Bill & Melinda Gates Foundation

Presidential Medal of Freedom Winner Bill Foege on Small Pox, Vaccines, and Everyday Heroes

May 02, 2012

Bill Foege possesses a rare and special combination of intellect, tenacity, compassion, and humility. A  Senior Fellow at the Gates Foundation from 2002 to January of this year, his calm, steady presence inspired us on a daily basis. As I learned the first time I heard him speak about his work in Africa and India, he also has a knack for storytelling that rarely leaves a dry eye in the room.

I spoke with him about winning the Presidential Medal of Freedom for his leadership in ending small pox, announced last week by President Obama. Musician Bob Dylan, astronaut John Glenn, and several others will be celebrated this spring. Seattle sociologist Gordon Hirabayashi, who passed away three months ago, will also be honored for his courage and subsequent legal challenge after refusing to board a bus headed to an internment camp for Japanese Americans during World War II.

Q. How did you react to getting the call from the White House?

My first assumption was that my wife was right, I’m losing my hearing. It’s one of those things that never enter your mind, so it took a while for it to make any sense.

Then my thought was, you know, the nice thing about this is it will give some attention to global health, there’s never enough of that.

Q. Including more attention to people in the field?

One email I received this week came from a person I worked with in India, he was just on a four-day trip in southern Sudan, there was rain and mud and the bridge was out, dysentery everywhere, and he said, “It reminds me of the old days in India and it’s so much fun.”

We need to get those everyday heroes  into situations where they are heard, locally in their own countries, and internationally.  The people that work day in and day out under difficult field conditions and somehow can keep it up, they are the ones who really deserve the praise.

Q: What lessons from small pox eradication apply today?

The good things that happen in health simply don’t happen by chance. It requires someone with a vision saying this is what we would like to do, lots of people buying in to that objective, and then figuring out how to develop and execute a strategy.

You need unwarranted optimism. You need to keep trying to figure out what is the ultimate barrier to having something happen. Until you get to that ultimate barrier, you don’t know what it would take to finish off a disease.

Q: The world is launching an emergency action plan to end polio. What is the biggest barrier?

I think it’s a great strategy to make this an emergency. It changes the kind of resources that are available. What we need is a realistic understanding of what the problems are right now.  

An emergency situation provides some ability to change what you can do in conflict areas. It’s no surprise that Pakistan and Afghanistan are problems. Conflict is really our biggest barrier at the moment. If we didn’t have conflict, you could go in these areas and apply your science in a way that would actually work.

Q: Which of your fellow winners are you most excited to meet at the award ceremony?

I can tell you the one I would be most excited about and won’t meet. That’s Gordon Hirabayashi. He’s actually been a hero of mine for decades. When Congress did the turnaround (on the internment of Japanese Americans during WWII), he wrote a touching piece about how great it is to be born in a country that can admit its mistakes.

Q: What does it mean to you that you’ve earned this award?

I would say first of all I didn’t earn this award.

Look what it takes to fund and do the research on a vaccine, what happened with committees in Congress, the production of vaccine, the making of bottles, syringes, needles, stoppers, cardboard, then for transport the airplanes and  Land Rovers, and the education system for health education.

Put it all together and it takes one million people to get one dose of vaccine into a child in Africa.

The Measles Initiative recently celebrated reaching one billion children in 10 years with measles vaccine. For all of the failings and foibles of people, it means a billion times, everything worked. And that’s no small thing.

That’s the kind of experience we are applying to the end stage of polio and to global health in general. Things can work.

Read Bill Foege’s account of how smallpox was eradicated 30 years ago in his book House on Fire.

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