Bill Gates, Jr., Co-founder of the
Bill and Melinda Gates Foundation
U.N. Secretary General's Luncheon United
Nations - New York, NY
Thursday, 9 May 2002
Your Excellencies, Ladies and Gentlemen.
Thank you for this invitation to speak. It's an honor
to address so many heads of state. And it's a particular
honor to do so alongside Secretary General Annan and
President Mandela, whose contributions to humanity make
them two of the most admired men in the world. I'd also
like to thank Carol Bellamy and UNICEF for their commitment
to children and for sponsoring this meeting of world
Is the world going to take care of its
children? That is the question we came here to answer.
While many important issues will be discussed
at this historic Special Session, it's my belief that
improving health is the best way to start improving
the future for our children.
Today, one in 12 children dies before
the age of 5 mostly from preventable diseases - from
measles, malaria, diarrhea. One in 12.
Disease leads to poverty, and poverty deepens disease.
But the good news is that where health takes hold, women
choose to have fewer children; and literacy, equality,
the environment, and economic opportunity all improve.
When health improves, life improves by all measures.
My personal commitment to improving global
health started when I learned about health inequities.
I remember reading the 1993 World Development Report.
Every page screamed out that human life was not being
as valued in the world at large as it should be.
My wife Melinda and I were stunned to
learn that 11 million children die every year from preventable
causes. That is when we decided to make improving health
the focus of our philanthropy.
The leaders here who face public health
challenges know personally the inequities in global
- 95% of all new HIV infections occur in developing
- 99% of TB and malaria sufferers live in developing
Yet where demand for health spending is greatest, supply
Rich governments are not fighting these diseases because
the rich world doesn't have them. The private sector
generally is not developing vaccines for poor countries
because poor countries can't buy them. Of the $70 billion
spent globally on health every year, only 10% is devoted
to research on diseases that make up 90% of the total
Market-based capitalism works well for the developed
world, but our human values and compassion are needed
to save these children. Markets alone won't do this.
What will happen if we do nothing?
On current trends, a hundred million people will have
been infected with HIV by 2005. Without a decisive intervention,
China could soon have 20 million cases. India also is
at a tipping point it can act aggressively and
keep prevalence below one percent as Brazil has done,
or see infection rates skyrocket as they have in parts
Without an aggressive global effort to reverse the
course of the AIDS epidemic, the impact on our children
will be catastrophic:
- Half of all 15-year olds in South Africa and Zimbabwe
will lose their lives to AIDS.
- 44 million children in Africa will have lost one
or both parents to AIDS by 2010.
We can't change the past. But we can change the future,
as long as we start now. The challenge is daunting,
but I am optimistic.
I believe we have never been in a better position to
make dramatic improvements in global health.
Today, we have several unique opportunities:
The first opportunity is to learn from our successes.
Thirty-five years ago the United Nations launched a
successful campaign to eradicate small pox. Looking
back, that campaign has prevented 350 million people
from contracting smallpox and 40 million from dying
It has also shown that eradicating disease is a good
investment. The total twelve-year cost of the smallpox
eradication effort was $300 million the same
as a single-year cost of small pox vaccination, quarantine
and treatment the year the campaign began. In other
words, we didn't spend any more, we just spent it more
wisely, and now we're saving $300 million every year
because we eradicated small pox.
The same principles that led to that success are now
being put to work to eradicate other diseases, including
The second opportunity comes from proven models of
collaboration. One of our earliest grants was to establish
the Vaccine Fund, a fundraising arm for the Global Alliance
for Vaccines and Immunization, or GAVI, whose goal is
to fully vaccinate every child in the world, which would
save the lives of 3 million children every year.
GAVI is a collaboration of our foundation, the Rockefeller
Foundation, the World Health Organization, the World
Bank, our host UNICEF, the vaccine industry and governments
in both developed and developing countries. This is
a phenomenal range of talent, resources, and experience.
One recent example of the work of GAVI and the Vaccine
Fund is a $40 million grant, which will be matched by
the government of China, to dramatically increase the
use of hepatitis B vaccine in China.
Just before this luncheon, I helped announce another
example of a promising global collaboration, the Global
Alliance for Improved Nutrition, or GAIN. GAIN is a
coalition of national governments, multilateral organizations,
foundations, and private companies that are fortifying
foods to address micronutrient deficiencies in low-income
It costs relatively little to fortify foods with Vitamin
A, iron, iodine and other micronutrients, and by doing
so it will save lives, reduce health care costs, improve
productivity, and help children reach their potential.
These are the kinds of initiatives that break new
ground in collaboration and prove that it is possible
to launch global responses to global health challenges.
The third opportunity comes from the increased attention
being given to global health. Take the last year alone:
The United Nations, under the leadership of Kofi Annan,
held a Special Session on AIDS.
The Global Fund to Fight AIDS, TB and Malaria was
established and it has just announced its first round
Global health was a central topic at the World Economic
The President of the United States pledged to increase
development assistance by $5 billion a year.
These things were not happening three or four years
ago. They represent new opportunities. These opportunities
can all work in our favor. But to build on them, we
have to do three things:
First, we must increase the visibility of what is
happening to our children. Health inequities continue
to worsen. I believe this is because people who see
the worst of it don't have the resources to defeat it,
and the people who have the resources to defeat it don't
see the worst of it.
I believe that if you took the world and you randomly
re-sorted it so that rich people lived next door to
poor people so, for example, people in the United
States saw millions of mothers burying babies who had
died from measles or malnutrition or pneumonia
they would insist something be done.
And they would be willing to pay for it.
Second, we can't just tell people about the problems.
We have to tell them about effective, affordable solutions
- about how little money it takes to save a life.
If people knew that the measles vaccine costs only
If they knew we could prevent children from dying
of malaria with a bednet that costs just $4
If they knew we could prevent a child's death from
diarrhea for 33 cents using Oral Rehydration Therapy
If they knew these facts, more and more people would
provide the resources needed to solve these problems.
The third critical element is political leadership.
This is something that only the distinguished guests
in this room can provide. Foreign aid and foundation
giving can achieve important advances, but the big examples
of national success have all required political leadership.
This is especially important on the issue of AIDS.
Many of you have been willing to speak out about AIDS
and its impact. That has been part of every national
success story, including Uganda which brought
its HIV prevalence from above 30% to below 10%; and
Thailand which cut infection rates of high-risk
groups by two-thirds.
Another important act of political leadership
is to increase health budgets. A strong commitment from
you will inspire a stronger commitment from your partners.
These partners look to you for clear results and transparent
Leaders in the developed world have said
they will increase their support as you increase success.
I believe you should take them at their word
and hold them to their word.
We are in a better position than ever
before to make dramatic improvements in global health.
We have models of success. We have breakthrough interventions
for childhood diseases. We have global collaborative
efforts. We have rising demand for action and the political
will to tackle these issues.
With more visibility and more resources
and more political leadership, we can eradicate diseases
like polio. For fifty years children have suffered from
a disease we know how to prevent. Let's end it. Let's
eradicate Guinea worm. Let's get vaccines to every child
and save 3 million lives every year. Let's recommit
ourselves to developing and deploying vaccines against
AIDS, malaria and tuberculosis. If we do this, we will
change the world's view of what's possible.
It all depends on our answer to the fundamental
question: Is the world going to take care of its children?
It's our choice. But we must choose now.
Personally, I hadn't planned on getting involved in
philanthropy until later in life; when I was in my sixties;
when I could devote full time to it. But the more I
learned, the more I realized there is no time. Disease
won't wait. So I committed myself to this cause, and
I will keep that commitment for the rest of my life.
And I am thrilled to be a part of this effort.
I believe together we will take care
of our children. We can do it and nothing on
earth is more important.
Thank you all very much.