Bill Gates 2002 lunch speech at the United Nations

May 9, 2002
U.N. Secretary General's Luncheon
United Nations - New York, New York
Prepared remarks by Bill Gates, Co-chair

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 leaders.

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 health:
· 95% of all new HIV infections occur in developing countries
· 99% of TB and malaria sufferers live in developing countries
Yet where demand for health spending is greatest, supply is lowest.

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 disease burden.

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 of Africa.

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 of it.

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 polio.

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 countries.

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 of grants.
· Global health was a central topic at the World Economic Forum.
· 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 a quarter…
· 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 accounting.

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.