Global-health stars converge on Seattle

The glitterati of global health are gathering in Seattle — but if you're not on the guest list, you'd be hard-pressed to know.

Even many participants remain in the dark about the most elite of the four conferences and meetings scheduled here this week: the get-together of international-health leaders who call themselves the H8.

The H8, or Health 8, don't share their agenda and rarely issue statements.

But there's little mystery why the members would travel to Seattle, home of the Bill & Melinda Gates Foundation. The Microsoft co-founder and his wife have poured billions of dollars into improving the health of the world's poor, and their philanthropy has made Seattle a prime destination for the far-flung enterprise known as global health.

That's also why the Pacific Health Summit opened here Tuesday evening, drawing 250 people from 25 nations to tackle the problem of drug-resistant tuberculosis. Many of the world's most respected scientists are in town for the related Global Health Research Congress. Also meeting in Seattle this week are the heads of government agencies and foundations that fund health research, such as the U.S. National Institutes of Health.

All of the events are invitation-only and press coverage is restricted. Journalists can attend the summit and research congress but must agree not to quote participants by name. Organizers say the rule allows for more open discussions.

But few of the prominent officials and researchers in town will make it past the door for Friday's H8 meeting.

The group's name is a play on the G-8, or Group of 8, the annual forum that brings together the leaders of the world's most powerful nations.

Instead of presidents and prime ministers, the H8 is made up of the heads of the seven international organizations that guide health policies and programs for much of the world: the World Health Organization; the World Bank; UNICEF; The Global Fund to Fight AIDS, Malaria and Tuberculosis, and others.

The eighth party is the Gates Foundation, the only private philanthropy with a seat at the table.

Other nonprofits grumble about the Gates Foundation's favored position. Critics who argue the Seattle foundation already exerts too much power over global-health priorities are alarmed by its involvement in the exclusive club of the H8.

"If people are concerned ... it's probably because of questions about whether the Gates Foundation, through this vehicle, is having influence that a private entity does not normally have," said Ruth Levine, vice president of the Center for Global Development.

The foundation's global-health chief, Dr. Tachi Yamada, was a major player in organizing the H8 two years ago.

The idea is to foster cooperation and communication among organizations that have not always worked well together, and thus speed efforts to bring lifesaving-health improvements to people in poor nations, said Dr. Nils Daulaire, a senior fellow at the Global Health Council.

"Given the level of resources and the challenges involved in getting things done in the global-health arena, any time major actors get together and get their priorities straightened out ... I think it's good thing," he said.

The swine-flu pandemic will be a topic at Friday's meeting, Daulaire said.

UNICEF media chief Christopher de Bono described the group's discussions as informal. "This is not something where there is this cabal of people sitting in a room, taking decisions about other people's health," he said.

But even if the H8 doesn't cast formal votes, it can still be very influential, said William Hsiao, professor of economics at the Harvard School of Public Health. "They can influence decisions — that's why they get together," he said.

The membership of the H8 reflects the changing power structure in global health, Hsiao said. Older organizations like WHO and The World Bank are seeing their influence wane as private philanthropies, businesses and nongovernmental organizations become bigger players.

In addition to the Gates Foundation, the H8 includes GAVI, an organization started by the Gates Foundation to boost childhood-vaccination rates, and the Global Fund, which helps programs in developing countries, another relative newcomer heavily supported by the Gates Foundation.

The Gates Foundation exerts its influence in many ways, and its involvement with the H8 is only a small part of the picture, Center for Global Development's Levine said. "I see it as an honest attempt to coordinate among big, sprawling organizations that barely can coordinate among themselves," she said.

In addition to spending huge sums to develop a malaria vaccine, discover new TB drugs and fight AIDS, the Gates Foundation leverages its influence and its founders' cachet behind the scenes to nudge nations, businesses and government agencies to do more for global health.

Some are pressing the foundation to be more open about its activities, and that's something the H8 should also consider, said Michael Reich, professor of global-health policy at the Harvard School of Public Health.

Reich says he's glad the organizations are talking to each other through the H8 but would like them to share their agendas and conclusions with the public.

"It might even help them advance ... the goals they're trying to achieve," he said.

Sandi Doughton: 206-464-2491 or sdoughton@seattletimes.com