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Environmental health officer Haliru Usman testing sewage for the polio virus in Nigeria with Sue Desmond-Hellmann. (Photo via Gates Foundation)
Environmental health officer Haliru Usman testing sewage for the polio virus in Nigeria with Sue Desmond-Hellmann. (Photo via Gates Foundation)

Bill & Melinda Gates Foundation CEO Sue Desmond-Hellmann thinks a Nigerian health officer’s work collecting sewage is “a thing of beauty.”

It may seem like an unusual way to describe the work of Haliru Usman, but his samples are part of a disease surveillance program that led to the first year without a single child being paralyzed by wild poliovirus on the African continent. This landmark, Desmond-Hellmann says, proves that many of the world’s deadly diseases can be eliminated through innovation.

“This is exactly why the Gates Foundation invests in innovation,” she said in an open letter Monday, a status report on the Gates Foundation’s work, approach and goals. “There are now new diagnostic technologies, new drugs in clinical trials, new products to reduce insect populations, and – borrowing a chapter from the polio eradication playbook – state-of-the-art mapping and micro-planning can guide our efforts with greater precision.”

Desmond-Hellmann took the helm as CEO of the Gates Foundation in 2014. As an oncologist and public health specialist with 14 years of experience in the biotechnology industry, these issues are particularly resonant with her. She believes that sleeping sickness, a fatal parasitic infection endangering millions in sub-Saharan Africa, can be eradicated with many of the same practices used to fight polio.

Sleeping sickness, a deadly disease transmitted by tsetse flies, disproportionately affects the rural poor in Africa. Today, the disease is closer to elimination thanks to advances in screening, treatment and vector control. (Photo via Gates Foundation)
“Sleeping sickness, a deadly disease transmitted by tsetse flies, disproportionately affects the rural poor in Africa. Today, the disease is closer to elimination thanks to advances in screening, treatment and vector control.” (Photo via Gates Foundation)

Traditionally, the Gates Foundation has taken on the financial risks associated with developing products for the poor to encourage commercial partners to address global health concerns. But when it comes to sleeping sickness, companies are devoting resources despite small chances of turning a profit. This fact makes Desmond-Hellmann optimistic about the future.

“In other words, private sector partners are involved in sleeping sickness programs for a simple reason: it’s the right thing to do,” said Desmond-Hellmann in the letter. “I spent a significant portion of my career in the biotechnology industry, and am excited by what can happen when the capabilities of private companies are unleashed on the problems of the poor. Corporate social responsibility is one path to impact.”

The impetus for the letter is to bring more transparency to Gates Foundations operations and open up a dialogue about the importance of philanthropy. In it, Desmond-Hellmann highlights three initiatives from the organization: Tobacco control, diseases disproportionately affecting the poor, and U.S. K-12 education.

All three of these issues, Desmond-Hellmann says, prevent impoverished communities from reaching their full potential. She uses the Philippines as an example. By implementing a high Sin Tax on tobacco the government was able to extend fully-subsidized health insurance to over 43 million poor Filipinos.

In addition to these success stories, Desmond-Hellmann also notes some of the challenges facing the organization.

The Gates Foundation has struggled to make meaningful progress in U.S. education reform. It is particularly difficult, Desmond-Hellmann says, to institute system-wide reforms and create new, thriving public schools.

“Unfortunately, our foundation underestimated the level of resources and support required for our public education systems to be well-equipped to implement the standards,” she says. “We missed an early opportunity to sufficiently engage educators – particularly teachers – but also parents and communities so that the benefits of the standards could take flight from the beginning.”

These challenges have motivated the Gates Foundation to double down on its efforts in education. For example, the organization is supporting a partnership with EdReports.org, a site that provides free access to teacher-led reviews and stats on instructional materials. The Foundation supports the Common Core teaching program outlined in the video below.

Impoverished communities are hit hardest by failures in our education system and the other issues outlined in Desmond-Hellmann’s letter. Her hope is that, by opening up a dialogue on these issues, individuals, non-profits, and businesses will be mobilized to address them.

“What if we channel the best science and technology, leverage global partnerships, and mobilize heroes and health workers like Mr. Usman to realize a vision decades in the making?” she asks. “It is a real honor to work with so many others dedicated to writing history’s answer to that question.

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