Endgame: Will Gates’ Latest Give Be Polio’s Death Knell?

The Bill and Melinda Gates Foundation is not messing around with polio. The foundation has been a major funder of global eradication efforts since the late 1990s, beginning with a $50 million grant to the United Nations Foundation. Over many years, Gates has not strayed from its plan to rid the world of polio, which calls for accelerating “targeted vaccination campaigns, community mobilization, and routine immunizations.” The foundation is also partnering with like-minded organizations to improve polio surveillance and outbreak response endeavors.

The anti-polio drive by Gates and other funders has often been criticized as a misallocation of resources, given just how few people are actually affected by this disease nowadays. But Bill Gates has seen this goal as something of a holy grail, and stuck with it. As he once explained to a reporter: “Polio’s pretty special because once you get an eradication, you no longer have to spend money on it; it’s just there as a gift for the rest of time.”

Back in 1988, the World Health Assembly launched the Global Polio Eradication Initiative or GPEI. At the time, the wild polio virus was present in over 125 countries. The virus paralyzed some 350,000 people each year, most of them young children. (The Gates Foundation is a major supporter of GPEI as is Rotary International, another outfit keen on ridding the world of this dread disease.)

Since GPEI’s early days, major progress has been made toward elimination and eventual eradication. The number of polio cases has been reduced by around 99 percent due to increased immunization efforts, with a drumbeat of good news in the past few years. Now, there are only two polio-endemic countries: Pakistan and Afghanistan.

Related: Rotary International, Gates Foundation Reach Polio Milestone in Africa

We're in the endgame here with polio, but Gates is still making big grants—most recently, a $38 million grant to Takeda Pharmaceutical Company.

Takeda and Gates have entered into a partnership in which Takeda will “develop, license, and supply at least 50 million doses per year of Sabin-strain inactivated poliovirus vaccine to more than 70 developing countries.” The $38 million grant will leverage Takeda’s vaccine manufacturing platform to make the doses available and affordable to poor countries that are currently receiving support from Gavi, the Vaccine Alliance.

This is some serious cash, but it’s a mere drop in the bucket compared to the nearly $4 billion Gates has contributed to various polio elimination and eradication causes over time.

We should add that Gates is not the only big private player in this space. Rotary International is also a major force behind the anti-polio drive, and it’s not unusual for Gates and Rotary to join forces in this regard.

In 2014, Rotary International made a $75 million donation toward polio eradication efforts, focusing its fight in Afghanistan, Nigeria, and Pakistan. Gates reinforced and grew Rotary’s big give by agreeing to a dollar-for-dollar match Rotary's commitments toward its self-imposed 2018 deadline for polio eradication. Rotary International has had polio eradication in its crosshairs since the late 1980s. Since then, the organization has committed over $1 billion to the fight.

The money, progress, and the commitment from world leaders including the G7 all point to polio elimination and eradication sooner rather than later. One reason that Gates is still pouring so much money into polio is to ensure that these hopes really come true.

Back in 2000, it seemed that the global polio eradication campaign was reaching its conclusion. At the time, wild poliovirus type 2 had all been decimated and the types 1 and 3 of the virus were limited to just a couple of hundred cases worldwide. Then a setback occurred—a child in Hispaniola was paralyzed due to the administration of a live virus vaccine. Outbreaks have occurred across 16 countries since then.

Suddenly, eradicating polio became much more complex. Organizations realized the world could not be rid of polio if it did not stop using live virus vaccines, a standard practice for decades.

Which brings me back to Gates’ $38 million grant to Takeda. That money is being used to manufacture and produce a Sabin-strain inactivated poliovirus vaccine. These efforts speak to the WHO’s polio eradication endgame of not only eliminated polio, but polio paralysis due to live virus vaccines as well.

And just to give you an idea of just how big Gates and Rotary are as players in this arena, world governments and their partners have committed some $9 billion over 25 years toward polio eradication according to GPEI. Over that same general time frame, Gates and Rotary have contributed $5 billion toward the cause.