The blog of Bill Gates
gatesnotes
The blog of Bill Gates

A bet on humanity worth every dollar

Log in
|
Sign up
 
GO
Your search for "", with selected filters, does not match any posts. Please try again with a different search term or reset filters.

Popular searches include: Books, Malaria, and Future of Food.
RELATED ARTICLES ON
Logout:


Become a Gates Notes Insider
Become a Gates Notes Insider
Join the Gates Notes community to access exclusive content, comment on stories, participate in giveaways, and more.
Already joined? Log in
spacer
LOG IN
SIGN UP
Sign up with your social account:
Sign up
Sign up
Or sign up with email:
TITLE
FIRST NAME
LAST NAME
EMAIL
This email is already registered. Enter a new email, try signing in or retrieve your password
PASSWORD
ADDRESS
Why are we collecting this information? Gates Notes may send a welcome note or other exclusive Insider mail from time to time. Additionally, some campaigns and content may only be available to users in certain areas. Gates Notes will never share and distribute your information with external parties.
ADDRESS LINE 1
Bill may send you a welcome note or other exclusive Insider mail from time to time. We will never share your information.
ADDRESS LINE 2
CITY
STATE / PROVINCE / REGION
ZIP / POSTAL CODE
COUNTRY
Sign up
Join the Gates Notes community to access exclusive content, comment on stories, subscribe to your favorite topics and more. We will never share or spam your email address. For more information see our Sign Up FAQ. By clicking "Sign Up" you agree to the Gates Notes Terms of Use / Privacy Policy.
Street address
City
postal_town
State Zip code
administrative_area_level_2
Country
Data
Personal Information
Title
First name
Last name
Save
Cancel
Email address
This email is already registered
Save
Cancel
Please verify email address. Click verification link sent to this email address or resend verification email.
Password
Save
Cancel
Address
ADDRESS LINE 1
ADDRESS LINE 2
CITY
STATE / PROVINCE / REGION
ZIP / POSTAL CODE
COUNTRY
Save
Cancel
Email & Notification Settings
Send me updates from Bill Gates
You must provide an email
Send me Gates Notes survey emails
Send me the weekly Top of Mind newsletter
Send me comment notifications via email
On-screen comment notifications
Interests
+ Saving Lives
+ Energy Innovation
+ Improving Education
+ Alzheimer's
+ Philanthropy
+ Book Reviews
+ About Bill Gates
Deactivate Account
Click the link below to begin the account deactivation process. Deactivate account If you want to permanently delete your account and remove its content, please send us a request here.
Ok
Gates Notes Insider Sign Up FAQ

Q. How do I create a Gates Notes account?

A. There are three ways you can create a Gates Notes account:

  • Sign up with Facebook. We’ll never post to your Facebook account without your permission.
  • Sign up with Twitter. We’ll never post to your Twitter account without your permission.
  • Sign up with your email. Enter your email address during sign up. We’ll email you a link for verification.

Q. Will you ever post to my Facebook or Twitter accounts without my permission?

A. No, never.

Q. How do I sign up to receive email communications from my Gates Notes account?

A. In Account Settings, click the toggle switch next to “Send me updates from Bill Gates.”

Q. How will you use the Interests I select in Account Settings?

A. We will use them to choose the Suggested Reads that appear on your profile page.

spacer
BACK
Forgot your password?
Enter the email you used to sign up and a reset password link will be sent to you.
EMAIL
This email is already registered. Enter a new email, try signing in or retrieve your password
Reset Password
Bill's Suggested Posts
I've read this book
Books to Read
Reset your password.
Set New Password
Your password has been reset. You will now be redirected to the sign in page, or you can click here
Ok
Get emails from Bill Gates
Send me updates from Bill
You must provide an email
Send me comment notifications via email
On-screen comment notifications
This email is already registered
Continue
We will never share or spam your email address. For more information see our Sign up FAQ. By clicking "Continue" you agree to the Gates Notes Terms of Use / Privacy Policy.
You're in!
You're in!
Please check your email and click the link provided to verify your account.
Didn't get an email from us? Resend verification email
spacer
Update Your Profile Information
UPLOAD A PROFILE PICTURE
your image
Uh Oh!
The image you are trying to upload is either too big or is an unacceptable format. Please upload a .jpg or .png image that is under 25MB.
Ok
Title
First name
Last name
Save
Cancel
Email address
This email is already registered
Save
Cancel
Please verify email address. Click verification link sent to this email address or resend verification email.
EMAIL AND NOTIFICATION SETTINGS
Send me updates from Bill Gates
You must provide an email
Send me comment notifications via email
On-screen comment notifications
SELECT YOUR INTERESTS
+ Saving Lives
+ Energy Innovation
+ Improving Education
+ Alzheimer's
+ Philanthropy
+ Book Reviews
+ About Bill Gates
Continue
Confirm Account Deactivation
Are you sure you want to deactivate your account?
Deactivating your account will unsubscribe you from Gates Notes emails, and will remove your profile and account information from public view on the Gates Notes. Please allow for 24 hours for the deactivation to fully process. You can sign back in at any time to reactivate your account and restore its content.
Deactivate My Acccount
Go Back
Your Gates Notes account has been deactivated.
Come back anytime.
Welcome back
In order to unsubscribe you will need to sign-in to your Gates Notes Insider account
Once signed in just go to your Account Settings page and set your subscription options as desired.
Sign In
Request account deletion
We’re sorry to see you go. Your request may take a few days to process; we want to double check things before hitting the big red button. Requesting an account deletion will permanently remove all of your profile content. If you’ve changed your mind about deleting your account, you can always hit cancel and deactivate instead.
Submit
Cancel
Thank You! Your request has been sent
Please complete your account verification. Resend verification email.
This verification token has expired.
Your email address has been verified. Update my profile.
Your account has been deactivated. Sign up to re-activate your account.
View all newsletters in the newsletter archive
You are now unsubscribed from receiving emails.
Sorry, we were unable to unsubscribe you at this time.

Thanks for visiting the Gates Notes.
We'd like your feedback.

Yes, I'll take the survey No thanks
Become a
Gates Notes Insider
Join the Gates Notes community to access exclusive content, comment on stories, participate in giveaways, and more.
SIGN UP
The blog of Bill Gates
A bet on humanity worth every dollar
Follow
Next
 
Profile & Settings
Sign Out
Profile & Settings
Sign Out
Hello,
Profile & Settings
Comment History
Sign Out
Please complete your account verification. Resend verification email.
today
This verification token has expired.
today
Your email address has been verified. Update my profile.
today
Your account has been deactivated. Sign up to re-activate your account.
today
View all newsletters in the newsletter archive
today
You are now unsubscribed from receiving emails.
today
Sorry, we were unable to unsubscribe you at this time.
today
0
0
0
Please complete your account verification. Resend verification email.
today
This verification token has expired.
today
Your email address has been verified. Update my profile.
today
Your account has been deactivated. Sign up to re-activate your account.
today
View all newsletters in the newsletter archive
today
You are now unsubscribed from receiving emails.
today
Sorry, we were unable to unsubscribe you at this time.
today
Back to profile
Comment History
You have not left any comments yet.
title
in reply to
name
description
It looks like you're using an older version of Internet Explorer which may not display all the features on this site. Upgrade Now » close
Calculated risk

A bet on humanity worth every dollar

In Part 2 of the Netflix documentary series Inside Bill’s Brain, the director notes that my analytical approach to my job isn’t particularly inspiring. He’s got a point. I describe what I do as “optimization”—a wonky way of saying I try to make sure our limited resources help as many people as possible. I’ll never be the intrepid health worker on the front lines fighting disease. But if our foundation and its partners can help that worker reach more children with better tools, we all can create better lives for generations to come. Our decision to fight polio is one of the best examples.

Gates Notes Insiders get exclusive access to three stories from the cutting room floor of Inside Bill’s Brain.
To read the stories and watch bonus videos, log in or sign up.
Become an Insider
Log in

In 2007, our foundation joined a decades-long effort to eradicate polio. We made our first big grants for what we thought would be a five-year, final push to end polio, a disease that had terrorized the human race for thousands of years. Over a decade later we are still pushing. Risky bet? Yes, but I think we were right.

The Netflix documentary talks a lot about my willingness to dive into projects, like polio eradication, where there’s no guarantee of success. In the second episode, my friend Bernie describes me as a risk taker, making his point with a story that involves a surfboard, a volcano, and a dislocated shoulder.

Watching the series got me thinking about what the word “risk” really means. In the polio fight, the risk takers are the thousands of health workers and volunteers braving war zones and getting to some of the hardest-to-reach places on earth to deliver vaccines to kids. They are the heroes of polio eradication.

The risks I take are more like what Warren Buffett does when he makes an investment on the bet that it will be worth ten times as much down the road. Warren spends a lot of time looking for a company that has great long-term prospects. Then he makes a big investment and holds it for many years. He’s famous for staying the course through market gyrations and economic cycles.

Our foundation isn’t after financial gain, but we’re aiming for similar ten-fold returns in social impact—in people living better-educated, more productive, longer and healthier lives. Like Warren, Melinda and I pick our areas of focus carefully. Whether we invest $100,000 or $100 million, the decision is always calculated. I spend a lot of time thinking, analyzing data, and talking to experts to judge whether we can really help make a difference. It’s the part of my job I love the most. I’m never happier than when I’m diving deep into the details of a problem, to understand how any proposed solution would work—or fail.

I also feel pressure to make every dollar and every day count. Warren gifted our foundation his wealth to make the world better, and Melinda and I feel a lot of responsibility to use that gift wisely. I say no to a lot more opportunities than I say yes to.

Ultimately, no matter how much analysis we do, I have to be comfortable with a lot of uncertainty. We are tackling problems where progress is measured not just in years but often decades—where your end goal doesn’t change, but your path to get there might have to. The trick is to do whatever I can to keep learning and to be open to new and novel ways to bring us a step closer to our goals. That approach has guided every big bet I’ve made in my career from Microsoft to today—including polio.

In the spirit of the title of the documentary, here’s a look at what I was thinking when we took that bet and set our foundation on one of the riskiest ventures it’s ever attempted.

I had a model in my mind: smallpox, the only human disease ever successfully wiped out. Smallpox was one of humanity’s big killers—at least 300 million people died of it in the 20th century alone. But by 1980, the disease was gone, thanks to a concerted push by global health organizations and thousands of dedicated health workers. That’s one of the greatest achievements of our age.

Early on, Melinda and I were lucky to work with Bill Foege, a key architect of that feat. He made it clear to me why eradicating a disease is a gift to all future generations. People are freed forever from a deadly threat, while the resources that were devoted to fighting that disease are freed up for solving other problems. Plus, victory is energizing: the defeat of smallpox helped inspire a global push to raise vaccination rates and lower childhood mortality. Such benefits, Bill Foege said, can make eradication “the ultimate return on investment.”

Galvanized by the smallpox success, health ministers from United Nations member states came together in 1988 and targeted polio as the next disease to go. They formed the Global Polio Eradication Initiative (GPEI)—a partnership that includes WHO, Rotary International, UNICEF and CDC.

Polio can wither limbs, paralyze lungs, and even kill. There is no cure. And yet we’ve long had the means to prevent the disease: with a cheap, safe, easy-to-administer vaccine. When the GPEI started running vaccination campaigns in 1988, polio was paralyzing 350,000 people a year. By 2007, there were only about 1,300 cases—but progress had stalled, raising the risk that the virus would surge back, and decades of gains would be lost. At the time, I was soaking up everything I could on eradication, its history, science, and epidemiology. I had only seen one polio vaccination campaign (in India) so I planned more trips.

Bill Foege and others at the foundation put together a team and we walked through the possible advances that could help us break through. Polio travels with stealth; nine out of ten people who are infected develop mild symptoms, if any, but can still spread the virus to others. So to stop it, you have to reach nearly every child with multiple doses of the vaccine over time.

That takes money and organization; it requires political cooperation and parents who trust the process and are willing to have their children be immunized. It takes an army of volunteers and trained health workers who can be counted on to knock on doors throughout a village in search of every last child and keep accurate records of who they immunized and who they missed. Stopping polio requires scientists and trained people on the ground watching out for reports of children whose limbs become abruptly paralyzed. None of the countries where polio remained in 2007 had all the pieces needed to complete that puzzle. That was the challenge, but also where we saw opportunities.

We bet that with innovations including better disease surveillance and improved mapping, we could get a clearer picture of where the virus was hiding, and that computer models could better predict where it might go. We saw ways to increase the number of vaccination campaigns and improve their quality. Deploying precise genetic tests to sample sewage could help us track the travels of different strains of the virus in the environment before it paralyzed children.

We spent about six months studying the problem and then dove in. Back then I was sure we’d be done with polio by now.

Ten years have taught us a lot. For all the great technologies and fresh ideas about how to stop polio, the real test is how they play out on the ground—in the villages and clinics of the last few countries where the disease has dug in. Unfortunately, in some places, these last steps to eradication have been slowed by risks that I underestimated, including war and political unrest. But in far more places, we’re beating the disease, as people, from parents to presidents, commit to the hard work of ending polio.

As of 2011, polio was completely gone from India, a country that experts thought would be the last place to wipe out the virus because of its size, complexity and the fact that tens of millions of its citizens live in extreme poverty. The children most at risk were in underserved, inaccessible regions, where they were often missed because of their families’ frequent moves in search of work. But leaders at all levels of government made it a priority to find those children—setting up vaccine booths in train stations, sending out vaccinators on motorbikes, boats and donkeys—and halt the disease.

In Nigeria, both traditional religious leaders and local, state and federal officials have been instrumental in building community trust in the polio program, ensuring parents allow their children to be immunized, and strengthening the quality of the vaccination campaign. It’s commitment like this that has enabled Nigeria to reach three years without a single case of wild poliovirus, which means Africa could be certified wild polio-free in 2020. This is unprecedented progress.

Global cases of wild polio this year have ticked up from the 33 cases last year, and no doubt we’ll face new challenges as we focus on Afghanistan and Pakistan, the two remaining countries where the virus has yet to be stopped. The job is to keep moving forward, adjusting to the unexpected with new ideas and energy so we can reach the last unprotected child and achieve a polio-free world. That’s a bet worth every dollar.

 

 

Also on Gates Notes