Dr. Perkin: Good afternoon, and thank you all for coming.

I'm Dr. Gordon Perkin, and today I have the incredible job of announcing a great new partnership formed to launch a major world health initiative for children.

First, let me begin briefly by introducing our four speakers. Many of you know Bill Gates, the CEO of Microsoft, but I'm wondering whether you know of his giving. Bill and Melinda were honored last night by the For All Kids Foundation for their work in the areas of world health and population, education, community giving, and libraries. And today Bill is with us in his capacity as trustee of the William H. Gates Foundation.

Melinda Gates, who is co-founder of the William H. Gates Foundation will also speak.

Next is Carol Bellamy, executive director of the United Nations Children's Fund, and former director of the Peace Corps.

Also with us today all the way from Melbourne, Australia, is Sir Gustav Nassle (sp), who is chairman of the World Health Organization's Scientific Advisory Group of Experts that oversees the global program for vaccine and immunization.

Each of these individuals will provide an important contribution in explaining today's announcement.

Again, my name is Gordon Perken, and I'm president of PATH, or Program for Appropriate Technology and Health, a non-profit international organization dedicated to improving the health of women and children. PATH is headquartered in Seattle, with working offices in eight countries around the world.

Since 1977, PATH has managed more than 800 health and family planning projects in more than 85 developing countries. Over the past 10 years, PATH has been the operating agency for the International Task Force on Hepatitis B Immunization, a group of independent professionals working to establish Hepatitis B immunization throughout the world. The task force played a key role in activities leading to the 1992 World Health Assembly's recommendation that Hepatitis B vaccination be extended to all the world's infants. And now that role will expand for PATH due to the generosity of Bill and Melinda Gates.

Today, I have the great pleasure in announcing that Bill and Melinda Gates have committed $100 million to a worldwide vaccine program that could save the lives of millions of children each year. The Bill and Melinda Gates Children's Vaccine Program will put in place a sustainable effort that will assure that the world's children will be protected against vaccine preventable diseases.

This program has been developed over the past year, following numerous consultations with leaders in world health and immunization, including the World Health Organization, UNICEF, the World Bank, and representatives from the pharmaceutical industry. The program will focus on three types of activities to reach its goal. First, it will carry out a number of studies of vaccine effectiveness in countries where these trials have yet to be undertaken.

Secondly, it will support model or demonstration programs in a number of countries to demonstrate the most effective way of introducing these new vaccines into national immunization programs.

And, thirdly, it will explore new financing mechanisms to facilitate countries purchasing the new vaccines that they require for use in their programs.

The Children's Vaccine Program will build on the incredibly successful expanded program of immunization, which WHO sponsored over the past 25 years. This program has built the capacity to reach 80 percent of the world's children with six vaccines, saving more than three million lives each year.

The program will also work with partner organizations, with the World Health Organization, with UNICEF, with the International Vaccine Institute in Seoul, Korea, and with other organizations and agencies involved in immunization.

Bill and Melinda Gates' $100 million gift will ensure that the newest vaccines to prevent childhood diseases will be available to children throughout the world without regard for social, economic class or status.

Bill and Melinda's generosity may well equate to the single largest individual donation for children's health in this century. On behalf of the children and families who will benefit from this program but never know of Bill or Melinda Gates, I would like to thank you both for this gift.

Now, it's my pleasure to introduce Bill Gates.

Mr. Gates: Thanks, Gordon.

It's a great pleasure to be here this afternoon. In the last year, it's been fun to learn about the vaccine programs and the incredible work that's been done. For me, working in the technology business, you know, every day there's incredible advances, and we're creating better tools for learning and communications that really make me optimistic about how these can be used in the future to help people achieve more of their potential.

Besides information technology, really the other miracle technology in my view is the great advances in medicine. The increased understanding of the genome, the rapid creation of new biotechnology products, it's really quite amazing. Just this morning I spent at a board meeting of a small biotech company called Icos that I'm involved in, and heard about their work to help cure diseases like asthma, or multiple sclerosis.

We're all very fortunate to be living at a time in which positive changes are incurring in many critical areas. And there's no area more critical than health care. I think a major challenge of the 21st Century will be to spread the benefits of the new technology as widely as possible. This is the cause that Melinda and I have chosen to focus on in giving back to society the resources that we have in our stewardship.

About three years ago, Melinda, my father and I began learning about health and population issues. And what we learned was quite a mix of both goods news and bad news. We learned from the experts about the introduction of vaccines and the incredible impact those have had on public health throughout the world. A phenomenal success story is the expanded program on immunization or EPI that Gordon mentioned. And that World Health Organization program, which started in the 1970s, took immunization from 5 percent of the world's children in 1980 to today where over 80 percent of the kids get the six basic vaccines, preventing such common childhood diseases as measles and diphtheria. EPI can be credited with saving several million lives every year, and preventing blindness, paralysis, and mental disability in another three-quarters of a million kids. And all of this costs less than $15 per child, even in the poorest countries. Well, that's the good news.

The bad news is that many new vaccines that have the potential to save millions of lives are only available in developed countries: these include things like Haemophilus Influenza Type B, sometimes called Hib, Hepatitis B, rotavirus, and pneumococcal. More people die from the consequences of Hepatitis B than die from AIDS around the world. A vaccine to prevent it is available. One of our daughter's first shots was to protect against Hep B. Even though she didn't like it at the time, I'm sure she'll be glad that there's no chance she'll ever get that disease.

The only thing standing in the way of saving millions of additional kids lives in developing countries is ensuring an adequate supply of new vaccine. So, our program has a simple goal: make vaccines you and I take for granted available to children regardless of where they live.

Over the last few years, Gordon Perkin of PATH has worked with my dad, Melinda, and me to help us understand the challenge here. We've also gotten to know a number of the scientists involved, which has been fascinating for us. In fact, just last month, we had a dozen scientists over to talk about their excitement for this new phase of the children's vaccinations program.

Now, I'd like to introduce my wife, Melinda Gates.

Ms. Gates: As parents of a young toddler, Bill and I know that there's nothing more important to parents than having a healthy child. A long time before your child is born, you pause a lot and think about, is it a boy, is it is girl, is it going to have hair, is it going to have blue eyes or brown eyes? When they put that child in your arms, the only thing that you care about as a parent, when it first arrives, is it's healthy. And soon thereafter begins a process of taking your child to the pediatrician, regular, scheduled appointments for those first two years. They become so routine in the United States that we almost take the vaccination process completely for granted in our country. It's just so much a part of what you do with a newborn when you have a young child.

In the developing world, however, it's quite a different picture. When you're a young mother and you have your first child, you're lucky if it's born healthy. Once, soon after it's born, you do start to think, maybe there's something I can do for my child that will help it have a long life, and you might hear of a vaccination program in a village or a town nearby that's maybe 50 or 100 miles away, but you decide it's certainly worth it as a young mother. And you pack up your newborn, and your many other children in most cases, usually putting one on the front and one on the back with a homemade backpack made out of a piece of cloth, and you walk 50 or 100 miles to a village to have your child vaccinated.

You stand in line, often for several days, and you hope as you stand in line that they're actually going to sterilize that needle that's used on the child in front of yours and for your child as well when they give them the vaccine.

Safely vaccinated, you're really pleased that you've given this new start in life, such a good start in life to your young child. But, there again, you have to start the process all over again, because the vaccines, as we know in the United States, sometimes take multiple doses. So while you walk home that time, you may be back in several months, assuming there's a nurse practitioner there, to actually get the rest of the shots that your child needs.

There's a major and worrisome gap between what happens in the developed countries versus what happens in the Third World countries with vaccines. What we think of here as a basic in health care is very different from those in other countries. Today, there's a 15-year gap between a vaccine being developed in the developing world, and when it's available in the Third World countries. That simply to us is completely inexcusable, especially when you think about some of these new vaccines, and the fact that they really, really benefit a lot of the children in the Third World countries in some ways more than our own children here at home.

Bill and I really want to find innovative solutions to the inequalities that are existent today in health care. The Gates Children's Vaccine Program is a major group effort in that direction. It's going to require consensus, finding common ground, and dedication to remaining focused to find good solutions. It's about a group of some of the strongest organizations and powerful organizations in the world, who are coming together to help us in finding the solutions for the world's children. Those organizations are the World Bank, the World Health Organization, the International Vaccine Institute, the United Nations Development Program, the U.N.'s Children's Vaccine Initiative, UNICEF, and some amazing names have lined up to really help us out. And PATH, as you heard earlier, is the organization that's really going to help pull those efforts together.

Bill and I, as he said, met with many of the representatives at our home last month, to really talk about some of the possibilities. And I have to say, both we and they came away very energized from the meeting about all the possibilities. The infrastructure is already there. These organizations have done fantastic work over the last 30 years. And they've already carried six different vaccines out into the third world. Now, we feel like it's time to get these new vaccines out there, and to not let there be such a large gap between the time it's delivered here, and the time it's delivered in the Third World.

So we're pleased today, there are many representatives in the room, we're pleased today to be here with them and we thank them for all the efforts they've already started and for contributing with us in this major global effort.

Thank you.

Dr. Perkin: Thanks, Melinda.

Carol, would you come up for a minute?

Thank you.

Ms. Bellamy: Thank you very much.

Well, as you've already heard from the first two speakers, the dramatic expansion of immunization services, particularly during this decade, have saved the lives of many, many young children. I'll give you an example, just to use 1997 figures alone, child immunization against measles, hepatitis B, tetanus toxoid, pertussis and polio helped prevent probably about 150 million cases of these diseases, and undoubtedly prevented many millions of children, it's estimated at least 3 million children from dying. So it's really -- it's an extraordinary story about what these vaccines have done to achieve better health for children.

Despite this progress, however it is still estimated that there are approximately 12 million children, worldwide, most of them in developing countries, who die each year from totally preventable causes. Some of these causes can be responded to by the vaccines that you've already heard of. But, some of them really will respond to the new vaccines that are on. And I worry a little bit about using the word new, because it shouldn't suggest that they are not totally appropriate. These new vaccines do not require any more investigations. We know they work. Measles vaccine was on the market for many years before the pressure was able to be placed to bring the cost down enough for measles vaccines to be used in developing countries.

So we know what works. The systems, as you've heard, are there. They've been put in place, there's been an extraordinary partnership over many years, a partnership with WHO, UNICEF, the countries themselves, donors, building on this partnership, I think what we now have with this extraordinary gift by Bill and Melinda Gates is an even expanded partnership. By the way, I thought that Bill Gates actually sounded like a UNICEF country representative the way he was talking about the immunization program. So not only is there an expanded program of immunization, I think we have an expanded partnership that can actually go out and save lives: 12 million children still die every year in developing countries from totally preventable causes.

If we can just save one child, that makes a difference, but millions can be saved. The Convention on the Rights of the Child says that a child has a right to health, not just a rich child, not just a child who lives in North America or Europe, but a child who lives in the poorest community. What is happening today doesn't solve all the problems, but I can tell you what a big difference this will make in really giving a push, move this immunization worldwide, global program ahead.

Thank you very much.

Dr. Perkin: Thank you, Carol.

Dr. Nassle, please.

Sir Gustav: When the history of science and technology in this remarkable era of ours is finally written, I believe the consensus will be as follows: the 19th Century was the century of engineering. Industrial revolution reached it's full potential, culminating with Henry Ford. The 20th Century is undoubtedly the century of information and communication -- radio, television, computers, and the Internet have reshaped the world. The 21st Century, I firmly believe, will be the healing century, the century of healing, when humanity at last conquers the specter of disease. My confidence stems from the might of the new biology, and particularly of molecular genetics, and immunology.

The new biology is giving us tools for the prevention, early diagnosis, and treatment of disease, which are well nigh miraculous. The great New York physician, scientist, and author Lewis Thomas termed medical science the youngest science. And so indeed it is. With all the vigor and hope of youth, with burgeoning power, with imminent flowering of an accelerated and confident maturity. Of all the new tools, vaccines are by far the most cost effective. A recent study by the World Bank found that vaccination programs save more lives per dollar spent than any other medical intervention.

I've had the honor of chairing the scientific advisory group of the global immunization effort. This is a wonderful collaboration between the World Health Organization, UNICEF, Rotary International and others. This effort has eradicated small pox from the world. They said it would take 10 years, it in fact took 11. And in 1977, small pox was conquered. It's raised routine immunization coverage from 5 percent to 80 percent, as you've heard, saving millions of lives each year. And it is on the threshold of eradicating polio milatis, although we will need more help from the world community before that fantastic goal can be achieved. But, this program has had difficulties in introducing newer vaccines into the developing countries, largely because of lack of financial resources.

Ladies and gentlemen, what a nightmare it would be if the research sector were indeed to develop effective vaccines against all the major pathogens during the healing century, but the children at greatest risk were denied them. Enter Bill and Melinda Gates. Through the unique act of generosity that we're celebrating today, a galvanic new factor has been introduced into the equation. The Gates Children Vaccine Program will solve the strategic issues surrounding the introduction of new vaccines, will through disease-burden studies help to sort out global priorities, and will through demonstration projects prove the benefits obtainable through new respiratory and diarrheal disease vaccines.

Furthermore, this outstanding private sector initiative will catalyze greater industry participation as a global inventor and will act as a spur to other potential partners. In an era where governments have limited funds for discretionary expenditures, in a deregulated, borderless world, where large international corporations have more power than many nation states, public sector-private sector partnerships will be absolutely essential to build a civil society and a more equitable world.

On behalf of the whole international scientific community, I salute Bill and Melinda Gates, on this historic day and I pledge to do my utmost to ensure that their benefaction exerts maximum leverage. The children whose lives will be saved will, in due course, find a voice to speak for themselves.

Dr. Perkin: That was great.

Before we move to a Q&A period, I'd like to recognize several in the audience who are associated with this program, and who will almost entire be available at the end of this conference for additional interviews, questions or background information.

First, William H. Gates, Sr., Bill's dad and director of the William H. Gates Foundation.

Second, Dr. Michael Schultz. Dr. Schultz is executive Director of Health Technology and Pharmaceuticals, World Health Organization, vaccines at WHO fall under his direct supervision.

We have three senior members of the Children's Vaccine Program Secretariat at PATH: Dr. Mark Kane who is the program director will be joining the program early next year; Dr. James Maynard, technical director of the Children's Vaccine Program and who is currently with PATH and working on the program, and Mr. Scott Wittit, who is the communications officer for the program, and will be available.

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