January 21, 2009

Thank you, John. And thank you all for such a warm welcome. I am excited that the Gates Foundation has joined Rotarians in the fight against polio. That’s why I put on my Rotary hat. And I’m honored to address the men and women who help guide the work of more than 33,000 Rotary clubs around the world.

I’d like to start by telling you about my wife Melinda’s Aunt Myra. We see her a few times a year. Aunt Myra worked for many years taking reservations for Delta Airlines. She lived in New Orleans until Hurricane Katrina, and then she moved to Dallas, Melinda’s home town. She loves to see our kids. When we all get together, she’ll sit down on the floor and play games with them. Aunt Myra also has polio. She’s in braces, and she has been ever since she was a little girl.
[PAUSE]

Our children only know what polio is because of their aunt. Otherwise, the disease would just be another historical fact they learn about in school.

In fact, even though I was born just three years after one of the worst polio epidemics in American history, I didn’t know anyone with polio when I was growing up. That’s how far we’ve come.

The same story of success has been repeated over and over again for children not just in the United States but also in Bolivia and Vietnam and Croatia and Morocco.

In the last 20 years, thanks to your hard work, polio has declined by 99 percent. In 1988, 350,000 people got polio. By 2008, the number was down to just a couple of thousand.

That is an amazing statistic, and it is part of a trend of overwhelming progress in the whole field of global health.

My favorite statistic about global health is this: In 1960, 20 million young children died. Two years ago, that figure was 10 million. In short, in my lifetime, the world has learned how to save more than 10 million children every year.

Surely, that is humanity’s greatest accomplishment in the last 50 years. And innovations both simple and complex made it possible. From knit caps that keep newborns warm to the most advanced vaccines, innovations can save lives.

But it doesn’t happen without the phenomenal work of groups such as Rotary, which make sure that innovations reach the people who need them.

Bill Gates | Rotary Polio Speech | January 21, 2009 2

Rotary has raised $800 million to fight polio. Just as important, you have kept it high up on the world’s list of priorities. Together with WHO, UNICEF, CDC, and other partners, you’ve stopped millions of cases of polio. And you’ve saved more than a million lives. Without Rotary, the world wouldn’t be anywhere close to a 99 percent decline in polio.

The Gates Foundation made its first donation to the fight against polio 10 years ago. Ted Turner gave $25 million to stop polio, and he told me that since I was twice as rich as him, I should give twice as much. Ted is very convincing, so Melinda and I followed his advice.

So we are relatively new to this effort. We have been involved for one decade. You have been raising money for many. You have immunized billions of children. You started the fight, and you will stay in it until the end. That’s why our foundation is so excited to be your new partner. With Rotary involved, we were confident enough to make such a big investment. And we will be here to celebrate with you when the fight is over.
[PAUSE]

But you heard what Bob Scott just said. You know the facts. This has been a tough few years for polio eradication. There’s no denying it. We’ve heard more than once that this is the year we’re going to eradicate polio. We get excited for the final push, and then we hear it’s going to take more time and more money. It’s frustrating.

So let’s be crystal clear: Eradicating a disease is hard, slow, painstaking work. We can’t circle a year on the calendar and say we’ll end polio by this date or that date. That sets us up for failure. Because even steady progress can feel like it’s not enough if you miss an arbitrary deadline.

When I worked at Microsoft, I learned an important lesson about predicting the future. Often, we expect too much too quickly, but we don’t expect enough over the long-term. Change doesn’t happen on a schedule, but it can be more sweeping than anybody imagined.

Take computers. For decades, only giant companies and government agencies had them. When I was a teenager, we started to realize that it was possible to give regular people access to computer technology on their desktops. But I couldn’t have predicted the exact year it was going to happen. I also couldn’t have predicted that before I turned 50, tens of millions of people would have computers in their pockets!

The same lesson applies to the fight against polio. If somebody says we’ll eradicate polio tomorrow, they’re wrong about the immediate future. But if somebody says we won’t eradicate polio ever, they’re wrong about the long-term.

We do not know when, but we do know that we will eradicate polio. We have the strategy and the tools. And, starting with the Rotarians in this room, we have the will to do it. That is why I am here today. I want to tell you why I am certain that you and your partners will overcome the obstacles to eradicating polio. [PAUSE]

Bill Gates | Rotary Polio Speech | January 21, 2009 3

We know exactly how many children got polio last year: 1,618. Compared to the numbers from 20 years ago, that may not seem like a lot. It may be tempting to think that’s good enough. But there is no such thing as containing polio at its current level forever. The billions of dollars, the army of health workers, the undivided attention of government officials—those resources simply aren’t sustainable year after year.

The harsh mathematics of polio makes it clear: We cannot maintain a level of one thousand or two thousand cases a year. Either we eradicate polio, or we return to the days of tens of thousands of cases per year. That is no alternative at all. We don’t let children die because it is fatiguing to save them.

Our commitment as a foundation is to work with you, and your partners, until no children die from polio.

I was in India last November, and I saw what this horrible disease does to children.

I was in a slum in East Delhi, and I held a nine month old girl named Hashmin in my arms. My dad and my sisters were with me, and we talked to Hashmin’s mother in the courtyard outside her home. Hashmin was dressed in a beautiful bright orange dress. She obviously didn’t understand why people were poking her legs and looking so serious. But she’ll never be able to kick a ball around, never be able to play hide and seek with her friends, because she has polio.

As I held Hashmin, I thought, “We can end this!”
[PAUSE]

There are many reasons why eradicating polio is so difficult. You have to immunize hundreds of millions of children. That’s hard enough, but many of these children are constantly moving as their parents look for work. Many more live in very hard-to-reach areas, forcing vaccinators to climb mountains, ferry across fast rivers in monsoon season, and navigate some of the world’s largest slums.

In southern Afghanistan, children are cut off from vaccinators by war. In some communities in Nigeria, vaccinators have to overcome widespread fear that the vaccine is unsafe. Sometimes the job is difficult because of the sheer numbers. In the state of Uttar Pradesh in India, 500,000 babies are born every month. Unless we run a near-perfect program, every time, everywhere, the virus lives on.

And then there are the scientific challenges. It’s very hard to determine if a child has contracted polio. With many diseases, like smallpox, it’s obvious. But to be sure you’re dealing with polio and not one of the many conditions that can resemble it, you’ve got to collect stool samples and send them off to a lab for analysis.

And there are some places where it takes multiple doses of vaccine to make a child immune. I didn’t know that when I first got interested in polio. I just assumed the standard number of doses we give in the United States was sufficient. But in some places children need as many as 10 doses because they’re already infected with so many other viruses that the vaccine can’t do its job properly.

Bill Gates | Rotary Polio Speech | January 21, 2009 4

To overcome all these obstacles, it takes a massive effort. But we have seen over and over again that endemic countries are eager to put in that effort. They do it because they know it will pay off. The last 20 years of the polio eradication effort have proved that.

Take the example of India. The polio-fighting infrastructure in that country is just staggering. Twice a year, India sponsors a National Immunization Day. One will start next month, in fact. More than 2 million people, from highly trained professionals to volunteers, will be involved in pulling it off. They will set up 800,000 vaccination booths around the country—at schools, hospitals, community centers, and other places like that.

After that, vaccinators will visit more than 200 million houses, one by one. 200 million. To make sure they don’t miss anybody, they will also go to train stations, bus stations, and ferry terminals to immunize children who are on the move. So in the span of just a few days, more than 170 million children in India will be vaccinated against polio.

But even that’s not always enough. Hashmin, the baby I met, had been immunized. But she still got polio, because she lived in one of those areas where children need many doses of the vaccine.

That’s where innovation comes in. Innovation will knock out polio in those few remaining, very stubborn pockets.

Innovation looks different in every country. That’s because it has to be tailored to the specific needs of the people who live there. Innovation isn’t good for its own sake. It’s good when it makes people’s lives better.

So in Nigeria, innovation is building better relationships with leaders in the north, because they’re essential to getting immunization rates up, especially among those who have never been vaccinated before. In Pakistan, it’s something as simple as a new system for marking the fingers of children who have been vaccinated.

One of the great innovations of the past decade is the genotyping that tells us where individual cases of polio came from. We can actually analyze a stool sample from a paralyzed child in Angola to determine that this particular virus came all the way from India. That’s just amazing. When you have that technology, you can draw detailed maps with arrows showing the precise path of polio around the world. Without that innovation, we’d be tearing our hair out trying to solve the mystery of how exactly polio spreads. With it, we have an accurate map—and the information we need to target our efforts.
[PAUSE]

Now, it takes a huge amount of political will to run campaigns that are this comprehensive—and to keep innovating so each one is more effective than the last one. But I’ve seen overwhelming evidence that the necessary political will exists.

Bill Gates | Rotary Polio Speech | January 21, 2009 5

Time after time, governments have done the right thing when it comes to eradicating polio. I met with representatives of the Indian ministry of health in November, and I was very impressed with their dedication to eradication. I am going to Nigeria next month to meet with political and religious leaders, including the new minister of health. I’m also meeting with Rotary representatives there, and I’m going to northern Nigeria, where polio is the worst, to see it for myself. There are signs of progress in some of the toughest states in Nigeria, and I’m looking forward to working with Nigerian officials to build even more momentum.

Of course, political will doesn’t come from governments alone. Rotarians have always provided the majority of the will power behind eradication. I attended a small Rotary fundraising lunch in Delhi, and I had so much fun talking to Rotarians about their passion for this work. Mrs. Birla, who organized the lunch, committed another $1 million to the campaign. One attendee gave $1.5 million, on top of the money he’d already donated. Another gave his first $250,000. That was just one lunch, less than two hours, and it will save lives. One thing is for certain. The world would not be where it is without Rotary, and it won’t get where it needs to go without Rotary. You have so much to offer.

You are volunteers. There are more than one million Rotarians around the world, and many of you have actually traveled to help out with immunization days. I’ve had the great privilege of administering a dose of the vaccine to a child. Many of you have, too. It’s a beautiful thing to immunize a child against polio.

Everybody should get to have that feeling—the human connection to the great work Rotary is doing. The trips Rotarians take are essential not only because your members do some of the important work of immunizing children, but also because—up close—they really understand the impact they have.

When people work hard and see success, they get more energy, not less. They want to work even harder, so they can see even more success.

You are also advocates. When Rotarians talk, people listen. So you can help foster that last full measure of political will. If you live in a donor country, you can push your government to make sure polio is a foreign aid priority. In the United States and throughout Europe, Rotarians have been instrumental in making sure that the fight against polio gets the funding it deserves.

If you live in a country with polio, you can work with leaders in your country to support polio campaigns. Every time I’ve been at high-level meetings about polio, Rotary has been in the room. You need to stay in the room until there is no more need for those high-level meetings.

Finally, you are donors.

Bill Gates | Rotary Polio Speech | January 21, 2009 6

Hundreds of thousands of Rotarians around the world have contributed to this fight. The money you donate pays for the day-to-day costs of eradication.

As you know, we made a grant of $100 million to Rotary one year ago to further your efforts. We are confident that you will raise the $100 million match. Because right now, we have to keep pushing. Right now, we have the opportunity to eradicate disease for only the second time in the history of the world, after smallpox.
[PAUSE]

And to that end, I’d like to make an announcement: We are redoubling our commitment to polio, and to Rotary. We will make a new $255 million grant to Rotary, bringing our total commitment to $355 million. What that means for you is that you no longer have a $100 Million Challenge on your hands. Now you have a $200 Million Challenge on your hands.

It’s not just the Gates Foundation and Rotary. I’d also like to announce that the governments of Germany and the United Kingdom have committed an additional $280 million to eradicate polio.

Just think of what you’ve done. You’ve leveraged your 25 year commitment to polio into more than $600 million to pay for the most aggressive push yet to end this deadly disease.
[PAUSE]

We are making this grant and asking you to raise a total of $200 million by June 30, 2012 because we know that eradication doesn’t come in an instant. We know that it’s a formidable challenge to eradicate a disease that has killed and crippled children since at least the time of the ancient Egyptians. We don’t know exactly when the last child will be affected.