Our Challenge is Not Money, But How Best to Spend it, Say Bill and Melinda Gates in 2020 Annual Letter

GatesNotes/

When we started our foundation 20 years ago, the world was, in many ways, very different from the one we live in now. It was before 9/11, before the Great Recession, and before the rise of social media.

Then, as now, there was no shortage of worthy causes, and there was a good argument to be made for investing in many of them. We’d known for a while that we wanted to give away the majority of our wealth from Microsoft and use it to make people’s lives better. The challenge, of course, was how to do that in a meaningful and high-impact way.

As we were thinking about what our philanthropic priorities would be, we spent a lot of time meeting with experts and poring over reports. What we learned convinced us that the world should be doing more to address the needs of its poorest people. At the core of our foundation’s work is the idea that every person deserves the chance to live a healthy and productive life. Twenty years later, despite how much things have changed, that is still our most important driving principle.“At the core of our foundation’s work is the idea that every person deserves the chance to live a healthy and productive life.”

There is no question that this new decade is beginning at a time of tremendous unrest and uncertainty around the world. But even in a moment as challenging as this one—in fact, especially in a moment like this one—we remain committed to supporting advocates, researchers, government officials, and frontline workers who are making a healthy and productive life possible for more people in more places.

For the last 20 years, our foundation has focused on improving health around the world and strengthening the public education system in the United States because we believe that health and education are key to a healthier, better, and more equal world. Disease is both a symptom and a cause of inequality, while public education is a driver of equality.

We know that philanthropy can never—and should never—take the place of governments or the private sector. We do believe it has a unique role to play in driving progress, though.

At its best, philanthropy takes risks that governments can’t and corporations won’t. Governments need to focus most of their resources on scaling proven solutions.

Businesses have fiduciary responsibilities to their shareholders. But foundations like ours have the freedom to test out ideas that might not otherwise get tried, some of which may lead to breakthroughs.

As always, Warren Buffett—a dear friend and longtime source of great advice—put it a little more colorfully. When he donated the bulk of his fortune to our foundation and joined us as a partner in its work, he urged us to “swing for the fences.”

That’s a phrase many Americans will recognize from baseball. When you swing for the fences, you’re putting every ounce of strength into hitting the ball as far as possible. You know that your bat might miss the ball entirely—but that if you succeed in making contact, the rewards can be huge.

That’s how we think about our philanthropy, too. The goal isn’t just incremental progress. It’s to put the full force of our efforts and resources behind the big bets that, if successful, will save and improve lives.

To be clear, the risks we take are different from the ones the true heroes of global progress take all the time: the health workers who brave war zones to get vaccines to children who need them, the teachers who sign up to work in the most challenging schools, the women in the world’s poorest places who stand up against cultural norms and traditions designed to keep them down. What they do requires personal sacrifices we never have to make—and we try to honor them by supporting innovations that might one day make their lives easier.

Altogether, our foundation has spent $53.8 billion over the last 20 years. On the whole, we’re thrilled with what it’s accomplished. But has every dollar we’ve spent had the effect we’ve hoped for? No. We’ve had our share of disappointments, setbacks, and surprises. We think it’s important to be transparent about our failures as well as our successes—and it’s important to share what we’ve learned.

In this year’s letter, we write about the work we’ve done on health and education and why we think the risks we’ve taken have set us up for future progress. We also write about two issues that have emerged as priorities for us—the climate crisis and gender equality—and how they will factor into our next 20 years.

Some of the very first investments we made as philanthropists were aimed at correcting inequities in global health. So, we’ll begin this letter there, too.Global healthMelinda: When we first started working in global health, we were shocked to learn how many children in low-income countries were still dying from diseases that could have been prevented with vaccines that were widely available in countries like the U.S. It drove home for us that the challenges of poverty and disease are always connected.

Since this wasn’t something that markets and governments were solving on their own, we saw an opportunity for philanthropic dollars to help. We worked with the World Health Organization, the World Bank, and UNICEF to create Gavi, the Vaccine Alliance. Gavi brings together governments and other organizations to raise funds to buy vaccines and support low-income countries as they deliver them to children.Bill: After World War II, the world came together to create a series of international organizations aimed at increasing economic and military cooperation among nations, including the UN, WHO, and NATO. Gavi was a chance to drive similar cooperation around getting vaccines to kids.

We weren’t entirely sure what to expect. Thanks to Microsoft, I was familiar with the risks of starting a new organization. The risks we were taking with Gavi were different, though. Instead of trying to introduce a new product and appeal to customers, we were trying to prove to the world that an international partnership for vaccines was not only possible but necessary. If we failed, we could discourage governments and other funders from investing in future efforts.

There were so many questions. Could we really raise enough money to convince manufacturers to supply vaccines that developing countries could afford? And even if we did, could we get countries to take on the difficult task of getting new and underused vaccines out there to children?

The answers to both questions turned out to be a resounding yes. By 2019, Gavi had helped vaccinate more than 760 million children and prevent 13 million deaths. It has also succeeded in bringing more vaccines and supplies into the market while lowering prices. For example, a single dose of the pentavalent vaccine, which protects against five deadly infections, used to cost $3.65. It now costs less than a dollar.

0