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“Melinda opens up about her personal journey from private citizen to public advocate.”
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A Solid Investment
Why our foundation invests in India
There is no better place to have an impact than India. That is why I believe India is a solid investment for anyone who cares about development.
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There is a lot of debate in the UK right now about whether the country should continue giving aid to India, a country that’s no longer among the poorest in the world.

It’s not my place to decide how the UK spends its money, but the Bill & Melinda Gates Foundation has invested more than $1 billion in programs to fight disease and poverty in India, I am pleased with the results of those investments, and we are going to continue to invest more in the future.

There are two reasons for our commitment to India. First, our mission as an organization is to help all people live a healthy, productive life—and a huge number of people who are sick and impoverished live on the subcontinent. There are 400 million Indians living in extreme poverty, more than in all 48 countries of sub-Saharan Africa combined.

Half of the malnourished and underweight children in the world live in India. These children are in no way less deserving of the opportunity for a good life, even if their country’s GDP is growing.

A lot of India’s disease and poverty is concentrated in the poor states in the northern part of the country, including Bihar and Uttar Pradesh, where our foundation—and the UK government—focus a lot of our work. If Uttar Pradesh were a country in its own right, it would be the fifth largest in the world. Bihar would be twelfth largest. And both would be among the poorest. We invest in India because that’s where the need is, and we know we will have an enormous impact by working there.

Another reason we invest in India is that we’ve found the government can be a very effective partner, especially by scaling up the very best ideas and sustaining them over the long term. India started paying for its own polio eradication program and did a great job running it, which is why the country recently marked an entire year without a single case of polio.

Here’s another example: One of the first programs we worked on in India was called Avahan, an HIV prevention program that’s now reaching millions of the people most at-risk for contracting and spreading the virus. With many international partners, we helped launch the project, refining it and measuring its impact along the way. After the first 10 years, the government of India has decided to take it over.

This is a great example of what collaboration between funders and governments can achieve. Avahan is saving lives, and it would not exist if we hadn’t provided funding and technical assistance to test out a promising new idea. However, the Indian government is scaling and sustaining the effort over the long term. This pattern has been repeated across the country over the past several decades, and aid has steadily become a smaller and smaller portion of the national economy.

I go to India at least once a year to see the progress of the work our foundation is doing there and I’m always struck by two things—the dynamism of the place, and the tremendous need. Unfortunately, the former doesn’t cancel the latter out. The UK has a long history of extraordinary generosity and an established track record of making an impact on the lives of the poorest people in the world. There is no better place to have an impact than India. That is why I believe India is a solid investment for anyone who cares about development.

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