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During  an Africa Media Interview,  CEO of the Bill & Melinda Gates Foundation, Dr. Susan Desmond-Hellmann, an expert in health and medicine (oncology and biotechnology) and a leader with strong underpinning of working at a large institution, spoke to Sola Ogundipe  about  the Foundation’s efforts to promote equity for all people around the world. She talks about strategies and priorities to eliminate poverty, polio and malaria while facilitating relationships with key partners. Excerpts:

Dr. Susan Desmond-Hellmann

POLIO eliminationLet me just start by saying how incredibly pleased we are with the progress in polio.  You know very well that we don’t want to be premature in celebrating or declaring victory, so to speak, but polio progress and our colleagues in Nigeria and our colleagues at WHO, UNICEF, Rotary, deserve much credit for the hope we have now in polio.

What’s next?  Well, let me tell you, disease eradication, and we’ve seen this with polio, is a very, very challenging thing to do.  And so we’re cautious and hopeful that a few things are in our sights.

Malaria eradication

In malaria what we’ve said is we would like to be in a position, you know, so many of us with SDGs have focused on 2030.  We’d like to have the world in a position to consider malaria eradication by 2030.  And that strategy is very much a regional one.  So focusing on regions is very important.  So malaria’s very, very, very different than polio, but focusing on regional control to allow for the concept of elimination is important.

Support for malaria vaccine

The Foundation has been supporting a broad portfolio of work in malaria that has included support for the vaccine development for malaria.  I’m not sure of the specific investment you’re asking me about, so I can’t tell you whether we support that specific investment, but I can tell you that the foundation has a very large program in malaria that includes a variety of different investments that includes a vaccine, but increasingly we understand the need for more technical advances, more technical advances in mosquito control, in medications, given the emergence of resistance, for example, in vector control.

We know that the Anopheles mosquito has increasingly become resistant.  We also know that even with our best remedies, that the malaria parasite is resistant. So we have a portfolio of investments, and I can tell you for sure we’ve continued to have as a high priority malaria.

Neglected Tropical Diseases

The Neglected Tropical Diseases, what people call NTDs, are also quite positive right now.  Now, I give an example in the letter of one of those neglected diseases that we think the African sleeping sickness is a great example of something that really we are on the brink of eliminating, and that’s because of very smart partnerships, innovative partnerships between private companies, nongovernmental organizations and governments.

African sleeping sickness is not a common illness, but it’s a devastating infectious disease that impacts the poorest people.  So that’s a great example of how we fight disease, focusing on the poorest.

Emerging health threats

From a very big picture perspective, pandemics and the threat of pandemics has been extremely important for our foundation, and in fact Bill Gates has written extensively and spoken extensively about how while the world, especially on Ebola, we almost got a little fortunate.  As sad and concerning as Ebola is and was, had Ebola been flu, we wouldn’t have been in a position to be as effective as the world needs to be in combating these global threats together. So we have participated in the global dialogue about how to be better ready for any of these infectious threats.

Specifically in Ebola our foundation has made significant investments in a number of things, particularly in the early and middle phases of the Ebola threat, making sure that we invested, together with other colleagues, in containing the spread of Ebola, specifically outside of the West African countries, working with innovators to come up with better and more effective diagnostics and therapeutics and vaccines.

Primary healthcare

Something that I think is extremely important, not only to those West African countries but globally, increasingly, we’re investing in primary healthcare and in health systems, in collaboration with government, because in the end, these individuals need good healthcare, and in the absence of a strong healthcare system, we won’t see or effectively combat these diseases.

Vaccines and health innovation

Making a new vaccine or having a new vaccine available is not enough by itself.  As you probably know, we’ve invested in GAVI and we think GAVI is a very exciting, new way to think about public, private, NGO partnerships.  So GAVI has made it possible to have lower cost vaccines and allows us to think about low-income countries and their access to vaccines.

We’ve also, together with GAVI, but also many other partners and national governments, increasingly been focused on delivery and development.  So we’ve invested,   and I’ll give you some examples  we’ve invested in supply chain, and specifically cold chain, because we understand that the supply chain is essential to getting those inputs to where people need them and can benefit from them.

We’ve also invested in aspects of delivery that are related to demand, why would people want to accept a vaccine or seek a vaccine for themselves or their — their children.

And finally, as I mentioned before, increasingly we’re working in collaboration with governments to look at what are the elements of a healthy primary care system, what does a system need to do, as you said, to actually get these inputs, these very important interventions like a vaccine to the people who are the most remote who need them the most.

Investing in innovation

And so I would say over the last decade that’s been a shift for our foundation, not just investing in innovation but to make sure those innovations get to the people who need them, through supply chain, social marketing, community collaborations, and better communication, and finally health system strengthening.

Narrowing the poverty gap

If you take a step back and you look at narrowing the poverty gap, what we have felt is  extremely important is to look very broadly across the world at where we see those big gaps and where we see poverty hitting people the hardest. And so the — the most important tactics that we’ve taken, so Bill and Melinda are Americans, and we’re headquartered in Seattle.  So the poverty gap and the gaps and inequities in the U.S., the decision for the foundation has been to invest in U.S. education, both K-12 and then college or postsecondary education.

Outside the United States there’s a number of different ways that the foundation feels we can make a contribution.  First and foremost, we’ve made very important investments in health.  So we don’t think it’s possible for someone to have the chance at a healthy and productive life if they’re struggling with health issues or very high rates of maternal mortality, childhood mortality.