Melinda French Gates on Saving Lives

The co-chair of the world’s largest philanthropy talks about what can be done to improve global health and poverty

Melinda Gates, with caregivers in Rampur Bhuligadha, India, says infant deaths can be halved by 2025. (Barbara Kinney / Bill & Melinda Gates Foundation)
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“We decided we would use our money to help give everyone, no matter where they live, the opportunity to live a healthy and productive life,” Melinda French Gates tells Smithsonian.

One of the few people in the world who can say such a thing and mean it literally, Gates is a co-chair of and, by most accounts, the conscience of the Bill & Melinda Gates Foundation, the world’s largest philanthropy.

It was in 1994 that Melinda French, then a Microsoft executive, married the company’s founder and chairman, Bill Gates. The couple launched the foundation that same year with a donation of stock worth $94 million, and has since made contributions valued at $28 billion.

The foundation has given some $22.7 billion to development, education and health projects in the United States and more than 100 nations. Executive editor Terence Monmaney’s e-mail exchange with Melinda Gates focused on the charity’s health efforts.

Your foundation has donated $1.5 billion to the GAVI Alliance, a partnership to deliver vaccines to children in developing nations. The program may have averted as many as five million premature deaths. What does its success mean?
It reinforces our conviction that strategic investments can make a huge difference in poor people’s lives. GAVI also teaches us that partnerships are critical to having an impact at the scale we’re aiming for. If these partnerships keep growing, we believe vaccines can significantly reduce child mortality rates in the near future. That’s why vaccines are the foundation’s number one priority. We’ve already spent $4.5 billion to help develop and deliver vaccines, and in January we announced a $10 billion commitment to extend this work over the next decade.

As you look toward 2050, what achievements in global health do you anticipate?
I believe polio and malaria will be eradicated. I hope an AIDS vaccine will be widely available. Not only will those three changes alone save about three million lives per year compared to today; they will also save billions of dollars we’re currently spending on treatment, which means we can invest more in other priority areas.

One of those areas is neonatal and maternal health. I expect that by 2050, women around the world will have the ability to give birth in a safe, healthy environment and have access to basic health care for themselves and their families. Right now, almost nine million children under the age of 5 die every year, four million of which are newborns. I am confident we’ll see a dramatic decline in both of these numbers. In fact, we believe that the total number of deaths among children younger than 5 can be cut in half by 2025, using tools that are already available.

Poverty is often viewed as intractable. What has your experience taught you about it?
History has shown that it’s possible for people to overcome even extreme poverty and hunger. Many countries that used to receive aid in the 1960s, like Brazil and Thailand, are now net donors. In fact, the number of countries receiving aid has been cut in half since the 1960s.

We also know that certain strategies have an immense impact. Investing in agriculture, for example. Advances in agriculture during the Green Revolution doubled food production, saved hundreds of millions of lives and laid the groundwork for broader development in many countries.

Recent history has also shown that access to financial services can empower people, especially women, and build up families and entire communities. At the Gates Foundation, we are particularly interested in the potential of small-scale savings accounts to improve poor people’s lives. When people have reliable access to savings, they don’t risk total destitution if there’s a death in the family or a bad crop.


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