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Published on: 13/11/2014

Bill Gates is a practised and polished public speaker, so today's OneWorld organised "conversation" with him was as stimulating and inspiring as you would expect. And there was lots to applaud and agree with in what he said: from his (perhaps to some) surprising admission that he "mainly agrees" with Thomas Piketty on the need for more progressive taxation (he differs primarily on whether that should come from wealth or consumption taxes); to his strong endorsement of the need for government leadership and public provision of goods like education and health (with philanthropy backing the crazy innovative ideas); and his promise to keep pushing the Dutch to get back to 0.7% of GDP to aid – from where they have recently and shamefully slipped (last are my words not his!).

Bill spent most of his talk focussed on the Bill Melinda Gates Foundation's global health work –especially vaccine development. He illustrated his talk with a story about the foundation's success fighting rotavirus through vaccine development. Which opens the way for my only (minor) "but" on what was an otherwise thoroughly satisfactory talk.

The "but" is this. Bill presented a vaccine for rotavirus as something that would not only reduce the completely unnecessary death toll from this disease, but also improve nutritional status and perhaps mental development of children. Both of which are of course negatively impacted by chronic diarrhoea.

But diarrhoea has many causes other than rotavirus, so while a vaccine will undoubtedly contribute to the fight against childhood diarrhoea it won't solve the problem on its own. And of course, as we all know, non-rotavirus diarrhoea won't be solved by a one off vaccine anyway. If it is to be solved, it will be through the slow and boring work of improving hygiene behaviours, and providing people with decent quality toilets that remain functional over time and clean/safe water supplies.

So, from my (and IRC's) perspective, it was a pity that in focussing so strongly on the foundations global health work and the thoroughly laudable work on vaccine development, Bill didn't find any time to talk about the equally critical work that the Foundation does on sanitation. Because, whether for improving quality of life or avoiding early childhood death – sanitation is every bit as important and just as much in need of support as vaccine development.


At IRC we have strong opinions and we value honest and frank discussion, so you won't be surprised to hear that not all the opinions on this site represent our official policy.

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