Dr Gopee

Bill Gates and the Sense of Possibility

— Dr R Neerunjun Gopee

‘When I was a teenager, I was captivated by computers because I believed they would change the world. I couldn’t predict the exact future, but I was amazed at this sense of possibility to improve and empower.’

On Tuesday 16 May, I had the good fortune to listen to Bill Gates delivering his speech to the 64th World Health Assembly in Geneva, where he was an invited Guest Speaker. As I sat there in the midst of the vast international audience, I reflected momentarily on another great human being of world stature whose address had once held me spellbound: Nobel prize winner Ilya Prigogine. He was the keynote speaker at the India International Centre in New Delhi in January 1996, where a three-day workshop on ‘Culture and Development’ was being held, presided by the Chairman of the IIC, Shri Karan Singh.

Ilya Prigogine won the Nobel Prize with Isabelle Stengers in chemistry for their work on something called ‘dissipative structures,’ which was explained in relatively simple layman’s language in their book ‘Order Out of Chaos’ that I had read. I could not for the life of me imagine what all this had to do with culture or development – until he started unfolding his ideas, transposing a model of the evolution of the structures of the universe to that of human cultures, to me a truly mind-blowing perspective and yet one that made so much sense out of the seemingly chaotic world in which we live. Trust great scientists to see things with such clarity and show the way to those who would listen and act upon their ideas.

From his speech, I gathered that several key personalities around the world have been listening to those of Bill Gates about how to transform the lives of people who were under their responsibility. As he described what he was doing – through the Bill and Melinda Gates Foundation – he was direct, matter-of-fact, as if it was just the natural thing for him to do, saving the lives of millions and easing the lives of as many again, using mostly his own fortune. He displayed the same sense of humility that he had shown when he was walking towards the pulpit, appearing almost shy for a man who is undoubtedly used to face people by their hundreds and perhaps thousands too a lot of the time.

And yet what he is doing is tremendously important for the health of populations across the world, why for the world itself because, as he rightly pointed out, ‘the greatest asset of every country is the energy and talent of its people. Disease saps that energy and squanders that talent.’ Convinced that preventing disease through vaccines ‘it’s possible to reduce this burden (of disease), and allow countries to tap into people’s full energy and nurture their talent,’ he is practically on a crusade ‘to free billions of people from this burden of sickness’ and ‘unleash more human potential than ever before.’

He explained how he got angry when he learnt that what he took for granted in his country was not true for much of the world. In sub-Saharan Africa which he had visited in 1994, hundreds of thousands of children died from diarrhoea. In the United States, by contrast, children no longer died from diarrhoea. He realized that health benefits were not uniformly available to everybody worldwide, and took the decision ‘to use not only my time but also all the wealth I’d acquired to confront that inequity,’ work towards which ‘my wife Melinda and I will devote the rest of our lives.’ His vision had changed from that of thirty years ago when he had started Microsoft – ‘a computer for everyone’ – to ‘good health for every human being,’ for he saw an opportunity for progress in what he considered to be the most rewarding work he could imagine: health and development.

Along with WHO and its Member States, he would promote a Decade of Vaccines. He qualified vaccines as ‘an extremely elegant technology. They can be inexpensive, they are easy to deliver, and they are proven to provide lifelong protection from disease,’ comparing them to the powerful and simple technologies they dreamed about at Microsoft. He had a vision of what the world would look like by the end of that Decade: polio eradicated, five or more new vaccines available to all the children of the world, and every country having a delivery system to make sure that those vaccines are getting out to every child.’ For this dream to materialize, there was a need to focus on strong immunization systems, and for accelerating the progress on vaccines.

He gave a concrete example of how the GAVI Alliance (Global Alliance for Vaccines and Immunization) that he had created, committing about 800 million US dollars to it, had partnered with other relevant stakeholders to introduce a brand new vaccine against meningitis A – a disease that was ravaging millions of children in Burkina Faso, Mali and Niger in West Africa. Along with WHO and another partner, his Foundation created the Meningitis Vaccine Project, setting a target price of 50 cents that would make the vaccine affordable.

To make this happen required a new approach: so the Project worked with a Dutch company to get key materials, arranged a technology transfer from the United States, and then partnered with the Serum Institute of India to provide the low-cost manufacturing – all this within a year. He went on to describe how the Serum Institute of India, led by Dr Cyrus Poonawalla, has really made huge advances in providing low-cost vaccines, provided more measles vaccines than anyone else, is driving down the price of pentavalent vaccines, and has plans to provide inexpensive diarrhoea and pneumonia vaccines in the years ahead.

He also gave the example of how enlightened technical and political leadership when combined can turn situations around, as in the case of polio in Nigeria. A nationwide effort led by Dr Muhammad Pate and other leaders in the ministry of health, supported by President Goodluck Jonathan and the minister of health, had brought down the polio rate by 90%, largely because the agency of Dr Pate had a robust accountability mechanism. He also referred to how the Chief Minister of Bihar Nitish Kumar had through sheer leadership skills taken a basic system and made it work very well, enough to up the vaccination rate of Bihar from 30 to 60% within a few years.

He appealed for strong leadership and innovation to make the Decade of Vaccines successful. As an encouragement, his Foundation will, starting next year, bestow an award on an individual or organization that makes the most innovative contribution to that Decade: innovation in science, delivery or funding. And every January in his Foundation annual letter, ‘I’ll talk about that winner to make sure that pioneering global leaders get the credit they deserve.’

Not once during his speech did he ever mention what he or his Foundation would get, or expect to get, in return. The sober tone throughout was about how others would benefit, how health and other leaders would get recognition for good work they would do in favour of those exposed to diseases that were potentially preventable and that numbered by the millions.

It was a great privilege to have the opportunity to see and listen to a man with such a great conviction about what working together could achieve for the world. And I asked myself whether there was any lesson for my country from the person I had seen and heard? Yes, I told myself, there is, and it is this: if only those who were in a position to change things for the better had a little of that sincerity of Bill Gates and some at least of his palpable humility, then perhaps things might change for the better – even if they were not capable of feeling that ‘sense of possibility’ …

RN GOPEE

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