Gates Package — page 112

Gates Foundation project Creating a vaccine that can survive at room temperature << OLE Object: Picture (Device Independent Bitmap) >> In 2010, the Serum Institute of India, with funding from the Gates Foundation Meningitis Vaccine Project, developed MenA friVac, the first meningitis vaccine to be pre-qualified by the World Health Organisation for use at temperatures of up to 40C for up to four days. This made distributing the medication in rural areas much easier. It isn't just governments that may be unequal to the task. On this analysis, the democratic process in most countries is also straining to cope with the problems thrown up by the modern world, placing responsibilities on voters that they can hardly be expected to fulfil. "The idea that all these people are going to vote and have an opinion about subjects that are increasingly complex -- where what seems, you might think ... the easy answer [is] not the real answer. It's a very interesting problem. Do democracies faced with these current problems do these things well?" Compared with fixing the US healthcare system, the issues of global health and development taken on by Gates' foundation are, by his own estimate, relatively straightforward. But the work has required him to develop new skills: a willingness to engage with politicians and to develop reserves of diplomacy and persuasiveness. With more than 1,000 staff members and the ambition to shape the broad strategies directed at solving the problems it takes on, the foundation does much more than simply hand over money. It relies on partnerships with a wide range of government agencies and other bodies to have any effect -- and that has forced Gates, the uncompromising and impatient tech leader, to apply the human touch. Workers at the foundation say that he has been closely involved even at a regional and district level in winning the needed political backing. Gates, for instance, says he personally "bonded with" Nitish Kumar, the highly rated chief minister of the Indian state of Bihar, over the latter's strong backing for vaccination efforts. Sometimes in the field of global development, however, it is enough simply to be Bill Gates: the fame and wealth work their own magic. "If ... I need to go to the Indian parliament and say, 'Let's get serious about vaccines,' then yes -- since I'm giving my own money [on a] large scale and spending my life on it and I'm a technocrat -- yes, that can be quite valuable." If this brand of international development diplomacy has required new skills, however, some things haven't changed. Talk to almost anyone who has worked with Gates and they have a story about his intensity. On trips to the developing world his tirelessness wears out those around him. Inside the foundation, he shows the kind of endurance that once inspired and exhausted Microsoft product managers. "He wants to do the work with us at the most granular level. He will sit in four-hour meetings with us going over slide page after slide page," says Raja Rao, who heads the foundation's work on perfecting the cold chain. "I've seen him sit in a room for 11 hours nonstop just talking about technology, eating snacks and drinking Diet Coke." Gates Foundation project Re-thinking the child health record Paper health records are one of the most reliable sources of medical information. Yet they are often less useful than they might be: lacking enough space to include all relevant information and made of cheap paper which can disintegrate. In June, the foundation launched the $50,000 Records for Life Contest in search of a more durable format to increase usage and the accuracy of information recorded. Many of the works on the bookshelves in Gates' office overlooking Lake Washington are scientific tomes on the diseases that he is combating -- of which, with characteristic diligence, he now has a deep personal understanding, according to others at the foundation. A voracious reader -- he has always taken periodic breaks from his regular routine to read about and ponder the biggest problems he has taken on -- his conversation is littered with references to authors. Given the smallest excuse, he plunges into a description of the different types of polio and vaccines -- and then into the genetic tests that show how the disease once persisted and spread in areas like Uttar Pradesh even when full outbreaks were rare. This is the Gates who once ruled Microsoft with a command of detail and intellectual intensity that led to the kind of culture that was capable of dominating the tech world -- even as it tipped over into behaviour that brought a regulatory backlash. "I was a kind of hyper-intense person in my twenties and very impatient," he says. "I don't think I've given up either of [those] things entirely. Hopefully it's more measured, in a way." If the manner has mellowed, though, the uncompromising attitude is still very much in evidence. It is at once one of the strongest assets and one of the biggest hindrances in his plan to save some of the world's poorest from the