How to Make a Healthier World


No child should die of measles in 2019. Or any disease that can be prevented by Vaccine or basic preventive care. That’s the view of Sue Desmond-Hellmann, CEOof the Bill and Melinda Gates Foundation, speaking to Edie lush on this Episode. Yet children still do die needlessly. Which shows the world still has work to do to continue to grow healthier. Progress over the last decades has been remarkable. The near abolition of measles is just one example. A good part of the credit goes to two organizations, The Global Fund and Gavi, the vaccine alliance. Their work has helped people live longer healthier lives, particularly in the poorest places on earth. But now governments must decide whether to replenish their funds. Sue Desmond Hellman argues that it is the best investment in the future.

Featured guests

Sue Desmond-Hellmann

Sue Desmond-Hellmann is a physician, scientist and philanthropist and has been a pioneer for healthcare for more than 30 years. After moving to Uganda in 1989 to work on HIV/AIDS and cancer she has since driven major developments toward the eradication of disease, poverty and inequality. She completed her clinical training at the University of California at San Francisco (UCSF) in the 1980s and later became the first female chancellor for the university. Today she is the CEO of the Bill & Melinda Gates Foundation. The foundation works to ensure more children and young people survive and thrive, combat infectious diseases that hit the poorest hardest and empower people – especially women and girls – to transform their lives. Sue is the recipient of numerous honors and awards. She was listed among Fortune magazine’s “top 50 most powerful women in business” for seven years and, in 2010, was inducted into the American Academy of Arts and Sciences and elected to the Institute of Medicine. She was also listed as one of the world’s seven most “powerful innovators” by Forbes Magazine in 2009.

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Susan D-H: 00:02  No one should die of measles in 2019 that should never happen. A Child should never die for want of an affordable vaccine.

Susan D-H: 00:11 It is not an exaggeration to say a health crisis anywhere is a health crisis everywhere

Susan D-H: 00:17 We are dead serious about causing an impact

Edie Lush: 00:31  This is the Global GoalsCast the podcast that shows how we can change the world. In this bonus episode, we’re going to talk about two organizations that have changed the world by helping people live longer, healthier lives, particularly in the poorest places on earth. And Claudia, I know they’re important to you. They’re the Global Fund and Gavi

Susan D-H: 00:51  Two incredible organizations, very close to my heart, both of them. The question is whether we will step up the fight and help them achieve their incredible goals and missions. And that will depend on whether governments and philanthropies renew their funding. In a moment we will hear from our special guests, on why they should and why the world should step up the fight this year.

Edie Lush: 01:17 But first, let’s thank the sponsors, make it possible to bring you this episode and every episode of the Global GoalsCast

Claudia R E:  01:29  Our thanks to Mastercard for sponsoring Season Two of the Global GoalsCast, and to CBS News Digital for being our media partner, and, to Harman Kardon the official sound of the Global GoalsCast.

Edie Lush:  01:49  Welcome back. I’m Edie Lush

Claudia R E: 01:51  And I’m Claudia Romo Edelman. You know, Edie, we love to talk about what’s going right in the world, the champions that are making a difference. And sometimes it is not so easy. Progress isn’t that clear, but in one very important field, the progress is not just clear its amazing.

Edie Lush: 02:10 That’s right. We can debate about whether the world is a better place than it was like 20 years ago. But one area of progress is beyond dispute. The world is a much healthier place. The World Health Organization says that globally people are living longer and healthier lives.

Claudia R E: 02:27  And part of the reason is the work of two incredible organizations. One of them is Gavi, the vaccine alliance, and we featured Seth Berkley, its CEO in our season one on the episode of trust. The other organization is the Global Fund to fight AIDS, tuberculosis, and malaria. These are unique organizations that draw their support from governments, private philanthropy and corporate contributions.

Claudia R E:02:54  They changed the game from calling on the M-game to the B game. Organizations used to gather millions of dollars and the Global Fund and Gavi started calling it the billion dollar game. And both organizations have launched major drives to guarantee funding over the next few years. They call it replenishment as in replenishing the money that they need to continue their work into the 2020s to move closer to fulfilling the Sustainable Development Goal number three, health and wellbeing for all.

Edie Lush: 03:30 Claudia, for a closer look at this, I sought out the CEO of the bill and Melinda Gates Foundation, which as you know has been one of the strongest supporters of Gavi and the Global Fund. I caught up with her in Davos.

Edie Lush:  03:44 Thank you very much for being with us. I want you to tell me in your own words what you think the impact of those funds has been so far.

Susan D-H: 03:51 It literally is impossible for me to overstate how much global fund and Gavi have contributed to everything we celebrate in global health. I’ll give you just one fact. Since 1990 under five mortality has been cut in half. It is not at all an overstatement to say, if not for the Global Fund for Aids, TB, and malaria and Gavi for vaccines for the poorest children of the world, the world would have never seen that kind of gains.

Edie Lush: 04:23  So it’s up for replenishment in the next 18 months and we need governments and the private sector to recommit. What’s your message to them?

Susan D-H:  04:31   This is a great buy. My message is – if you want a return on investment, if you’re a government, if you’re a philanthropist, if you’re somebody who cares about the world and your fellow humans, this is a great investment.

Susan D-H: 04:45 The return on investment is extraordinary. About 20 bucks for every one bucks spent. And one of the really fun things for a person like me working with Bill, Melinda and Warren is I work around people who are pretty smart business people and it’s not typical in the global development area you talk about return on investment. Global Fund and Gavi are great returns on investment.

Edie Lush:05:07  So tell me why that is. Why is it such a good return on investment?

Susan D-H:  05:10  Well, I think there’s two reasons that I want people to know about. Let’s start with Global Fund. One of the things that I think is so important to remember because it’s easy to forget the early days of the epidemic, HIV, AIDS, tuberculosis, and malaria remained some of the most important killers of human beings. When we see something like HIV aids controlled by antiretroviral therapy by modern medicine, and we don’t really see tuberculosis and malaria in the United States, we think of those as travelers’ diseases.

Susan D-H: 05:46 In fact, for most people in the world, particularly for people in the poorest areas of the world, these diseases still kill and they cause a lot of what we call morbidity. They cause a lot of suffering. So the Global Fund is really important because those are the diseases that the poorest people of the world struggle with. Gavi on the other hand is important because of the near miraculous benefit of vaccines. Bill and Melinda started the Gates Foundation in part because they recognize that children in poor areas would die of a vaccine preventable disease. Like no one should die of measles in 2019. That should never happen. So something that’s affordable and accessible and safe and effective, a child should never die for want of an affordable vaccine. And Gavi is really based on that premise.

Edie Lush: 06:45  The big developed countries have been among the biggest contributors to Gavi and the Global Fund, billions of dollars in the last two decades. The United Kingdom, United States, France. But now these countries are caught up in a wave of nationalism that makes winning their help for the rest of the world. More difficult. I asked suit, Desmond-Hellmann, how supporters of Gavi and the Global Fund would address this.

Susan D-H: 07:09 We’re very concerned about the current dialogue.We’re, we’re concerned not because we get into politics because we don’t, we don’t choose sides in politics, but we do believe very, very strongly in a global view for health. And these replenishments are really about a global view for health. And so no matter if you think, Gosh, I’m worried about the people in my neighborhood, I’m worried about the people in my community, my country, or if you have learned in school to think about Europe and Asia and Subsaharan Africa, I don’t actually care how you think about the world, your politics are your politics.

Susan D-H: 07:51 What I am very confident is that the entire world benefits from the funds that governments and philanthropists put against the Global Fund and Gavi, it’s money well spent. I’ll give you an example, 2015 the world got really scared about Ebola and what that taught us because of global travel and because in fact things like mosquitoes or bats or other agents that carry infectious diseases don’t know about our borders and don’t really care much about our borders because people move and the vectors, we call them – mosquitoes or bats or whoever’s carrying disease – they move across country lines. It is not an exaggeration to say a health crisis anywhere is a health crisis everywhere and so it’s actually just practical and important. Again, these are best buys so governments can get a great return on what ultimately is not only the health of the world, but the health of their citizens.

Edie Lush:  08:50  Because I was interviewing her during the World Economic Forum’s annual gathering, I asked Desmond Hellmann about the sharp criticism of the elites who gather at Davos and the claim that their efforts to help the world are really empty gestures intended to protect their own status.

Susan D-H:  09:08 I couldn’t disagree more. I think in philanthropy, just like private industry, just like government, just like the nongovernmental organizations, there are people with different values. There’s tactics and strategies and approaches that are either helpful and cause good outcomes, and then there’s some that fail. I think it is frankly silly to target any of those sectors and take one or two examples where people haven’t done a good job or where they, you disagree with their values and paint a picture broadly in one sector as if everybody signifies that one outlier or that one bad outcome. Here’s what I know. Before I came to Bill and Melinda Gates Foundation, I was chancellor at University of California, San Francisco and tremendous philanthropists, help us drive scholarship for students, an entirely new campus at mission bay for Science. I grew to be so positive about the generosity of the donors that help create new children’s Hospital at UCF, so I got really passionate about philanthropists and the good they could do in a public university in California after the big recession. Then I come to Bill and Melinda Gates Foundation and I can tell you that we are absolutely not perfect. We’ve made mistakes, we’ll make mistakes, but we are dead serious about causing an impact

Edie Lush: 10:41  That was Sue Desmond-Hellmann at the bill and Melinda Gates Foundation, a really impressive woman. Claudia, tell me about this replenishment of the fund compared to the last one.

Claudia R E: 10:52 As you know, Edie, I was working for the Global Fund for four years and I was the head of marketing and I had the opportunity to be part of two replenishments. As a fact, one of the first replenishments of the Global Fund on the global scale. And every year you step up the funding that is needed. But this year it is 14 billion dollars. I just don’t know whether you realize how much is that money at the end of the day, you know, like again, organizations work on the M game and the global fund goes into the B game and changes the model of the way in which we deal with issues. So before the Global Fund existed, every organization was fighting small old pieces on their own. And the Global Fund came as a new unique model as our war chest, putting everybody to say like, look, instead of actually everyone trying to defeat such a monster like aids, tuberculosis, and malaria, let’s put all the efforts, all the monies, everything in a coordinated manner and $14 billion this year is just an incredible effort. I think that the past two replenishments have been around 10 or $12 billion and it sounds easy to have just like a step up of $2 billion but that’s massive. And I think that what the Global Fund has demonstrated is that they save incredible amount of lives, that it is an very, very flexible organization that it was able to reform itself to be really, really increasingly effective. We’re very close to finding vaccines, for example, for aids and things that will change completely the spectrum of health overall. And without the global fund being totally replenished, Edie, the Sustainable Development Goals will not be able to be achieved as easily because they touched not only goal three but a number of others, the incredible progress that the world’s, so during the 80s taking 20% of the kids around the world that were vaccinated to 80% it’s a massive thing. But guess what?

Claudia R E: 12:57  Since the eighties that’s it. We are in plateau in 80% so we’re not able to move from 80% to 100% or actually to say not only we have a couple of vaccines to kids, but a number of vaccines so that you know, once and for all you get all the vaccinations that you get to as many people as possible in one

Edie Lush:  13:16  Its that last mile question isn’t it? And I think that health is the great success story of the global goals. The original Millennium Development Goals were very much about health. I don’t need to tell you that of course, but I’m just reminding myself. But a large measure, they were met and we’ve also meet, seen a lot of people alongside these great strides that Gavi, the global fund has been making. Also we’ve seen development. So we’ve seen more people move into the middle class around the world. They eat better, they get better medical care. But the reason that we talk about health so much and the reason that it’s such an important thing to focus on SDG three is because it’s so interrelated with the other goals, like improving incomes, educating everyone, reducing inequality.

Edie Lush: 14:03  I think the thing that I wonder about and I wonder what you think about this, that things have changed since those millennium development goals. Health was a real top priority and now it’s just one of 17. People like the Secretary General for really very real and important reason to think that curving climate change is the top priority. Now, of course among the arguments is that improvements in health won’t continue if those billions of people around the world are exposed to scorching heat, climate driven famines and dislocation caused by flooding and complex over water. So how do you keep health up there as important as the rest of the goals, especially when so much focus is on climate change.

Claudia R E: 14:41 I invite you to actually have a look at the global fund website and see the video of step up the fight. You will actually see that the curve is exponentially going down on the number of deaths of people and the amount of people in treatment on aids tuburculosis and malaria.

Claudia R E: 14:57  So it goes like (sound effect)

Edie Lush: 15:00 Just like that? With that sound effect?

Claudia R E: 15:00 And then we can come to a place like, (sound effect) and that’s it, 2030 boom end bye. But there’s a risk right now that if we don’t address that, then it’s going to be like, (sound effect) and it’s going to come back. So we don’t want to do that because all the progress that we have made has not only, you know, like signified an incredible number of lives, but also an incredible number of billions of dollars that could be lost.

Edie Lush:  15:25   I really love those sound effects. I mean I know it’s a serious subject, but I really love the sound of that because I just have to tell you. So I think we could get into that for three facts and actions. Now what do you think?

Claudia R E: 15:37 I think that’s right.

Edie Lush: 15:38  Okay, so number one, in 15 years, the global death toll of malaria has been cut in half. That’s from nearly 840,000 deaths in 2000 just under 440,000 deaths in 2015

Claudia R E: 15:55   Fact number two the maternal mortality ratio has declined by 30% since 2000. There’s still more to go.

Edie Lush: 16:02 And number three Claudia, you mentioned this just a minute ago, AIDS is the leading cause of death among young women, yet it is treatable. Every two minutes a teenager is infected by HIV, yet it is preventable. So let’s go to our three actions.

Claudia R E:  16:20  Action number one, find out in your country what’s happening to Global Fund. Lobby your government to do their part in the replenishment by raising your voice. Find out more at

Edie Lush: 16:34   Action number two, do something yourself. Support our partner Malaria no more by buying a bed net. You can find their website in a link in our show notes

Claudia R E:  16:45   Support our partner Product Red by buying one of the red products. Very cool. All of them. Every dollar you spend helps save a life.

Edie Lush: 16:59   And that’s the Global GoalsCast for this episode. Don’t forget to subscribe on apple or wherever. Get your podcasts and follow us on Twitter, Instagram, and Facebook. I’m Edie Lush.

Claudia R E:   17:13    I’m Claudia Romo Edelman. Thank you so much for listening.

Edie Lush: 17:16  Adios

Michelle C:   17:21  Music in this episode was by Andrew Philips, Angelica Garcia, Simon James, Katie Crone, Amy Edwards, Ashish Pillowall ,Alex Vallejo and Ellis. This episode was made possible thanks to the support of Mastercard, CBS News digital, and Harman, the official sound of global goals cast. This episode would not have been possible without Keith Reynolds, founder and president of Spoke Media who lent us his ear.