Wall Street Journal - January 25, 2012
BRUSSELS - Bill Gates, the world's second-richest man, wants more
The co-founder and former chief of Microsoft Corp., who has
recast himself as a philanthropist, doesn't want the money for
himself. Instead, as the world economic crisis drags into a fifth
year and increasingly takes on the pallor of a chronic condition,
Mr. Gates frets that some debt-straddled governments will reduce
their financial support for health programs in developing
"I don't see us getting the same type of [aid] increases that we
had from 2000 to 2010 - that's just not realistic," said Mr.
Gates in an interview here on Monday. "The question is now
whether we can sustain modest increases so that people, for
example, who need AIDS drugs, are able to receive them."
Bill Gates tells WSJ's Gautam Naik about the progress his
foundation has made in fighting dangerous diseases in the
developing world and argues that economic slowdown is no excuse
for governments to reduce their commitment towards global health.
On Wednesday, Mr. Gates will be at the World Economic Forum
meeting in Davos, Switzerland, where he plans to exhort wealthy
donors - especially governments - to keep funding a range of
crucial projects in the developing world, from tuberculosis drugs
and antimalaria bed nets to maternal care and vaccines. His plans
to make his case by showcasing ideas, backed by his foundation,
that have helped cost-effectively tackle problems in global
As co-founder of the Bill and Melinda Gates Foundation, Mr. Gates
says he travels extensively and keeps an eye on the scores of
projects supported by his Microsoft wealth.
"I get a sort of ringside seat to see where innovation really is
having an impact," said Mr. Gates. "I'm getting to see probably
more than the political leaders and hopefully that will get them
to see this choice, in favor of the poorest."
These are tough times for global health aid. The boom years ran
from 2002 to 2008, when double-digit increases in total spending
were recorded each year, according to research done at the
Institute for Health Metrics and Evaluation at the University of
Washington in Seattle, Wash.
Although the economic crisis hit in 2007, it didn't have an
immediate impact; total funding for global health rose 17% from
2007 to 2008, for example. However, the level of annual increase
fell to 4% from 2009 to 2011, according to preliminary estimates
done by the institute and recently published in the journal
"It's been very hard for politicians to convince their
populations to increase the amount of money they give to poor
countries," said Katherine Leach-Kemon of the Seattle institute,
a co-author of the journal study.
Bill Gates visited the European Parliament in Brussels on
Tuesday. On Wednesday, he will attend the World Economic Forum
meeting in Davos, Switzerland.
Ms. Leach-Kemon estimates that spending in 2011 from all donors
for health aid to developing countries totaled $28 billion, about
what Americans spend on Black Friday, the big shopping day after
Development assistance from the United Nations agencies fell
slightly from 2010 to 2011. Growth in such spending from
government-funded entities also slipped to 4%, partly reflecting
lower growth in U.S. government contributions.
Not all countries have been belt-tightening. While debt-strapped
Italy has recently made sizable cuts, Britain still plans to meet
its original commitments, Mr. Gates said.
One story that enlivens Mr. Gates is the vaccine-led fight
against polio in India, where not a single case has been recorded
in the past 12 months. Not so long ago, the country of 1.2
billion was regarded as the epicenter of the disease and one of
the biggest obstacles in the drive to eradicate it.
Globally, the number of polio cases has dropped to 1,349 in 2010
from an estimated 350,000 in 1998, according to the World Health
Organization. As a result, "there have been over three million
kids in the last decade who haven't been crippled by the
disease," said Mr. Gates, whose foundation pays about a fifth of
the $1 billion annual cost of polio vaccinations globally.
Eradicating the disease could re-energize vaccine campaigns
against other diseases that are currently falling short. "I'd
hope that we could get vaccination coverage from 70% [today] to
90% and get some of the newer vaccines into the delivery system"
for other major diseases, said Mr. Gates.
Cutbacks in global health spending could hurt programs that treat
HIV/AIDS, especially in Africa. The cost of providing lifesaving
AIDS drugs in a well-run program has dropped to $300 per patient
per year, according to Mr. Gates. But unlike the case with
malaria or tuberculosis, AIDS drugs need to be provided over the
"That's a tough situation where you have to pick which people get
the drugs - a terrible situation where people are fighting over
the drugs and nobody is getting a full" course of treatment, said
In recent months, Mr. Gates has made an effort to persuade other
billionaires to give away most of their wealth in their lifetime
or in their will. In the latest annual letter detailing his
foundation's activities, he notes that 69 people have signed up
to the idea so far. One is Mark Zuckerberg, co-founder of
Facebook. The Gates Foundation, whose endowment includes
contributions of more than $9.5 billion so far from Warren
Buffett, has made total grant commitments of $26.19 billion since
its inception in 1994.
"We make mistakes, we have dead ends," said Mr. Gates. "But
enough of it works that we have a real sense of excitement, just
as there was at Microsoft."