Thirty years ago, polio infected
about 350,000 people per year. But last year, just 21 contracted the disease.
That
reduction stems from a worldwide increase in vaccination efforts, which
has a compounding effect: The lower the number of known carriers, the less
chance the disease will spread.
Bill Gates, whose Gates
Foundation has heavily funded this work, did some math on the avoided fallout,
which he posted to his personal blog in January. Over the last several decades,
about 2.5 million kids have been vaccinated, resulting in at least 16 million
people without paralysis. One of the biggest innovations in the anti-polio
movement, though, is how Gates helped pay for it.
In 2014, the Gates Foundation
announced a partnership with the Japanese government, which agreed to add to
its already-strong track record of working to end polio by providing a loan of
$76 million to Nigeria to further its progress. With the help of international
aid investment, Nigeria has steadily reduced the prevalence of polio since
2012, when the country accounted for half of all cases globally. Rather than
keep the developing country on the hook for the multimillion-dollar tab for
that progress, the Gates Foundation offered to repay it, if Nigeria achieved
certain benchmarks: Over 80% of the country’s highest-risk areas needed to have
more than 80% of their residents covered by vaccines, according to a Gates
Foundation spokesperson. As of this year, those conditions have been met.
While the foundation declined to
share its exact logic for outsourcing the loan, the reason is pretty obvious.
Short term, the nonprofit could focus money elsewhere–it spends an estimated $3
billion annually in international aid–and incentivize on-the-ground partners to
hit the aforementioned health benchmarks with the promise of repaying the cost.
“The aim of this innovative mechanism is to support the recipient government’s
commitment to its polio eradication efforts without imposing a financial
burden,” noted the Japan International Cooperation Agency at the time of the
announcement. The Gates Foundation knows this tactic works: It did the same
thing with $51 million in aid for Pakistan in 2011. (Only Pakistan, Nigeria,
and Afghanistan are currently struggling with the disease.)
Overall, the foundation’s hope is
to totally wipe out the disease. That goal necessitates a more strategic attack
plan, and a more consistent way of measuring success, than if, for instance,
the foundation was just aiming to lower rates of infection. “Gates’s commitment
to end polio is certainly a bold, ambitious goal, and this move is one towards
a ‘winnable milestone,'” adds William Foster, a partner at Bridgespan, a
nonprofit consultancy, in an email to Fast Company. That’s one of the key
factors that Bridgespan has identified as crucial for audacious philanthropic
change.
It’s important to note that
countries aren’t considered disease-free once their number of reported cases
hits zero. For two years beginning in 2014, Nigeria believed itself to be
polio-free, only to see two cases pop up in 2016. Health officials expect it
will take several years to ensure there are no further outbreaks.
“The Gates Foundation is pleased
to repay the loan [from] the government of Japan thanks to the strong
leadership of the Nigerian government in polio eradication,” says Paulin
Basinga, the foundation’s director in Nigeria says in an email to Fast Company.
But major progress is worth even more than that. Ultimately, the full
eradication of polio is an investment in both health and morale building. Gates
recently told Fast Company, “The whole let’s-do-more thing doesn’t make any
sense if you don’t think there’s some great progress taking place.”
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