Bill Gates on ending disease, saving lives: 'Time is on our side' | Talk to Al Jazeera



you know our dream without knowing if it was all achievable was to have a dramatic impact in the case of what will help one of the richest people in the world Bill Gates initially made his fortune by founding and running the Microsoft Corporation nearly 20 years ago he founded the Bill and Melinda Gates Foundation where he now works all of the time with an endowment of more than 50 billion dollars is the world's wealthiest private foundation and aims to enhance health care and education and to reduce poverty it's a key player in global healthcare but controlled by just three trustees gate his wife Melinda and billionaire Warren Buffett the Foundation's been credited with helping to save the lives of more than a hundred million children through increasing access to essential vaccines but it's not without controversy critics say it has excessive influence and the health care policy in the developing world some argue it's fast resources but narrow focus on health care provides a band-aid to health crises that are caused by deeper political problems in many of the world's poorest countries many of the people exposed to the diseases that the foundation aims to eradicate live in sub-saharan Africa and that's where much of its work is focused at a recent African Union summit in Ethiopia's capital addis ababa gates came to meet with heads of state to talk about health care almost as many children will be born in africa who specifically trying to accomplish and how does the answer to those who say his foundation tries to solve problems that some of those same heads of state seem unwilling to address themselves we'll discuss all of this with Bill Gates as he talked to al-jazeera mr. Bill Gates thank you for talking to Al Jazeera so we're here in Addis Ababa the capital of Ethiopia which is the seat of the African Union African leaders you're hoping to talk to them here what are you hoping to get out of it well I was invited to come to the summit and give brief remarks on my focus is on the opportunity of the human capital here in Africa that if the right things are done with young people in terms of health and education that there's a very bright future for the continent there's a lot of great exemplars here who've done an amazing job getting their primary health care system working and you know no reason why that can't be done in in all 54 countries and in terms of specifics from the summit are you hoping to get anything concrete from from this meeting well the the health meeting there'll be a number of pledges and discussions about the big health funds Global Fund Global Alliance for vaccines which both over the next 18 months have major replenishments going on and seeing that some domestic resources from the African countries are going into these causes will help a lot with that and there needs to be a clear message about you know these countries really valuing that work so that we can continue cutting HIV deaths cutting malaria deaths getting more innovative vaccines out to all the children of Africa the villain villain melinda gates foundation focuses particularly on health care in some of the poorest countries in the world what's the reason for this focus on the health care well I was stunned to learn that hundreds of thousands of kids most of them in Africa were dying and diarrhea over half of those lives could have been saved if there was a vaccine that was used in middle-income and upper income countries called the rotavirus vaccine and so our foundation found other partners particularly the aid donors and created the Global Alliance for vaccines and so now that rotavirus vaccines getting out to almost all of those children's and that these new vaccines are the biggest reasons why Africa's cut child mortality almost in half since gobby was created so it's kind of amazing that you know for less than a thousand dollars you're saving life you're improving the health of the survivors and as you improve health countries generally choose to reduce their population growth voluntarily so you're making all the challenges of the environment and jobs and stability that much more solvable out into the future the foundation also spends money on public education programs in the US why is it that you do public education in the US and then health in the world's poorest countries why not education in the the world's poorest countries as well well by far the biggest program we have is the Global Health Program and that's over 60% of our money it's helping to invent new tools like malaria vaccine AIDS vaccine and then supporting these primary healthcare systems to get out to all the children in the US we picked education as our big cause and you know once we've had a major major success in the US I'm sure there'll be lessons for the entire world on that but you know we saw the biggest deficit in the u.s. is the the lack of equal opportunity which is what the country stands for the health system although very expensive you know it's it's working you know quite well we didn't see anything huge we could do there we do talk to the people who do international education we think that's very important but taking on the big diseases and these delivery systems you know that's our priority that's where we have incredible depth of expertise and you know over the next several decades even something like malaria we should get it close to eradication so they you know you can really bring a dramatic solution and health that enables education and prosperity so a lot of people think that if all the world's poorest countries were healthy functioning democracies then it's the governments that should be providing public health care but the Gates Foundation of course is spending a lot of money on public health care are you not doing the government's jobs for them well absolutely it's a job for government to do and once countries reach a certain level of income say like Vietnam or Indonesia or India then they graduate from aid eligibility that is they're entirely using domestic resources and that's the goal of development aid is is to help countries graduate so the track record theirs is pretty fantastic now a lot of countries are in terms of their being very poor or the lack of governance that's not going to happen anytime soon and so as human beings you know we should care about those deaths we should care about the malnutrition and we should help build that government capacity so we're not in to stay in any country for the long run that's that's the government's job but you know take something like creating a malaria vaccine the poor countries who have malaria don't have the the skills or the resources to do it and the rich countries it's they haven't seen malaria for a long long time and so there are a few things but some people call global public goods we're having a foundation pick those scientists get behind them so the patients these are 10 to 20-year projects many of them and you have to have multiple approaches and change based on you know what what looks like it might be successful there's a rule that our foundation saw that wasn't mean fulfilled but it's not the long-term funding of the health system a lot of health care campaigners in many of these poorest countries are skeptical skeptical about the political will of the government to provide the health care that it should be providing to the population you know often they argue it's not a priority and you know corruption of course is the threat or too much is spent on big infrastructure projects and other things what can the Gates Foundation and what does the Gates Foundation do to try to hold these governments to account for the money that they should be spending on health care well we're purely in an advisory role we're not in control of any decisions the World Health Organization is in working with these countries the one thing we can do is we can highlight the exemplars and Africa has lots of exemplars even government's were some of the other functioning isn't too strong like Zimbabwe manages to keep its primary health care system functioning fairly well some that are fairly well-off like Nigeria actually particularly in the north don't manage to make the primary health care system work well so when leaders are interested in improving then there are lessons you know from Ethiopia or wander many many countries that can be applied so we're here to help when there's the will to go in and and make that effort and I want to talk about the the size and the scale of the Gates Foundation which understand is the largest philanthropic foundation in the world I think you're spending about four to five billion dollars every year I mean that's as much as or more than the entire government budget of you know many other countries in this continent so that comes with of course an enormous amount of influence your you know you're a big player in terms of global healthcare but understand that the trust is controlled by just three people that's you and your wife Melinda and Warren Buffett isn't that like an enormous concentration of of power and in you know in a sector that's of course meant to represent and help millions of people and meant to include a diversity of opinions and voices well the resources were using for our work don't come from governments they not solicit from other people this is taking the success that Warren Buffett had at Berkshire and the success I had at Microsoft and applying those resources in you know the free market system you know people can take their wealth and you know spend it on consumption or pass along to their kids you know what we've chosen to do is focus on the diseases of the poor and make sure that the best scientists in the world are working on HIV and malaria and malnutrition of prematurity things where the understanding is still not there and you know be great if that had been done before we came along actually in healthy the amount of controversy is less than you'd expect because the idea of savings children's lives it's just not that controversial and so taking and we built the infrastructure that can measure these deaths and the malnutrition through what's called the International Health metrics and evaluation which is funded by us now we know the various causes of death that's called the global burden of disease it's a brilliant website lets you see over time by country by age by disease what's going on and it's clear you should take the things like malaria diarrhea pneumonia that are killing lots and lots of kids and figure out how to say how to save those lives and so you know there's always tactics about ok which drugs should we put the money into or someone thinks ok you know my disease is right for a breakthrough but we're all united by this idea that lives have equal value and what's being done you know Falls way way short of taking the richness of the world and the great science of the world and helping the children particularly in Africa to live healthy lives in a lot of these poorest countries democracy activists and political opposition would argue that their health care is there is just one symptom of a much more fundamental problem of governance a lack of democracy and we're talking about countries that have disputed elections or you know sometimes no elections at all they would say that there's a myriad of problems and health cares you know a symptom of something much more fundamental I mean you have the foundation has a you know a lot of wealth and a lot of influence just by going for health care is it like you're putting maybe just a bandaid on these much bigger more fundamental issues well certainly if someone knew how to write checks and create perfect democracies then that should be looked at as a potential and investment as opposed to you know giving a kid a measles vaccine and keeping them alive you know I'd still argue that a measles vaccine no matter what form of government that child lives under those parents do care and you know malaria measles vaccine is a fairly cheap thing we've cut deaths in half and you know there is no great correspondence between form of government and how well the health care is run you know Nigeria collects the least in taxes of any country of any size and so even though it is a democracy the primary health care system in the north is not delivering and so you know it doesn't just because you have a democracy doesn't necessarily mean that those things happen now as countries get wealthier which does mean being serious about the health they do tend to become more democratic and do you think there's a second sequential chain in development that begins with healthcare that can then bring other developmental benefits and if so how does it work well of the overall aid which is about a hundred and thirty billion a year from which is mostly from the rich governments you know our foundation is a is pretty small percent it is large relative to foundations because we're over five five billion a year but it's small compared to the government budget so these these donor amounts about twenty percent goes to health and that's gone up quite a bit since 2000 it's partly the HIV emergency partly the realization the profound success you can have at very very low cost the fact that we measure and we can tell you even at a sub-national level what the disease burden looks like and as the health care system working well or not and and so if somebody wants to fix it we actually get them lots of timely dated a pretty small district area so yes health I no one would ever say that health alone is enough but if all those lives hadn't been saved from HIV if we weren't coming along cutting malaria deaths even the kids who survive are greatly damaged by the disease and the the malnutrition and so if you want to invest in their education which of course you should you want them to be healthy enough that cerebral malaria or malnutrition don't leave them stunted and we know that the learning outcomes for the kids which are pretty high percentage over a third those are very very limited so health fits in with you know infrastructure and government governance and education as the things that you know most people now live in middle income countries and you know so we've learned a lot about development and particularly the critical world that health plays I wanted to ask you about the role of intellectual property rights in in public healthcare in global healthcare Microsoft fought hard to try and to lobby for laws that would favor corporations in protecting intellectual property rights and of course the argument for that is that corporations will be more inclined to invest more if if they're in if their intellectual property is protected so they can earn more returns but many healthcare campaigners argue that the laws should go the opposite way all that the laws as they exist act to the detriment of the people in the poorest country who need medicines they argue that the intellectual property laws favor the big farmer and disadvantage the poor people who depend on medicines to survive having moved from IT to you know to global public health what's your view on this now well you sort of miss characterizing them as opposition but in any case the the ideal case is if a disease exists in the rich world and in the developing world then you get all your profit recovery and your Rd risk from the middle income in rich countries with tiered pricing and so when Gavi goes in to get vaccines or when global tonton goes in to get malaria drugs or HIV drugs there's no intellectual property increasing the price that it's the cost base and so our foundation is an expert in okay what is it costing on the margin to make these things and can we use volume commits or should we use a upfront spending to get a process optimized and so the developing countries are getting these medicines at a cost-based price in the meantime the fact that these companies have an incentive to invent new medicine that's the great greatest hope we have particularly for the non communicable diseases where today the costs of cure are just so very very high you know so sickle cell disease you know we hope that gets solved in the rich countries and then we can take and cost reduce that solution and bring it to these countries so you won't see patent lawsuits in poor countries where some hey so that's something there was one brief thing like that you know South Africa was sort of low middle-income we're on the AIDS drugs at first the pharmaceuticals didn't have the tiered pricing and that was a mistake they agreed it was a mistake and so we're very involved in making sure that that those medicines are made very very cheap in fact we just gave four hundred million of Vol guarantees to switch the first-line HIV medicine to a new a new set of drugs that are much less likely to have drug resistance and so we made sure that the cost based manufacturing because of those long guarantees they could stay at this less than hundred dollars a year so we are you know we have a lot of smart people making sure that medicines are getting to these poor countries at absolutely the lowest cost possible and you know somebody sees an idea to do that better you know we're the place that will take a look at that because we have no incentive other than improving these health outcomes I read that the Bill and Melinda Gates Foundation is due to wind up twenty years after both you and Melinda have passed on but why not keep up the good work because many other foundations will keep going for forever well the cause our biggest cause these diseases that are more prevalent in the poor countries we hope to have largely solved you know polio is close to getting done smallpox was done quite some time ago you know during my lifetime or certainly within 20 years after malaria HIV TB every one of these diseases can either be eradicated or brought to a very low level so there will be rich people in the future and they will understand better whether the problem is you know genetic modification robots you know what progress still needs to be made on climate change or other environmental issues so you know I can't from my grave be as analytical as I am today and so these resources will go to global health they're doing our best to get rid of these things so people you know it's like when you read in a book about consumption and somebody died of consumption you're like what is that well of course it's tuberculosis but in the rich world you don't see it much anymore these diseases should be a distant memory by the time our foundation wraps up its work and in the next 10 years what do you think we can achieve well it's pretty exciting we have a pipeline of new vaccines you know of course there's the danger that the rich world is distracted you know between turning inward or you know various polarization things the idea of keeping this a generous that's something that we need to remind people that even though it's far away even though everyone once a while they'll hear about some small percentage that went astray the actual impact of these donations to lift these countries up is pretty fantastic so assuming we maintain this great commitment that the donor country should be very proud of and it's been used to build capacity and drive towards eventual graduation you know I think by 2030 we can cut under 5 deaths in half again so it went from 12 million a year before our foundation was started now it's at 6 million a year and by 2030 we think with some innovation better delivery we can get that below 3 million a year so that's you know down to 2 and a half percent you know from 10 percent to 5 percent to 2 and a half percent and so you know time is on our side the science is making progress people are seeing the good examples as long as people maintain their commitment mr. bill gates thank you very much we're talking to Al Jazeera thank you

22 comments

  1. Those white Devils they are liars I'am so done from them they created war and disses around the world if he so care about global health care why he did not care about his own country US and European

  2. Mr, Bill stop over POPULATION if you can that is the problem providing halt environment that dos, not exist for this pepole…

  3. bill gates is giving out vaccines to African people to control the population once u take them u become barren n cannot have no more children

  4. La présidence de la plus grande nation du monde devrait être dirigée par des hommes au courent des événements mondiaux comme des problèmes internes de sa nation
    Je n'ai jamais compris pourquoi ces hommes qui changent radicalement le monde ne s'y présente jamais car ce qu'ils font est la vraie poltique réaliste qui change le monde

  5. I've heard of hypocrisy but this foundation an this guy takes the cake,
    There is an energy that would stop all pollution, (rid this world of gas engines diesel engines, hydro an nuclear plants, replace electric motors an generators, but they just ignored any request to help.
    People an this type of foundation will only give to those who give back to themselves personally,
    If they were serious if reducing help diseases, this world needs to eliminate all use of fossil fuels an all electric nuclear sources, But why do they continue on their blind track an we are still stuck in reverse !
    The answer is greed an selfishness for self,
    If they were not filthy rich, I assure you they would not be talking like this.

  6. Western Immigration policy means that 90% of the doctors that graduate leave their country of origin to work in the West. Things like Ebola spread so far and kill so many because there is a shortage of doctors, by the time the medical community becomes aware of an outbreak it is far too late stop it ripping through the population. Meanwhile in the West we have health checkups where healthy people go to the doctors so that the doctor can tell them there is nothing wrong with them.
    We could train our own doctors but it is cheaper to steal them and kill millions in the process while we feel good about being 'diverse'.

  7. It's all a them lie afrikan people never ever take the this Neanderthals Cave devil vaccines bring it in to European they need it better

  8. He is not fully forthcoming partly because he is ignorant of sustainable development doesn't happen in a vacuum and partly because he is not transparent on his own interest with the ruling regimes.

    If he is genuine, he could change the condition of Africa for a fraction of the resource supporting the free press and Democratic institutions with much better outcome.

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