First ever village-level mapping of childhood undernutrition in India reveals sharp local disparities

The study is the first to predict and map the burden of childhood undernutrition across all of the nearly 600,000 villages in rural India, and the methods developed to do so could be applied to other health indicators and help advance the field of “precision public health,” in which interventions and policies are tailored to smaller populations that are disproportionally affected by specific health issues, according to the study’s authors.

“By applying state-of-the-art data science techniques to existing public health indicators and census data, we created a framework that we hope can help local and regional decision makers better understand the substantial village disparities in childhood undernutrition,” said S.V. Subramanian, corresponding author and professor of population health and geography at Harvard Chan School. “Mahatma Gandhi once said that India lives in its villages. Now we can bring the power of data science to aid public policy thru precision targeting and help ensure that children in all of India’s villages are given an opportunity to grow healthy and thrive.”

The study was published April 26, 2021, in the Proceedings of the National Academy of Sciences.

Childhood undernutrition is a major problem in India; the country accounts for almost one-third of the global prevalence of childhood stunting. Precisely identifying areas with high levels of undernutrition, however, can be difficult because childhood nutrition data—and other key public health data—is typically analyzed at the district level. There are 640 districts in India per the 2011 census, a district can cover hundreds of square miles, and each district has an average rural population of 1.3 million people. Studying childhood nutrition data at this scale can result in oversimplified or misleading analyses that overlook substantial disparities within a district. Moreover, this approach can foster a lack of political accountability for the agencies responsible for crafting and implementing policies and interventions.

To obtain a more granular understanding of childhood undernutrition, the research team focused on India’s 597,121 inhabited census villages. Villages are the smallest unit of governance in India, and the researchers said that mapping and analyzing nutrition data at the village level could provide a more accurate understanding of childhood health and result in more informed and effective local politics in India.

The team combined data from numerous sources including the 2011 census and the 2016 Indian Demographic and Health Survey, which contained anonymized GPS data on approximately 20,000 “clusters,” or villages or groups of villages. The researchers then created a machine-learning prediction model to extrapolate the available data and estimate the prevalence of key indicators of undernutrition, including stunting, underweight, and wasting, for every village in the country.

The findings showed substantial variations in undernutrition across villages. For instance, the average predicted rate of stunting across all villages was 37.9%. In 691 villages, however, the average predicted rate of stunting was under 5%, while it exceeded 70% in 453 villages. In all districts, the authors noted, they found a mix of villages with high and low burdens of undernutrition.

The authors said the village-level model they created could potentially shift the paradigm of policy discussions in India by enabling policy makers and public health officials to better prioritize villages struggling with a high burden of undernutrition. The authors also created a publicly available dashboard that allows users to explore the village maps and associated data in an interactive manner.

“We focused on India, but this approach can be developed and applied to other countries to predict local health, nutrition and population estimates and better understand disparities,” said first author Rockli Kim, assistant professor at Korea University and a visiting scientist at the Harvard Center for Population and Development Studies.

The Clock is Ticking: as TB claims some 1.4 million lives in 2019

More than a century has passed since the March 24, 1882, announcement by Robert Koch that Mycobacterium tuberculosis (Mtb) bacteria cause tuberculosis (TB), but the disease still ranks as one of the world’s great killers, claiming some 1.4 million lives in 2019 alone.

The National Institute of Allergy and Infectious Diseases (NIAID) of the United states on Wednesday joined the World Health Organization and others in acknowledging the need for continued, concerted efforts to combat TB, even as the world stand in the shadow of the COVID-19 pandemic, which threatens to slow or reverse progress in global TB control.

“The 2021 World TB Day theme, The Clock is Ticking, reminds us that time is of the essence. We cannot delay the research needed to identify, develop, test, and deliver new or improved TB diagnostics, treatments, and vaccines. On this World TB Day, NIAID stands with the global health community in a renewed commitment to ending this disease”.

TB-causing bacteria spread through the air and the disease usually affects the lungs, although other organs and parts of the body can be involved. Most people infected with the disease can co-exist with the bacterium for months, years or a lifetime without ever developing symptoms (termed latent TB infection.)

By some estimates, up to a quarter of the world’s population has latent Mtb infection. People with latent TB infection cannot transmit the bacteria to others. However, they have a 5-to-10% lifetime risk of developing active TB. Symptoms of active pulmonary TB disease include cough, fever, and weight loss. Malnourished individuals, smokers, people receiving immunosuppressive therapies, and those with compromised immune systems, including those with untreated HIV infections, are at increased risk of developing active TB.

In collaboration with the Bill and Melinda Gates Foundation, NIAID is funding studies to analyze clinical samples collected in trials of BCG and M72/AS01 E vaccines. These studies aim to define the immunological basis of the observed protection from TB disease. Defining how and which immune responses correlate with high degrees of disease protection allows investigators to design new and improved TB vaccines.

To further advance the development of potential TB vaccines, NIAID established three Immune Mechanisms of Protection Against Mycobacterium tuberculosis (IMPAc-TB) Centers in 2019. Multi-disciplinary research teams in the Centers are elucidating the immune responses involved in preventing initial TB infection, establishing latent TB infection, or transitioning from latent infection to active TB disease. Findings are informing development of novel TB vaccine candidates.

NIAID says the clock is indeed ticking, and on World TB Day 2021, NIAID takes time to reflect on the dedication of scientists, clinicians, trial volunteers, and others who work tirelessly to make TB a disease of the past.

“We stand with global health partners in firm resolve to apply cutting-edge research, investment, and collaboration to make that day come soon.”

COVAX warns SARS-CoV-2 is reminder viruses by their very nature mutate

The emergence of variants of SARS-CoV-2, the virus that causes COVID-19,  serve as a powerful reminder that viruses by their very nature mutate, and that the scientific response may need to adapt to remain effective against them, according to COVAX statement on new variants of SARS-CoV-2.

In light of recent news stories regarding the preliminary data on minimal effectiveness of the AstraZeneca/Oxford vaccine at preventing mild to moderate COVID-19 disease caused by the viral variant B.1.351, it is important to note that primary analysis of data from Phase III trials has so far shown – in the context of viral settings without this variant – that the AstraZeneca/Oxford vaccine offers protection against severe disease, hospitalisation and death. This means it is vitally important now to determine the vaccine’s effectiveness when it comes to preventing more severe illness caused by the B.1.351 variant. 

Additional studies will also allow us to confirm the optimal vaccination schedule and its impact on vaccine efficacy. CEPI has announced funding for additional clinical research to optimize and extend the use of existing vaccines, which could include “mix-and-match” studies of different vaccines used in combinations that may improve the quality and strength of the immune response.  Such studies could be useful in optimizing the use of available vaccines, including the AstraZeneca/Oxford vaccine.

The WHO Strategic Advisory Group of Experts on Immunization (SAGE) convened today to review evidence on the AstraZeneca/Oxford vaccine, including emerging evidence on performance against viral variants, and to consider the demonstrated impact of the product and the risk-benefit assessment for use cases with limited data.  These recommendations for use of the AstraZeneca product are being finalised and will be presented to the WHO Director-General on 9 Feb 2021.    

Even though this recent news on effectiveness of the AstraZeneca/Oxford vaccine against the B.1.351 variant is based on a limited study size which focused on low-risk participants and used interval doses that were not optimized for immunogenicity, these results confirm we must do everything possible to reduce the circulation of the virus, prevent infections and reduce the opportunities for the SARS-CoV-2 to evolve resulting in mutations that may reduce the efficacy of existing vaccines

Bill Gates and Dr. Fauci: the collaboration to end Covid-19

National Institutes of Health Director Dr. Francis Collins and National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci meet with Bill Gates of the Bill and Melinda Gates Foundation to discuss research opportunities in global health in June 2017 at NIH.
Credit: National Institutes of Health | FlickrCC

Dr. Anthony Fauci and billionaire philanthropist Bill Gates talk regularly these days, and as you would imagine, they mostly talk about ending the pandemic.

More specifically, right now, “we’re talking a lot about these variants and what that will do,” Gates, whose Bill and Melinda Gates Foundation has committed $1.75 billion to the fight against Covid-19, told Frances Stead Sellers during a Washington Post Live Special Wednesday. There are multiple Covid variants, emerging from the United Kingdom, South Africa and Brazil, which spread more easily and quickly.

While the new variants don’t affect the ability to diagnose Covid, “it does mess up the antibodies,” Gates said. “To some degree, it’ll affect the vaccines.”

The mRNA vaccines from Moderna and Pfizer-BioNTech currently in use in the U.S. and other countries appear to provide a degree of protection against the U.K. and South African strains. However, the AstraZeneca vaccine, which is approved for emergency use in the U.K. and India, only offers “minimal protection” against mild to moderate disease caused by the South African coronavirus variant. Johnson & Johnson, which applied for emergency use authorization in the U.S. Feb. 4, also said its vaccine provides less protection on the South African strain.

With that in mind, Gates said that he and Fauci are currently discussing whether “we need to create a new variant of the vaccine.” Gates’ foundation is funding trials in Brazil and South Africa that will produce more definitive data about whether or not a new vaccine is needed, he said. That data will be available later this month, he said.NIH H/O-FlickrCC: Bil Gates Anthony Fauci Dr. Francis CollinsBill Gates (left), Dr. Anthony Fauci (far left), director of NIH’s National Institute of Allergy and Infectious Diseases, and Dr. Francis Collins (right), NIH director, in 2018.Credit: National Institutes of Health | FlickrCC[Fauci] and I were talking about the critical path in our last call and how to orchestrate Gates Foundation resources and government resources to get to the bottom of those questions,” Gates said.

“Gates said Fauci and the scientists on the Foundation’s team often share information, during an interview with CNBC’s “Squawk Box” in October. For example, Fauci sees scientific innovations (like research on antibody therapies for Covid) that may not be on the Foundation’s radar; and the Foundation can provide a global perspective that informs Fauci’s work, he said.

“It’s a helpful collaboration, which we’ve always had,” Gates said.

Early on in the pandemic, during the Trump administration, Gates said “sometimes those conversations [with Fauci] would be a bit frustrating.” For example, he and Fauci would discuss innovations, but “it wasn’t clear who [in the administration] would pay attention.”

The pair have also been the target of baseless conspiracy theories around the virus, including that Gates was using Covid-19 vaccines to implant monitoring microchips in billions of people.

“Dr. Fauci and I are out in the conspiracy theory threads quite a bit,” Gates said in the Washington Post interview.

“[I]t’s disappointing that that kind of titillating, oversimplistic explanation is easier to click on then, you know, the truth about what a great job the world has done to get these vaccines going,” Gates said.

Fauci and Gates have known each other for more than a decade, often collaborating on the Foundation’s vaccine efforts. They worked together on the Foundation’s Global Vaccine Action Plan, in which Fauci served on the leadership council. They also worked together through a collaboration between the Foundation and the National Institutes of Health aimed at developing gene-based therapies for HIV and sickle cell disease.

Credit: Cory Stieg@CORYSTIEG

These breakthroughs will make 2021 better than 2020

The latest on the innovations that will let us go back to normal.

By Bill Gate

This has been a devastating year. More than 1.6 million people have died in the COVID-19 pandemic, with more than 75 million cases and tens of trillions of dollars in economic damages. Millions of people are out of work and struggling to pay their bills, and more than a billion children are missing out on crucial time in school. In the U.S., this year also saw the horrifying killings of George Floyd and Breonna Taylor, ruinous wildfires, and a presidential election unlike any other in modern times.

But there is good news coming in 2021.

I spent most of my time this year working with colleagues at the foundation and around the world on ways to test for, treat, and prevent COVID-19. When I think back on the pace of scientific advances in 2020, I am stunned. Humans have never made more progress on any disease in a year than the world did on COVID-19 this year. Under normal circumstances, creating a vaccine can take 10 years. This time, multiple vaccines were created in less than one year.

Unfortunately, we are not out of the woods quite yet. Computer models suggest that the pandemic could get even worse over the next month or so. We also need to learn more about a new variant of the virus that has appeared, which seems to spread faster but not to be more deadly.

Still there are two main reasons to be hopeful. One is that masks, social distancing, and other interventions can slow the spread of the virus and save lives while vaccines are being rolled out.

The other reason to be hopeful is that in the spring of 2021, the vaccines and treatments you’ve been reading about in the news will start reaching the scale where they’ll have a global impact. Although there will still need to be some restrictions (on big public gatherings, for example), the number of cases and deaths will start to go down a lot—at least in wealthy countries—and life will be much closer to normal than it is now.

In this post, I want to share where things stand on COVID-19 innovations as we wrap up this year and move into the next. I’ll start with vaccines, since they’ve been in the news so much and that’s the area I get asked about the most.

How COVID-19 vaccines work

Year in Review 2020

You probably know that two vaccines—one developed by Moderna, the other by Pfizer and BioNTech—have received emergency approval in the U.S. The Pfizer/BioNTech vaccine has also been approved in the U.K. and other countries. And several other companies will probably be announcing results of clinical efficacy trials soon.

What you might not have read is that the success of the first two vaccines also bodes well for many of the other candidates. Virtually all of the vaccines now undergoing efficacy studies attack the same part of the novel coronavirus as the first two do. (It’s the protein that spikes out of the virus, giving the coronavirus its crown-like shape as well as its name.) Now that researchers know attacking that particular protein can work, they have reason to be optimistic about other vaccines that do the same thing. 

Despite this basic similarity, the various vaccines use different approaches to attacking the virus. The ones developed by Moderna and Pfizer/BioNTech involve what’s called mRNA technology—an approach our foundation is intimately familiar with, because we’ve been funding research on it since 2014 as a way to create vaccines for malaria and HIV. It’s great that the technology is now allowing unprecedented progress on COVID-19.

It’s no accident that mRNA vaccines were the first out of the gate. By design, this type of vaccine can be created faster than conventional ones. It works by using messenger RNA to deliver instructions that cue your body to produce the distinctive spike protein. Then your immune system kicks in and attacks anything with that spike on it, including the COVID-19 virus.

Making mRNA vaccines is relatively fast because it’s much easier to produce large quantities of an RNA sequence that codes for the spike protein than it is to grow the spike protein itself. And there’s a bonus benefit: Unlike most conventional vaccines, mRNA vaccines don’t contain any virus at all, which means you can’t get COVID-19 from them.

Unfortunately, there aren’t yet many factories where mRNA products can be made. Some also need to be stored at temperatures as low as –70°C, which makes them particularly difficult to distribute in developing countries, though this is more of an engineering challenge than a scientific barrier.

An example of a different type of vaccine is the one made by AstraZeneca. Instead of using mRNA, it attaches the spike protein to an otherwise benign virus that causes the common cold in chimpanzees but is harmless for humans. Then your immune system learns to attack that spike, and you’re protected from COVID-19.

In its clinical efficacy trials, the AstraZeneca vaccine was on average around 70 percent effective, versus 94 to 95 percent for the Pfizer and Moderna vaccines. But 70 percent is still high enough to be effective at stopping the disease. And it’s reason to be hopeful about other vaccines that take a similar approach, such as Johnson & Johnson’s.

I don’t blame you if you have a hard time keeping track of all the companies working on vaccines. But it’s a nice problem to have! With so many companies pursuing different approaches, there was a much better chance that some would prove to be safe and effective. There are two already and more may be coming.

It’s unheard of to have so many companies working on vaccines for the same disease, because making a vaccine is inherently risky work. Not only can it take years to get a product to market, but it can cost billions of dollars and involve major scientific challenges—especially when the disease is as new to us as this one is.

Why were so many companies willing to take the risk this time? Judging from the conversations I’ve had with their leading scientists and executives, I think one reason is that they saw a chance to use their expertise to help end the pandemic. It also helped that others stepped up to bear some of the financial risk. In some cases, it was a national government, such as the U.S. or Germany. In others it was the group called CEPI, the Coalition for Epidemic Preparedness Innovation, which is funded by our foundation and several government and philanthropic partners.

Of course, developing the vaccines themselves is only part of the challenge. And it may not even be the hardest part.

How do you make 5 to 10 billion doses?

Year in Review 2020

The world will have to manufacture around 5 billion doses if there’s a vaccine that requires only one dose, or 10 billion in the current scenario of two-dose vaccines. (This is assuming that 70 percent of the global population must be covered in order to break transmission of the disease.)

Is 5 to 10 billion doses a lot? Well, all the vaccine companies in the world typically produce a total of fewer than 6 billion doses a year. That includes flu shots, routine childhood immunizations, and so on. So to produce all the COVID-19 vaccines needed without cutting back on any others, the manufacturing capacity will at least need to almost double, and more likely almost triple.

To help ease the manufacturing burden, our foundation helped put together what’s called “second-source agreements.” We paired vaccine companies in rich countries with counterparts in developing countries that specialize in producing safe, high-quality, and affordable doses at a very high volume.

A second-source agreement is designed to make the most of both skill sets. A company that excels at production agrees to manufacture products designed by another company with a viable vaccine candidate. For example, the biggest vaccine manufacturer in the world, Serum Institute of India, is producing doses of AstraZeneca’s vaccine. They’ve already begun production, so there will be doses available for low- and middle-income countries if AZ’s vaccine is approved for use. And our foundation took on some of the financial risk, so if it doesn’t get approved, Serum won’t have to take a full loss.

It’s hard to overstate how unusual these second-source agreements are. Imagine Ford offering up one of its factories for Honda to build Accords. But given the scale of the problem and the urgency of solving it, many pharmaceutical companies are seeing the benefit of working together in new ways like this.

It’s similar to how, during World War II, the U.S. ramped up its manufacturing capacity at a mind-blowing rate by converting auto factories into tank and truck factories—only this time, the government isn’t involved. Companies are responding to the crisis by doing away with business as usual.

And how do you distribute 5 to 10 billion doses around the world?

Year in Review 2020

In addition to manufacturing, there’s the challenge of making sure that COVID-19 vaccines will be distributed equitably. That’s both a logistical hurdle and a financial one.

Sixteen pharmaceutical companies have already committed with our foundation to ensuring that vaccines and other lifesaving tools will be made available in a fair way. The world’s top experts in shipping and delivery will need to figure out how to move all these vaccines around the planet while keeping them at the right temperature every step of the way. National governments will be responsible for in-country distribution of vaccines on a scale and level of complexity unlike any other public health campaign ever.

And rich countries will need to step up with new funding through organizations like GAVI, which has a phenomenal track record of helping immunize children in poor countries.

The issue of equity is one that both Melinda and I have been working on, not only as it relates to vaccines, but also the way the recovery needs to encompass everyone, including people of color in the U.S. and people in poor countries around the world. Melinda will cover this in detail in our Annual Letter, which we’ll release next month.

One other challenge will remain when vaccines are widely available: the sizable percentage of people who will hesitate to take them. Some are afraid of vaccines already. Others may worry that the COVID-19 vaccines were rushed and might be less safe than, say, the flu shot they get every year. And in some communities, people have an understandable historical mistrust of the government’s role in medical studies.

It doesn’t help that there are false conspiracy theories about vaccines, including some that involve Melinda and me. For our part, we will keep talking about the sole reason we fund vaccines: because we’re passionate about saving lives and making sure all children have a chance to grow into adulthood. We feel a responsibility to give our wealth back to society, and we believe that no outlet for our giving returns more value to the world than helping develop and distribute vaccines. They are a medical miracle that made it possible to cut the childhood death rate in half in the past two decades.

I hope credible leaders—politicians, community leaders, scientists, and family doctors especially—will help explain the safeguards in the system. The FDA is one of the most respected drug-regulating agencies in the world for a reason. Its approval process is second to none. No safety steps were skipped in approving COVID-19 vaccines. If enough people are willing to join the first wave of recipients, then hopefully others will see the benefits and want to take it too.

In the search for treatments, failure was a success

Year in Review 2020

As I often tell the team at the foundation, we can’t be afraid of failing—and when we do fail, we should do it quickly and learn from it. Here’s an example of how we failed quickly with potential COVID-19 treatments, but in the most productive way possible.

In March, we joined Mastercard and Wellcome in creating the Therapeutics Accelerator. The idea was to use robots developed by the pharmaceutical industry to quickly screen thousands of existing chemical compounds in the hope that one of them might lead to a treatment for COVID-19. We wanted to know: Do any biotech or pharma companies already have something on the shelf that could be the solution to the pandemic?

The answer was no.

That was disappointing, but it was a useful disappointment. It spared the medical field millions of dollars and a year or two of laboriously going from one company to another, testing one compound after another. In that sense, it wasn’t a failure at all. Scientists knew within months where the dead ends were, so they didn’t waste time going down them.

One of the successful treatments you’ve probably heard about is a steroid called dexamethasone. The cool part of the story is how quickly scientists were able to figure out that it works for severe cases of COVID-19.

The dexamethasone trial was done through a network called RECOVERY, which was set up with various protocols that allowed it to run rapid trials of COVID-19 drugs. It took just four months for RECOVERY to demonstrate that the drug reduced mortality by 30 percent in severe cases—and they did this study amid a lot of confusion and misinformation about other putative therapies that didn’t work out. Dexamethasone has become a standard of care in severe cases, and the speed with which it was studied and approved is a good sign for the future.

Another approach to treatment you may have read about is called monoclonal antibodies. These are created by taking the antibodies in the blood of COVID-19 survivors and flowing them past a spike protein to see which ones stick the most. (The stickier they are, the better they are at attacking the virus.) Then you figure out the gene sequence that makes that antibody, use a factory to make billions of copies of it, and give them to patients.

Although you may not have heard about antibody treatments before the pandemic, there’s nothing new about them. Today they’re used in some of the most popular medicines in the world, including arthritis treatments.

The key question surrounding COVID-19 antibodies is whether manufacturers make enough of them so they can be delivered to the entire world? It depends partly on the size of the required dose. Some treatments have involved doses as large as 8 grams. If something substantially smaller—such as 0.5 grams—works well, then it will be possible to treat far more people. Scientists also need to see if it’s possible to replace the current IV infusion with a two-shot dose.

If researchers solve the dosage and infusion challenges, then the main limiting factor will be manufacturing capacity. To deal with that, our foundation underwrote a second-source agreement in which Fujifilm Diosynth will produce an antibody developed by Eli Lilly. These doses will be earmarked for low- and middle-income countries and priced accordingly, so that millions of affordable doses will be available within 90 days of regulatory approval.

Bill and Melinda Gates: Covid-19 will change how the world thinks about health forever

At this time last year, the world was just starting to understand how serious a novel coronavirus pandemic could get.

Only a few weeks after we first heard the word “Covid-19,” we were closing our foundation’s offices and joining billions of people worldwide in adjusting to radically different ways of living. For us, the days became a blur of video meetings, startling news alerts, and microwaved meals — and we are well aware of how lucky we are compared to others. Over the past year, Covid-19 has killed over two million people worldwide, sickened millions more, and thrust the global economy into a devastating recession.

The experience of living through a pandemic has driven home what many people in developing countries knew all too well already: Health is the bedrock of any thriving society. If your health is compromised — or if you’re worried about catching a deadly disease — it’s hard to concentrate on anything else. Staying alive and well becomes your priority to the necessary detriment of all other things.

If you live in a wealthy country like the United States, chances are that last year was the first time an infectious disease has upended your life. That’s because in high-income countries infectious diseases are no longer what epidemiologists would call “a meaningful health burden.” In low-income countries, however, infectious diseases like malaria and tuberculosis are still major killers and adjusting life to account for a highly contagious pathogen is unfortunately nothing new. (Just ask the millions of people who sleep under a bed net each night.

But in 2020, a virus that had no regard for borders or geography upended lives all over the world, collapsing some of those distinctions between rich countries and poor countries. In doing so, it brought new meaning to the term “global health.”

In the past, “global health” was rarely used to mean the health of everyone, everywhere. Instead, “global health” was a term that people in rich countries used to refer to the health of people in non-rich countries — essentially a synonym for “developing country health.” If you attended a global health conference any time in the last decade, you were much more likely to hear about diseases in Uganda than diseases in the United States.

This past year, though, that changed. In 2020, global health went local. We all saw firsthand how quickly a disease you’ve never heard of in a place you may have never been can become a public health emergency right in your own backyard. Viruses like Covid-19 remind us that, for all our differences, everyone in this world is connected by a microscopic network of germs and particles — and that, like it or not, we’re all in this together.

Although history will probably remember these as the darkest days of the pandemic, hope is finally on the horizon. It’s possible that by the time you read this, you or someone you know may have already received a Covid-19 vaccine. The fact that these vaccines are already becoming available is, we think, pretty remarkable — and all credit is due to the largest public health effort the world has ever seen. No one country or company could have achieved this alone: Funders around the world pooled resources, competitors shared research findings, and everyone involved had a head start thanks to many years of global investment in technologies that have helped unlock a new era in vaccine development.

Of course, developing safe and effective vaccines is only the beginning of the story. Now, the world has to get those doses out to everyone who needs them — in high-income and low-income countries alike. Until vaccines reach everyone, new clusters of disease will keep popping up all over the world, and lives will continue to be lost. That’s why we were glad to see the United States include $4 billion for Gavi, the Vaccine Alliance, in its latest Covid-19 relief package. Gavi will play a key role is distributing vaccines to low-and-middle-income countries — and smart policymakers understand that we can’t defeat Covid-19 until we defeat it everywhere.

The two of us are optimistic that the pandemic the world is living through right now will lead to a long-term change in the way people think about global health. Going forward, we hope that rich countries will have a deeper understanding that improving health in low-income countries not only saves lives overseas but also puts us in a better position to defeat the next set of global challenges.

Just as World War II was the defining event for our parents’ generation, the coronavirus pandemic we are living through right now will define ours. And just as World War II led to greater cooperation between countries to protect the peace and prioritize the common good, we think that the world has an important opportunity to turn the hard-won lessons of this pandemic into a healthier, more equal future for all.


Culled from CNN


Bill Gates becomes top US farmland owner

While Microsoft founder, Bill Gates, is known throughout Africa and developing countries for his support for agricultural growth, he is now the owner of the most farmland in the United States, according to Land Report.

The Land Report researchers concluded that Gates, now the fourth richest man in the world, and his wife, Melinda, own 242,000 acres of farmland.

They own roughly 52,000 more acreages than the Offutt family, who sit at No. 2 on Land Report’s list of families who own the most farmland in the U.S.

In total, Bill and Melinda Gates have acquired land in more than a dozen states. However, his largest land holdings are in Louisiana (69,071 acres), Arkansas (47,927 acres), Nebraska (20,588 acres), Arizona (25,750 acres) and Washington state (16,097).

Bill Gates speaks during the 2019 New Economy Forum at China Center for International Economic Exchanges (CCIEE) on Nov. 21, 2019, (Hou Yu/China News Service/VCG via Getty Images)

According to Land Report’s research, Gates and his wife had hired former Putnam Investments bond fund manager Michael Larson in 1994 to help them diversify their personal assets.

These investments included a stake in AutoNation, the Charles Hotel in Cambridge, Mass., the Four Seasons in San Francisco and upward of 100,000 acres of farmland in various states, Land Report said, citing a 2014 profile of Larson in the Wall Street Journal.

However, Land Report’s latest findings show that the 100,000 figure has since surged to more than twice that amount.

Although Gates is widely known as the man behind tech behemoth Microsoft, he is no stranger to agriculture.

Since the early 2000s, Gates and his wife have made the foray into the agriculture space through numerous investments to support farmers in the developing world.

In 2008, The Bill & Melinda Gates Foundation announced $306 million in grants designed to boost the yields and incomes of millions of small farmers in Africa as well as “other parts of the developing world so they can lift themselves and their families out of hunger and poverty.”

The foundation also teamed up with the Department for International Development (DFID) to support agricultural research projects in developing countries in order to help small farmers increase their yields and incomes.

Roughly a year ago, Gates created the nonprofit Gates Ag One to further their goals of supporting agriculture in developing countries.

Credit: Fox/Business