25 January 2010

Africa: Bill Gates Issues Upbeat Take on African Health, Food Initiatives

Photo: PHOTOESSAY: Investing in Health Care in Malawi and Ethiopia

From the Bill and Melinda Gates Foundation, a photo essay from Malawi on Kangaroo Mother Care, the technique of wrapping newborn babies to the bare chest. This promotes easy access to heat and breastfeeding, which are key to the growth of low birth…

Cape Town — Software entrepreneur-turned-philanthropist Bill Gates issued an upbeat assessment Monday on the prospects of overcoming the challenges faced by the world's poorest people – many in Africa – in the fields of health and agriculture.

"With vaccines, drugs, and other improvements, health in poor countries will continue to get better, and people will choose to have smaller families," he said. "With better seeds, training, and access to markets, farmers in poor countries will be able to grow more food. The world will find clean ways to produce electricity at a lower cost, and more people will lift themselves out of poverty."

He made the comments in the second annual letter he has issued to the public to discuss his and his wife's philanthropic work through the Bill and Melinda Gates Foundation.

In a nuts-and-bolts exposition of the foundation's objectives and its practical experiences, Gates explained the central role the organization has given in its work to promoting innovation.

The huge number of innovations of the past two centuries has fundamentally changed the human condition, he said, but society traditionally under-invests in innovations which benefit poor people and in education and preventative health care. Consequently, he and his wife saw the foundation's key role as investing in such areas.

Outlining specific interventions, Gates noted that although the number of children dying before the age of five was falling – from nearly 10 million in 2005 to under nine million in 2008 – the world was making little progress in reducing the deaths of children within 30 days of their birth. To address this, the foundation had funded pilot projects promoting an integrated approach among health professionals.

"The pilots showed that the right integrated approach made a huge difference," he wrote. "It involved educating the mothers and the birth attendants as well as giving them some new tools such as easy-to-use antibiotics. Based on some of the early success we're seeing, we are now increasing our investment to see if we can scale up these approaches."

But, he added, the foundation was allocating its biggest investment to inventing new vaccines and improving the distribution of those already used. Since the vaccine against diphtheria, tetanus and whooping cough had been introduced in developing countries, deaths from tetanus were down 88 percent and from whooping cough 70 percent. If coverage was boosted to 95 percent, almost all deaths from the three diseases would be stopped.

The Global Alliance for Vaccines and Immunization (GAVI), which gave grants to help pay for new vaccines and for poor countries to improve coverage, was promoting vaccines preventing hepatitis B and HiB ((Haemophilus influenzae type B), which causes meningitis and other problems. Boosting coverage of HiB vaccine to 80 percent could save 250,000 lives a year in the poorest countries.

"With the progress on these vaccines," Gates said, "GAVI will add a focus on two vaccines that are already being used in rich countries: one for rotavirus, which causes diarrhea, and another for pneumococcus, which causes pneumonia. ...Rotavirus vaccine could save 225,000 to 325,000 lives per year, and pneumococcal vaccine could save 265,000 to 400,000 lives per year."

The current tools for fighting malaria were not enough on their own to eradicate it, Gates added, so the foundation was funding new innovations, such as the invention of new insecticides for bed nets because some mosquitoes were developing resistance to the current insecticide. In some areas, candles or chemical sticks might be developed to deliver insecticide, and investments were being made in making drugs cheaper, and developing new anti-resistant drugs. And, in a high-risk investment, it was backing the development of a malaria vaccine – which might be achieved in eight to 15 years.

Although polio had been driven down to fewer than 3,000 cases a year, Gates wrote, eradicating it finally was the hardest part of the struggle. Last year, the foundation had worked with a number of northern Nigerian states to cut cases by 50 percent, and those involving the most virulent strain by 90 percent.

The Bill and Melinda Gates Foundation had also in recent years invested heavily in innovations to increase agricultural productivity, Gates noted in his letter. Among them were developing new seeds, training farmers better and giving them easier access to input and markets.

"Just like in health, there isn't a lot of market incentive to use the latest science for the needs of the poor," he said. "The foundation's approach is to fund projects focused on the specific growing conditions in developing countries and the crops that are grown by poor farmers."

In an interview with AllAfrica, Gates said he is optimistic about Africa. "Getting success stories out about Africa is particularly important," he said, 'because when you just hear the current statistics, it can be a little depressing." He said that "the trend line is positive enough and there are enough cool things" happening in Africa that he is hopeful that the positive stories will get more exposure.

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