Melinda Gates: Why women's and children's health is at risk around the world

Editor's Note: (Melinda Gates is co-chair of the Bill & Melinda Gates Foundation. The opinions expressed in this commentary are her own.)

Imagine all the people in New York City. And Los Angeles and Chicago. Plus London and Paris. And Berlin.

That's how many people are alive today because of four global health funds you've probably never heard of. With money from donor governments, foundations and the private sector, these funds deliver vaccines, drug treatments, contraceptives and other lifesaving health supplies to people who need them.

But these global health funds are at risk. Collectively, the Global Polio Eradication Initiative; Gavi; the Global Fund to Fight AIDS, Tuberculosis, and Malaria; and the Global Financing Facility need to raise billions of dollars in the next 18 months to keep doing their work.

With politicians around the world turning to the rhetoric of isolationism, I worry governments that have been reliable donors, including my own country the United States, will stop investing and let the funds run low. This could squander the opportunity to make historic progress in the fight against disease through sustained investment in the global health funds.

The oldest of these funds, the Global Polio Eradication Initiative, was created in 1988, when the world recorded about 350,000 cases of the disease. Last year, that number was 33. That's a 99.99% drop, and it wouldn't have happened without GPEI and its partners and donors.

Gavi, the vaccine fund, has saved 10 million lives since it was created in 2000, but that stat actually understates its impact. That's because preventing disease not only saves a lot of lives, but also saves people from lifelong disability and suffering. Gavi has vaccinated nearly 700 million children who now have a much better chance at a good life.

I visited Mbatha hospital in Kenya in 2011, where half the patients were children with pneumonia struggling to breathe. I remember thinking that this ward wouldn't be so full within a year or two, because, with Gavi's support, Kenya had just become the first country in Africa to vaccinate children for the leading causes of pneumonia. Now, more than half of African countries do.

The Global Fund to Fight AIDS, Tuberculosis, and Malaria has saved so many lives that it's transformed the demographics of many low-income countries. In Zimbabwe, for example, life expectancy has gone up from 44 to 61 since the Global Fund was created in 2002 — because HIV is no longer a certain death sentence but a treatable infection.

I'm very enthusiastic about the newest global health fund, a fund for women and children's health and nutrition launched in 2015 called the Global Financing Facility, or GFF. Though the GFF hasn't had time to accumulate impressive impact statistics yet, we know that putting women at the center of global health and development supercharges progress.

One study in Bangladesh showed that when women have access to family planning — when they have control over their bodies and their futures — they earn 40% more and their children are 30% less likely to die. If the GFF gets the money it needs to support family planning and other maternal and child health initiatives, we can expect numbers like this around the world.

So far, I've described the impact of the global health funds in terms of lives saved. That's a pretty good metric by itself, but it's also part of something bigger: Saving lives is the first step toward a more prosperous and peaceful world.

The spreading rhetoric of isolation is based at least in part on fear, especially of mass migration and terrorism. But those things are most likely to happen in places where there is no hope, no opportunity. The global health funds foster hope and generate opportunities, because people who are alive and healthy have the chance to be innovative and productive. According to the Copenhagen Consensus Center, every $1 invested in the global health funds creates $20 in social and economic benefits.

When our foundation started investing in these funds, we believed they were high-risk, high-reward. Our foundation was new, and so were the funds. But we were willing to take the risk because we knew the potential reward would be huge. The past two decades have shown that the reward is even higher than we thought. With sustained investment, the global health funds will continue to save millions upon millions of lives and pave the way for a secure and stable future. Those are the kinds of investments the world should be doubling down on.