On Monday, in a Manhattan town house that once belonged to polio’s most famous victim, Franklin D. Roosevelt, Bill Gates made an appeal for one more big push to wipe out world polio.
Although that battle began in 1985 and Mr. Gates started making regular donations to it only in 2005, he has emerged in the last two years both as one of the biggest donors — he has now given $1.3 billion, more than the amount raised over 25 years by Rotary International — and as the loudest voice for eradication.
As new outbreaks create new setbacks each year, he has given ever more money, not only for research but for the grinding work on the ground: paying millions of vaccinators $2 or $3 stipends to get pink polio drops into the mouths of children in villages, slums, markets and train stations.
He also journeys to remote Indian and Nigerian villages to be photographed giving the drops himself. Though he lacks Angelina Jolie’s pneumatic allure, his lingering “world’s richest man” cologne is just as aphrodisiacal to TV cameras.
He also uses that celebrity to press political leaders. Rich Gulf nations have been criticized for giving little for a disease that now chiefly affects Muslim children; last week in Abu Dhabi, United Arab Emirates, Mr. Gates and Crown Prince Sheik Mohammed bin Zayed al-Nahyan jointly donated $50 million each to vaccinate children in Pakistan and Afghanistan. In Davos, Switzerland, Mr. Gates and the British prime minister, David Cameron, announced that Britain would double its $30 million donation. Last month, when the Pakistani president, Asif Ali Zardari, went to Washington for the diplomat Richard C. Holbrooke’s funeral, Mr. Gates offered him $65 million to initiate a new polio drive. Twelve days later, publicly thanking him, Mr. Zardari did so.
However, even as he presses forward, Mr. Gates faces a hard question from some eradication experts and bioethicists: Is it right to keep trying?
Although caseloads are down more than 99 percent since the campaign began in 1985, getting rid of the last 1 percent has been like trying to squeeze Jell-O to death. As the vaccination fist closes in one country, the virus bursts out in another.
In 1985, Rotary raised $120 million to do the job as its year 2000 “gift to the world.”
The effort has now cost $9 billion, and each year consumes another $1 billion.
By contrast, the 14-year drive to wipe out smallpox, according to Dr. Donald A. Henderson, the former World Health Organization officer who began it, cost only $500 million in today’s dollars.