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Gates' Goal Shows High Hopes for Global Health

MELISSA BLOCK, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block.

MICHELE NORRIS, host:

And I'm Michele Norris.

It's a big gift and its been given to an organization with big ambitions. One day after Warren Buffett announced his unprecedented $31 billion donation to the Bill and Melinda Gates Foundation, the question is what can a charitable foundation with unprecedented resources realistically achieve? Bill Gates has made it clear he's not thinking small.

Mr. BILL GATES (Bill and Melinda Gates Foundation): Within our lifetime I would expect that all these top 20 diseases, we would have vaccines and medicines to eliminate the disease burden of those.

NORRIS: Melinda Gates has said she dreams of a vaccine to conquer AIDS. Those aspirations top even Richard Nixon's 1971 declaration of a war on cancer.

As NPR's Richard Knox reports, the Gates dream for global health may not be too farfetched.

RICHARD KNOX reporting:

It's safe to say that public health experts were bowled over by Bill Gates's vision of ridding the world of the top 20 diseases, but that doesn't mean they thought he was overreaching.

Mr. NILS DAULAIRE (Global Health Council): I don't think Bill Gates's statement was grandiose at all. He recognizes what can be done. Now, with this level of resources, I'm hoping it will.

KNOX: That was Nils Daulaire of the Global Health Council. He says the 12-year-old Gates Foundation, with a mere $30 billion endowment, has already raised the sense of possibilities beyond what anybody in the field has ever seen.

Mr. DAULAIRE: The whole focus on the development of new vaccines against AIDS, tuberculosis, malaria, various childhood diseases, those were kick-started by investments from the Gates Foundation.

KNOX: But eliminating the world's top 20 diseases? Do Bill and Melinda Gates know what they're talking about?

Dr. CHRISTOPHER MURRAY (Harvard University): I think nobody on the planet could call Bill or Melinda naïve.

KNOX: Dr. Christopher Murray of Harvard is author of a 1000-page tome called The Global Burden of Disease. He says it doesn't matter how long the wish list of diseases is.

Dr. MURRAY: I'm sure some will be achieved and some won't be, but I'm a huge believer in articulating ambitious objectives and striving for them. I think that's actually what drives change in the world.

KNOX: Murray says the world's leading killers offer the Gates Foundation many opportunities to make a big difference with existing medicines and methods, diseases such as pneumonia and diarrhea that kill millions of children every year. Creative management and yes, money, can make a big difference. But the top killers include much bigger challenges.

Dr. MURRAY: They include heart disease, stroke, road traffic accidents and actually depression, and the challenge is to come up with strategies, drugs, vaccines that are affordable for poor countries.

KNOX: It's not entirely clear whether Bill Gates meant to include these non-infectious diseases on his hit list. Until last November, Dr. Richard Klausner was Chief of Global Public Health for the Gates Foundation.

Dr. RICHARD KLAUSNER (National Academy of Sciences): It never purported, at least while I was there, to be talking about all disease. We really didn't work on cancer, heart disease, depression. This is really about neglected diseases, where this level of resources and this level of attention can really have an impact and, you know, it's only $60 billion.

KNOX: It's all relative. Once the Gates Foundation gets its new money, that $60 billion will allow it to disburse around $3.5 billion a year. That's more than three times what the World Health Organization spends, but it's only a small fraction of the $80 billion the world devotes to drug and vaccine research and development and it's a tiny fraction of the $400 billion the world's poor and middle income countries spend on health.

But Harvard's Chris Murray says the Gates Foundation has a disproportionate effect on setting agendas. People in the field are already talking about a golden age of public health, an era undreamt of just six or eight years ago.

Dr. MURRAY: We have hundreds of students coming in to Harvard College who are incredibly excited and motivated about doing something in global health and that's completely caught people by surprise.

KNOX: But can that be sustained, even with the Gates' billions, against such daunting problems?

Dr. MURRAY: My only fear about this sort of golden opportunity or golden era that we're living through is that if two or three years roll by and we haven't got anything much to show for success, then I think there'll be a huge countermovement to say we focus too much on global health.

KNOX: Murray says there are still those who say health is a luxury that poor countries should worry about after they've had more development.

Richard Knox, NPR News. Transcript provided by NPR, Copyright NPR.

Since he joined NPR in 2000, Knox has covered a broad range of issues and events in public health, medicine, and science. His reports can be heard on NPR's Morning Edition, All Things Considered, Weekend Edition, Talk of the Nation, and newscasts.