Each year, in early January the Gates Annual Letter is published. The letter, written by Bill and Melinda Gates, takes stock of the achievements of the global development community in the past year, as well as looking forward to challenges and opportunities ahead. The Gates Annual Letter also pinpoints what needs to be done if we are to reach ambitious targets to help millions of people around the world emerge out of poverty.
2015 is set to be a crucial year – we will reach the end of the Millennium Development Goals (MDGs), and world leaders will sit down in New York in September to make a deal on what follows them. This year’s letter reflects the momentous nature of 2015. It looks back at the 15 years of progress since the MDGs were established, and plots a way forward for global health and development priorities until 2030.
With global health at the core of our work at DSW, we decided to take a look at the Gates Annual Letter 2015 and pinpoint 3 key takeaways from the letter for the health community; what has been achieved and what still needs to be accomplished. Here’s what we thought.
Huge progress has been made to improve the health of people in the world’s poorest countries
As the letter says, up until very recently, the world was split in two when it came to health, with one half having little or no access to life-saving vaccines, treatments or care during pregnancy. In low- and middle-income countries in 1990, 1 in 10 children died before the age of 5 due to disease or malnourishment, and maternal and newborn mortality were shockingly high. Since 1990, however, huge progress has been made to reduce and reverse these numbers. This has been achieved through investment in the development and rollout of new treatments and vaccines, and the building up and improving of health care systems. Now, only 1 in 20 children die before the age of 5, still too much but a significant improvement, giving these children the opportunity to grow up and fulfil their potential. Polio has been virtually eradicated across the globe, and we are closer than we ever were to defeating debilitating diseases like River Blindness, Elephantiasis and Guinea Worn – diseases which affect millions of people every day.
Rates of maternal mortality have been reduced by almost 50% worldwide between 1990 and 2013, thanks to improved maternal and post-natal care. However, that latter figure shows that there is still much work to be done and the world is unlikely to reach the target of reducing maternal mortality by 75% by 2015. We need to continue to keep the pressure on international and national actors to accelerate the progress that has been achieved in the last 15 years. The big idea at the centre of 2015’s Gates Annual Letter is just that – that the next 15 years to 2030 will see an even faster improvement in the health of millions of people living in some of the world’s poorest countries. This can only be achieved through an ambitious post-2015 sustainable development agenda.
Investment in innovation has been crucial to global health breakthroughs
We have already mentioned the progress that has been made in beating neglected tropical diseases. Investment by donor governments and the private sector – industry and private donors – in recent years have accelerated the development and accessibility of vital vaccines and medicines to treat diseases that disproportionately affect young children. Investment in research and development for new methods of prevention, diagnosis and treatment have been vital, in tandem with improving health systems, in reducing child and maternal mortality, but we are only at beginning to see how this investment could change the global health landscape. As the letter sets out, with continued support for global health R&D we could be on the verge of a breakthrough against malaria. There are improved diagnostics and early interventions are beginning to come online thanks to research being done by Product Development Partnerships (PDPs). The next step will be scaling these up and ensuring that they are accessible to the communities that need them the most.
Progress on defeating HIV & AIDS and Malaria depends on international investment
Important strides are also being made in the fight against HIV & AIDS – in prevention and treatment. New forms of contraceptives are offering greater protection to young women, which is particularly important in a climate where, in sub-Saharan Africa, females 15 to 24 years old are twice as likely as young men to be living with HIV. Research is ongoing into a HIV vaccine, and there are continuous improvements in the treatment of HIV in vulnerable populations, like children. The Gates letter is optimistic that by 2030 malaria will go the way of smallpox and polio, and we will have passed the tipping point in the fight against HIV & AIDS. This will only be achieved if investment in R&D for global health receives sufficient international political support and the financial support necessary to continue to make life-changing breakthroughs. What we are now seeing, however, is funding for this kind of research is quite volatile. As the 2014 G-Finder report found, there have been increases in this area by some donors, but others seem to be pulling back. To counteract this, at the EU level at least, DSW launched the “Let’s Save Lives” campaign in October 2013 to secure the EU’s support for global health R&D and we will continue to work on this into 2015.
Gates Annual Letter 2015: What next?
Whatever happens at the UN General Assembly in New York in September, 2015 will be a landmark year for development. As the successors to the MDGs, the emerging Sustainable Development Goals will be crucial in determining what progress can be made on global health in the next 15 years. Ambitious goals around issues such as innovation for global health, improved reproductive, maternal, new-born and child health can lock in the achievements that have already been made in the last decade and a half. They can also ensure that the optimism expressed in this year’s Gates Annual Letter 2015 is well-founded. We will be working hard throughout the year to make sure that is the case!