As part of the global effort to stop Ebola in West Africa from becoming an even more horrific, entrenched and ongoing infectious threat – an ‘endemic’ disease like malaria or TB as opposed to a sporadic outbreak – the Bill & Melinda Gates Foundation has donated $50 million.
It is the largest emergency relief grant ever made by the world’s biggest philanthropy, which tends to mostly support longer-term, proactive and preventative measures against diseases of poverty rather than these kind of reactive, emergency relief efforts during a crisis.
Chris Elias
“We are leaning into this in a significant way,” said Chris Elias, head of the development program at the Gates Foundation.
The foundation, which does fund some emergency or humanitarian relief operations but usually only at the level of a million dollars or so per crisis, in July provided $1 million to UNICEF to support its efforts fighting Ebola in Liberia, Sierra Leone and Guinea and in the last few days gave more, including $10 million to the World Health Organization.
It’s not yet clear where the balance of the promised $50 million from Gates, which includes $2 million to the Centers for Disease Control Foundation, will go. But some of it will be in support of research aimed at improving drug treatments or preventative vaccines against Ebola, according to a statement issued by the philanthropy.
“We will move money quickly to the organizations responding now on the front lines,” Elias said. “Secondly, we will invest in research and development for diagnostics , therapeutics and vaccines for Ebola.”
The WHO has estimated that at least $600 million will be needed to deal immediately with this outbreak, the first ever in West Africa and the largest since the deadly virus was discovered in 1976 from outbreaks in east-central Africa. About 2,300 people have so far died in this outbreak, out of an estimated 4300 people diagnosed with the infection. That’s a lower fatality rate than seen in previous outbreaks but it’s not at all clear if these numbers truly capture the extent of the spread of this disease.
A team of Oxford scientists recently published a report, summarized in this Washington Post article, that found 22 countries in central Africa are at risk for animal-to-human transmission of the Ebola virus. Bats are believed to be the primary source, or animal reservoir, of the virus.
Over the last week or so, Elias said, it became clear to the leadership at the Gates Foundation that this outbreak demanded an extraordinary response from the international community – and from the foundation, which has made global health its primary focus.
“We are working urgently with our partners to identify the most effective ways to help them save lives now and stop transmission of this deadly disease,” Sue Desmond-Hellmann, CEO of the Gates Foundation, said in the prepared statement. “We also want to accelerate the development of treatments, vaccines and diagnostics that can help end this epidemic and prevent future outbreaks.”
Gates Foundation staff are already on the ground in parts of West Africa, Elias added, working to assist in the response and also assessing where best to put the additional funding. In Nigeria, he noted, Gates staffers who had been focused mostly on polio eradication worked with local government and civil society groups to establish an emergency operations center in Lagos.
“That probably helped prevent a much larger outbreak in Nigeria,” Elias said. “We’ve never seen an Ebola outbreak of this magnitude before and we need to respond quickly to bring it under control. But we also have to think about how this fits into the longer term health and development needs of these poor countries.”
Many contend this Ebola outbreak in West Africa was fueled as much by poverty, poor governance and lack of basic health services (or other basic infrastructure) as by the nature of this virus – which actually doesn’t spread that easily, as compared to many infectious diseases. Elias said some of the $50 million is intended to help ‘scale up’ hospital and health capacity in these poor countries.
But it’s hard to scale up capacity in a community that may lack not just a hospital or clinic or enough drugs to treat the sick but basics such as clean water or electricity. I asked Elias to describe what the Gates Foundation has been doing to encourage the development of such fundamental infrastructure in these poor communities so the next time Ebola emerges they can respond before the outbreak spins out of control.
“This disease certainly has spread because of the weakness of the health systems in these countries,” Elias said.
That’s why the foundation, as part of its global push to expand child immunizations, also funds basic improvements in health care in poor countries. Even the Gates Foundation focus on improving the livelihoods of smallholder farmers, he added, can lead over time to broader improvements in the health of communities by increasing income and infrastructure of all kinds, including health services.
