The Conversation BILL GATES

The Microsoft co-founder and co-chair of the Bill & Melinda Gates Foundation is spending much of his prodigious fortune 1 trying to change the world—by tackling the diseases that hurt the poorest of the poor. But this year, a generation’s worth of progress is being threatened by a once-in-a-century pandemic. Can an all-in bet on science and innovation set us back on course?

-  CLIFTON LEAF

PANDEMIC VS. PROGRESS

Since 2017, the Bill & Melinda Gates Foundation has issued an annual scorecard, called the Goalkeepers Report, on how we’re doing in the fight against global poverty and disease. In the latest assessment, you began with words I’m guessing you’ve never uttered before: “This progress has now stopped.”

GATES: Yes, the United Nations developed these goals for humanity, which are about basic needs: getting rid of extreme poverty, providing access to education and healthcare. And so that creates a framework for us to do a report card every year and try to highlight the countries that are doing things well—we call them exemplars—so that we can get others to adopt best practices. The visibility of gradual progress is very low: Since 2000, we’ve cut childhood death rates in half, for example, but the progress is mostly invisible to people. This year’s report, however, is quite a contrast. Due to the direct effects of the pandemic, in terms of the deaths it has caused, but also due to its gigantic indirect effects on fragile health systems in the developing countries, we’ve regressed. So routine immunisation rates, which we’ve worked to raise to 84% over the last 25 years, are down 14 percentage points in the past year. The pandemic has pushed almost 37 million more people into extreme poverty—until 2020, that number had been going down every year for two decades. 2 So the call here is to say, “Hey, we’ve got to bring this pandemic to an end.” And then we have to work to catch up and get back to where we were at the start of 2020 on things like vaccination and education, so that we can resume that positive trajectory.