WEF LIVE: Bill Gates Joins Global Health Panel with Rwanda ICT Minister and Global Fund Chief | APT

To go into these refugee camps and do screening for TB because frankly, whenever you get situations with large numbers of displaced people, you end up with TB. And the question is not replacing any radiologists, there were no radiologists. And so if you want the screening to be interpreted, there is no alternative. So in some ways, I think one of the reasons this may well take off faster in low-middle-income countries is because there won't be the resistance from people who say this has taken my job and I don't want to change the way we do things, because in fact it's compensating for the fact that those people don't exist.

But I want to pick up on the horizontal point that Bill made, which is one thing many medical systems in low-middle-income countries have excelled at is creating paperwork. There is an enormous amount in many healthcare systems of literally paper records with carbon copies and all this kind of stuff, and that makes it very difficult to capture because it's on paper. It also just creates an enormous amount of time for overstretched healthcare workers.

Do you mean like records, patient records?

Oh, where if you've ever gone to some village and the community health worker will proudly take out a big kind of thing like this and they've carefully written in the name of each patient and what they had and all this kind of stuff, and then you think to yourself, well, A, that took quite a long time, but B, how is that captured in any kind of national disease surveillance system? And the big difference is that now in Rwanda, your community health workers have an app on their phone. It has the details of the patient. They put it in, it's all recorded. They can look at what happened last time. They don't have to go back through the files. And also from a national point of view, that data that's being inputted by the community health worker is being captured. So your community health worker, you've got like 60,000, they become your disease surveillance system, right? And that's incredibly powerful. And then once you've got that kind of level of data capture, you can be applying AI tools for pattern recognition of all sorts of ways of detecting perturbations. You know, this region is seeing something slightly different we didn't expect. So taking paper out of the system, capturing the data, I think that's incredibly powerful.

Can you do that? Can you guys at the Global Fund go and take all those paper stacks and make them digital?

We're certainly investing in it. I would say that different countries are at very different states in terms of where they are on that pathway. But we do face a challenge, right? There's less money than there was. I mean, that is the reality, and a lot of the money that was being invested in things like disease surveillance has stopped.

Like recently?

Yeah.

Why?

Well, because major donors around the world have...

The US is excluded, right?

Well, it's actually quite broad-based. We've seen quite a lot of donors reducing funding quite significantly. And that means that we face a challenge, which is that, let me put this in perspective. We've actually just had our eighth replenishment. We've just raised just under 12 billion with some donors still to go. Actually, that shows remarkable commitment in this context by the donors who support the Global Fund. But we are going to be allocating less money to countries, and they have had sharper reductions from other sources. So countries are going to face some very difficult choices. Do they invest in underlying system things like disease surveillance and laboratories, or do they invest in basic life-saving things like first-line treatment of malaria, keeping people on antiretrovirals? And so there will be some very difficult trade-offs there. But I think the thing that's exciting about AI is it allows us to kind of change the equation a bit and maybe get quantum leaps in efficiency and effectiveness. That means we get, in a sense, more bang for the buck, and that's what we've got to be really focused on—not the cool tools so much as where can we really disproportionately have greater impact.

Bill, what about the funding? Is it governments pulling back? What is going on in that environment?