On Wednesday, January 21st, Bill and Melinda Gates made a very big, very public bet: "The lives of people in poor countries will improve faster in the next 15 years than at any other time in history," they wrote in their annual letter. "And their lives will improve more than anyone else's."
Beneath that bet were some very big sub-bets: that the world will cut the number of children who die before the age of five in half; that we’ll wipe four major diseases — including polio and Guinea worm — off the face of the earth; that African farmers will be able to increase their yields by half.
The optimism comes at a time when Americans, in particular, are feeling pretty pessimistic. 2014 often felt like a parade of horrors, and a majority of Americans say their country is on the wrong track. So when I spoke with Gates, I wanted to know why he was so confident about the future. An edited transcript of our conversation follows.
Bill Gates' case for optimism
Ezra Klein: We've just gone through this year that felt, to many in America at least, like this unrelenting march of horrible news. We saw Ebola rampage through West Africa, we saw a caliphate establish itself in the Middle East, we saw Boko Haram kidnapping women in Nigeria.
And amidst all that, you say you think the lives of people in poor countries will improve faster in the next 15 years than at any other time in history. What gives you that confidence?
Bill Gates: It’s the nature of the news to highlight the really bad, really sudden incidents. Look at the deaths of children under five — there were six and a half million of those deaths last year — the percentage that were connected with any headline is less than one percent. The daily deaths from pneumonia, diarrhea, malaria — there's no news hook to those. You could study the headlines very carefully, and you wouldn't have a sense of what's up with the bottom two billion.
I can understand how people see things if they just read the headlines. But in terms of African GDP, African agricultural productivity, science coming up with better understandings of biology that create concrete tools that can deal with epidemics, it was actually quite a good year.
How running Microsoft is different from leading the Gates Foundation
Ezra Klein: In the beginning of your letter this year, you draw a line from the bet that you and your colleagues at Microsoft made on software and the bet you're making on human development now.
The work you did in software was work that used technology to scale. But so much of the work in human development is using tremendous amounts of manpower to spread basic, low-tech solutions across huge land masses. How do you see those bets as connected?
Bill Gates: The work of the foundation can be divided into sort of an upstream R&D piece, where we’re trying to create an HIV or malaria vaccine, that is more analogous to the core work of Microsoft, where you're picking great scientists for a a five-, six-year project that has a chance of meeting these problems.
Downstream of the foundation, the most critical partner is actually the country that we're delivering in. We’re working with the government of India or Nigeria or Ethiopia and learning about why sometimes governments in poor countries work very well, like say the vaccination system in Ghana or Rwanda, and why sometimes they work very poorly, like in northern Nigeria.
In some ways, I was more prepared for the upstream part of this work. The Microsoft downstream equivalent was to get word of mouth going and build an enterprise sales force and a product support team and go speak at user groups. Way easier. It didn't force me to figure out totally new partnerships or work with organizations I didn't understand.
Ezra Klein: I'm interested in this upstream/downstream distinction you're making. What are the problems where the impediment right now is a lack of mobilization and coordination of our existing resources? And what are the problems that, in your view, are waiting for a technological breakthrough to become solvable?
Bill Gates: Mankind went until something like 300 years ago with average lifespan staying at 26 years and under-five mortality being over 30 percent in the very best countries.
There's no doubt that energy intensification, which led to mechanization, which led to electrification, which led to the ability to deliver food year round — they are the things that have allowed us to get under-five mortality from 30 percent to now five percent. We’ve got average lifespan worldwide up to 62 years from 26.
But take northern Nigeria, which is actually financially better off than some other countries. Why does it still have about a 13 percent under-five mortality rate, when you can go to poorer countries like Ghana or Rwanda and they have half that? That’s a delivery system that is working very poorly.
So, yes, the world would be way, way, way better off if you could get maximal usage and competent delivery systems and explanation to everybody in the world. You ought to be able to counsel safe practice, like use condoms with people you might be at risk of acquiring HIV from. And in some countries, that message — in most communities in some countries, that message absolutely gets across. But we're going to need more than that before we can go for HIV eradication. When we finally defeat HIV, there will be at the core of that a drug or — almost certainly a vaccine — that's pretty phenomenal. And then you'll see the uptake in some countries will be very rapid, and the other countries won't be.
The real promise of online education
Ezra Klein: One of the things I was interested to see in your letter was the optimism about using online education as a way of revolutionizing school systems in the developing world. There's currently a lot of online education experimentation even in the US, but it hasn't caught on in a way where it’s a substitute very often for more formal education.
You've done a lot of work in this area. I'm curious what you've concluded, what you think are the approaches that have promise and what you think needs to be changed from the model most people think of when they hear "online education," which is a teacher in front of a camera connected to a broadband connection.
Bill Gates: That’s what online education started out as 15 years ago. The idea was if we stuck a camera in a Harvard classroom and just let somebody click on that, then the world would magically be changed and tons of people would watch those things. In fact, I did watch a ton of those things. My favorite course on crystallography and physics happened to be on open courseware.
But for most people, it just wasn't enough. They could turn on that first lecture, but as soon as they'd get confused, they'd drop out from it. It didn't have the kind of social structure and supports that we think of in typical education.
When we think of the potential for online education, there are two different ways to look at it. One is to say, "What about the motivated students that really know they want to learn?" You know, this is the equivalent of when a Carnegie library would go up in a town, who were the strivers that actually went in there and started checking out books and got a real uplift because of that availability. Is that 10 percent of the kids, 20 percent of the kids? Now add online support, bulletin boards, interactivity, feedback, personalized progress. We will get those things in different languages for different subjects in extremely high quality for free, delivered even to fairly small screen sizes, connected up over mobile networks.
If I told you a math teacher 50 years ago was better than any math teacher today, you couldn't say, "Oh, that's silly." Their blackboard, their chalk, were capable of expressing and motivating kids as well as most tools we use today. Saying this will be a magic 15 years in education, that's predicting something that there is no precedent for. It’s just like saying that we'll eradicating four diseases — that's unprecedented.
Why Breaking Bad proves the world is improving
Ezra Klein: Before we go on to disease, I want to ask you about something implicit in the vision you just laid out. You talked about how a lot of these products are of incredible, incredible utility to the motivated. Kevin Drum, who writes for Mother Jones, has a line I've always thought was interesting, which is that the internet makes dumb people dumber, and smart people smarter. Do you worry about the possibility that the vast resources the internet gives the motivated, including online education, will give rise to a big increase in, for lack of a better term, cognitive or knowledge inequality that leads to further rises in global inequality?
Bill Gates: Well, you always have the challenge that when you create a tool to make activity X easier, like the internet makes it easier to find out facts or to learn new things, that there are some outliers who use that thing extremely well. It's way easier to be polymathic today than it was in the past because your access to materials and your ability if you ever get stuck to find people that you can engage with is so strong.
But to say that there's actually some negative side, that there actually will be people that are dumber, I disagree with that. I mean, I'm as upset as anyone at the wrong stuff about vaccination that's out there on the internet that actually confuses some small number of people. There's a communications challenge to get past.
But look at IQ test capability over time. Or even take a TV show today and how complex it is — that's responding to the marketplace. You take Breaking Bad versus, I don't know, Leave it to Beaver, or Combat!, or The Wild, Wild West. You know, yeah, take Combat! because that was sort of pushing the edge of should kids be allowed to watch it.
The interest and complexity really does say that, broadly, these tools have meant that market-driven people are turning out more complex things. Now, you can say, "Why hasn't that mapped to more sophistication in politics or something like that?" That's very complicated. But I don't see a counter trend where there's some group of people who are less curious or less informed because of the internet.
I'm sure that was said when the printing press came along and people saw romance novels and thought people would stay indoors and read all the time. But I just don't see there being a big negative to the empowerment.
Why Gates is hopeful about polio but afraid of the next major pandemic
Ezra Klein: Sure. You said you believe we’re going to be able to eliminate four diseases in the next 15 years. I wanted to get you to expand on that a little bit. We've been through this year where an infectious disease was more prevalent in the headlines than I've ever seen one before, despite the fact that as horrifying as Ebola was, its toll was much lower than diseases like malaria and pneumonia that we know much better. Where are we now, and where do you think we're going to be able to go in the next 15 years?
Bill Gates: I'm saying all these positive things, so let me just say one negative thing.
If you take some high threshold like 10 million or 50 million deaths, what's the chance that 10 million or 50 million people will die in the next 20 years because of some event?
Well, there's no earthquake or volcano that would get to that magnitude. It would have to be a pretty large war. You know, that's a big war. You really only get World War I and II in recent past up at those levels. And look at the resources we put into being prepared for war. I'm not saying that's a mistake, but it's quite gigantic in terms of equipment, training, planes, and people who could go anywhere. An epidemic like 1918 Spanish flu was capable of getting up to those death levels.
Ezra Klein: Related to what you were just saying about pandemics, what do you think people in the developing world should be most worried about? We talked a little bit earlier about how the news media tends to focus on very pressing, spectacular threats that are often blown out of proportion to their actual risk level. What’s beyond the scope of your organization that keeps you up at night?
Bill Gates: The one problem of great importance that we don't address directly is the quality of governance in poor countries.