:00:45. > :00:49.Welcome to the 2013 Richard Dimbleby lecture. The lecture was
:00:49. > :00:54.founded over 40 years ago in memory of my father, who was one of the
:00:54. > :00:56.BBC's great founding broadcasters. Its purpose is to give a unique
:00:56. > :01:01.platform to individuals of distinction who've made their mark
:01:01. > :01:05.as leaders in the arts, business, science and politics and there by,
:01:05. > :01:10.in the broadest sense, have made a significant contribution to the
:01:10. > :01:14.culture of our times. Very few, if any of our previous speakers, could
:01:14. > :01:20.claim to have made a bigger mark than this evening's lecturer. Bill
:01:20. > :01:24.Gates is of course, one of the world's most famous and successful
:01:24. > :01:28.entrepreneurs, the founder and chairman of a huge global
:01:29. > :01:32.corporation. He started out, by his own account, as the ultimate
:01:32. > :01:35.computer geek. As a college student, he also had the imagination to see
:01:35. > :01:39.that one way or another, the digital age would transform the
:01:39. > :01:44.lives of everyone on the planet and not only that, he real aislesed
:01:44. > :01:50.that the new technologies could be -- he realised that the new
:01:50. > :01:54.technologies could be available to all of us. In 1975, at the age of
:01:54. > :01:59.20, he dropped out of Harvard to per sue this vision. With his
:01:59. > :02:03.childhood friend Paul Allen he set up what is now that software giant,
:02:04. > :02:09.Microsoft. By the age of 31, he was a billionaire and very soon after
:02:09. > :02:13.that, one of the very richest men on the planet. Ever since, he's
:02:13. > :02:17.been at or around the top of those lists which name the men or women
:02:17. > :02:23.who seem to be shaping the course of our history. Today, however,
:02:23. > :02:27.that is not least because he is also one of the world's great
:02:27. > :02:31.philanthropists, a 21st century descendant of a long American
:02:31. > :02:34.tradition which has yet to be emulated to anything like the same
:02:34. > :02:39.degree in any other nation. It started on a large scale almost 20
:02:39. > :02:49.years ago and is now renowned as the Bill and Melinda Gates Gates
:02:49. > :02:53.Foundation. Supported by others, including Warren Buffett. It is now
:02:53. > :02:57.the biggest charitable organisation in the world. It operates in more
:02:57. > :03:03.than 100 countries. Its guiding principle is simple - every life
:03:03. > :03:06.has equal value. Bill and ple Linda are at the forefront of a global --
:03:06. > :03:11.Melinda are at the forefront of a global programme to help people,
:03:11. > :03:15.wherever they may be, to lead healthy and productive lifes. Their
:03:15. > :03:18.commitment and immersion in this project is self-evident.
:03:18. > :03:21.Individually and together, though they never boast of it, the
:03:21. > :03:24.foundation takes up virtually all their time and energy. Tonight,
:03:24. > :03:30.Bill Gates is here to tell us how he arrived at this point, why it
:03:30. > :03:35.matters to him and what he believes he can and will achieve. The
:03:35. > :03:45.lecture is entitled "The Impatient Optimist". Would you please welcome
:03:45. > :03:59.
:03:59. > :04:04.Bill Gates. Thank you Jonathan. It's a pleasure
:04:04. > :04:08.to be at the Royal Institution to honour Richard Dimbleby. As I got
:04:08. > :04:13.ready for this evening, and learned more about him, I developed a
:04:13. > :04:19.strong sense of admiration. To prepare for a recent trip to
:04:19. > :04:24.Ethiopia, I read up on that country's history. I kept seeing
:04:24. > :04:28.Jonathan Dimbleby's name. In 1973, he stumbled upon, those were his
:04:28. > :04:33.words, the brutal famine that emperor Haile Selassie had been
:04:33. > :04:37.concealing from the outside world. The documentary he produced, The
:04:37. > :04:41.Unknown Famine, did what great journalism is supposed to do -
:04:41. > :04:45.shine a light on the dark corners where human misery is hiding. The
:04:45. > :04:49.images of starvation from The Unknown Famine set the world on
:04:49. > :04:53.fire. Television viewers in the United Kingdom and other countries
:04:53. > :05:00.started sending donations, a total of 150 million to help alleviate
:05:00. > :05:05.the suffering. When another famine tore through the Horn of Africa a
:05:05. > :05:11.decade later, Michael Buerk and Bob Geldof helped to get a bigger
:05:11. > :05:14.public response. These two operations set the standard for how
:05:14. > :05:20.we react to global catstrophes. When people saw the famine,
:05:20. > :05:28.actually saw what it was doing to children, they found a way to take
:05:28. > :05:32.action. I'm optimistic about people. I believe a vast generosity is part
:05:32. > :05:39.of our nature. The key question is whether the people who need our
:05:39. > :05:43.generosity become visible or remain invisible. For my wife Melinda and
:05:43. > :05:48.I, the problem of global health and equity became visible 15 years ago,
:05:48. > :05:55.when we saw a simple pie chart in a newspaper breaking down the major
:05:55. > :05:59.causes of death among children. One of the bigger slices of the pie,
:05:59. > :06:03.representing 500,000 dead children annually was labelled rotavirus.
:06:03. > :06:09.I'd never heard of it. Melinda had never heard of it. It turns out
:06:09. > :06:13.it's the leading cause of diarrhoea, preventible with a vaccine that
:06:13. > :06:20.only children in rich countries were getting. Our reaction was
:06:20. > :06:25.somewhere between disbelief and disgust. How could we not have seen
:06:25. > :06:30.even the bearest outlines of this tragedy. That rotavirus slice in
:06:30. > :06:34.the pie set us on fire. I was in my early 40s and Melinda was in her
:06:35. > :06:40.mid-30s. I was running Microsoft and we were starting a family. We
:06:40. > :06:44.had plans to do a philanthropy later, when there was more time.
:06:44. > :06:48.But all of a sudden, it didn't seem like there was time to waste. We
:06:48. > :06:55.decided to do everything we could to get this vaccine out to every
:06:55. > :06:58.child who needed it. Now, 12 of the world's poorest countries are
:06:59. > :07:05.already giving the rotavirus vaccine to their children. That
:07:05. > :07:09.number of countries is scheduled to climb to 40 by 2015. The rotavirus
:07:09. > :07:13.mortality numbers are starting to come down. However, hundreds of
:07:13. > :07:19.thousands of children are still dying from a disease that is both
:07:19. > :07:24.preventible and treatable. The tension between how much the world
:07:24. > :07:29.has achieved and how much is left to achieve is the reason Melinda
:07:29. > :07:32.and I call ourselves impatient optimists. Tonight, I'll talk about
:07:32. > :07:38.the project I'm spending most of my time on right now. It is the
:07:38. > :07:42.subject about which I am most impatient and most optimistic. The
:07:42. > :07:49.fight to eradicate polio. Most people in developed countries know
:07:49. > :07:54.polio as a disease that used to paralyse lots of children. But it
:07:54. > :07:57.isn't merely a historical curiosity. It still strikes children today. We
:07:57. > :08:00.are working to wipe the virus off the face of the earth. We have
:08:00. > :08:05.almost succeeded. There are only three countries in the world where
:08:05. > :08:10.the virus is still being transmitted. Viewer than 250
:08:10. > :08:14.children were paralysed last year. Stopping these last cases of polio
:08:14. > :08:21.in these last countries is among the most difficult tasks the world
:08:21. > :08:27.has ever assigned itself. But it's also among the most important. The
:08:27. > :08:33.best of who we are, our capacity for innovation, our resill yepbs,
:08:33. > :08:39.our sympathy for each other has gotten us to this threshold. Only
:08:39. > :08:42.disease, poverty and indifference still stand in the way. The fight
:08:43. > :08:46.to eradicate polio is a proving ground, a test, its outcome will
:08:46. > :08:50.reveal what human beings are capable of and suggest how
:08:50. > :08:54.ambitious we are about our future. When Melinda and I created the
:08:54. > :08:57.foundation, we didn't know a lot about global health. We were
:08:57. > :09:03.looking for an education. As luck would have it, one of the giants of
:09:03. > :09:08.the field, one of the men most responsible for eradicating
:09:08. > :09:18.smallpox happened to live in Seattle. He offered his help. His
:09:18. > :09:21.name is Bill Foege. His father was a Lutheran minister. When Bill was
:09:21. > :09:26.choosing a career he couldn't decide between public health and
:09:26. > :09:31.preaching. He chose health, but his ministerial instincts still come
:09:31. > :09:35.out when he speaks about his work. He's one of the most articulate and
:09:36. > :09:39.inspiring leaders in a field where matters of life and death tend to
:09:39. > :09:44.be mumified by jargon and statistics. I still look at his
:09:44. > :09:53.speeches to remind me who global health is for. Here's a passage
:09:53. > :09:57.from Bill's recents book on smallpox, House on Fire. In early
:09:57. > :10:05.October 1977, a couple with two small children both with smallpox
:10:05. > :10:09.approached the hospital in Merka, Somalia. They asked an employee for
:10:09. > :10:13.directions to the infectious disease ward. A considerate person,
:10:13. > :10:18.he took them into the ward rather than directing them. Although he'd
:10:18. > :10:25.been vaccinate today was evidently not an effective take. Two weeks
:10:25. > :10:32.later, on October 26, 1977, he developed the last smallpox rash
:10:32. > :10:37.that Africa would ever see. In 1978, smallpox was declared to be the
:10:37. > :10:41.first disease to be fully eradicated.
:10:41. > :10:45.Bill Foege has the unique ability to see the forest and the trees to
:10:45. > :10:52.celebrate the common decency of a man who refused to shun the sick
:10:52. > :10:57.and appreciate the historic majesty of completely eradicating a disease.
:10:57. > :11:02.He continues, "In medicine, the medical practitioner is obliged to
:11:02. > :11:06.apply the best knowledge of the times to each patient. In public
:11:06. > :11:10.health the obligation is to apply the best knowledge to the entire
:11:10. > :11:17.human community. The purpose of public health is to promote social
:11:17. > :11:22.justice. By 1978, publy health achieved its first complete success
:11:22. > :11:27.in social justice for current humanity and for all future
:11:27. > :11:31.generations. Bill helped me understand that it
:11:31. > :11:38.is possible to eradicate polio bay plying the best knowledge of our
:11:38. > :11:42.times and achieve the next complete success in social justice. In the
:11:42. > :11:47.early years of our learning from Bill and many others, we developed
:11:47. > :11:51.three convictions that are at the core of our work today: The first
:11:51. > :11:56.condition is that when health improves life improves by every
:11:56. > :11:59.measure. Many sceptics say - what's the point of saving a child from a
:11:59. > :12:06.rotavirus death if the child won't get enough to eat or learn to read
:12:06. > :12:10.or earn an income? While it's true that we also need to invest in
:12:10. > :12:16.important areas like agriculture and education, in addition to
:12:16. > :12:21.health, it's naive to think that these issues are separate. Disease
:12:21. > :12:25.insin waits itself into every aspect of life. For a very high
:12:25. > :12:29.percentage of African children it stunts their brain development. It
:12:29. > :12:34.inhibits the absorption of nueftrigs. It weakens their drve
:12:34. > :12:38.nutrition. It weekens their immune system for their life. Our goal
:12:38. > :12:42.isn't merely to eliminate the deaths, it's to help lift the heavy
:12:42. > :12:47.burden that sickness places on poor people's existence, so they can
:12:47. > :12:52.seize the opportunities in the worlds of school, work and family.
:12:52. > :12:57.In fact, when parents are more confident that their children will
:12:57. > :13:00.survive, they tend to decide to have fewer children, gradually
:13:00. > :13:07.bringing down population growth and leading to all sorts of beneficial
:13:07. > :13:11.effects. The second conviction, progress is already happening at an
:13:11. > :13:15.enormous scale. This is my all-time enormous scale. This is my all-time
:13:15. > :13:19.favourite chart. In the year that I was born, more than 20 million
:13:19. > :13:24.children under the age of five died. Last year, that number was 6.9
:13:24. > :13:26.million. Keep in mind, that the million. Keep in mind, that the
:13:26. > :13:32.world population keeps growing. The improvement is even more impressive
:13:32. > :13:39.than it sounds. If the rate of death had remained constant since
:13:39. > :13:44.1960, 31 million children would have died last year. The tens of
:13:44. > :13:51.millions of lives already saved inspire us to do more because they
:13:51. > :13:55.prove what's possible. The third conviction is that vaccines are a
:13:55. > :14:00.miracle tool. They prevent disease from striking, which is better than
:14:00. > :14:06.treating it after the fact. They are also relatively cheap and easy
:14:06. > :14:11.to deliver. However, millions and millions of children don't get them.
:14:11. > :14:15.This is still stunning to me. Before we started the foundation,
:14:15. > :14:21.we assumed all the obvious steps were already being taken. Wield'
:14:21. > :14:27.have to go after the more difficult, more expensive or least proven
:14:27. > :14:33.solutions. In fact, our first big health investment was devoted to
:14:33. > :14:37.improving the delivery of basic vaccines. I'm not saying it's a
:14:37. > :14:44.simple matter to reach children with vaccines. It's actually quite
:14:44. > :14:53.difficult, but universal coverage with today's vaccines is achievable.
:14:53. > :14:56.It's also possible if we invest to invent new vaccines for diseases
:14:56. > :15:01.like malaria. Both achievements will save millions of children's
:15:01. > :15:04.lives. They're a major focus for our foundation. Delivering one
:15:05. > :15:11.vaccine in particular, the polio vaccine, is the top goal of our
:15:11. > :15:16.foundation. I'd like to turn now to that vaccine and to the disease it
:15:16. > :15:22.prevents and explain why they are such a priority. Polio's been with
:15:22. > :15:25.mankind for a long, long time. Archaeologists have found ancient
:15:25. > :15:32.Egyptian carvings depicting people with withered limbs and walking
:15:32. > :15:37.with canes. Around the turn of the twentsth century, increased
:15:37. > :15:43.urbanisation -- Twentieth Century, increased urbanisation caused
:15:43. > :15:47.epidemics of polio, which caused paralysis and extreme terror. When
:15:47. > :15:49.the virus appeared, typically in the summer, it surged through
:15:49. > :15:57.cities and towns filling up hospital wards with paralysed
:15:57. > :16:02.children in a matter of days. An Irish journalist was infected in
:16:02. > :16:06.the 1956 epidemic in Cork and has written about the panic that
:16:06. > :16:10.surrounded him. "It was only on 13 June that the first case of polio
:16:10. > :16:15.was reported in Cork city. By early July, the number had risen to six.
:16:15. > :16:18.For the first time, reports of an epidemic begin to appear in the
:16:18. > :16:24.local press. They were usually accompanied by subheadlines
:16:24. > :16:27.claiming there was no occasion for undew alarm or outbreak a mild one.
:16:27. > :16:31.These repeated understatements somehow conveyed the very sense of
:16:32. > :16:36.fear which the newspapers were trying so hard to avoid. By the
:16:36. > :16:42.middle of July, the number of children entering the fever
:16:42. > :16:47.hospital in Cork had risen to four a day. People swimming in the river
:16:47. > :16:52.Lee which flowed through Cork were threatened with prosecution. A
:16:52. > :16:55.month into the epidemic, many were convinced that not only were the
:16:55. > :16:58.dire facts of the epidemic suppressed in the city but that it
:16:58. > :17:06.had spread to Dublin, where people were dying like flies in the fever
:17:06. > :17:16.hospitals. Fortunately, that 1956 epidemic was among the last in
:17:16. > :17:16.
:17:16. > :17:22.Western Europe. Jonas Saulk's polio vaccine had been approved the
:17:22. > :17:25.previous year. When the second oral vaccine became available in 1960,
:17:25. > :17:33.mass vaccination drove infections in developed countries down to
:17:33. > :17:37.nearly zero. The fear and eventually, even the memro of polio,
:17:37. > :17:40.faded away. -- memory. Polio wasn't gone, it just wasn't so
:17:40. > :17:47.frighteningly visible in rich countries any more. It became a
:17:47. > :17:51.disease of poverty, but in 1988, the World Health Assembly passed a
:17:51. > :17:58.resolution supporting the global eradication of polio. In that year
:17:58. > :18:04.the virus was circulating in 125 countries. It paralysed 350,000
:18:04. > :18:06.children. Within eight years of the resolution, most countries had
:18:07. > :18:13.resolution, most countries had built strong polio programmes.
:18:13. > :18:17.Cases were down almost 90% globally. Melinda and I made our first
:18:17. > :18:19.contribution to the campaign in 1999 and based on the trend lines,
:18:19. > :18:26.we thought we were helping fund the we thought we were helping fund the
:18:26. > :18:33.final stages of eradication. In 2000, the virus was circulating in
:18:34. > :18:39.20 countries. By 2003, that number was just six. In 2005, Egypt and
:18:39. > :18:46.Niger were declared polio free, leaving only four endemic countries.
:18:46. > :18:50.But this virus is stubborn. In 2006, people in 13 countries that had
:18:50. > :18:56.already achieved polio-free status were infected by travellers from
:18:56. > :19:01.one of the four endemic countries. In several countries, as far flung
:19:01. > :19:05.as Indonesia and Yemen, these importations led to large polio
:19:05. > :19:12.outbreaks. It would be five years before India celebrated its last
:19:12. > :19:17.case. There are still three endemic countries left - Afghanistan,
:19:17. > :19:23.Pakistan and Nigeria. I can say without reservation that the last
:19:23. > :19:30.mile is not only the hardest mile, it's also much harder than expected.
:19:30. > :19:35.Let me try and explain how hard it is to eradicate polio by comparing
:19:35. > :19:41.it to smallpox. Every single person infected with the smallpox virus
:19:41. > :19:46.gets an unmistakable rash on their skin. The eradication straty,
:19:46. > :19:49.pioneered by Bill Foege was called ring-fencing. As soon as you saw a
:19:49. > :19:56.case, you vaccinated aggressively in nearby towns to contain the
:19:56. > :20:01.virus. Polio, on the other hand, is transmitted silently. Only 1% of
:20:01. > :20:06.infected people show symptoms. The other 99% are contagious, but they
:20:06. > :20:11.don't know it. When you do see symptoms, they're not unique to
:20:11. > :20:15.polio. They start with a fever and a headache. A few days later,
:20:16. > :20:21.ordinary muscle aches get increasingly severe and your
:20:21. > :20:26.reflexes slow down. Then, paralysis sets in. And the point at which a
:20:26. > :20:29.health worker sees a child with paralysis begins a two-week waiting
:20:29. > :20:35.period during which stool samples are collected, sent off to the lab
:20:35. > :20:42.and tested. So by the time a positive diagnosis is confirmed,
:20:42. > :20:47.the virus may have travelled hundreds of miles in any direction.
:20:47. > :20:53.So ring-fencing doesn't work. Everybody everywhere is at risk at
:20:53. > :20:58.all times unless they're immune. Therefore, the way to stop polio is
:20:58. > :21:02.to fax nait an extremely high percentage of the -- vaccinate an
:21:02. > :21:06.extremely high percentage of the population, leaving no reservoir of
:21:06. > :21:11.susceptible people for the virus to survive. This threshold, what's
:21:11. > :21:18.called herd immunity, varies by location. But it's never lower than
:21:18. > :21:22.80% and in some locations, it's as high as 95%ment Now -- 95%. Now
:21:22. > :21:31.achieving 95% coverage is difficult. Even rich countries, like the
:21:31. > :21:36.United Kingdom only vaccinate 95% of their children. So how can poor
:21:36. > :21:43.countries possibly achieve this high level of coverage? Take the
:21:43. > :21:46.example of India. The most recent country to eliminate polio. India
:21:46. > :21:50.started with the same basic approach that the UK and other
:21:50. > :21:54.developed countries use, which is that you have children come into
:21:54. > :22:01.the clinic at a young age for routine visits. When they visit
:22:01. > :22:07.they get their vaccines. But in India, far too many Indian children
:22:07. > :22:12.never see the clinic. So, the only way to get the coverage rates up is
:22:12. > :22:18.to add a supply-side approach to the clinic-base add proch. They go
:22:18. > :22:21.out to the community and find the children. They go after every child
:22:21. > :22:27.under the age of five and vaccinate them house by house. Think about
:22:27. > :22:32.what this requires. India has more than a billion people. It's 15
:22:32. > :22:36.times larger than the United Kingdom. It has some of the most
:22:36. > :22:39.severe terrain and weather in the world. Behind me I'm showing a
:22:39. > :22:46.photograph taken in Bihar in the north of India during a flood in
:22:46. > :22:51.2007. What you see are health workers walking for miles in waters
:22:51. > :22:57.up to their waist to find and vaccinate children living in a
:22:57. > :23:04.remote area along the Kosi River. Periodically, they'd reach a
:23:04. > :23:07.village, like this one. Notice the vaccine box that's being carried on
:23:07. > :23:12.the person's head. Not only do vaccinators have to track down
:23:12. > :23:17.every child, but they have to keep the vaccines cold the entire time.
:23:17. > :23:22.And this process doesn't just happen once. It happens six to 12
:23:22. > :23:28.times a year so that they can get out and vaccinate every child three
:23:28. > :23:34.or more times to get very high levels of immunity. Every day
:23:34. > :23:38.75,000 new children are born and this is why India's polio programme
:23:38. > :23:45.is so large. It employed over two million people, almost entirely
:23:46. > :23:50.paid for by the Indian government. So India's accomplishment in wiping
:23:50. > :23:56.out polio in 2011 is among the most impressive global health successes
:23:56. > :24:00.there's ever been. I've just described some of India's
:24:00. > :24:05.challenges. The challenges in Afghanistan, Pakistan and Nigeria
:24:05. > :24:10.are just as daunting, but somewhat different. A decade ago in Nigeria,
:24:10. > :24:13.some leaders in the northern part of the country started a rumour
:24:13. > :24:19.that the polio vaccine reduced fertility in the children who
:24:19. > :24:24.received it. Campaigns had to be suspended for a year while
:24:24. > :24:28.officials disproved these allegations. A large epidemic
:24:28. > :24:32.sliced through northern Nigeria and polio spread back into about 20
:24:32. > :24:37.nearby countries where it had been eliminated. All those countries had
:24:38. > :24:44.to ramp up again for an intense fight to eliminate the virus.
:24:44. > :24:49.Nigeria, the -- in Nigeria, the rumours persisted to. This day,
:24:49. > :24:55.some parents refuse to let their children be vaccinated. In
:24:55. > :24:57.Afghanistan and Pakistan, militants in some areas won't give
:24:57. > :25:01.vaccinators access to local children. Even in some of the
:25:01. > :25:08.places where vaccinators can go, there's no guarantee against the
:25:08. > :25:14.threat of violence. When I lay out these facts, I often get two
:25:14. > :25:18.questions: First, given the challenges is it possible to -- is
:25:18. > :25:23.it possible? And second, should we bodger to put all the efforts into
:25:23. > :25:28.this to get the eradication? So I'm going to spend the rest of my time
:25:28. > :25:36.answering these two questions. I'll answer yes, we can eradicate polio
:25:36. > :25:39.and yes, we should. At the time Melinda and I created
:25:39. > :25:44.our foundation, we included provision in the bilaws saying that
:25:44. > :25:51.within 20 years of the last of us to die the foundation should spend
:25:51. > :25:56.all of its money against the causes of health inequity. We believe that
:25:56. > :26:01.between now and then the great inequity can actually be eliminated.
:26:01. > :26:06.That's why we do this work. Because we believe in the power of
:26:06. > :26:10.innovation to solve that problem. Innovation is amazing, an amazing
:26:10. > :26:14.thing. After all, knowledge is increasing. There's constant
:26:14. > :26:19.invention of new things. Once they're invented they're not
:26:19. > :26:25.uninvented. They keep moving forward. The Royal Institution
:26:25. > :26:29.where we are today is an important part of this great history of ideas.
:26:29. > :26:33.Here many leading scientists of the modern age have lectured about
:26:33. > :26:38.their discoverries, building the foundation of our understanding
:26:38. > :26:43.idea by idea. It was my belief in innovation that
:26:43. > :26:48.led me, at a young age, to start Microsoft. When I was a teenager,
:26:48. > :26:53.computers were the size of a car and far more expensive. I had to
:26:53. > :26:56.sneak in to computer labs at a nearby college to get a bit of
:26:56. > :27:01.computer time. Now the idea of computer time being incredibly
:27:01. > :27:07.scarce doesn't even make sense. In the 1970s, it was considered wild
:27:07. > :27:12.when we talked about the idea of everybody having a computer. We
:27:12. > :27:19.said a computer on every desk top. Now we can almost take for granted
:27:19. > :27:23.that there's a computer in almost every pocket. So this pace of
:27:23. > :27:28.innovation is accelerating. The same is true of our understanding
:27:28. > :27:32.of polio. It was first recognised 4,000 years ago. But it was only
:27:33. > :27:38.200 years ago when we figured out that it was contagious. 100 years
:27:38. > :27:43.ago we learned it was caused by a virus. And 50 years ago, we
:27:43. > :27:48.developed the first vaccine to prevent it. 25 years ago, we
:27:48. > :27:52.resolved to eradicate it. I asked the Science Museum if I could
:27:52. > :27:59.borrow this machine to show you an example of what polio-related
:27:59. > :28:07.innovation looks like. This is a Smith-Clarke Junoir Cabinet
:28:07. > :28:13.Respirator, better known as an iron lung. This version was developed by
:28:13. > :28:18.George Thomas Smith-Clarke in 1956. In addition to paralysing arms and
:28:18. > :28:23.legs, the polio virus can affect the nerves that let you control the
:28:23. > :28:30.muscles that inflate your lungs. In these cases, patients are unable to
:28:30. > :28:35.breathe on their own. Behind me you can see a photo of what it looked
:28:35. > :28:43.like when an iron lung was used to help children breathe. They were
:28:43. > :28:49.sealed inside it. For centuries, artificial respiration was
:28:49. > :28:53.something that medicine sought, drowning and gas inhalation were
:28:53. > :28:57.common causes of death in the 19th century. Nothing could be done to
:28:57. > :29:01.revive people who stopped breathing. One early device that seemed to
:29:01. > :29:07.work required a person operating it to blow into a tube 30 times a
:29:08. > :29:16.minute or 43,000 times a day. To test the first iron lung,
:29:16. > :29:19.researchers injected a cat with a south American poison until it
:29:19. > :29:23.stopped breathing. Then they put it into the prototype. The machine
:29:23. > :29:29.breathed for the cat, with the air going in and out of the machine
:29:29. > :29:35.inflating the cat's lungs. When the poison wore off, the cat survived.
:29:35. > :29:40.The inventors raced each other to make improvements to this iron lung
:29:40. > :29:44.concept. Now children who had inability to breathe with polio
:29:44. > :29:49.many of them recover but they remember vividly their time in the
:29:49. > :29:55.iron lung with horror. Upon derg possible death, their parents could
:29:55. > :30:01.only see them in a mirror, touched above their immobilised heads. This
:30:01. > :30:11.did save thousands of lives and it fulfilled the aspirations of the
:30:11. > :30:14.medical community. But now, this contraption filled with oral
:30:14. > :30:22.vaccine has saved millions of lives. It's the reason the iron lung is
:30:22. > :30:28.now in a museum. This is innovation. When a solution is so powerful that
:30:28. > :30:32.it changes the way we think about a problem, not how can paralysed
:30:32. > :30:36.lungs inflate, but how can we keep them from being paralysed in the
:30:36. > :30:40.first place. Innovation is helping us overcome the obstacles that
:30:41. > :30:45.still stand in the way of eradication. In the past year,
:30:45. > :30:49.Nigeria started using a new technology in an innovative way to
:30:49. > :30:55.solve an important problem. How do you vaccinate every child when you
:30:55. > :31:00.don't know how many there are? The polio programme has always used
:31:00. > :31:05.microplans to create little maps for vaccinators. These maps cover
:31:05. > :31:08.the entire country and point out where the vaccinators are supposed
:31:08. > :31:12.to visit. They're called micro because they get down to the level
:31:12. > :31:16.of the individual hut and they're supposed to show a lot of precision.
:31:16. > :31:21.But the maps on which the microplans were based look like
:31:21. > :31:27.this. These maps simply weren't accurate
:31:27. > :31:32.enough or detailed enough to drive universal coverage. Thousands of
:31:32. > :31:37.settlements were simply overlooked. The distances between different
:31:37. > :31:42.locations could be off by a long, long amount, meaning that what a
:31:42. > :31:47.microplan said was a 20-mile trip during the day might end up being
:31:47. > :31:51.more than 40 miles and something that couldn't abcheefd in a day. --
:31:51. > :31:55.achieved in a day. The result was a plan that didn't actually plan to
:31:55. > :32:01.vaccinate every child and that didn't actual lay chief vaccination
:32:01. > :32:04.of every child in the plan. -- actually achieve vaccination of
:32:04. > :32:10.every child in the plan. Now we're using high resolution sat lie
:32:10. > :32:14.imagery to get the latest maps that look like this.
:32:14. > :32:19.This process has identified thousands of additional settlements
:32:19. > :32:23.that had been missing from the micromans. These maps show the real
:32:23. > :32:27.-- microplans. These maps show the real distances. So vaccinators are
:32:27. > :32:32.assigned a full day's work, but no more. The question is no longer how
:32:32. > :32:36.many children are there and where might we find them all? It is how
:32:36. > :32:43.do we most efficiently visit every child on this map? Innovations like
:32:43. > :32:48.this are a key reason for my optimism. Innovation alone won't
:32:48. > :32:52.drive this. It's not inherently good or bad. It just has the
:32:52. > :32:56.potential to be transformative. To make sure the innovation transforms
:32:56. > :33:04.our world in positive ways we need to point it in the right direction.
:33:04. > :33:08.That takes public will. Many organisations helped push the
:33:08. > :33:13.eradication resolution through the World Health Assembly. But the one
:33:13. > :33:16.you wouldn't expect is Rotary International. They're a service
:33:16. > :33:19.organisation with 1.2 million members in almost every country of
:33:19. > :33:26.the world, including more than 50,000 in Great Britain and
:33:26. > :33:29.Irelandment Rotarians pledged to put service
:33:29. > :33:33.above self. It's their motto. They have no specific global health
:33:33. > :33:40.mandate. They're not polio experts. They're regular people, but they go
:33:40. > :33:44.out and spend their time working with families as part of this cause.
:33:44. > :33:47.For three decades they've spend time advocating for polio
:33:48. > :33:55.eradication, raising money, supporting vaccination and actually
:33:55. > :33:58.going out to get involved in the campaigns. Other key partners
:33:58. > :34:03.include the Center for Disease Control, UNICEF, and the World
:34:03. > :34:08.Health Organisation. All of them have special talents they bring to
:34:08. > :34:13.the campaign. But that's not enough. We need the broad community, people
:34:13. > :34:18.have nothing to do directly with the health of the poor. We need
:34:18. > :34:22.broad public will. Take the example of Nigeria, where the public had
:34:22. > :34:27.been reluctant to vaccinate children after rumours about the
:34:27. > :34:31.vaccine. I went there for the first time four years ago to meet two
:34:31. > :34:35.groups of leaders. The religious leaders in the north were in the
:34:35. > :34:40.best position to encourage anxious parents to vaccinate their children
:34:40. > :34:47.and the state governors who have the power to hold the health system
:34:47. > :34:52.accountable for quality work. I met with the religious leaders in the
:34:52. > :34:57.palace of the Sultan of sow co-toe. They heralded may rifle with
:34:57. > :35:02.Blairing horns. The Sultan gave me a white horse as a give. I demurred
:35:02. > :35:08.because I didn't have room on my plane. The Sultan and I got down to
:35:08. > :35:12.business talking about polio. The next day I met with a large group
:35:12. > :35:17.of state governors in the capital Abuja. At the end of this two-hour
:35:17. > :35:23.meeting we all signed a document, committing ourself to the goal of
:35:23. > :35:26.eve rad indication and spelling out -- of eradication and spelling out
:35:26. > :35:29.personal obligations. I see a strong commitment from leaders in
:35:29. > :35:36.all three endemic countries. In September I was in New York
:35:36. > :35:39.attending a UN polio meeting that included Presidents Jonathan,
:35:39. > :35:45.Karzai and Zardari, all there to talk about their commitment to
:35:45. > :35:50.eradication. The fact of their presence showed that the initiative
:35:50. > :35:55.has unprecedented momentum and commitment. We also need rich
:35:55. > :36:00.country governments to be generous as well. The proof of Great
:36:00. > :36:04.Leadership is the ability to be long siegtded and keep the big
:36:04. > :36:07.picture in mind. The UK government's decision to prioritise
:36:07. > :36:11.foreign aid, even in the face of financial challenges is exactly the
:36:11. > :36:16.kind of commitment I'm speaking about. In fact, as I travel across
:36:16. > :36:20.Europe, making the case for increases in aid budgets, I've
:36:20. > :36:26.never been more proud than I am now of the knighthood I was awarded in
:36:26. > :36:33.2005. So that leaves one final question -
:36:33. > :36:37.why is it worth it? Polio doesn't kill as many people as AIDS,
:36:37. > :36:44.tuberculosis, malaria or rotavirus. It's not even close. Why should the
:36:44. > :36:49.world focus on eradicating it? First of all, there's no such thing
:36:49. > :36:53.as keeping polio at its current low levels. We've gone to this point
:36:53. > :36:56.because vaccinators are wading through flooded rivers, governments
:36:56. > :37:01.in developing countries are investing scarce resources and the
:37:01. > :37:05.global health community is on high alert. These are not sustainable
:37:05. > :37:10.approaches. If we don't keep investing, cases will shoot back up,
:37:10. > :37:17.at least to the tens of thousands, in dozens of countries.
:37:17. > :37:22.Second, successful generates lesson that's will benefit all of tkphrobl
:37:22. > :37:25.health. We're on the verge of doing something -- global health. We're
:37:25. > :37:28.on the verge of doing something we haven't done before, reaching the
:37:28. > :37:31.vast majority of all children in the toughest places in the world.
:37:31. > :37:36.We're building systems, developing technology and training workers
:37:36. > :37:41.that make it possible to help people who didn't get help before.
:37:41. > :37:46.When polio is gone, we'll use the same systems, technology and people
:37:46. > :37:51.to deliver other life-saving solutions, especially routine
:37:51. > :37:54.vaccinations for diseases like rotavirus and measles. These are
:37:54. > :38:00.practical arguments. I believe they're convincing, however the
:38:00. > :38:05.argument that really moves me the most is more idealist iction. By
:38:05. > :38:10.doing something really hard for each other we'll demonstrate what
:38:10. > :38:13.is best about humanity. That will inspire us to be more ambitious
:38:13. > :38:16.about what is possible in other endeavours. Last month, nine
:38:16. > :38:22.vaccinators from Pakistan were murdered by masked militants. At
:38:22. > :38:25.the beginning of a three-day polio campaign. The youngest, a 17-year-
:38:25. > :38:29.old volunteer, received several death threats in the week leading
:38:29. > :38:33.up to the campaign and was forced to move between houses for her
:38:33. > :38:41.safety. She was standing a few feet from her sister when she was shot
:38:41. > :38:45.and killed. To me, the nihilism behind these coordinated attacks,
:38:45. > :38:48.seeking out the goodness to destroy it is the opposite of what the
:38:48. > :38:53.eradication fight is all about. The vaccinators were trying to stop
:38:53. > :38:58.disease and ease suffering so that people they would never meet could
:38:59. > :39:03.have a better life. They're heroes. There's two ways to memorialise
:39:03. > :39:08.them. The first is to do our best to ensure the safety of those who
:39:08. > :39:13.continue the campaigns and the second is to finish the task that
:39:13. > :39:18.they gave their lives for. I'm committed to doing whatever it
:39:18. > :39:23.takes to win this fight. I don't take that lightly. I'm in the a
:39:23. > :39:27.wishful thinker. The global polio community now has a detailed plan
:39:27. > :39:31.from getting here to eradication. It's based on a careful analysis of
:39:31. > :39:36.what countries have accomplished in the past and what still needs to be
:39:36. > :39:40.accomplished in the endemic countries. The plan says that if
:39:40. > :39:48.the world supplies the necessary funds, political commitment and
:39:48. > :39:53.resolve we will certify the eradication of polio by 2018.
:39:53. > :39:58.Funds, commitment and resolve, those are the key variables. If the
:39:58. > :40:03.world delivers, then we'll eradicate polio within six years.
:40:03. > :40:07.It will be an entry on a long list of improvements to the human
:40:07. > :40:10.condition. We cut the child mortality rate by 75% in the past
:40:10. > :40:18.five decades. We cut the poverty rates by 50% in the past two
:40:18. > :40:22.decades. We eradicated smallpox. These are mindboggling successes.