Bill Gates released his third annual letter this week. The letter is part a Year In Review of the human challenges the Gates Foundation works to address -- global health, agriculture, and education -- and part treatise on Gates' views and priorities for the future. The letter is a good read, not least because it is full of stories of global health victories and reasons to be hopeful. We are, as Gates points out, making progress. Only 15% of the world's people live in poverty today compared to 40% a generation ago, thanks to innovations that deliver better food and medicine to more people. Gates also makes a strong case that we need to invest more -- and more wisely -- in meeting basic human needs, or millions will die needlessly in 2012.
Below are parts that resonated most with me.
The Global Fund to Fight AIDS, Tuberculosis and Malaria. Gates writes, 'The cost of keeping a patient on AIDS drugs has been coming down, and it looks like getting it to $300 per patient per year should be achievable. That will mean every $300 that governments invest in the Global Fund will put another person on treatment for a year. Every $300 that's not forthcoming will represent a person taken off treatment. That's a very clear choice.'
It is a very clear choice. However, in spite of revolutionary successes in saving millions of lives the Global Fund has faced its most challenging year since its founding a decade ago. Because donors began walking away from their commitments in 2011, the Global Fund's board cancelled its plans to finance any new programs until at least 2014.
The Global Fund provides support to half the people in the world on life-saving antiretroviral therapy (ART) for AIDS and is the largest international financier of TB and malaria programs. Unless funding comes through this year that allows the board to reverse its decision, this will spell calamity for millions. Encouraging donors to come back to the table, Gates writes, "I am confident that [The Global Fund] is one of the most effective ways we invest our money every year, and I always urge other funders to join us in getting so much bang for our buck."
A few days later, Gates made this invitation more real. To mark the Global Fund's 10th anniversary, Gates announced at the World Economic Forum that his foundation will contribute $750 million to the Global Fund. While this is a critical injection of capital, it won't be enough to get the medicines, bed nets and other vital health services rolling again unless other donors (read: governments) follow suit with new contributions. RESULTS Educational Fund, MSF and others are calling on the Obama administration to convene an emergency donor conference to gather the funding. Let's hope it happens.
Polio is on the verge of eradication. Thanks to massive campaigning led by Rotary, UNICEF and others, only a handful of countries had any cases at all last year. These include Afghanistan, Pakistan, Nigeria and some of its neighbors. Just two weeks ago, India celebrated its first year of being polio free. Pakistan and Afghanistan present some challenges to eradication due to the security situation, but vaccine campaigners are forging ahead. Nigeria presents reason for concern, as it shows what will happen elsewhere if we don't carry the eradication campaign to its completion. After being on the verge of eradication, the job was left undone. The disease rebounded, and a small number of cases have begun cropping up again in Nigeria and several other places across the region. We know what's possible and we must finish this job.
New vaccines are making their ways into low-income countries. Thanks to the GAVI Alliance children in low-income countries are now receiving the same new vaccines against pneumonia and rotavirus (the leading source of diarrheal death) as children in wealthy ones. This past summer, donors from the public and private sectors came together and contributed $4.3 billion to GAVI -- exceeding the $3.7 billion fundraising target the agency set for itself. This shows that even during challenging economic times, resources can be found for important live saving investments.
HIV/AIDS is on the decline. Again, thanks to smart investments in the fight against the disease, 6.6 million people are alive today because they have access to high-quality antiretroviral therapy (ART). As Gates writes, "Ten years ago it looked as if almost all of these people would die because the drugs were available only in rich countries." What a difference a decade can make when we invest in public health. And with new evidence showing male circumcision can reduce infection by 60% and providing (ART) early can reduce the spread of infection by 96%, we know we can end AIDS.
We know we can end AIDS. It was a pretty good year and an absolutely astounding decade.
Kolleen Bouchane is the director of ACTION an international partnership of civil society advocates working to mobilize resources on global health.
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