China Daily Global Edition (USA)
Bill Gates’ big plans
What does his foundation have in store for China?
Yinuo Li, China office director of the Bill & Melinda Gates Foundation, oversees the team that works with China’s public, private and nonprofit sectors to address key domestic and global health, development and policy issues.
Li started as a medical biologist, with an educational background in that discipline. After spending about 10 years at McKinsey & Co, where she was most recently a partner at the firm’s office in Palo Alto, California, she joined the Gates Foundation in 2015.
The foundation’s office in Beijing opened in 2007 with a focus on HIV prevention, tuberculosis (TB) control and tobacco control. Along with those efforts, the office developed important strategic partnerships with China’s public and private sectors to develop and deliver low-cost, high-quality health and development innovations that can improve lives in other countries, particularly those in sub-Saharan Africa.
The following are edited excerpts of an interview with Li:
What is the Gates Foundation’s focus in China?
China has always been an important partner for the foundation in advancing our global goals. Our vision for China is ambitious. While we continue to support development within China in areas such as HIV, tuberculosis (TB), tobacco control, and philanthropic development, we are also committed to supporting China as a development partner for the rest of the world. By tapping into Chinese resources, innovation and expertise, we aim to replicate China’s remarkable success in addressing health inequity and poverty in some of the poorest regions of the world.
China’s domestic reforms, increasing global engagement and emerging capacity for innovation only serve to reinforce our faith in China’s potential as a catalyst for development worldwide.
What have been the foundation’s biggest accomplishments in China so far?
I’d like to highlight our TB program. China is one of the top TB “high burden” countries. According to the World Health Organization (WHO), nearly 1 million people develop tuberculosis (TB) in China each year — more than in any other country except India and Indonesia. In addition to a high burden of the disease, China has about one-fifth of the world’s cases of multidrug-resistant TB (MDR-TB), which is especially difficult and costly to treat.
In the past eight years, we’ve been working closely with the National Health & Family Planning Commission on a TB-control program, which has significantly improved the accuracy and speed of diagnosis and treatment and reduced MDR-TB patients’ share of the cost by 80 percent.
Currently, our work covers the building and implementation of TB prevention and control models that target reducing the number of TB cases, especially Multidrug Resistant Tuberculosis (MDR-TB) cases. We are also working with partners to drive innovations in diagnostics, treatment approaches, monitoring, service delivery models and new financial approaches. The recent release of the National TB Control Plan 2016-20 is especially exciting and we are glad to have been part of the progress.
What are the biggest challenges in the world?
Definitely there are many challenges. But as Bill Gates said, if anything kills more than 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war. Not missiles, but microbes.
Now, part of the reason for this is that we’ve invested a huge amount in nuclear deterrents. But we’ve actually invested very little in a system to stop an epidemic. We’re not ready for the next epidemic.
In a world more interconnected than ever, it is vital that governments and the private sector invest and work together to ensure we can stave off future epidemics.
The Gates Foundation has been working with our partners around the globe to explore new approaches to build such kind of partnership. Global Alliance for Vaccines and Immunization (Gavi) is a great example in case. It was created to bring together the best of what key UN agencies, governments, the vaccine industry, private sector and civil society had to offer in order to improve childhood immunization coverage in poor countries and to accelerate access to new vaccines. It’s very encouraging to hear that since its inception in 2000, Gavi has helped developing countries to prevent more than 8 million future deaths.
What is the biggest challenge in China?
China has made huge strides over the past three decades, bringing hundreds of millions of people out of poverty and meeting significant health challenges. However, China still has over 40 million people living below the national poverty line — making China second only to India in terms of the largest population of the poor.
China has committed to eradicating extreme poverty by 2020. It’s not an easy job at all, as finishing the last mile fight has always been challenging.
The Gates Foundation is committed to join the last mile fight in China. We just signed a MOU this March with the Office of Poverty Alleviation and Development on poverty alleviation policy research, and promoting and sharing China’s poverty alleviation experiences both in China and worldwide.
What’s the role of China in this process of making a difference?
While China is still a developing country with a range of its own development challenges, as it continues to develop at a rapid pace its role in international development will inevitably change.
In fact, China is playing an increasingly prominent role in helping the world meet its biggest health and development challenges.
In Africa, China is one of a number of stakeholders, alongside the US that is assisting in building local capacity for disease control. Also in Africa, Chinese expertise in agricultural technology and approaches are helping African farmers produce greater, more reliable yields.
It’s very exciting to see that China shows increasingly strong global leadership in helping other developing countries address their health and poverty challenges. For example, China hosted the latest G20 Hangzhou Summit in 2016, highlighting development as a priority agenda for the first time in G20. Another example is that China pledged $60 billion to promote African development at the Forum of China-Africa Cooperation in 2015.
The Bill & Melinda Gates Foundation and the National Natural Science Foundation of China launched a new Grand Challenge last year: New Interventions for Global Health. How has China been involved in the investment and partnerships fostering innovation to solve key global health and development problems?
A good example of health innovation is the Reinvent the Toilet Challenge (RTTC), an initiative the foundation supports in China.
RTTC is designed to stimulate creative solutions to managing waste from public toilet facilities through stand-alone, selfcontained modules. It is a great example of how Chinese-designed technology can be deployed to solve challenges that affect not just China but the wider developing world. Separately, the Chinese government is investing significantly in improving sanitary facilities across the country. The China National Tourism Administration has announced plans to build or rebuild 100,000 toilets nationwide in the next five years.
Other challenges need systemic solutions. An example of this is the work we are doing with the China Food & Drug Administration (CFDA).Through our work with the WHO, we are helping the CFDA improve its regulatory capacity.
Our ultimate hope is that the CFDA can become a “sustainable functional regulatory authority”. This is the key to creating an environment where Chinese producers of innovative, high-quality and low-cost vaccines can get their products to market in an economical way.
If more high-quality, affordable Chinesemanufactured products could be WHO prequalified; the ability of the global community to address global health challenges would be greatly strengthened.
Last year the foundation announced the establishment of the Global Health Drug Discovery Institute (GHDDI) in Beijing, in partnership with the Beijing Municipal government and Tsinghua University. How is the partnership going and what is the philosophy behind the partnership?
We are tremendously excited by the potential of the GHDDI to make a major contribution to disease control. We announced our intention to set up the Institute at the beginning of last year. And it was officially launched last month in Beijing, when Bill visited China.
GHDDI is the foundation’s first foray into founding such an institute globally. We hope this cooperation will leverage China’s technology R&D capacity, while ensuring that all information and knowledge gained from projects it funds will be promptly and broadly disseminated, and that all global health drugs developed as a result will be made available and accessible at an affordable price to those most in need. The success of this institute will play an important part in winning the fight against infectious diseases that disproportionately affect the poorest in developing countries.
Our philosophy behind philanthropy is to make markets work for the poor through catalytic philanthropy. As Bill once said, risk takers need backers. Good ideas need evangelists. Forgotten communities need advocates. And whether your chief resource is volunteer time or hard-earned dollars, for a relatively small investment, catalytic philanthropy can make a big impact