Bill Gates: Solving malnutrition is both a global health and economic imperative
Bill Gates: Solving malnutrition is both a global health and economic imperative
Every year, the Bill & Melinda Gates Foundation updates progress on the United Nations’ Sustainable Development Goals — how the world is doing to lift people from poverty; ensure gender equality; improve health, nutrition and sanitation; and more. With public health, there had been a boom — two decades of progress — to start this millennium. But this new report raises concerns that the golden age of improving lives and livelihoods may be in trouble.
Bill Gates is co-chair of the Foundation and co-founder of the tech giant Microsoft. He spoke with “Marketplace Morning Report” host David Brancaccio. The following is an edited transcript of their conversation.
David Brancaccio: Twenty years of focus on, for instance, making people healthier and environments cleaner and more sustainable. Followed by, well, I mean, COVID — pandemic gets horribly in the way. But are you also worried the world is getting — I don’t know — distracted from the problem?
Bill Gates: The awareness of the great progress we made since the turn of the century, cutting [deaths of those five years old and younger] from 10 million a year down to under five million a year — you know, it’s not widely known. And we have to get the word out about that, so that we get the resources, the focus that we need to continue. And the U.N. goals have us cutting those deaths in half again by 2030. Because of the stalled progress — which is not only the pandemic, but the interest payments that the African countries are having to make, which are cutting their health budget, and just the attention to Africa, with aid cut, [aid] being lower — means that it’ll be a challenge to get progress back to where it was for the first two decades of the century.
Brancaccio: It’s not just that we’re bored about thinking about helping people, right? There are a lot of distractions. There’s war. I mean, there was the pandemic. And there’s political instability in a lot of places.
Gates: Right. But, you know, if you have things like the vaccine fund called Gavi that’s saving lives for less than $1,000 per life saved, you’d hope that the moral value of that would be strong, even when there’s a lot of distractions out there. But we’re going to have a challenge to even raise as much for that as we did five years ago.
Brancaccio: Reading the report, I can see an embedded argument for what some would call “systems thinking.” Help me understand this: You don’t just work on nutrition or clean water or climate or trying to stop armed conflicts that produce refugee crisis. It’s about planning for how all these things fit together.
Gates: And, fortunately, we have many great examples — not only the rich countries — which solved their malnutrition a long time ago. But many countries in Asia that, by investing in nutrition, they’ve been able to grow their economies and actually get to the point where they’re no longer dependent on aid. So countries like Indonesia, Vietnam, even India itself are grown. And so the aid dollars can go to the remaining low-income countries to help them get out of the poverty trap, which malnutrition is a huge part of that.
Brancaccio: Malnutrition. I mean, we think of it as the world’s worst child health crisis, but it’s also an economic issue, right? You don’t mean that it’s costly to address, but you mean that hunger holds back a whole economy.
Gates: That’s right. If you’re unable to get the right diet, then malnutrition means that your body and your brain never developed. And so we have to invest so that when they grow up, they become an asset. That, as you educate them, it’s their productivity that’s driving economic growth.
Brancaccio: I mean, you’ve offered some practical ways forward. I mean, some of it quite practical: fortifying bullion cubes to add into meals could stop 16 million cases of anemia. Upgrading prenatal vitamins saves half a million people over 15 years. But here’s the systems thinking part, right: You also talk about boosting milk production in cows could stop more than 100 million cases of stunted growth, but you would have to increase milk production with a mind to its impact on climate change.
Gates: The poor countries are less than 4% of global emissions, including even the cows. And as you make these cows more productive, your emissions actually go down, because you get the efficiency benefit. And so the answer here is to go from three liters a day that they get in Africa up to what cows in the U.S. produce, which is over 30 liters a day. And it’s kind of amazing that by cross-breeding with the genetics from those very productive cows, we can actually drive milk production up by a factor of five or more.
Brancaccio: Back to your point about your concern that we’re dropping the ball here: Some of it is that we’re distracted by very real problems in the developed world. We have this terrible gap between rich and poor in this country, and you’d forgive people for if their first impulse was, “Let’s solve problems in my neighborhood.”
Gates: What we would add to that is that if you’re open-minded to spending 1% of the budget to help the poorest in the world, and that those interventions have to be, you know, say, 1,000 times more effective than things you do domestically, and you get other rich countries to pitch in so that you can lift these countries up. And that, over time, they are no longer dependent on aid, so it’s just an investment. It’s an investment in their stability; their child survival; their helping the world economy; their having health systems, so they’re not a source of the pandemic — by very smart use of that 1%, combined with a little bit of philanthropy.
Brancaccio: Now, the overall topic here is how to make the world a better, more sustainable place for people. Staying on that topic, but widening out, there are new challenges to well-being that were not anticipated by the United Nations. One of them is rapidly evolving technology, including artificial intelligence. AI could be a friend; AI could be a foe. Bill, do you wrestle, yourself, with the idea that the computer technology you helped create could become a new global threat to our well-being?
Gates: Absolutely. AI is going to be used by people with good intent. You know, for example, designing new vaccines, getting health advice out to people in Africa, where you have this unbelievable shortage of doctors. And so I think AI can be a technology where we don’t wait 10 or 20 years to bring the benefits to the poorest. We try to get it out at the same time. And the Foundation’s been doing a lot of grants to African innovators, so that they have access at this very, very early stage, while the entire world makes sure to accelerate the good uses and and try to minimize the negative effects.
Brancaccio: Does the minimizing include erecting strong guardrails that would stop AI from accentuating the bad?
Gates: Well, the main challenge today is that people with negative intent — criminals or people trying to influence opinions in some way — AI is just another tool for them, just like social media is. The level of sophistication will have to go up there. But, a lot of what I see when I go out into schools and see this at work, or see scientists accelerating their work on these key diseases, is that the opportunity — particularly in poor countries — is very positive.
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