As the world’s business, political and media elite made their annual trek to the Swiss town of Davos -– blanketed in more snow than I have seen there for a decade -– conventional wisdom had it they should have all the lightheartedness of a gray, winter, Alpine sky. The Eurozone crisis, the difficulty of getting tough political decisions in the United States, and worries in some of the champions among emerging markets – the chance of a property crash in China, for example, or of runaway inflation in India –- were all said to contribute to a note of pessimism among Davos devotees.

But even if you think that the prophets of global economic doom and gloom are right –- I don’t, as it happens, but that’s another story – there are plenty of reasons to be cheerful about the state of the world. Some of them were collected in Bill Gates’s annual letter on the work of the Bill and Melinda Gates Foundation, which should be required reading for the Davos crowd. The letter detailed some of the extraordinary advances that have been made in global health, for example, over the past decades, with the roll out of vaccines on a massive scale, tremendous progress, especially in India, on the eradication of polio, and, indeed, on the treatment and prevention of HIV/AIDS. I was particularly pleased that Bill’s letter made mention of the rotavirus vaccine that GAVI is rolling out to tackle one of the leading causes of diarrhea – an appalling killer of children, and one which has rarely gotten the public or political dissension that it deserves.

Of course, the letter pointed out how much more needed to be done so that all people, everywhere, could live lives of equal dignity. More funding needs to be devoted to research and development in agriculture –- a key goal of ONE this year. Those of us who advocate for increased resources to go to the world’s poor appreciate that in tough economic times, we have our work cut out for us. But when generous funders like the Gates Foundation and taxpayers around the world have done so much to combat extreme poverty and preventable disease in the last ten years, now would be the very worst moment to give up the fight. That fight is more likely to be won, as Bill pointed out in a passage on the need for more resources for The Global Fund to Fight AIDS, Tuberculosis and Malaria that is worth quoting at length, if citizens in the rich world understood just how much could be done with comparatively few resources.

“Between 2011 and 2013, assuming that all donors honor their commitments, the Global Fund will disburse $10 billion. This is a $2 billion increase, but not nearly the $12–$14 billion that is needed and was hoped for. Citizens of donor countries should know about the difference their generosity has made. The cost of keeping a patient on AIDS drugs has been coming down, and it looks like getting it to $300 per patient per year should be achievable. That will mean every $300 that governments invest in the Global Fund will put another person on treatment for a year. Every $300 that’s not forthcoming will represent a person taken off treatment. That’s a very clear choice. I believe that if people understood the choice, they would ask their government to save more lives.”

My job is to learn about global health and development — and to travel to poor countries to meet farmers who can’t grow enough food, mothers who can’t keep children healthy, and heroes in the field who are doing something about those emergencies. Very few people can devote the time to really understand these complex problems. Even fewer can actually meet the people who are struggling to overcome them. That is why I write an annual letter every year.

I want people to know about the amazing progress we’ve made. I also want them to see how much more progress it will take before we live in a truly equitable world.

In this year’s letter, I focus on food and agriculture (though I also provide updates about all the global health and U.S. education work we do). When I was in high school, a popular book called The Population Bomb painted a nightmarish vision of mass starvation on a planet that has outgrown its carrying capacity. That prediction was wrong, in large part because researchers developed much more productive seeds and other tools that helped poor farmers in many parts of the world multiply their yields. As a result, the percentage of people in extreme poverty has been cut in half in my lifetime. That’s the amazing progress part of the story, and not enough people know it.

But there’s the progress-yet-to-come part, and people need to know that, too. There are still more than 1 billion people who live in extreme poverty. They are located primarily in South Asia and sub-Saharan Africa, and they live on the edge of starvation. There is an irony in this, because most of them are farmers. We can help these 1 billion achieve self-sufficiency, just like we helped billions before them, but we stopped trying. At a certain point, the sense of crisis around food dissipated, and the proportion of foreign aid dedicated to agriculture dropped from one-fifth to less than one-twentieth.

My hope for my annual letter is that it helps people connect to the choice we all have to make. Relatively small investments changed the future for hundreds of millions of small farm families. The choice now is this: Do we continue those investments so that the 1 billion people who remain poor benefit? Or do we tolerate a world in which one in seven people is undernourished, stunted, and in danger of starving to death?

In times of tight budgets, we have to pick our priorities. It’s clear that in this particular time, we’re in danger of deciding that aid to the poorest is not one of them. I am confident, however, that if people understand what their aid has already accomplished—and its potential to accomplish so much more—they’ll insist on doing more, not less. That is why I wrote my letter. I hope you’ll take the time to read it and share it with your friends and family.

I’ve invited students from around the world to write their own annual letters too. You can send your letter, or any questions you have for me, to annualletter@gatesfoundation.org. I’ll be answering and talking about the ideas in your letters in a live webcast on February 2 on my Facebook page.

Experts have long considered India to be one of the toughest places in the world to fight and eradicate polio. After all, India is neither a small nor homogenous place, and just two years ago, India had 741 cases of polio—the most in the world. How did they achieve this milestone?

• They immunized, and they immunized again: India held two National Immunization Days (NIDs) in 2011, and during each NID, an amazing 2.5 million vaccinators delivered polio vaccines to more than 172 million children. For children who weren’t reached by the NIDs, India organized 7 Sub-National Immunization Days to focus in on more remote and high-risk areas.
• They innovated: Indians didn’t just rely on traditional vaccine education and delivery methods. They met parents and children where they were—at bus stops, in construction sites, on motorbikes. They also fostered pressure and incentives for their health care workers, ensuring accountability and consistency in their delivery program.
• They fought stigma and misconception: Particularly in Muslim sections of India where concerns about vaccines were more common, polio eradication programs engaged religious leaders at all levels to build trust among parents for this safe, effective health intervention.
• They led from within: Though the role of groups including the GPEI partners and the Gates Foundation can’t be overstated, India is a success story because Indians have also stepped up. Since the National Polio Surveillance Project was established in 1997 by the Indian Government and the WHO, the program has grown, become more effective and targeted, and has built a platform that now allows for greater progress on other diseases. Local stakeholders including teachers, religious leaders, and health workers have been on the front lines of the fight. And critically, the Indian government has financed the vast majority of the eradication effort with its own resources—an example for other emerging economies to follow.

And why, as an Africa-focused organization, should we pay so much attention to this achievement? For many in the global health community who often feel like the challenges are endless, this shows that real progress is possible—and not just in the “easy” places. This milestone should rejuvenate global efforts to eradicate polio, including from the last remaining endemic country in Africa (Nigeria) as well as other countries which had once eliminated the disease but have seen a resurgence in recent years (including Angola, Chad, and the DRC). At a time when vaccination rates are on the decline in some regions, each successful immunization campaign—and the press generated around it—also helps to reinforce the safety and value of vaccines for parents around the world. The tactics India used to achieve this goal should also serve as a lesson for other countries and other global health challenges; persistence, innovation, and country ownership are fundamental to effective development programs, and will remain so long after polio is eradicated.

Please join me in congratulating the millions of people who have dedicated time, resources, and political will toward making this a momentous—and happy—Friday the 13^th!

Photo credit: Bill and Melinda Gates Foundation

After spending the first day at the Gates Foundation’s Malaria Forum, I can report without question that Seattle is — excuse the pun — buzzing with excitement over the work that’s been done to fight this deadly disease. Hundreds of the world’s foremost malaria scientists and advocates have gathered, #endmalaria is trending on twitter here, and dozens of panels and videos have highlighted the remarkable progress we’ve made in the malaria agenda.

As is commonplace for these types of events, there were a number of announcements to kick things off. We learned from the Roll Back Malaria partnership that nearly a third of all malaria affected countries on course for elimination over the next decade — a truly remarkable possibility that would save millions more lives. We heard from WHO Executive Director Margaret Chan that, just weeks ago, Armenia was officially certified as malaria-free, adding its name to a growing list of countries that have eliminated the disease. And we’ve been told that more exciting news is set to come over the course of the Forum this week.

These announcements certainly make up the first half of the Forum’s “Optimism and Urgency” tag line, and a sense of urgency was also reinforced by other panelists’ remarks. Gates Foundation CEO Jeff Raikes noted that “the bigger the aspiration [on malaria], the more ambiguous the solution, and the more ambiguous the solution, the more important it is to have a rich intellectual dialogue” to best determine how we tackle this disease as a community. Malaria still kills nearly 800,000 people each year and is still rampant in some of the world’s toughest countries, so a push toward elimination and eradication is an obvious challenge. One panelist, Rob Newman from the WHO, also stressed that as we scale up commodities (drugs, bed nets, etc) and research for new tools, we must also do a better job of building human capacity to deliver these many pieces in a consistent way.

We also have lessons to learn and hope to gain from efforts to eradicate other diseases, like smallpox (eradication complete) or guinea worm (down to just a few thousand cases). Ciro de Quadros, who led smallpox eradication efforts in Latin America, stressed that we need to “hit hard the hardest hit” — in other words, we can’t ease up on a country or community just because it’s challenging. And Frank Richards, who leads on guinea worm efforts for the Carter Center, noted the importance of having “high-profile advocates for low-profile diseases”.

I’m heading into Day 2 of the Forum now, and will keep you posted with what I anticipate is big news from Bill and Melinda Gates later today!

The goal is to get readers engaged in a dialogue about solutions to worldwide and domestic problems, reflect the values of inspiration and urgency, and create an entire community of impatient optimists around the world.

The blog — or digital media hub, if you will — offers the tools to get people started on the right track. There videos, infographics and photos to help bring the issues to life. There are success stories and case studies. There are positive stories from the ground. And there will be lots of opportunities for brainstorming and open dialogue.

As Melinda Gates says, “I am convinced that through the telling of these stories, we discover what connects us. We can work together to create new ways of addressing the world’s most pressing problems. Social media is a tool for dialogue, community-sharing, and action.”

Join this community of impatient optimists who believe that the first step in changing the world is through educating oneself and stimulating dialogue. Luckily, in today’s digital world, being in-the-know is only a click away.

Despite the taboo nature of this topic, we’re excited to see the momentum that is building around providing access to water and sanitation to the world’s poorest people and the great work many of our partners are doing on the ground. This week, USAID’s Development Innovation Ventures launched WASH for Life, a $17 million partnership to help scale new approaches for WASH services to developing countries. But, that’s not all. The Bill and Melinda Gates Foundation is tackling the sanitation issue head on. Yesterday, they announced a $41.5 million donation into new program investments and new strategies.

Ironically, the Gates Foundation is using this money for toilets. Why are they spending money and time on toilets? Well, the toilet is an 18th century invention that reaches only one-third of the world’s population. This means that 2.6 billion people — meaning 40 percent of the world’s population — use unsafe toilets or openly defecate, resulting in many health complications and preventable deaths.

The Gates Foundation has a dynamic and forward-thinking approach — they want to reinvent this 18th century invention. To do this, The Gates Foundation’s Water Sanitation & Hygiene program collaborated with Grand Challenges Explorations (GCE) in Global Health and challenged 22 universities to create a proposal for a technologically advanced toilet. The criteria for the toilets are pretty intense. Each toilet has to be hygienic, affordable, and independent from a sewage system.

Surprisingly, eight of these universities not only devised proposals that met the above criteria, they also used technological and scientific advances to make the toilets even more cutting edge. These proposed inventions even have the ability to transform waste into energy, clean water and nutrients. It’s pretty incredulous, but if you don’t believe me, check it out for yourself. The Gates Foundation has a list of the eight toilet proposals that were awarded grants. These proposals, which were devised by expert teams at leading universities, might shock you with their utility and capabilities!

While poop will never be a trendy issue, it is undeniably important. So, stay in the loop about ONE’s sanitation efforts and keep the dialogue going by sharing the video above and keeping up with the various efforts that are making water and sanitation more accessible in the developing world.

Malaria, a disease which causes death, severe anemia, miscarriages, low birth weights and increased risk for mother-to-child HIV transmission was eliminated from the United States and Europe in 1970. Today, the disease remains endemic in 106 nations, with 90 percent of malaria deaths occurring in Africa. Yeah, you read that right — a disease that was eliminated decades ago in the West is still killing an estimated three-quarters of a million people each year. To be exact, malaria kills a child in Africa every 45 seconds.

The global malaria community recognizes that stronger and more collaborative efforts are critical to eradicate this deadly, but preventable disease. From 2000 to 2006, there was a 50 percent decrease in malaria through the use of insecticide-treated bed nets, indoor home spraying and preventative drug treatments.

The problem is that tools and medicines used to prevent and eliminate malaria are becoming increasingly weak. Mosquitoes have grown resistant to insecticides used in sprays and bed nets. And, even more problematic, malaria parasites are becoming unaffected by artemisinin, the key component of current treatment.

To address malaria head on, the Bill and Melinda Gates Foundation partnered with the PATH Malaria Vaccine Initiative, Medicines for Malaria Venture and other donors to research and invest in new methods for elimination and prevention. To better understand the new techniques being developed, the Gates Foundation created an infographic called “We Can End Malaria.”

As you can see from this infographic, the use of new tools and medicines show just how far sustained efforts can go in eliminating malaria. You can even click individual African countries and get exact numbers on how many lives can be saved.

Of course, eradicating malaria is a long-term challenge that demands collaborative partnerships and continued research on new treatments and vaccines. Although numerous challenges persist, it is promising and encouraging to see the new and improved steps in the path to eradication.

Growing up in a Ghanaian coastal village, the dry and dusty trade winds that blew in from the Sahara were associated with Advent, Christmas and happiness.

But as I moved inland with my work, they also became linked with meningococcal meningitis A (men A), Ghana’s most common form of meningitis, which brought major epidemics every eight to 12 years.

Men A strikes children and young adults suddenly, causing severe headaches, fever and a stiff neck. Patients can die within 48 hours.

I still remember the hospital wards where I used to work. Meningitis patients were usually on the floor because their seizures made them fall off the bed. As a medical student, I often had to bend the rigid patients into a fetal position so that I could extract the cloudy fluid from their spinal cord and confirm the suspected diagnosis. Year after year, we gave intravenous antibiotics every four hours and prayed the patient would survive without major complications.

In 1989, I became the district medical officer responsible for preventive health of a city of one million people. On one memorable occasion, with an epidemic threatening, a terrified crowd of people nearly broke down the vaccine cold store door in an attempt to get the vaccine. The fear on their faces was palpable.

Then, in 1997, the biggest-ever Men A epidemic struck, not just in the four northern regions as usual, but throughout the country, hitting about 20,000 people.

And just a few years later, in 2001 a close relative of mine, a healthy 20 year old, began complaining of a headache. He later collapsed and was given intravenous antibiotics. Within 48 hours, he was dead.

His death devastated my family, with rumors amok about the role of evil spirits. A decade later, my extended African family is still coming to terms with the loss.

I’m proud to say the GAVI Alliance has just committed another US$100 million to support the roll-out of a new conjugate vaccine, MenAfriVac, to rid the region of these men A epidemics. If our pledging conference is successful on June 13, GAVI will be able to roll this vaccine out to all African countries at risk.

This Christmas, I am taking my children back to Ghana. The new men A conjugate vaccine gives us the opportunity to celebrate without fear of this ancient scourge. It provides us hope for the future.

- Mercy Ahun, managing director of GAVI’s Program Delivery Team

Crossposted on Bill & Melinda Gates Foundation’s Foundation Notes blog

In Nigeria we have made remarkable progress in the fight against polio, with intense campaigns that drove polio down from 388 cases in 2009 to 21 in 2010 — a 95 percent reduction. We are extremely hopeful that these gains continue, although much hard work remains.

This progress is largely due to the immense momentum of our polio campaign, which has demonstrated that immunizations are safe, cost-effective tools to prevent infectious diseases and ultimately save children’s lives. We have seen non-compliance rates for immunizations fall because parents and traditional leaders have witnessed the effectiveness of oral polio vaccines to protect their children from paralysis and death.

The polio program has provided the momentum to combat other vaccine-preventable diseases, such as measles, that are costing lives of young children. In January, Nigeria launched a major campaign to administer both measles and polio vaccines to 31 million children under five — protecting children from two diseases. And during an upcoming national campaign later this month, health workers at fixed posts around the country will offer children doses of oral polio vaccines — along with an integrated package of other health interventions, including Vitamin A, deworming tablets and other routine immunizations.

From this broad perspective, conquering polio has an impact far beyond the immediate benefits of eradication. Perhaps polio eradication’s most enduring legacy will be that it lays the groundwork for countries like Nigeria to defeat other childhood diseases.

Still, there is significant work to be done. As long as polio exists in Nigeria, it can exist anywhere. To finally finish the job, we must keep up the momentum for mass immunization campaigns. Once Nigeria and the world win the fight against polio, it will inspire us to continue our intense efforts to tackle other pressing health challenges.

The Hausa people, who live in northern Nigeria, have a saying: When you shave a man’s head, it is getting the last hair that is the most difficult. Similarly, the final chapter of polio eradication -– in Nigeria and globally — will require even more effort than the previous ones. We must continue to work tirelessly to ensure that our momentum is sustained — so that we finish the job on polio and build upon that success to protect children from other deadly diseases.

-Dr. Muhammad Pate, executive director of Nigeria’s National Primary Healthcare Development Agency

Inspiration for your submission, via Bill & Melinda Gates Foundation

Basically, all you need to do is show the world that investing in small farmers in the developing world is the solution to reducing hunger and poverty. You can express this in a number of ways: build a game, write a Tweet, create an infographic, make a video or even design a poster. Read the full challenge details here. And for ideas, go to the Gates Foundation’s Inspiration Zone.

This is an important issue to us here at ONE, because most of the world’s poorest people are small farmers who grow their own food and make money from their plots of land. They often lack important tools and resources that enable them to grow more, and have more crops to take to market. One key to reducing hunger and poverty is to invest in farming families. This is already happening – and we are seeing successes around the world from these investments.

The Bill and Melinda Gates Foundation will highlight their favorite submissions on their social media sites and even include it in a blog post from Bill Gates. For more information, visit the “Join the Challenge” page on the website. The deadline is May 31st, 11:59 EST, so get cracking — you’ve only got a few more days!