Dr. Peter Piot, co-discoverer of the Ebola virus, former founding head of the United Nations AIDS program and many decades ago a graduate student studying infectious disease at the University of Washington, has agreed to serve a brief stint as a top health adviser to the Bill & Melinda Gates Foundation.
Not that long ago, Piot had criticized the Gates Foundation for putting too much of its global health money into research projects -- such as the search for a malaria vaccine -- and not enough into figuring out how to actually get the vaccines or new technologies to people in poor countries lacking functioning health care systems.
"That is the next challenge," he said. Clearly, Piot said, the Seattle philanthropy's emphasis in global health has been on finding technological solutions for major health problems in the developing world. "That's their niche."
And this has been a great success, he said, with the development of several new vaccines for previously neglected Third World killers such as rotavirus and the acceleration of research aimed at finding effective vaccines against the likes of malaria and tuberculosis. What remained neglected was the "delivery" end of the equation, he said.
"That is now getting far more attention than it used to," Piot said. He said the Gates Foundation, recognizing that it had overemphasized support for discovery and development in global health, has since added a third emphasis to its global health program -- delivery.
"Setting up (delivery) programs in developing countries was our main activity," said Piot, referring to UNAIDS (which is officially called the Joint United Nations Program on HIV/AIDS). The Belgian physician, who 13 years ago helped create UNAIDS, was one of the first to advocate for bringing expensive anti-AIDS drugs to Africa.
Many argued that the complexity and expense of the drugs made widespread use in poor countries impossible, but Piot argued that the world had no legitimate moral alternative. As a result of efforts by UNAIDS and other such advocates for AIDS treatment, he said, many millions of people in poor countries are getting the drugs and many are alive today who would have died otherwise.
Much remains to be done as many millions more still need the drugs, he added, and for every two people who get put on treatment today five more people still become infected with HIV due to lack of prevention programs.
Piot, who will serve as an official adviser to the Gates Foundation only until May when he moves to launch a global health program at the Imperial College in London, credits the UW's Dr. King Holmes with helping launch him on his career. Piot studied with Holmes here in the 1970s. Holmes, a world-renowned infectious disease expert, is now chairman of the UW's new global health department.
In 1976, Piot was one of the leaders of the medical team that first identified the deadly Ebola virus during an outbreak in Zaire (now the Democratic Republic of Congo). His goal for the near future, he said, is to help the Gates Foundation figure how to take the next crucial steps in advancing global health.
"They can't do everything so they need to be smart with their investments," he said. There are many critics who clamor for more money from Gates for "health systems strengthening," he said, but it's not always clear what needs to be done or if it is really a health care system problem.
"One of the biggest scandals of our time is that half a million women still die every year giving birth," Piot said. Part of that is lack of health care services, he said, but much of it is due to ignorance and lack of basic information.
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