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The New World

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I left Harvard with no real awareness of the awful inequities in the world — the appalling disparities of health, and wealth, and opportunity that condemn millions of people to lives of despair.

I learned a lot at Harvard. I got great exposure to the advances being made in the sciences.

But humanity's greatest advances are not in discoveries — but in how those discoveries are applied to reduce inequity. Whether through democracy, strong public education, quality health care, or broad economic opportunity — reducing inequity is the highest human achievement.

I left campus knowing little about the millions of young people cheated out of educational opportunities here in this country. And I knew nothing about the millions of people living in unspeakable poverty and disease in developing countries.

It took me decades to find out.

Imagine, just for the sake of discussion, that you had a few hours a week and a few dollars a month to donate to a cause, and you wanted to spend that time and money where it would have the greatest impact in saving and improving lives. Where would you spend it?

For Melinda and for me, the challenge is the same: How can we do the most good for the greatest number with the resources we have. During our discussions on this question, we read an article about the millions of children who were dying every year in poor countries from diseases that we had long ago made harmless in this country. Measles, malaria, pneumonia, hepatitis B, yellow fever. One disease I had never even heard of, rotavirus, was killing half a million kids 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 wouldbegin 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 died because their mothers and their 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 make a living, serving people who are suffering from the worst inequities.

We also can press governments around the world to spend taxpayer 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. This task is open-ended. It can never be finished. But a conscious effort to answer this challenge will change the world.

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.

It's hard 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. But complexity makes it hard to mark a path of action for everyone who cares — and that makes it hard for their caring to matter.

Cutting through complexity to find a solution runs through four predictable stages: determine a goal, find the highest-leverage approach, discover the ideal technology for that approach, and meanwhile, make the smartest application of the technology that you already have — whether it's something sophisticated, like a drug, or something simpler, 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 lifetime immunity with a single dose. So governments, drug companies, and foundations fund vaccine research. But their work is likely to take more than a decade, so in the meantime, we have to work with what we have — and the best prevention approach we have now is getting people to avoid risky behavior.

Pursuing that goal starts the four-step cycle again. This is the pattern. The crucial thing is to never stop thinking and working — and never do what we did with malaria and tuberculosis in the 20th century, which is to surrender to complexity and quit.

The final step is to measure the impact of your work and share your successes and failures so that others learn from your efforts.

If you want to inspire people to participate, you have to show more than numbers; you have to convey the human impact of the work — so people can feel what saving a life means to the families affected.

The defining and ongoing innovations of this age — biotechnology, the computer, the Internet — give us a chance we've never had before to end extreme poverty and end death from preventable disease.

The magical thing about this network is not just that it collapses distance and makes everyone your neighbor. It also dramatically increases the number of brilliant minds we can have working together on the same problem.

But for every person in the world who has access to this technology, five people don't. That means many creative minds are left out of this discussion. We need as many people as possible to have access to this technology, because these advances are making it possible not just for national governments, but for universities, corporations, smaller organizations, and even individuals to see problems, see approaches, and measure the impact of their efforts. I want to exhort each of the graduates here to take on an issue — a complex problem, a deep inequity — and become a specialist on it. Don't let complexity stop you.

Be activists. Take on the big inequities. You have more than we had; you must start sooner, and carry on longer.

Knowing what you know, how could you not?

Good luck. S

Excerpts from Bill Gates' speech are printed with permission of the Bill & Melinda Gates Foundation. The full speech can be found at www.gatesfoundation.org.

Opinions expressed on the Back Page are those of the writer and not necessarily those of Style Weekly.

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