The charitable foundation of Microsoft Corp. co-founder Bill Gates pledged $750 million Monday to vaccinate children throughout the developing world, one of the largest donations ever.
The funds also will support development of new vaccines for rotavirus, a diarrheal disease that kills 600,000 children annually, and meningitis, a deadly inflammation of the brain and spinal cord.
By itself, Monday's donation from the Bill and Melinda Gates Foundation is among the six largest in history. Combined with an identical $750 million Gates gave to establish the Vaccine Fund in 1999, it matches the biggest charitable gift ever — a $1.5-billion bequest from the estate of Joan B. Kroc to help the Salvation Army build community centers in the United States.
The World Health Organization credits Gates' first $750 million with helping to save 670,000 children's lives since 2000.
"We've never made a better investment," Gates said, announcing the newest vaccine gift.
The Vaccine Fund is the main fundraiser for the Global Alliance for Vaccines and Immunization, a Geneva coalition of governments, United Nations agencies, the World Bank and pharmaceutical makers. Since 2000, the alliance has provided about 353 million vaccinations against a wide range of illnesses.
Gates became interested in vaccination in the late 1990s, when immunization rates were falling and vaccines for such common diseases as hepatitis B and yellow fever were in short supply.
The Gates Foundation's initial contribution has since been followed by about $1 billion in support from several countries, including $219 million from the United States and $440 million from Norway.
The group's effect has been substantial in sub-Saharan Africa.
Uganda, which has received $40 million from the Global Alliance, vaccinated 81% of its children for diphtheria, tetanus and whooping cough (also called pertussis) in 2003, up from 53% in 2000. Angola, Niger and Guinea-Bissau are among the nations that more than doubled their vaccination rates during the same period with help from the alliance.
"Some ask, 'What works,' in foreign aid — here is your answer," Ugandan President Yoweri Museveni said in a prepared statement.
A baron of the computer age, Gates, 49, is an unlikely advocate for public health in the developing world.
His Microsoft holdings make him the world's wealthiest person, with a personal fortune estimated last year by Forbes magazine at $46.6 billion, most of which he has promised to give away before he dies. His Seattle foundation is the world's largest charitable organization, with an endowment of about $27 billion, according to the Chronicle of Philanthropy.
Gates, a Harvard University dropout, became a top benefactor of education in 1999 when his foundation pledged $1 billion over 20 years for minority student scholarships in technical fields.
Some of Gates' initial gifts supported technology projects, such as putting multimedia equipment in libraries, sparking criticism that his donations were partly aimed at boosting Microsoft products. That underscored his image as a corporate executive who would stop at nothing to further the cause of Windows, Microsoft's omnipresent software for personal computers.
Like tycoons John D. Rockefeller and Andrew Carnegie before him, Gates has been both admired and reviled as an implacable competitor. In high-tech circles he's often derided as the Darth Vader of software, managing an empire that gobbles up or destroys rivals. Antitrust regulators in the U.S. and Europe have repeatedly sanctioned Microsoft for monopolistic practices.
But Gates has become a more complex figure in recent years as he acknowledged that computers and Internet connections alone would not solve the problems of the poor.
"You want to send computers to Africa; what about food, and electricity?" Gates said in a 2000 speech. Computers are "amazing in what they can do, but they have to be put into perspective of human values."
That shift in focus has led the foundation to devote nearly $4.4 billion to fight global health problems.
"This is one of the reasons we are starting now to see progress in the neediest countries," said Jean-Marie Okwo-Bele, WHO's immunization director. "We are getting into a great era of hope."
Among the roughly 100 million babies born annually, about 27 million go unvaccinated — most of them in poor nations. Each year, more than a million children under 5 die from diseases that could have been prevented with common vaccines, according to the WHO.
The Global Alliance estimated that the cost of vaccinating 90% of the world's children for diseases such as measles, diphtheria and yellow fever by 2015 and producing new vaccines would take $8 billion to $12 billion more than is currently available.
By comparison, this year the WHO budget for immunization is about $218 million, and the entire WHO budget for all programs is about $1.4 billion.
The Gates Foundation has taken a long-term view of vaccination. Typically, foreign aid from national governments or the U.N. has been given for one or two years.
Pharmaceutical companies are reluctant to risk the ramp-up costs to supply vaccines to poor nations that may not be able to pay for them.
Gates said the new grant would be allocated over 10 years, partly to prod vaccine makers to make long-term commitments to research and production.
But money alone is not enough to accomplish the alliance's vaccination goals, said Mercy Ahun, head of country support for the Global Alliance.
Many of the targeted children live in areas so remote that their roads are impassible during the rainy season.
Their towns and villages lack electricity — leading to enormous logistical challenges of using solar- or gas-powered refrigerators to preserve the vaccine supplies, she said.
Sometimes, cultural distrust trumps the best of intentions.
The ongoing polio eradication campaign led by the WHO was set back when authorities in northern Nigeria — epicenter of the remaining polio epidemic — temporarily refused to allow the vaccinations out of fear they would harm children.
Pascal Villeneuve, UNICEF's chief of health and a board member of the Global Alliance, said in an interview that the alliance did more than provide vaccinations. In some areas, it served as a base to screen and treat children for other health problems.
In December, the first nationwide measles and polio vaccination campaign in the West African nation of Togo started deworming and distributing vitamin A to prevent blindness.
"The only contact many children have with the health system is through immunization," Villeneuve said.