It’s easy, in this age of Donald Trump, to think the world is crashing down around us. But Melinda Gates sees things differently. The philanthropist, who the Clinton campaign briefly discussed as a possible vice president option per a recent WikiLeaks-published email, wants you to know that things around the world are better than ever.
“If you look in the past 15 years, a billion people have been lifted out of poverty,” Gates says. “What Bill and I are seeing is that this progress can and should be sped up.”
It’s a jarringly optimistic take at a time where politics is so dark, but she has a point. Data on poverty, life expectancy, and deaths from war really does show that the world is improving, and there’s strong evidence that philanthropists and governments can help alleviate extreme poverty and the burden of deadly disease.
The Gates Foundation has spent upward of $36 billion trying to further this progress, funding programs to deal with diseases like malaria and expand poor people’s access to education and banking. But despite her vast resources, Gates openly says they can’t solve the world’s (vast) remaining problems on their own. Governments command far more money than even Gates can summon; they need to step up.
Which is why recent political developments are, from a development perspective, so worrying. The rise of political movements like Donald Trump’s, which are basically hostile to the idea of helping foreigners, suggest that Western citizens are becoming more hostile to programs that might benefit the world. So is Melinda Gates worried?
I spoke with Gates over the phone recently to discuss precisely these issues: How the world is getting better, what can be done to further progress, and whether politics is turning away from a commitment to global development. What follows is a transcript of our conversation, edited for length and clarity.
You and your organization have argued forcefully that the world is getting better. What’s your evidence for this?
If you look in the past 15 years, a billion people have been lifted out of poverty. More children are living past their 5th birthday — 3.5 million children. In terms of mom dying in childbirth, that number has almost halved in the past 15 years. Women and girls are both going to school; at primary levels, we have parity for boys and girls. Now the world is starting to work more on secondary schooling.
All of those things that I just mentioned are all huge progress in the past 15 years. And what Bill and I are seeing is that this progress can and should be sped up.
How much of this progress is due to government efforts, and how much of this is due to private organizations like yours?
It’s really government funds that are going to scale up to a large degree.
What a philanthropy or private foundation can do is come in and take risks that a government sometimes can’t or won’t take. We can also collect data [and] do pilot projects. But everything we do, for Bill and me, is looking at “how does this then scale?”
Something that we’ve just completed is the Global Fund for replenishment for HIV, TB, and malaria. What was raised was $12.9 billion on behalf of those three diseases. That takes government funding.
We and other private individuals absolutely contributed to that. We’re contributing to the diagnostics, the tools, getting the prices down of those drugs, experiments to make these things better. But it takes government funding to scale those investments up, and reach large numbers of people.
What do you think is an under-appreciated or important finding, maybe in a recent pilot program or study, that’s an effective way to help people and could be scaled up?
One of the things we’re looking at is contraceptive access for women around the world.
[Look at] a country like Senegal, that has gotten funding for contraceptives. It has developed a very innovative program for separating the public and the private pieces of it; the good private sector model has a really good supply chain going, even in the government clinics. They’re getting the word out to women, working with moms and Muslim leaders to get the world out — and they raised their contraceptive [access] rate by about 47 percent in a very short period of time.
That is a fantastic example that can be completely replicated. Other countries are starting to see that, and looking at what pieces of that could work in their own countries.
Another example that I’ve heard discussed is direct cash transfers: just giving money to the world’s poorest people. There’s a lot of really promising evidence that this is an incredibly effective tool for fighting poverty. What do you think about that?
There are very good models that have come out of places like Mexico and Latin America on direct transfers and cash benefits. And there’s great research on how they work — and they work incredibly well, particularly for women.
The reason I’m so excited about this for women is that women are at the center of the family often, and we know that every marginal dollar they get in their hands, they put two dollars back into their family. Those cash benefits would do all the right things in terms of girls’ education or financial services.
The other thing I’ll tell you about payments — mobile phones give us an enormous opportunity. When I travelled to the developing world 10 years ago, you just didn’t see the mobile phone penetration that you see today. And now, with mobile banking, it is really starting to become prevalent out in developing countries like Kenya, Tanzania, and the Philippines.
So the poor can start to save a dollar a day, two dollars a day. So for women who can’t go to the bank, or won’t be welcomed at the bank, they can actually start using their mobile phones to bank.
Do you have plans to scale up your investments in cash transfers for the poor?
We have plans to scale up our investments in financial services for the poor, and using mobile phones to do that. We have put a quite a bit of money on those programs, and we’re trying to get the digital rails and regulations changed around the world: India, Bangladesh, the Philippines, Ethiopia, Tanzania, Kenya.
We feel like working on the backbone of this. Then you can push the kinds of digital cash transfers you’re talking about through a system like that. And the benefits for the government is that there’s a lot less graft, but you have to get the rails and regulations changed first.
So there’s a lot of great news, and a lot of new exciting ideas for governments to fund. But there’s a big problem.
Around the developed world, you’re saying a wave of nationalism. You see the Trump campaign using the slogan “America First,” for example. This seems like a rejection of the kind of programs, focused on extreme poverty and disease that primarily afflict the developing world, that you were just talking about. How worried are you about these political trends slowing down development efforts?
I think that’s one of the [reasons] Bill and I were so heartened by the Global Fund. When we were fundraising for that, we looked out and saw what was actually going on about that, the national conversations around the world.
We were heartened to see that we’re still focused on our common humanity. When I go around and talk to young people in our country, or the UK, or France, or Germany, they’re focused on being global citizens. They know that humanity is about everyone, not just a nationalistic attitude in our own country.
Yet in Europe, far right parties have tripled their vote share in many countries in recent years. The refugee crisis has strengthened this effect, mostly by provoking an Islamophobic backlash. And, at some points during the US presidential campaign, models like FiveThirtyEight’s put Trump’s odds at nearly even with Clinton’s.
Doesn’t that suggest that, at a minimum, opposition to ideas about “global citizenship” are a lot less widely held than people like you and I would like to think? Isn’t that a threat to continued progress and global development?
Well, we’re always concerned. You talked about some of these fringe parties — I’m always concerned when we see politics like that. What we’re trying to do is to remind people that, despite the headlines and many tragedies that are occurring, the world is getting better for everyone.
And the way to improve the world is to focus on everyone. Not just high-income people or middle-income people who have the chance of getting ahead. It’s about everyone.
That’s the role of people like us: to remind people why we do the kind of work we do, and who we are as human beings.
Let’s talk a little about the refugee crisis, since you brought it up. I want to start with a big-picture look: How important has migration been in the optimistic story you’ve been telling about the world? Does letting people move freely make life a lot better?
About the refugee crisis, and the migration that’s going on today: It’s a tragedy. Most of those families don’t want to migrate. What family wants to get on the high seas, in a boat with their child, not knowing whether they’re going to survive?
They want to stay in their own countries, and they want to have economic opportunities. What we look at is how we make sure that we can get health and development right, so people can stay where they are.
It’s not just health and development, though. A lot of these people are fleeing conflict: Syria, Afghanistan, and the like.
Right, but what drives peace and security? Peace and security is driven by good health indicators, people being able to deliver their babies properly, education for kids.
Yes, you can get a bad world leader, and that’s a terrible thing. I feel sorry for any country that goes through that transition; we’re going to have good leaders and bad leaders come and go. All we can do [as philanthropists] in the middle of that, as the politics are being worked out, is you go in and make sure that people are getting financial services, getting good latrines, getting cooling, and getting those who move into different countries good jobs.
But when you look at many places around the world, we have better leadership than we’ve ever had before. If you want to get peace in a society and not having a society that’s rising up, trying to make change in our country, you’ve got to have peace and stability. The only way to do that is to have great health and great economic opportunity.
What can we do better, both private citizens and the US government, to help Syrians?
I think one of the things that Obama just did at the United Nations, saying that we’re going to take in another 110,000 refugees. Saying we’re going to put them up in cities, make sure they get good jobs, help their families — I think that’s what we can do as a country.
I think the best response for refugee issues, for citizens, is figuring out what’s going on in your community and how to help out.
If you have got refugees in their communities, figure out who locally is helping refugees. If they come into your schools, make sure they’re welcomed by your kid. Make sure they’re welcomed by your community. Make sure they’re given the things they need to so they can get on their feet the quickest.