Foundation improves global health care

JOHANNESBURG, South Africa -- At field offices in the African bush and at medical schools and research labs worldwide, doctors and scientists funded by Bill Gates are starting to make a difference on a continent all too familiar with poverty, disease and early death.

The Bill & Melinda Gates Foundation is considered a leader in international public health, spending billions of dollars combating HIV/AIDS and malaria, the two biggest killers in Africa, as well as acute diarrheal illnesses, tuberculosis and poor nutrition.

The foundation spends money on programs, otherwise underfunded, that deal with the cause of widespread illness and death in developing countries.

It already was the best-endowed private charitable foundation when billionaire Warren Buffett announced June 26 he was giving it 80 percent of his fortune. That doubled its endowment to about $60 billion.

Buffet made sure his money will be available soon, stipulating that his donations were to be spent in the same year they were received. In his letter to the Gates Foundation, Buffett said he admired the foundation and wanted to extend its "future capabilities."

Since its inception in 2000, the foundation has donated about $6 billion to finance programs and research projects to improve access to health care and the quality of that care in developing countries. Africa has been a prime beneficiary.

Botswana has the world's highest HIV/AIDS infection rate, and a child born today can expect to live less than 30 years. The foundation gave $50 million to a national HIV/AIDS prevention and treatment initiative, helping it to increase the number of patients getting life-prolonging anti-retroviral treatment from 3,000 at the end of 2002 to more than 48,000 today.

"Botswana was the first country in the world to meet the World Health Organization goal of having half of the identified and eligible patients in the country on anti-retroviral treatment. We could have never have done this without the help of the Gates and the Merck Foundations," said program spokesman Pierre Pelletier in Gaborone.

Malaria also plagues the continent, infecting 350 million-500 million people a year and killing about 1 million, the vast majority of them African children. The mosquito-borne disease kills about 2,000 children every day.

The foundation is funding a special project in Zambia assessing the success of fighting the disease with drugs, insecticide-treated nets and spraying. The goal is to reach 80 percent of the population, reduce malaria infections by 75 percent and use the program as a model for other countries. No target date has been set.

Julian Lob-Levyt, head of the Geneva-based Global Alliance for Vaccines and Immunization, said the Zambian project shows how the foundation tries to think creatively and to use its enormous intellectual capacity to solve problems.

The foundation has donated $1.5 billion to GAVI, which has helped immunize tens of millions of children, and has just guaranteed its funding for the next 10 years, Lob-Levyt said.

"They have developed their own staff that is hard to match. They have the best global health organization outside of the World Health Organization or perhaps the World Bank," Lob-Levyt said.

Dr. Melinda Moree, head of the Malaria Vaccine Initiative, said the foundation is involved in every aspect of the programs it funds. The initiative is working on a vaccine for children with help from the Gates Foundation.

"When there is a problem, they have access to some of the smartest people in the world," Moree said.

GAVI spokesman Jean Pierre Le Calvez said its program to provide vaccines for hepatitis B, yellow fever, tetanus and diphtheria has saved an estimated 1.7 million lives, about two-thirds of them in sub-Saharan Africa, since it began in 2000.

Lob-Levyt and others involved in global health projects believe that the foundation, bolstered with Buffet's massive donation, will broaden and deepen its commitment to improving health care in the developing world and improving its already astonishing success.

"What this will allow is Africa to make a generational leap. In the next 20 years it will make health gains it took Europe 150 years to achieve," Lob-Levyt said.

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On the Net:

Bill & Melinda Gates Foundation, http://www.gatesfoundation.org

Global Alliance for Vaccines and Immunization, http://www.gavialliance.org

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