Dhabi this week global leaders pledged
to wipe out several diseases that have
plagued humanity since the beginning of
time Bill Gates the crown prince of Abu
Dhabi these are just a few of the
dignitaries that signed on it was really
an important moment I mean in this time
of fake news it was an affirmation of
science and in this period of growing
nationalism it was a commitment to
global cooperation but you know honestly
as the leader of one of the largest
global health nonprofits in the world
and also is one of the organization’s
that’s going to be called on to make
this happen I kind of had a different
reaction do you dudes know what you’re
even asking for you me you know it’s
kind of like getting that email from
your boss asking her do the impossible
yesterday so I had a drink I went to
and then I started thinking you know
what’s the real opportunity this
presents the live saved and my own
personal conviction to social innovation
and activism and I knew it’s time to
kind of roll up my sleeves and go to
work you and I are living in an
extraordinary moment in human history
it’s so time when new ways to fight old
diseases are giving us the power to
banish some of the worst killers from
the earth and you know what most people
don’t even know this is happening so
today I want to share with you the story
of the global effort to eradicate
diseases a story of turning the
impossible to the possible now I’m not a
doctor or a scientist so I might not be
the person you would normally expect to
tell this story I’m more actually what
people call the practitioner you know
the guy that’s called in to get stuff
done I’m a liberal arts major
I’ve had many careers my mom still
worries about that and in my current
role I’m a business guy who’s frequently
at the leadership tables in global
health and in that role I’ve had to have
a few technical terms explained to me so
let me start there so control what do we
mean by controlling a disease that’s
when we work to reduce the incidence of
a disease usually through like a
prevention or a treatment program and
our goal there is to minimize death and
suffering then there’s elimination no
elimination is when we do that so well
that that disease no longer exists in a
specific part of the world malaria is
actually a good example did you know
that malaria used to be a major public
health problem here in the United States
then we committed to eliminated in fact
we put the CDs
in Atlanta right in the heart of the
epidemic and in 1951 we eliminated it
however many countries in Asia and
Africa today are still just controlling
malaria in fact about 400,000 people die
every year of malaria and most are kids
under five then there is eradication
that’s when not a single person on earth
is afflicted by this disease
we’ve only eradicated one human disease
in history one smallpox in the first
half of the 20th century about a 500
million people died of smallpox but we
eradicated it and declared it eradicated
in 1980 it’s actually one of the most
amazing achievements in human history
but what’s interesting as smallpox no
longer has to stand alone as sort of a
one-hit wonder because there are several
projects underway to eradicate other
diseases and it’s actually become a
global movement now remember I’m the
practitioner at the table so I usually
bring a pretty skeptical eye to this
these things like a movement and so I
ask the tough business questions like
okay can we do this how are we gonna
execute it should we do it can we well
it’s a qualified yes let me step back
how many diseases do you think there are
in the world fifty a hundred a few
hundred the answer is none of those it’s
actually thousands it’s a little creepy
to think about but most of those will
never be eradicated given what we know
today diseases like HIV
and tuberculosis or even Ebola these
were doing better at controlling but
eradication is unlikely however there is
a handful of diseases that with the
right emerging scientific tools and the
right targeted resources we can
eliminate and then eradicate in our
lifetime the global community health
community is kind of converged on this
list of targets so polio 30 years ago
about 350,000 new cases of polio rebut
were reported each year this year we’ve
only we’ve only seen 12 12 cases and
next year we think we’ll see the final
case of poliovirus in the world
[Applause]
and then there’s guinea worm you know
I’ve never actually heard of guinea worm
before I took this job I don’t know have
you all it’s pretty horrible you get it
from contaminated water and then this
long worm forms and it emerges sometimes
like through a blister on your skin or
even through your eye and it causes
immense suffering pain and often
lifelong disabilities 30 years ago there
about 3 and 1/2 million people in the
world had guinea worm last year we’ve
only had 25 reported cases thanks to
water filters by the way so yes we can
eradicate diseases so now you get to
that other because the next question
like okay but how do we do this well of
course there’s no easy answer and every
disease is pretty different but there
are some common challenges and the gwee
the global community we have actually
started creating some pretty interesting
solutions well the first thing you need
to do is create the right scientific
product the safe effective and
affordable things like vaccines and
drugs and diagnostics and tools but the
problem is is most companies actually
don’t invest in these products because
they’re primarily afflicting the poorest
people in the world so we’re trying to
come up with new approaches for instance
government incentives to get industry
engaged philanthropic support for
research and development nonprofits like
path who are actually developing
products ourselves and a number of
interesting scientific collaborations
with government in fact this has been so
successful that we’re seeing enormous
scientific achievements and we have
hundreds of products in our pipeline but
just having the right product isn’t
enough you got to get it to the
but needed and this presents huge
logistical challenges so for instance a
vaccine must stay cold so we have to
think about ways to keep vaccines
refrigerated in places there’s no
electricity and we’re working on new
formulations for vaccines where you
don’t even need refrigeration and then
there’s the transportation issues like
we’re working on new ways to reach
remote communities including drones and
actually better ways to track and manage
the supply chain with electronic
vouchers and barcodes and other things
so like a little bit Amazon meets global
health but then you have to think about
the workforce so you may be surprised to
know that in many places we work many of
the community health workers are
volunteers and there they’re never
enough of them so governments must
mobilize and train huge armies of people
to undertake this effort in 1974 there
are about two hundred thousand cases of
smallpox still in India the government
put on a workforce of tens of thousands
of people against this problem actually
they visited every other month about 90%
of every household in India the next
year due to this amazing workforce and
not a single case none but you know you
can get the logistics and you can find
the products and you can even get the
workforce in place but communities need
to participate and actually sometimes
they don’t the early 2000s in Nigeria
religious leaders some religious leaders
issued fatwas against some vaccines with
based on the false claim that they might
reduce fertility in other countries
we’ve seen vaccine workers deliberately
targeted and murdered now fortunately
we’re getting a lot better at working
with tribal and religious leaders to
engage communities and create demand
in fact in some instances they’ve been
our best allies okay so we’ve been doing
this for a long time figuring out how to
get all these parts working together so
what’s creating this movement now two
things the first the amount of political
and financial investments has risen
exponentially there have been you know
the Abu Dhabi is just the most recent
example they’ve actually been a number
of big commitments of money and global
leaders around the world are making more
political commitments and we’re starting
all sorts of organizations in fact
there’s one expressly called
the end fund the second accelerator is
the power of digital transformation
think about it
mobile phones analytics satellite
mapping software even AI it’s actually
amazing on the ground to see how much is
beginning to happen in Africa let me
give you an example in Zambia in certain
regions in southern Zambia ten years ago
one out of every two people had malaria
now just think of that with this
audience that would mean every other one
of you it would be either you or your
neighbor had malaria now it’s about one
out of 200 and it’s getting better the
main reason is that we are beginning to
see health workers use mobile phones to
track and manage every single case of
malaria real time and then they map the
affected areas and then everybody in
that area gets an anti-malarial drug and
that area is about like 100 meters it’s
the average the flight range of your
average mosquito maybe something you
want to remember the next camping trip
so anyway we actually start to give
every everyone in anti malarial
because it’s not only that the people
who have malaria symptoms have the
parasites but people who many people
don’t have those symptoms so we’re going
not only after treating sick patients
but we’re actually trying to eliminate
the parasites and then we’re actually
using very cool topographical
information to map on water and rainfall
patterns so we can isolate just where
mosquitoes are breathing the power of
this data has driven an 85 percent
reduction in malaria deaths in Zambia in
just three years
[Applause]
in fact in fact Zambia’s government has
declared a commitment to have to fully
eliminate malaria by 2021 okay so we can
do this and actually we’re getting
better and better on how but then I have
to ask this final and sometimes
surprisingly difficult
last question should we is disease
eradication worth it okay the estimation
of what we’ve spent on the polio
eradication so far is about fifteen
billion dollars and because these last
cases are so hard to do to get to that
we think that the last case will cost
about two hundred million dollars to
stamp out 200 million and in these same
places many kids aren’t getting any
measles vaccines for instance and
measles still kill a hundred thousand
people or more every year and a measles
vaccine only cost twenty five cents a
dose two hundred million twenty five
cents so a lot of global health leaders
or some are really concerned about this
trade-off and actually question the
opportunity cost you know should we be
spending should be going after more
urgent health needs or should we be
spending a couple hundred million
dollars to go after the last case of
polio is eradication necessary it’s
actually quite difficult moral and
political and business question and
actually they’re very legitimate
arguments on both sides in the end I
believe we should pursue disease
eradication in fact I think we must why
well first the human and financial
impacts are compelling in the polio
eradication effort we’ve already saved
13 million kids from paralysis and we
believe that once we’re done we’ll save
the world billions of dollars but then
there’s the equity argument I am NOT
okay with a world for wealthy countries
get to eliminate diseases and poorer
countries have to just keep working at
controlling them how can I accept that
what is absolutely essential for my
child’s health for our children’s isn’t
necessary for others but then think
about the historic potential that this
movement unlocks if we eradicate one
disease will get better it and know more
about eradicating the next and the next
and the next
moreover this has becomes a virtuous
cycle better health leads to smaller
families stronger communities more
productivity and and more prosperity and
so it reinforces itself moreover if we
eradicate diseases and if we prove we
can deliver on these audacious goals
will build more credibility to go and
get the financial and the political
support we need to go tackle the world’s
next big challenges to go bin the
amazing arc of human progress even
further that’s the world I want to my
kids to live in that’s why we should
continue to champion the global effort
to eliminate and eradicate diseases it
can be done thank you
[Applause] [Music]