Bill Gates is launching a network of disease surveillance sites aimed at reducing mortality rates among young children. The Bill & Melinda Gates Foundation is funding the project with an initial sum of $75 million, outfitting centers with the latest lab equipment and medical staff. These workers will primarily be tasked with collecting data on "how, where, and why children are getting sick and dying," but in the case of an epidemic — such as the ongoing Ebola outbreak in West Africa — they'll train aid workers and treat patients.
"Where is cholera, where is typhoid?"
"Our uncertainty about our disease estimates is pretty high," Gates told The Atlantic in an interview about the new initiative. "When we were going after the biggest killers that are everywhere, like pneumococcus for respiratory and rotavirus for diarrhea, we didn't need very precise figures." But now, he says, doctors are hunting down disease that are more sporadic and and they need concrete data. "Where is cholera, where is typhoid?" says Gates. "Should you do a vaccine for that or not? Cholera continues to be very episodic over time in different locations."
The network of sites — known as the Child Health and Mortality Prevention Surveillance Network, or CHAMPS — will track the ebb and flow of disease, making sure that vaccines and aid can be delivered where they're most needed. Six locations will be opened in Sub-Saharan Africa and South Asia first, but Gates says that with help from other donors the plan is to open shop in 20 locations. Staff at CHAMPS centers will gather data on sicknesses and deaths in a wide radius around their location, using genetic analysis and — when permission is given — minimally invasive autopsies to collect and study samples. "We need to know how to prioritize the creation and the volume procurement and delivery of these additional vaccines," says Gates.
"We're going to build capacity and be ready for epidemics."
Although child mortality rates have been brought down significantly in recent years (from one in 10 children dying before the age of five in 1990 to one in 20 today), Gates says that more effort is needed to push this figure lower still. The death rate for very young children, for example, has proved a particularly difficult challenge, with newborns still accounting for 44 percent of all childhood deaths.
Gates says that as well helping drive down these figures, the centers will also help deal with epidemics. He notes that the slow reaction to the ongoing Ebola outbreak in West Africa was due in part to the absence of local laboratories, with aid workers having to deal with difficult logistics like transporting blood vials across borders to test for Ebola. "We're going to build capacity and be ready for epidemics," Gates told The Atlantic. "The next epidemic might be something we haven't seen before. It might be flu, which we are outrageously still not ready for a big flu outbreak."