Bill Gates: ‘Death is something we really understand extremely well’: EK: What’s been the biggest surprise? What has the data shown works, or doesn’t work, that you simply didn’t expect?
BG: I was completely surprised that nobody was funding some of these vaccines. When I first looked at this I thought, well, all the good stuff will have been done. It was mind-blowing me to find things like Rotavirus vaccine were going unfunded. One hundred percent of rich kids were getting it and no poor kids were. So over a quarter million kids a year were dying of Rotavirus-caused diarrhea. You could save those lives for $800 per life. That’s like $20 or $30 per year of life. It’s just ridiculous that an intervention like that isn’t funded.
And I’m really surprised at the variance. Some very poor countries run great vaccination systems and some richer ones run terrible programs. The north of Nigeria has about 30 percent vaccination coverage, and they’re above average in terms of wealth within Africa. You compare that to, say, Somalia, which has absolutely no government at all, and they get about 60 percent vaccine coverage of children. So you have a place literally with no government getting a better vaccine coverage than a place that’s above average wealth.