty is an uphill battle

Reaching out to Africa

Microsoft founder Bill Gates has launched a revolution in international health with a pledge of billions of dollars to vaccinate the world’s children.

Long-term, he hopes to shatter the cycle of disease and poverty by eradicating illnesses, finding new vaccines for old scourges, helping governments improve such basic services as clean water and giving developing nations financial incentives to improve the health of their people.

He envisions all the world’s major health players working in concert.

Charting a path to safer vaccinations

PATH's Uniject Syringe

A Seattle gang of technologically talented do-gooders used to have to go to the big boys of international public health to seek support for their innovations. Today, thanks to Bill Gates, the folks at the Program for Appropriate Technology in Health, or PATH, are some of the big boys.

Dr. Gordon Perkin, former president of PATH, is now head of the Global Health Program at the Bill and Melinda Gates Foundation, directing the world’s largest health care philanthropy at the world’s largest private foundation.

PATH manages the foundation’s $100 million children’s vaccine program, a $50 million malaria vaccine initiative and helped start the billion-dollar - and growing -- fund created to pay for getting vaccines out to the world’s poorest children.

At cozy dinner, Gates issues a bold challenge
It took shape at a dinner of squash soup and lamb chops overlooking Lake Washington.

The suits and ties at the table assumed their expertise was wanted to determine the best ways to spend a $100 million Gates contribution to create the Children’s Vaccine Program for respiratory and diarrheal diseases.

They were wrong. Bill Gates was willing to spend 10 times that amount and issues a challenge: Lack of money no longer was to be an excuse for children dying of preventable diseases.

GAVI’s goal is clear, even if route to it is not

A toddler is vaccinated in Yamoussoukro, Ivory Coast, a nation where political unrest is putting immunization programs - and lives - at risk.

When the Global Alliance for Vaccines and Immunization (GAVI) met last November, speakers celebrated "new political momentum" for immunization and against diseases of poverty.

The goal was clear: vaccinate more kids. The debate over how is sometimes fierce.

Bill Gates paid more than $750 million in 1999 to launch the alliance of most of the world’s top public health organizations, the World Bank, drug manufacturers, leading research institutions, the Rockefeller Foundation and national governments. Now, they must learn to work together.

Vaccines are often low on industry’s agenda
No medical intervention produces so much benefit for such little cost as a vaccine. No one needs vaccines more than impoverished children of poor countries.

There's the catch. Vaccines need to be cheap; the drug industry needs to make money. Success for a global vaccine alliance depends on balancing public health and private profits.

Vaccine program hopes for success where others failed
The Bill and Melinda Gates Foundation has built its search for how vaccine development can be sustained in poor countries on the ashes of the failed Children’s Vaccine Initiative.

It too had had tried to work with all the players in immunization. But it ignored politics, and the effort crumbled.

Tailoring solutions to fit local customs
A Carter Center program used to give bicycles to village volunteers in Nigeria, who must travel many miles to distribute medication and teach water safety. But no longer -- the bicycles undermined the self-reliance of community-run health improvement programs.