During our discussions on this question, Melinda and I read an article about the millions of children who are dying every year in poor countries from diseases that we have long ago made harmless in this country.
Measles, malaria, pneumonia, hepatitis-B, yellow fever.
One disease that I had never heard of, rotavirus, was killing half a million children each year. None of them in the United States.
We were shocked.
We had assumed that if millions of children were dying and they could be saved, the world would make it a priority to discover and deliver the medicines to save them. But it did not.
For under a dollar there were interventions that could save lives that just weren’t being delivered.
If you believe that every life has equal value, it’s revolting to learn that some lives are seen as worth saving and others are not.
We said to ourselves this can’t be true, but if it is true it deserves to be the priority of our giving.
So we began our work in the same way anyone here would begin it. We asked: how could the world let these children die?
The answer is simple and harsh. The market did not reward saving the lives of these children and governments did not subsidize it. So the children die because their mothers and fathers had no power in the market and no voice in the system.
But you and I have both. We can make market forces work better for the poor if we can develop a more creative capitalism.
If we can stretch the reach of market forces so that more people can make a profit or at least earn a living, serving people who are suffering from the great inequities.
We can also press governments around the world to spend tax-payer money in ways that better reflect the values of the people who pay the taxes.
If we can find approaches that meet the needs of the poor in ways that generate profits for business and votes for politicians, we will have found a sustainable way to reduce inequity in the world.
Now this task is open ended. It can never be finished, but a conscious effort to answer this challenge can change the world. I’m optimistic that we can do this.
But I talk to skeptics who claim there is no hope. They say inequity has been with us since the beginning and will be with us until the end, because people just don’t care.
I completely disagree.
I believe we have more caring than we know what to do with. All of us here in this yard, at one time or another, have seen human tragedies that broke our heart.
And yet we did nothing. Not because we don’t care, but because we didn’t know what to do. If we had known how to help, we would have acted.
The barrier to change is not too little caring. It is too much complexity.
To turn caring into action, we need to see a problem, see a solution and see the impact. But complexity blocks all three steps.
Even with the advent of the internet and 24-hour news, it is still a complex enterprise to get people to truly see the problems.
When an airplane crashes, officials immediately call a press conference. They promise to investigate, determine the cause and prevent similar crashes in the futures.
But if the officials were brutally honest, they would say, “Of all the people in the world who died today from preventable causes, 1 half of 1 percent were on this plane.”
We’re determined to do everything possible to solve the problem that took the lives of the 1 half of 1 percent.
The problem is not just the plane crash but the millions of preventable deaths.
We don’t read much about these deaths, the media covers what’s new and millions of people dying is nothing new. So it stays in the background where it’s easy to ignore.
But even when we do see it or read about it, it’s difficult to keep our eyes on the problem. It’s difficult to look at suffering if the situation is so complex that we don’t know how to help and so we look away.
If we can really see a problem, which is the first step, we come to the second step. Cutting through the complexity to find a solution.
Finding solutions is essential if we want to make the most of our caring. If we have clear and proven answers any time an organization or an individual asks, “How can I help?”, then we can get action.
And we can make sure that none of the caring in the world is wasted.
The complexity makes it hard to mark a path of action for everyone who cares and makes it hard for that caring to matter. Cutting through complexity to find solutions runs through four predictable stages: Determine a goal. Find the highest impact approach. Deliver the technology ideal for that approach and in the meantime use the best application of technology you already have.
Whether it’s something sophisticated like a new drug or something simple like a bed net. The AIDS epidemic offers an example, the broad goal of course is to end the disease.
The highest leverage approach is prevention, the ideal technology would be a vaccine that gives life-long immunity with a single dose.
So governments, drug companies and foundations are funding vaccine research. But their work is likely to take more than a decade.