Bill Gates' annual letter calls for focus on eradicating polio, governments to sustain foreign aid

Bill Gates, co-chair of the Bill & Melinda Gates Foundation, "urged developed nations to help him wipe out polio 'once and for all' at an event to release his third annual letter [.pdf] Monday," Agence France-Presse reports. "Eradication will take amazing work, and I truly believe we can succeed," Gates said during the event, which was held "at the house in New York where Franklin D. Roosevelt recovered after being stricken with polio at age 39, before he ran for and won his first term as U.S. president," the news service writes (Zeitvogel, 1/31).

Polio "has been challenging to eradicate worldwide, but Mr. Gates argues [in his letter] that the job can be completed with enough financial support. The Gates foundation puts $200-million per year toward polio eradication, but Mr. Gates says a $720-million gap in needed support still exists for the next two years," the Chronicle of Philanthropy reports. "He cites estimates that savings from eradication of polio could be worth up to $50-billion over 25 years, when one considers the savings on treatments that would not be necessary, plus the economic contributions of adults who wouldn't get polio," the publication writes (Gose, 1/31).

In the letter, which is "a personal account" of Gates' priorities, according to a press release from the Gates Foundation, he "also calls on governments to invest in foreign aid, even in the face of a tough economic climate" (1/31).

"Woven throughout his letter was Mr. Gates' concern that the global financial crisis is crimping foreign-aid budgets," the Wall Street Journal writes. "Aid, is an easy target, he said. 'It's got in a sense the weakest constituency,' he said," the Wall Street Journal writes (Guth, 1/31). "I believe it is in the rich world's enlightened self-interest to continue investing in foreign aid. If societies can't provide for people's basic health, if they can't feed and educate people, then their populations and problems will grow and the world will be a less stable place," Gates wrote in the letter (1/31).

Making significant gains in the fight against polio could promote success in other global health work, according to Gates, the Wall Street Journal reports. "The eradication of smallpox - the only human disease to be killed off by man - in the late 1970s helped generate interest and funding in other diseases. The polio eradication effort was sparked at that time. Achieving eradication of polio can 'not only help us get vaccination rates up but also help us add in some new vaccines,' he said," according to the newspaper (1/31). 

Gates also "reminds his readers that 1.4 million children will die this year from diseases for which there are already vaccines - like measles, pneumonia and tetanus," the Associated Press writes (1/30). "If we simply scale up existing vaccines in the five countries with the highest number of child deaths, we could save 3 million lives (and more than $2.9 billion in treatment costs alone) over the next decade. In addition, researchers are inventing new vaccines for malaria, AIDS, and tuberculosis, and these would save millions more lives. But generous aid is required to realize the true lifesaving potential of vaccines," Gates writes in the letter (1/31). 

ABC News highlights some of the attendees at the event. "In the second row sat Dr. Peter Salk of San Diego, a son of Dr. Jonas Salk, inventor of the first polio vaccine ... Seated next to Salk were Debbe Sabin, a registered nurse, and Amy Sabin Horn, who represented their father, Dr. Albert Sabin, inventor of the oral polio vaccine made from live, weakened polio virus," ABC News reports (Allen, 1/31).  

Gates' letter "also emphasizes the need to continue improving U.S. schools, and urges more leadership, innovation and investment for issues like maternal and child health, malaria, HIV/AIDS and agriculture," according to the press release (1/31). The webcast of the event is available online.

Some Experts Question Whether Polio Eradication Is Possible

"However, even as he presses forward, Mr. Gates faces a hard question from some eradication experts and bioethicists: Is it right to keep trying?" the New York Times writes.

"Although caseloads are down more than 99 percent since the campaign began in 1985, getting rid of the last 1 percent has been like trying to squeeze Jell-O to death. As the vaccination fist closes in one country, the virus bursts out in another. In 1985, Rotary raised $120 million to do the job as its year 2000 'gift to the world.' The effort has now cost $9 billion, and each year consumes another $1 billion. By contrast, the 14-year drive to wipe out smallpox, according to Dr. Donald A. Henderson, the former World Health Organization officer who began it, cost only $500 million in today's dollars," the newspaper notes. Richard Horton, editor of The Lancet, and Arthur Caplan, director of the University of Pennsylvania's bioethics center, also question the focus on polio eradication.

"The United States is still committed," the New York Time adds. "If we fail, we'll be consigned to continuing expensive control measures for the indefinite future," said CDC Director Thomas Frieden. "Ezekiel J. Emanuel, chief bioethicist for the National Institutes of Health, who is seen as a powerful influence within the Obama administration, said he had 'not seen enough data to have a definitive opinion.'" Emanuel added, "But my intuition is that eradication is probably worth it." David Heymann, a former WHO chief of polio eradication, is also quoted in the piece and said he remains "very optimistic" that polio could be eradicated (McNeil, 1/31).

The Financial Times reports on some experts' doubts about polio eradication. The piece also notes Henderson's perspective, who said polio eradication had "become more of a 'movement' than a public health initiative capable of being examined by objective judgment." David Molyneux, head of the Global Alliance to Eliminate Lymphatic Filariasis and past president of the Royal Society of Tropical Medicine and Hygiene, said he unsure about "the feasibility of eradicating polio." He added, "A lot more could be done with the money."

The WHO's Polio Eradication Director Bruce Aylward "said it would be cheaper to pursue eradication because returning to a less intensive control programme ran the risk of reversion to a time with up to 1,000 deaths and 250,000 cases of paralysis globally every year" (Jack, 1/27).