Thinking Aloud: Melinda Gates on Global Development

June 3, 2015 by Darius 

The Bill & Melinda Gates Foundation is the world’s single largest private foundation and has taken as its mission improving health care and reducing extreme poverty around the world.  By some accounts, the Gates Foundation accounts, by itself, for 5% of global health funding.  Last month I had the privilege of seeing Melinda Gates speak about her work on behalf of the foundation.

Ms. Gates began by noting that previously, it was standard to have a 20- to 25-year time lag between the introduction of a new vaccine in the US or UK and when that vaccine became available to children in Africa.  The incentives simply weren’t there.  The Gates Foundation provided a pool of money to incentivize pharmaceutical companies to not only bring vaccines to the developing world faster but also to create vaccines against diseases that are not common in the developed world.  Now, the gap between vaccine development and deployment in the developing world has shrunk to as little as 1.5 years.  Ms. Gates said that the pneumonia vaccine, for example, was brought to Kenya a year and a half after it was introduced and included protection for strains of pneumonia found in Kenya specifically.

According to Ms. Gates, urbanization creates a ripple effect by creating new markets for “peri-urban” and rural farmers, which generates an influx of cash into these communities.  Combined with advances in mobile banking, this trend is providing a way for families in rural communities to start saving money for the first time: the markets provide the cash, and the mobile banking provides a safe place to keep the cash.  Gates stressed the importance of empowering women to foster development and reduce poverty.  She said that if an extra dollar goes into the hand of a woman in a family, she is 90% more likely to invest that money in her family (e.g., food, school fees) than if that cash goes to a man in the family.

Gates also discussed her organization’s work with contraceptives.  She said that in the 1970s, there was a global consensus on the importance of contraceptives for the developing world.  However, this consensus crumbled during the culture wars and fight over abortion in the US.  Moreover, when contraception was discussed for the developing world, it was generally in the context of condom distribution to prevent HIV/AIDS.  The Gates Foundation is trying to take contraceptives back out of the abortion debate and restore them as something the development community can agree on as necessary.  Specifically, Ms. Gates said that providing access to injectable contraceptives in Africa especially is vital.  She said that it is often impossible for women to negotiate condom use with their husbands because such a request is seen as implying that either the woman herself has AIDS or that she fears that her husband has AIDS.  Injectable contraceptives dodge this issue and allow women to take discreet control of family planning.

Cell phones have been important in lifting families out of poverty and in preventing and responding to violence.  Mobile banking has meant that a family is no longer tied to investing in goats, for example.  Mobile banking has also countered the bias many women face in entering a bank and has reduced that the threat of being robbed on the way to the bank.

Gates said that investment in health care networks and vaccination programs pay off in a myriad of ways, some of which are unexpected.  For example, when Ebola broke out in Nigeria last year, the network that had been created for polio surveillance and vaccination was able to spring into action against Ebola.  The virus was contained in Nigeria.

The Gates Foundation will continue to work at the forefront of the interwoven issues of health care, poverty reduction, and female empowerment throughout the developing world.

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