Widespread vaccination is one of the most significant medical advances of all time, saving at least 154 million lives over the past 50 years. But in the early 1980s, this critical medical tool was out of reach for four-out-of-five of the world’s children.
Despite years of separate efforts, the World Health Organization, UNICEF, the World Bank, and other organizations found themselves unable to move worldwide immunization rates above 20 percent. So, they reached out to former director of the U.S Centers for Disease Control and Prevention (CDC) Dr. Bill Foege – a legend in global public health through his role in eradicating smallpox – to help them unite their efforts.
Foege created a new task force, then known as the Task Force for Child Survival. In March 1984, he convened the group at The Rockefeller Foundation’s Bellagio Center (Bellagio Center) and guided them through a visionary process focused on building alignment and embracing a new approach to the work. The participants left the three-day gathering excited and energized, and they asked Foege to guide the Task Force as they worked to meet an audacious shared goal.
In just six years from that first Bellagio Center convening, the group helped quadruple the percentage of children around the world who had received at least one immunization – from 20% to 80%. Making lifesaving vaccines accessible to the vast majority of the world’s children was a landmark accomplishment, one the head of UNICEF called “the largest peacetime achievement in human history.” And that was only the beginning.
Over four decades, the organization now known as the Task Force for Global Health (Task Force) has built coalitions and partnerships that helped lower global childhood mortality by 60 percent, eliminate neglected tropical diseases in 50 nations, reduce polio by 99 percent, and strengthen public health capacity on every continent. We talked to Task Force President & CEO Dr. Patrick O’Carroll about how the legacy of that initial convening drives the organization’s work, what it takes to forge and maintain successful coalitions, and how the global public health sector can adapt in the face of a changing financing landscape.
"If you can get people to understand that they need to change the way they’re doing business, you can succeed.” - Dr. Patrick O’Carroll, President & CEO,
Dr. Patrick O'CarrollPresident & CEOTask Force for Global Health
What is the Task Force’s secret to building and maintaining so many successful coalitions over the last 40 years?
So much of our approach really was laid out in that first convening. The common goal is what binds people. To work effectively, a coalition has to identify and agree on that shared last-mile goal. What does success look like? Bill Foege said many times that the most important thing to come out of the initial convening was probably getting everyone behind the goal of raising the vaccination rates to 80%. That’s what got people excited and ready to commit to the work.
You also need the right people in the room. It isn’t the title that matters, but they need to have the power to make decisions and the willingness to work with others. They also need to leave their organizational or institutional hats at the door, setting aside those agendas to focus on the shared work. And if you can get people to understand that they need to change the way they’re doing business, you can succeed.
The fact that the convening took place at the Bellagio Center played a key role. By coming together for multiple days – separated from everything else – the participants were able focus on this incredibly complicated problem, build relationships and trust, and put a process in place to hold themselves accountable.
The Task Force’s work is not about us. We’re a catalyst that helps our partners work together better. But they’re the ones who get the work done. When there’s a success, we celebrate it as their success, from the village workers to the ministers of health and heads of government.
Those approaches have been there since the beginning, and they’re at the heart of what we do. They’re part of all of our programs. That’s why they work.
How has the Task Force built partnerships across the public and private sectors?
Merck had a drug that could treat a parasitic disease called onchocerciasis – also known as “river blindness” – which causes intense itching, a disfiguring skin disease, visual impairment, and, ultimately, blindness.
The drug was safe and effective, but the people who actually had the disease were never going to be able to afford it. So Merck’s CEO, Roy Vagelos, decided to donate the drug and went looking for a partner to help distribute it. He told Bill Foege that Merck would donate as much of the drug as needed for as long as needed, if The Task Force would ensure the drug got to people who needed it.
Thirty-eight years later, the partnership is still going. The Mectizan Donation Program is the longest running disease-specific drug donation program there is, treating more than 340 million people annually. River blindness has been eliminated completely in Colombia, Ecuador, Guatemala, Mexico, and Niger, and several other countries are close to elimination.
To guide distribution, we set up an independent expert committee who provides scientific, medical, and technical oversight. They identify where the drug is needed and how much needs to be distributed, and they make sure that the program continues to run in a way that conforms to all the appropriate medical and scientific standards. That’s how we’ve been able to do this public-private work in a way that is demonstrably ethically sound. It’s all very transparent, and it’s been very much to the benefit of humanity.
How have the challenges faced by the Task Force changed over the past four decades?
Global public health programs have shifted toward building countries’ capacity to address their own health needs, which is great to see. Our founder, Bill Foege, set us up with that philosophy from the beginning, and it’s part of everything we do.
For example, we support a network of field epidemiology training programs in countries around the world. The CDC’s Epidemic Intelligence Service provided a model for building the epidemiological capacity of state and local health departments in the U.S., and other countries decided to create their own versions. We work with the CDC to help seed these programs and get them going. The work has been tremendously successful, helping more than a hundred countries build their own capacity to quickly detect disease outbreaks and bring them under control. They were critically important during COVID.
Some things stay the same. Every newborn child needs to be immunized. There are annual influenza outbreaks. But we do see changes beyond the usual suspects. Take climate change. Could our partnership model help the global health community better anticipate and mitigate against the climate-driven spread of the insects that transmit malaria? Another new area is antimicrobial resistance, which is killing people right now because antibiotics no longer work to treat their diseases. It’s exactly the kind of issue where the Task Force can be helpful, because there are lots of great people working on it, but not in optimal alignment.
Unfortunately, there have been sharp reductions in funding for global public health efforts, which make addressing issues like these even more challenging. All of those problems involve politics, but there are things we can come together around and work together on if we’re serious.
How can public health systems adapt to realignments in global health funding?
To preserve the public health gains we’ve made over the past decades and keep moving forward, everyone is going to have to think differently. That means more countries will have to step into leadership roles. It means finding new ways to keep the work going more efficiently, using modern tools and making hard decisions about how to continue the progress we’ve made.
The Task Force held a convening at the Bellagio Center last month (in August, 2025) to look at how to continue the work of the Neglected Tropical Diseases Initiative, which just lost $100 million in external funds. The experts we pulled together were heavily weighted towards people from Global South countries where people are most affected by neglected tropical diseases. We had country leaders, ministers of health, and program leaders telling us what was possible.
One goal was to help people figure out what working differently really looks like. What’s the framework? How can we finance the runway to bring it about? How do we engage philanthropy? How do we build the capacity for people to advocate for funding? If we can get people aligned on where we’re going and how to get there, then this convening could create a model that can be used for issues like malaria, tuberculosis, and others. We’re still working to understand what this new model will look like, but we know it will require creativity and a willingness to try things in new ways.
People in global health are incredibly mission-oriented and positive, and they don’t take no for an answer. Failure is not an option. With greater efficiencies, a different way of doing business, and new commitments from countries, we can hopefully find a way forward.
Today’s challenges – from antimicrobial resistance to reimagining global health financing – can seem daunting. Dr. O’Carroll believes that overcoming them requires stepping away from the day-to-day and thinking about big goals. “We usually just focus on what’s in front of us. But, every once in a while, you need to take the time to gather with people and look down the road,” O’Carroll said. “Where do we want to go? How can we get there in a better way? How do we get visionary people in the same room and on the same page to help us go forward? That’s what the Bellagio Center does for us, and it’s what the Task Force tries to do for our partners.”
Learn More:
- Listen to Dr. O’Carroll discuss the power of the Task Force’s model on the On Leadership Podcast.
- Watch a video history of the Mectizan Donation Program.
- Read Dr. Bill Foege’s account of the first Task Force convening.
The opinions expressed in this article are those of the author. The Rockefeller Foundation is not responsible for and does not endorse its content.