Questions submitted to #askbillg:
QUESTION: As 2015 fast approaches, how well do you think the Millennium Development Goals have been fulfilled thus far?
BILL GATES: The Millennium Development Goals have been absolutely fantastic because they established a report card that clarifies how well we’re doing at taking care of those most in need. The goals have been wonderful in getting people to focus their aid and find best practices. They've focused political attention in the developing countries themselves, encouraged U.N. groups to work together, and encouraged donors to coordinate.
The goals set for 2015 were very ambitious, and in many countries they won't be achieved. In some countries, like Ghana and Vietnam, they all will be achieved. Some goals, like reducing maternal mortality by three-quarters, simply weren't achievable, but the progress has been really good. By 2015, on the original goals overall, I think the whole world would get a B grade.
Then we’ll set some new goals. They’ve been so successful that a lot of people want to expand them. I’m a big believer that they should continue to include clear goals to meet the needs of the poorest. Not that there shouldn’t be other goals, but those focused on the world’s poorest have a special place. Our foundation is involved in the discussions about setting targets for 2030.
QUESTION: Since unclean water is the root of most diseases in developing countries, will you ever take personal interest in water projects?
BILL GATES: Unclean water is the source of some disease, but not most. It's not related to malaria, AIDS or respiratory disease. It is the source of a lot of diarrheal disease, a lot of parasitic diseases that are really quite terrible. So, having clean water is super-important, and it is a major focus for our foundation.
Generally, what makes water dangerous is human waste getting into it. Some places have issues with arsenic contamination or with women having to walk long distances for water, but mostly it’s a sanitation issue. And sanitation is really under-funded. We need to have better toilets. We need to have ways of cleaning water.
We have some very ambitious goals to reinvent the toilet. Meanwhile, we’re funding quite a few water-related projects. In the past, chlorine packets have been given to people to pour into their water at home, but the usage has always been disappointing. We made a grant to the University of California - Santa Barbara to help develop a mechanism to automatically add chlorine to water at the pump. The chlorine stays active for over 24 hours.
QUESTION: Why did you decide to address health after IT? Are there similarities or differences? Can IT be leveraged more for health?
BILL GATES: Well, health is so basic: Not having your child die, not having your children suffer from so much disease that their brain never develops and they can't achieve their potential. Clearly, health comes before access to computers. I wanted to do whatever could do the most to reduce the worst inequities in the world.
Health and IT are similar in that they both involve science, innovation and breakthroughs that can benefit many people. Both involve R&D that’s risky, global and making lots of progress. There are amazing people who work on both.
In a sense, IT is a key to progress on health. Computing power and software enable our health researchers to analyze genomics data and collaborate over the Internet, for example. IT is very, very important.
We’ve been involved in piloting efforts to help people use IT to improve their own health – to remind them to take their TB medicine, for example, or remind mothers about best practices in caring for newborns. The broad term for this is "mHealth." It's still pretty small and at an early stage. But we have a lot of hope for it.
QUESTION: Do you ever see the Gates Foundation work complete? Do you have an exit plan? An end goal?
BILL GATES: We do hope to complete our work. Over the next 15 or 20 years, we hope to see malaria eradicated, an AIDS vaccine delivered, and a lot of our other health goals achieved. We’re working to help make vaccines very cheap over time, so that health improvements can be self-sustaining. So that’s an exit plan.
There will still probably be quite a lot to do to improve the health of the poorest, so I expect that health will be our foundation’s top focus for the rest of my life. Twenty years after Melinda and I aren’t around to help guide it, the foundation will spend all its money and go out of business. So that’s our ultimate exit plan.
QUESTION: (From @NickKristof) How do key national stakeholders address education disparity and promote innovative #edu solutions?
BILL GATES: At its most basic, education is about having teachers who show up, who are well-trained and prepared, and who teach well. Probably the biggest challenge in many countries, rich and poor, is running an effective teacher personnel system. Even relatively wealthy countries, like South Africa, do a poor job on this. Mexico does quite a poor job. Vietnam does well, and China does a great job. The disparities are quite phenomenal.
Someday, technology and Internet access may help make education less completely dependent on the local teacher personnel system. But not even the United States is there yet, so that day is very far off in most other countries. Meanwhile, it’s tough for external actors to have a huge impact on teacher training, hiring, pay, evaluation and so on. The OECD has done really amazing work in identifying best practices that develop and support good teaching. It’s just incredibly important.