Improving Conditions for the Poorest of the Poor
Here’s one of those “What’s wrong with this picture” quizzes.
Bill and Melinda Gates, co-chairs of their Foundation, the most powerful philanthropic force on Earth, gave an hour-long interview on Charlie Rose (PBS) that aired last night. Here are my notes, followed by a comment:
• The Foundation aims primarily to remove the threat of dread diseases and improve living conditions for the poorest of the poor.
• The emphasis is on malaria, which kills about 600,000 each year, mostly young children.
• A side emphasis is on polio. The Foundation has successfully removed it from Africa, though it still exists in Pakistan because of the Taliban’s prohibition on vaccines.
• Diseases like HIV took the last 15 years to eliminate, and it’s likely that some of these new diseases will take another 15 years to rein in, though the Foundation is making great progress in lowering the costs and speeding the approval process of vaccines, so that more of them become available to more people sooner.
• There are one thousand people currently dying in a certain hospital (St. George V). Admission is essentially a death sentence because all patients have a form of tuberculosis that is resistant to all but two available drugs (one of which causes deafness and the other insanity) and staff are hard to find for fear they’ll be infected.
• Though the mortality rate for infants and children under five years old is less than half what it was 20 years ago, it’s orders of magnitude higher than that of the developed countries.
• Health issues begin with malnutrition, which is rampant. This normally leads to diarrhea, the bacteria of which prohibits the digestive track from absorbing whatever meager level of nutrition that children can take in.
• Health issues also extend to hygiene; as an example, people who really want to use a latrine, as opposed to defecating outdoors, sometimes need to wait more than two hours to do so.
• About 2% of the U.S. economy consists of philanthropy. Bill Gates believes that more bright minds need to be focused on medicine to address the diseases that pervade the third world.
• He is optimistic because the trend to charitable giving has grown in the past few years, by virtue of the Giving Pledge (where a great number of billionaires have pledged half their net worth to charities of various kinds).
• Another source of optimism lies in the fact that the GDP in Africa has grown as well. (Though what about GDP per capita, given the soaring population?)
• Outside of disease the biggest issue is farming. In Africa, 60% of the people are farmers, but they import most of their food from the U.S., where 2% of the people are farmers.
• Farming output per acre is 20% what it is in the U.S. The goal, and it’s achievable, is to raise this to about 65%.
• Collecting the small amounts of potable water that exists, which duty falls almost exclusively on the shoulders of women, normally requires walking at least up to two miles per day—sometimes as many as 12.
• The biggest breakthrough in women’s reproductive health came recently with the advent of sanitary pads, before which girls needed to miss 7 – 8 days of school per month.
• By far the biggest single IT breakthrough in African history is the cell phone (though users walk on average one mile per day to charge them).
• The application that has, far and away, the greatest value is online banking, enabling farmers to save $1 on banking transactions, which is huge for them.
OK, so you’ve read this summary. Now what’s wrong with this picture?
It’s this: If we are to succeed in alleviating human suffering in the third world, the real issue isn’t curing disease; it’s generating less suffering in the first place.
It’s hard to sound smart when I’m second-guessing Bill Gates regarding whatever he’s thinking on this or any subject. At this point in his life, he’s tightly focused on his passion to eliminate the diseases that pervade the third world, the most terrible of which is malaria. What could possibly be wrong with that?
I sure wish I had ten minutes with him to make this point: Of the list of the 20 sovereign countries with the highest birth rates on Earth, 19 of them are in sub-Saharan Africa, and his resources would be far better spent addressing the social conditions that cause tens of millions of babies to be conceived each year who are doomed to be malnourished and condemned to die in searing agony. Almost all those who survive their childhood will live in unimaginable levels of poverty, disease, ignorance and squalor. Before they die, however, in most cases they will reproduce themselves with an appalling number of offspring, thus repeating and expanding the cycle.
The 60-minute show last night mentioned contraception for just a few seconds, during which Melinda offered this: a) Finding some means of contraception means that both babies’ and the women’s health are likely to be better, and b) It’s women’s #1 issue. (Yes, that’s right; it’s by far the most important request that women make: Please! Help me stop having so many children!)
In the few moments devoted to the subject, she mused: “It’s weird. When I visit them, all I want to talk about is vaccines; all they want to talk about is contraception.”
But is that really so weird? If I were having those conversations, I’d be inclined to regard them as perfectly rational, though desperate, pleas for help.
Apparently, living under these miserable conditions, and caring about the welfare of their children as only mothers can, means wanting to create fewer of them. Mothers seem to know something that defies our understanding as philanthropists: alleviating suffering means manufacturing less of it. This is what these women are telling us with heart-piercing clarity. Why is this so hard for us to grasp? Why aren’t we listening?
Fortunately, the Foundation has a certain level of focus on education, and obviously that’s better than none at all. But we all need to realize: it’s really the only thing that matters. Educated women have a small fraction of the fertility rate that uneducated women do.
Indeed, if there’s an answer here, it lies in providing a broad level of education for women. Over a period of decades, it has been proven to result in better family planning, far higher personal productivity resulting in higher self-esteem and more focus on the workplace, and, at the end of the day, families that are healthier, stronger, and smaller. If anything about this is “weird,” it’s that we can’t seem to comprehend this concept.
Global warming will spread enough famines, diseases and wars around the world to control population growth or even eliminate humans altogether depending on how hot it gets over the next few centuries. Three degrees of temperature rise will cut human populations in half and six degrees will wipe out 90% of us. At the end of this century people will look back on what the Gates Foundation spend millions or even billions of dollars on and declare it was a huge waste of money and should have been spent to control greenhouse emissions.
Bill Gates has not been entirely absent from the clean energy space, but it’s clearly “not his thing.” I’m not sure why this is, given his powerful intellect and his facility with math/science. More here: http://2greenenergy.com/2015/01/24/clean-energy-mitigation-climate-disruption/
I agree with your comments. I have sent 2 letters to Bill Gates say ing that the world needs an EXAMPLE of a country that can supply 100 % of its Energy needs from renewable Energy, Hydro,wind,Geothermal,Tidal,and run Electric cars in 90% of uses.Diesel will be required for heavy vehicles and farm tractors until clean alternatives are developed,but new clean Electricty generation is ready to build now to power all electric cars as they are imported. This country is New Zealand and we could reduce our import bill for Petrol by 2,5 Billion $ each year by using our own Electric power for cars.But the Government moves like a Dinosaur. What hope is there for our grandchildren?
The hope for our descendants is that people move forward at the local level without waiting for government at the federal level to come together and move us forward.
I’m with you all the way. I’ll never forget what Ed Rendell (ex-governor of Pennsylvania) said on this subject: http://2greenenergy.com/?s=rendell&submit=Go.
Here is a Rendell quote I like. According to Rendell: “Over 90% of Democrat voters are in favor of Congress passing legislation that prioritizes clean energy. In fact, over 75% of Republican voters are in favor of the exact same thing. Clearly, the will of the American people is being frustrated by special interests.”
I like that one too. In fact, I was in the room when he said that. http://2greenenergy.com/2011/06/21/ed-rendell/
Craig, well said.
If William and Melinda Gates mentioned contraception too much, other parts of their work might suffer. There are many religionists who irrationally and cruelly oppose contraception and any organization which promoted it would find its work greatly impaired. It may be for that reason that the Foundation has said little about contraception even though they fully understand its importance. Fortunately, there are other organizations which do support contraception.
It would make more sense to increase funding for those organizations the primary function of which is to make contraception available. Slightly off subject, it is bizarre that many of those who support contraception and realize that it is unreasonable for married people to abstain from sex expect gay persons to abstain from sex for their entire lives.
Solar power, despite its serious limitations, could greatly improve the lives of many people in Africa. For example, it makes no sense that people should have to walk two or more miles to recharge a cell ‘phone. The little power required to recharge a cell ‘phone could, at minimal cost, be provided by a tiny solar system. Even small solar systems could provide the minimal lighting required to improve people’s lives. Even a couple small LED lights, which require little power, could make life easier and more productive for many people and, by reducing the use of kerosene lighting, would reduce indoor air pollution thereby improving health. Even if the solar system were not entirely reliable and simply enabled the LED lighting to be used perhaps 80% of the time, it would still be a big improvement. So, although I do not believe that renewable energy systems would be practical as a major source of power for most large prosperous countries, they do have an important rôle to play.
Ok, silly and trivial, but I gotta ask… How far is “at least up to two miles per day”?
Ha! It was a typo. Damn. It’s amazing how many times I reread that and couldn’t see it. My proofreader didn’t catch it either.
Control population, get campaign finance and election reform to let honest sensible people to be elected, who can fix all of these issues.
It seems to me Bill Gates was very ruthless in taking ideas from other people and companies.
His product is bloated, breaks, is part of the reason for cyber insecurity, and has cost alot of people alot of headaches. I admire his trying to improve things and make the world better. There may be ways to get better results per dollar invested.
I wasn’t going to go there, but now that someone has: Yes, the process by which Bill Gates got into this exalted position was unlovely to say the least. But he and the media juggernauts are working very hard to put that fact as far out of mind as possible, and they’ve been hugely successful.
In fact, I’m sure most people reading this have no idea what I’m talking about. Anyone who’s interested should Google “Microsoft illegal trade practices” and read some of the 686,000 results. But again, our memories are short, public relations campaigns are powerful, and Bill Gates is viewed as a saint.
I’m actually not trying to dredge this up; I’m trying to point out that, if he really cares about this (and he appears to) his approach simply won’t work.
In most countries of the third world, those under the poverty line are majority. Should beheading be the solution to a headache? Poverty has its causes, not evident to most. As in math, the only way to solve a problem is to make an analysis of the evidences, sometimes not very easy to see.
Interesting. What are you suggesting?
There are novel new concept technologies out there (mine being one of them) that are not being provided even any seed funding. And if they could get funding; would quickly unleash millions and probably billions of dollars of investment in tens of thousands of climate change mitigation projects all around the world, and every dollar invested in alternative energy based climate change mitigation projects (early on before global warming passes a few more tipping points and goes viral) will do a lot more good in limiting global warming’s eventual harm than many billions of dollars could after the fact. Why? Because building sea walls to protect cities like New Orleans, Boston, Los Angeles and London would cost trillions and will not work, and because droughts, diseases and starvation will result from climate change and will most likely be the what causes the eventual end of this planet’s human occupation.
I think it is unfair to suggest that the Gates foundation is ignoring the causes of poverty. I think it is important to treat the symptom as well as the causes. Yes the vaccines only solve the immediate problems but parallel programs on education (especially for women) are what lead to the understanding that healthcare and more education reduce birth rates and have done so globally for many years. It is not so long ago that high birth rates poor nutrition and poverty were the realities of life in my home country or yours. Let us suggest that we in the know in the West should spend more of our private and public money dealing with the root causes of suffering rather than attacking those who are dealing with the results.
Craig: It is a sad situation for so many people around the world. You see these poor children in these desperate situations in countries that should not be having these problems, and I can mention the USA, and other “developed” countries.
I live in an underdeveloped country, and I can see this problem every day of every year, and it doesn’t matter what party of government is in power, (and I can talk of at least 45 years) and the only thing that remains the same is: we need more money to take care of the problem (as if the amount of money were a difference). The most urgent need in our country is: health and education; and every “new” “party” that comes to power promises to take care of the problem, but every time it’s the same: Education and health always have problems with money.(or rather: lack of everything)
One can wonder:
Is it really about money? Does it really matter if in a neighbor country they tax people higher? Isn’t it more about honesty, empathy, effective use of resources, priorities?
I can tell you that if an enterpreneur has a problem with something, THAT’S what he will tackle first, and more if it’s that important!
But we all know that to improve the lives of so many people in countries that are governed by people that don’t have the empathy to take the responsibility to act is the biggest problem we have.
There are many american organizations working with education, health, food, water projects, and keep coming. The USA country is the most generous country in the world and has always been a helping hand to so many people around the world.
We can e proud of being americans in that respect.
But why is it that such an empathy doesn’t grow from within? Well that’s another book (by someone else)