New global era can end dis­eases of poverty

The National - News - - FRONT PAGE - BILL GATES Bill Gates is the co-founder of Mi­crosoft and the trustee and co-chair of the Bill and Melinda Gates Foun­da­tion

Ifirst met Sheikh Mo­hamed bin Zayed in 2011 when we be­gan work­ing to­gether on child­hood im­mu­ni­sa­tion and po­lio erad­i­ca­tion. His deep com­mit­ment to global health is ev­i­dent not only in his fi­nan­cial sup­port but also in his abil­ity to bring to­gether part­ners in the global health com­mu­nity and draw on the UAE’s ex­per­tise and re­la­tion­ships in the re­gion.

Since we first met, I have come to Abu Dhabi sev­eral times for im­por­tant global health con­ven­ings hosted by Sheikh Mo­hamed. The most re­cent was yes­ter­day’s Reach­ing the Last Mile Fo­rum, where more than 350 global lead­ers gath­ered to ad­dress is­sues cen­tral to elim­i­na­tion of in­fec­tious dis­eases like malaria and ne­glected trop­i­cal dis­eases such as river blind­ness and lym­phatic fi­lar­i­a­sis.

To ac­cel­er­ate these ef­forts, Sheikh Mo­hamed es­tab­lished the Global In­sti­tute for Disease Elim­i­na­tion, with sup­port from our foun­da­tion. Based in Abu Dhabi, Glide’s mis­sion is to ad­vance the global un­der­stand­ing of what has been ef­fec­tive in disease elim­i­na­tion and help coun­tries trans­late that knowl­edge into ac­tion. At the fo­rum, Dr Si­mon Bland, the new chief ex­ec­u­tive of Glide, ex­plained in de­tail what that would look like. For ex­am­ple, Glide will draw on the les­sons learned from po­lio erad­i­ca­tion to help coun­tries tackle other in­fec­tious dis­eases, in­clud­ing devel­op­ment of coun­try-spe­cific elim­i­na­tion strate­gies. It will also cham­pion greater aware­ness of these dis­eases – river blind­ness, in par­tic­u­lar.

The fo­rum was im­por­tant for an­other rea­son. Fun­ders and part­ners of the Global Po­lio Erad­i­ca­tion Ini­tia­tive (GPEI) re­newed their fi­nan­cial and po­lit­i­cal sup­port for one of the most am­bi­tious and sig­nif­i­cant public health ef­forts ever un­der­taken: end­ing po­lio world­wide, for­ever.

When the ini­tia­tive was cre­ated in 1988, three types of wild po­liovirus cir­cu­lated in 125 coun­tries that paral­ysed more than 350,000 chil­dren ev­ery year. To­day there is one type of wild po­liovirus that re­mains in just two coun­tries and the num­ber of cases has been re­duced by 99 per cent. That means 18 mil­lion peo­ple to­day are walk­ing who would oth­er­wise have been paral­ysed.

This progress has not been easy and the last steps to re­duce the threat of po­lio and erad­i­cate the disease may be the tough­est. Po­lio per­sists in some of the most dif­fi­cult places on earth: in war zones in­ac­ces­si­ble to vac­ci­na­tors, among mi­grant and no­madic pop­u­la­tions, in re­mote ar­eas, in neigh­bour­hoods where some par­ents do not want their chil­dren im­mu­nised and in com­mu­ni­ties lack­ing in ba­sic health ser­vices that are un­able to pro­vide po­lio vac­cines as part of rou­tine im­mu­ni­sa­tion drives. Given that there are fewer cases of po­lio, de­tect­ing the virus be­comes more dif­fi­cult. As most peo­ple in­fected show no signs of paral­y­sis, the virus can cir­cu­late silently for long pe­ri­ods of time be­fore it causes paral­y­sis in a child.

So the ini­tia­tive has had to get cre­ative about how to reach ev­ery child who may be at risk of get­ting po­lio, while also tai­lor­ing strate­gies to track and stop ev­ery last trace of the disease. There are a num­ber of ways in which the ini­tia­tive has done that.

For one, it has cre­ated the largest disease sur­veil­lance sys­tem in the world to look for chil­dren with symp­toms of po­lio or ev­i­dence of the virus in sewage sam­ples.

Hun­dreds of vac­ci­na­tors have been po­si­tioned at bor­der cross­ings and other tran­sit points to reach chil­dren who may not have been im­mu­nised at home. Emer­gency op­er­a­tions cen­tres have been es­tab­lished in en­demic coun­tries like Pak­istan, Afghanista­n and Nige­ria to en­able a quick re­sponse to out­breaks.

To in­crease re­cep­tive­ness to the po­lio vac­cine, the GPEI has in­te­grated po­lio im­mu­ni­sa­tion cam­paigns with ba­sic health ser­vices such as bed nets, vitamin A sup­ple­ments and re­fer­rals to lo­cal health clin­ics for those who need treat­ment.

The ini­tia­tive works with re­li­gious cler­ics and tra­di­tional lead­ers and has en­gaged fe­male vac­ci­na­tors who have the cred­i­bil­ity to in­crease com­mu­nity ac­cep­tance of the vac­cine.

In the face of out­breaks of a form of po­lio that can pop up in pop­u­la­tions with very low immunity, the GPEI is work­ing with Gavi, the Vac­cine Al­liance to en­sure that all chil­dren are ad­min­is­tered the po­lio vac­cine through stronger health sys­tems and vac­ci­na­tion cam­paigns. In ad­di­tion, a promis­ing new oral po­lio vac­cine is cur­rently in clin­i­cal tri­als that if proven safe and ef­fec­tive will be an ad­di­tional tool to pro­tect chil­dren from all forms of po­lio.

I am op­ti­mistic that with the GPEI’s per­sis­tence and cre­ativ­ity – and the con­tin­ued sup­port of part­ners, donors, and en­demic coun­try lead­ers – we will erad­i­cate po­lio.

I was en­cour­aged this week to see the world rally again in sup­port of the ini­tia­tive with com­mit­ments from a wide range of donors in­clud­ing Sheikh Mo­hamed; coun­tries such as Ger­many and Aus­tralia; en­demic coun­try lead­er­ship from Pak­istan, Afghanista­n and Nige­ria; GPEI part­ners like Ro­tary In­ter­na­tional; and phil­an­thropic or­gan­i­sa­tions in­clud­ing Al­waleed Phi­lan­thropies, Bloomberg Phi­lan­thropies, the Cha­rina En­dow­ment Fund, Dalio Phi­lan­thropies, the Tahir Foun­da­tion, and the Ningxia Yan­bao Char­ity Foun­da­tion. These were in ad­di­tion to the United King­dom that an­nounced its sup­port ear­lier this month. The sup­port demon­strated by these donors and part­ners is a pow­er­ful ex­am­ple of what is pos­si­ble when we come to­gether to tackle one of the world’s big­gest chal­lenges.It is ex­cit­ing to see this hap­pen­ing in other ar­eas of global health be­yond po­lio.

Last month, the Global Fund Re­plen­ish­ment Con­fer­ence raised $14 bil­lion to con­tinue the fight against Aids, tu­ber­cu­lo­sis and malaria. And next June the global com­mu­nity will meet to reaf­firm its sup­port of Gavi and its com­mit­ment to en­sur­ing equal ac­cess to vac­cines for chil­dren in the world’s poor­est coun­tries.

While each of these part­ner­ships is fo­cused on solv­ing a spe­cific prob­lem, to­gether they sig­nal a new era in global health where we are learn­ing from one an­other how to send the dis­eases of poverty into re­treat. It is a re­mark­able mo­ment – bring­ing us closer to a world where the place you are born does not de­ter­mine your op­por­tu­nity to sur­vive.

In­no­va­tions and part­ner­ships are ac­cel­er­at­ing the progress against dis­eases of poverty


Po­lio drops ad­min­is­tered at a rail­way sta­tion in Lahore

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