Why is the Gates Foundation still in China?
By Tom Paulson on 6 May 2014
http://www.humanosphere.org/global-health/2014/05/why-is-the-gates-foundation-still-in-china/
The China office of the Bill & Melinda Gates Foundation is one of its biggest – second only, in size and staffing, to that of the philanthropy’s India office.
Yet China, compared to India and other poor or middle-income nations hamstrung by many living in extreme poverty, seems capable of taking care of itself.
>Why is the Gates Foundation still in China?
“We want to help make China a global center for research and development,” said Ray Yip, long-time director of the China program for the Gates Foundation. “It’s a 180-degree change from what we were doing originally.”
The philanthropy, in its early days, approached China as another low- or middle-income country that could use some help fighting diseases of poverty and maybe with agricultural productivity.
“But we’ve evolved in our approach, partly because trying to assist China in that traditional philanthropic way is sort of like giving money to a rich person,” chuckled Yip, who was in Seattle recently for a Gates Foundation meeting on global product development. Or well, not sort of at all.
So why not just close up the Gates Foundation’s shop in China given its focus is supposed to be on helping the poor and move the talent and resources to a poor country that needs the help much more?
“We think we can still help, but in a different way,” said Yip. China has become relatively wealthy, he said, and is moving more toward becoming a donor of aid and development rather than a recipient. One of its biggest potential contributions, he said, could be in the development of new drugs and vaccines for poor countries.
Many, if not most of the world’s most effective medications against malaria stem from China’s discovery and development of anti-parasitic drugs based on plant extracts of artemisinin, sweet wormwood, or Qinghaosu.
And then there’s the story of the Japanese encephalitis vaccine, which we’ll get to in a minute.
“In the beginning in China, we were operating more like a public health agency focused on implementation and delivery of services,” said Yip, a pediatrician who got his medical degree in Minnesota, served in China on AIDS issues for the U.S. Centers for Disease Control and Prevention and has generally spent most of his career focused on getting health care to the poor.
Early on, the Gates Foundation offered China direct assistance on a number of health fronts – mostly against HIV and TB, which it does still to some extent. The Chinese, as noted above, already had a pretty handle on malaria. But as China has rapidly become wealthier, Yip said, it clearly didn’t make sense to keep doing that.
But just packing up and leaving also didn’t make sense, he said.
==GATES FOUNDATION >>CHINA >>>CDC==
“In the beginning in China, we were operating more like a public health agency focused on implementation and delivery of services,”
said Yip, a pediatrician who got his medical degree in Minnesota, served in China on AIDS issues for the U.S. Centers for Disease Control and Prevention and has generally spent most of his career focused on getting health care to the poor.
>Why is the Gates Foundation still in China?
While the foundation still does a lot aimed at getting existing health services and products to the poor (polio and other child vaccines, etc), the global health program under Trevor Mundel has been narrowed in scope to focus on helping the biomedical and drug industry develop new products specifically tailored to meet needs in poor parts of the world.
“In a sense, we are just shining a light on what they are doing already,” said Julie Jacobson, who heads up global health product development team focused on especially neglected diseases.
Jacobson, first while at Seattle-based PATH and then later with Gates, helped coordinate a decade-long effort aimed at enlisting China’s help with a disease few Americans have even heard of – Japanese encephalitis virus.
A cousin to West Nile, JE is much deadlier – killing one in four it infects – and much more widespread in India. Millions of people, mostly in Asia, get infected by this mosquito-borne virus, most of them poor and lacking in access to life-saving treatments. Many die and the survivors often end up mentally and physically disabled.
She and PATH discovered this massive, neglected disease when working in the Indian state of Andhra Pradesh on a Gates Foundation project aimed at improving a number of immunization programs for children. They had come intending to expand basic immunizations and also introduce a new hepatitis B vaccine, but soon discovered the Indians were much more concerned with JE.
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