Bridging the Gap: Bill Gates and PAHO Chart Path for Affordable Weight-Loss Drugs in Developing Nations
London, UK – October 10, 2025
In a pivotal push to combat the global obesity epidemic, the Bill & Melinda Gates Foundation and the Pan American Health Organization (PAHO) are exploring innovative strategies to slash the costs of blockbuster weight-loss medications, making them viable for low- and middle-income countries. This marks the first public acknowledgment from both organizations of targeted efforts to address the stark inequities in access to drugs like Novo Nordisk’s Wegovy (semaglutide) and Eli Lilly’s Mounjaro (tirzepatide), which have revolutionized obesity treatment in wealthier nations but remain out of reach for billions elsewhere.
The Obesity Crisis: A Ticking Time Bomb for Global Health
Obesity affects approximately 1 billion people worldwide, with 70% residing in low- and middle-income countries—regions already strained by infectious diseases and limited healthcare infrastructure. The World Health Organization (WHO) projects that the economic toll of overweight and obesity could balloon to $3 trillion annually by 2030, exacerbating chronic conditions like diabetes, heart disease, and certain cancers. WHO’s draft guidelines this year endorsed these GLP-1 receptor agonists as effective obesity interventions for adults, yet lambasted pharmaceutical giants for prohibitive pricing and restricted supply chains, confining their use largely to high-income markets where monthly costs exceed $1,000.
Enter the Gates Foundation and PAHO: In separate interviews with Reuters, Bill Gates and PAHO Director Dr. Jarbas Barbosa outlined complementary approaches to democratize these therapies. “We are starting the conversation,” Barbosa emphasized, signaling PAHO’s intent to engage manufacturers and generics producers on safe usage protocols and regulatory hurdles.
Gates Foundation’s Playbook: From HIV to Obesity
Bill Gates, whose foundation has long championed equitable drug access, drew parallels to its ongoing HIV initiatives. The organization is partnering with Indian firm Hetero to produce a new HIV prevention drug for just $40 per year in developing markets—a model ripe for adaptation to obesity treatments. Gates pledged: “Any drug that’s effective in high-income countries—we’ll figure out how to make it super, super cheap so that it can get to everyone in the world.”
Potential tactics include:
- Generic Acceleration: Semaglutide’s patent expires next year in key markets like China and India, paving the way for low-cost biosimilars. The foundation could subsidize production scaling.
- Clinical Data Support: Funding trials to assess efficacy and safety in diverse populations, generating evidence for faster regulatory approvals in the Global South.
- Supply Chain Overhaul: While obesity isn’t the foundation’s top priority—malaria and other killers remain focal—rising chronic disease burdens demand action.
This foray into metabolic health represents a strategic pivot for the Gates Foundation, traditionally laser-focused on infectious threats, but one Gates views as essential amid obesity’s “new urgency” in fueling non-communicable diseases.
PAHO’s Regional Leverage: Bulk Buying for the Americas
As WHO’s arm for the Americas, PAHO serves 35 member states through a pooled procurement fund that negotiates volume discounts on essentials like vaccines and antiretrovirals. Barbosa indicated this mechanism could extend to weight-loss drugs, aggregating demand to drive down prices from hundreds to potentially tens of dollars monthly. Early steps involve drafting usage guidelines and convening stakeholders, including Novo Nordisk and Eli Lilly, to explore tiered pricing or technology transfers.
Novo Nordisk echoed commitment in a statement: “We recognize the unmet need for our treatments and are deeply committed to serving patients around the world.” Eli Lilly has yet to comment publicly, but industry watchers anticipate similar outreach as generics loom.
Challenges and Broader Implications
Success hinges on navigating intellectual property barriers, ensuring supply stability, and integrating drugs into holistic strategies—lifestyle interventions, not just pills. Critics warn of over-reliance on pharma solutions in under-resourced systems, but proponents argue affordable access could avert millions of cases of obesity-related illness, yielding massive economic dividends.
As Gates noted, this isn’t about supplanting core priorities but adapting to evolving threats. With obesity rates surging in Africa, Asia, and Latin America, these efforts could redefine global health equity. Stakeholders anticipate pilot programs in select PAHO nations by mid-2026, with Gates Foundation involvement potentially scaling worldwide. The clock is ticking—$3 trillion by 2030 demands bold, collaborative action now.