We did not expect this: an annual open letter from Bill and Melinda Gates

Original author: Bill and Melinda Gates
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How would you describe 2018? Did he turn out the way you were waiting for him?

We would answer this question rather negatively. Starting from particularly destructive natural disasters and ending with a record number of women going to the polls, 2018 turned out to be full of surprises. Looking back, we are not evaluating the world as we saw it in forecasts a couple of years ago.

The advantage of surprises is that they can often serve as a call to action. People may be concerned about the fact that reality did not coincide with their expectations. Some surprises help people understand that the existing order of things needs to be changed. Some surprises emphasize the fact that the transformation has already begun.

Twenty-five years ago, we read an article that said that hundreds of thousands of children in poor countries die from diarrhea. This surprise helped shape our view of real values. We believe in a world where innovation is accessible to everyone, where children do not die from diseases that can be cured. But we saw a world still dependent on inequality.

This discovery was one of the most important steps on our path to charity. We were surprised, then we were furious, then we started to act.

There were pleasant surprises. When we first began to learn something about malaria, we thought that the world would not get real benefits until someone invents a long-acting vaccine. However, due to bed nets and other measures, malaria mortality has fallen by 42% since 2000.

In this annual message, we describe nine more things that surprised us on our journey. Some of them bother us. Others are inspiring. And they all prompt us to act. We hope that they will encourage you to act, as only in this way can the world be made better.

1. Africa is the youngest continent


The median age of its inhabitants is the smallest in the world.


Bill : the world continues to grow old, and the age of Africa remains almost the same. This can be confusing, but everything becomes clear if you look at the details.

In general, the median age in the world is growing. In all corners of the world people live more and more. More children survive to adulthood, and women give birth to fewer children than ever before. As a result, the global population is gradually creeping toward middle age.

Except Africa. The median age of the inhabitants is 18 years. In North America it is 35 years old [ in Russia - 40 / approx. transl.]. And in the coming decades, an increase in the number of young Africans is expected.



There are many reasons for this. One of them is that the annual number of newborns is increasing in the poorest parts of Black Africa , although it is falling in other parts of the continent. This can be an asset or a source of instability. Melinda and I believe that the right investment can unlock incredible potential. Young Africans will shape the future not only of their individual communities, but of the whole world.

Melinda : economists, describing the conditions for the prosperity of countries, emphasize such a factor as “human capital” - this is another name for the fact that the future depends on the availability of good medicine and education for young people. Health and education are two parts of the same engine of economic growth.

If Black Africa invests in youth, the region will be able to double its share of the global workforce by 2050, and provide a better life for hundreds of millions of people.

Among the main forces affecting the planet is the education of girls. Educated girls have better health. They are richer. If all the girls in the world received 12 years of quality education, women's earnings in their entire lives would increase by $ 30 trillion, an amount exceeding the size of the US economy. Their families benefit from this. The more education a woman has, the better she is fit for raising healthy children. UNESCO estimates that if all women in the lower and middle economies had finished high school, child mortality would be halved.



The boom of healthy, educated, and developmental African youth that promotes girls, instead of leaving them behind, would be the best indicator I can imagine.

2. DNA tests based on samples taken at home can help in the search for serial killers, as well as prevent premature birth


Scientists have found a potential link between preterm birth and certain genes


Bill : When the police used the results of genetic tests to capture the " Golden State Killer " last year, the news hit the headlines around the world. However, this is not the only discovery made through home-made DNA tests. After examining 40,000 samples sent by volunteers to the 23andMe website, scientists discovered a potential link between preterm delivery and six specific genes - including those that regulate the use of selenium by the body.

Some people have a gene that prevents them from properly processing selenium. A study from 23andMe (funded by our foundation) found that pregnant women with this gene are more likely to give birth prematurely. This suggests that selenium plays a role in determining the onset of labor.

Understanding what leads to premature birth is extremely important. Each year, 15 million babies are born this way. Such births occur among mothers around the world - although in some groups their frequency is higher (Melinda will tell about this), and babies born too early in poor countries are more likely to die.

Only this year, a study will be completed on how exactly this mineral affects the risk of preterm birth. But if this connection is solid, selenium may one day become an inexpensive and simple solution to the problem of prolonging pregnancy.

This connection is one of several breakthroughs we have made in recent years. Improving tools and sharing data allows us to finally figure out why babies are born prematurely and what we can do to prevent this. I especially like the simple blood test for the likelihood of premature birth, developed by a team from Stanford. It can show when the baby is born, and the woman will have the opportunity to carry out all activities together with the doctor to minimize the risk.

Melinda: Despite the promising discoveries described by Bill, I am still amazed at how little we know about premature birth. I can’t imagine anything else that would affect 10% of people in all parts of the world, and at the same time get such little attention.

For the majority of preterm births, the cause cannot be determined, and we do not know why certain groups of women are at high risk. For example, it remains a mystery why tall women have a longer pregnancy. In the United States, there is a mystery why black women born there are more likely to experience premature births than women emigrating from African countries. There is a sociocultural theory that racism and discrimination against black women in America puts them at such a level of stress that it worsens their health. Another theory suggests that women growing up in the United States have a different set of microorganisms. But so far we don’t know anything for sure.

What we know is the complex nature of preterm birth. Of great importance is how early the baby is born: 36 weeks is much better than 34 weeks. Our goal is not to prevent preterm birth completely, which is probably not possible. We must work on prolonging pregnancy, bringing the deadlines closer to normal. And finally, we are starting to fill in the gaps in knowledge about how this can be done.

3. We will build whole New York every month


For 40 years! The number of building materials in the world will double by 2060


Bill : I would like more people to understand what they have to do to prevent climate change. You probably read about some progress on the issue of electricity due to the cheapening of renewable energy. But electricity accounts for only a quarter of the greenhouse gases emitted around the world.

Production is not far behind, it accounts for 21%. Most people imagine production as gadgets crawling along the assembly line, but this also includes materials used in construction. The production of cement and steel takes a lot of energy from fossil fuels, and carbon is emitted as by-products into the atmosphere.

In the coming decades, urban population growth will increase, and by 2060 the number of building materials in the world will double - it is approximately as if we were building a new New York every month. This is a huge amount of cement and steel. We need to figure out how to crank it all up without worsening climate change.

Production is not the only source of greenhouse gases. Agriculture is responsible for 24%. This includes cattle blowing gases from both ends. (For me this came as a surprise - I did not think that I would ever write about cow flatulence).

In general, if we want to solve the problem of climate change, we need to reduce to zero all greenhouse gas emissions from all agents - agriculture, electricity, production, transport and construction. I consider these five areas to be the biggest challenges in climate change.



You should not think that people will simply stop using fertilizers, transport goods on container ships, build offices or fly on airplanes. It will also be dishonest to demand that developing countries restrain their growth for the sake of everyone else. For example, for many people in low- and middle-income countries, cattle is a necessary source of income and nutrients.

Part of the solution is to invest in innovation in all five sectors so that we can engage in it without destroying the climate. Each of them requires breakthrough inventions.

I can report on some progress. The European Commission recently decided to invest in research and development in these five areas. The $ 1 billion Breakthrough Energy Ventures (BEV) fund, to which I am involved, uses five of these tasks to manage our investments in clean energy companies. BEV works separately from the actions that our foundation organizes, helping farmers adapt to climate change.

However, we need to be much better at telling people about emerging issues. It would be good if their media coverage corresponded to their depth. Solar panels are great, but they should also talk about trucks, cement, and how cows fart.

4. Data may be sexist


Do girls do more housework than boys? How much


Bill : I spend a lot of time researching data related to health and development. It is amazing how little data we have on women and girls. I think that the main reason is that we create an artificial separation when some problems are “female” and some are not, and women's problems are not studied so deeply. This blocks progress for everyone. You can’t improve anything if you don’t know what is happening with half the population. And this is no excuse when technology makes it so much easier for us to collect all the data.

Melinda : How much money did women in developing countries make last year? How much property do they own? How much more time do girls spend on household chores than boys?

I dont know. And no one knows. This data is simply not there.

Bill and I could easily fill out the entire annual letter with discourse on the role of data in driving progress for the world's poorest people. Data helps you make the right decisions and policies. They help us set goals and measure progress. They help to uphold and hold accountable.



Therefore, such a great harm is caused by the lack of data on the lives of women and girls. This makes it difficult to help improve their lives.

The problem is not only that some women are not at all in the statistics. In addition, the data that we still have - and on which policy makers are based - is very bad. They can even be called sexist. We love to consider the data objective, but the answers we receive often depend on the questions asked. When questions are biased, the data is the same.

For example, the scarce data on women in developing countries that we have are mainly related to their reproductive health - this is where researchers focus their attention in places where the main roles of women are mother and wife. But we do not have data on how much these women earn or what they own, since in many countries income and assets are counted by household. Since the husband is considered the head of the family, the entire contribution of a married woman is attributed to him.

When you have nothing else besides such incorrect data, it is quite easy to underestimate the economic activity of women - and measure whether their economic condition is improving.

Three years ago, our foundation made a major contribution to filling some of these empty spaces in the data. We are part of a network of organizations accelerating the gender revolution in data - providing people with data-gathering tools with new tools, and training them to break down existing data sets by gender, in order to look for new ideas there.

Such work in collecting and analyzing data may seem boring. However, using them to empower millions of women and girls is not at all boring.

When I was in Kenya a few years ago, data collector Christina allowed me to go with her when she went around at home, studying the lives of women in the poorest parts of Nairobi. She told me that most of the women she meets at work have never been asked questions about how they live. Kristina says that when she knocks on the woman’s door and explains that she has come to learn more about her, this makes them understand that they matter, that someone cares about them.

I think her thought is very important. What we decide to measure depends on what is considered valuable in society. Therefore, the world cannot accept the answer “I do not know” to questions about the lives of women and girls.

5. You can learn a lot about managing your anger by studying teenage boys.


Melinda : The year before last, Bill and I spent one day in a state prison in Georgia. We tried to learn more about the link between poverty and mass imprisonment. As we wrote in last year’s letter, our foundation expands its work beyond education, so we study poverty in the United States from many points of view.

Most of all, we remember the conversation with a small group of prisoners. If we had any idea of ​​what a person who committed a violent crime should be, then they did not fit him. During our meeting, they were funny, friendly and thinking.

We talked about their plans for life after the release and about the circumstances that led to their arrest. Although we did not analyze their misconduct in detail (some of them were serious violent crimes), most of them said that they considered themselves generally good people who fell under bad influence and did something terrible at the time of intense stress. They take responsibility for what happened, and if they had a second chance, they would have done everything differently. But at the right moment, they made the wrong decision.

Every day, in different places in the United States, people find themselves in similar situations - they interact with circumstances that can lead to violence or death. A growing set of studies suggests that working with young people to improve their control over their own impulses can help them better get out of situations like these, as a result of which they will remain in school and not be in trouble. Here, programs such as Becoming a Man (BAM) go on stage.

YOU helps young people living in criminal areas with high gangster activity to listen to their emotions and hone their decision-making skills. Her success attracted a lot of attention: a study by the University of Chicago found that YOU reduced the number of arrests in people participating in the program by about half.

Last year, Bill spent time in the program and met with a group of high school students. When he returned home, I immediately realized how moved his experience gained. “I was not just watching the work of the BAM group,” he told me. “I participated in it.”

Bill : I heard about YOU as our foundation begins to invest in programs that help children grow socially and emotionally. I was surprised how effective such an approach can be, and wanted to see it in action. I could not imagine how much he could touch me.

I attended one of the small meetings where students participating in this program communicate twice a week with a counselor. After the students invited me to join them - and there you need to be invited formally - I sat in a circle where there were five young men, first and second year students. They began to take turns expressing their views on the topic of the day. Anger was discussed in my presence. When was the last time you were angry? How did you deal with this, what could be done differently?

Although some guys talked about the typical disappointments of adolescents - the teacher treated them unfairly, they constantly died in a video game - others had tragic stories. One recently watched a member of his family go to jail. Another told how they shot his friend.

In turn, I gave an answer that was not like the others. I talked about how angry I was at the meeting, where I found out that the number of cases of polio is growing. I am fortunate that I can worry about such problems. What worried teenagers from the circle that day was much more personal. Polio was hardly on their list of priorities, and I understand why.

But although our situations were very different, we can all understand the desire of others to learn how to control their anger. This is an important skill and part of growing up. Growing up, if I thought that my parents were dishonest with me, I could act very sharply with them. At Microsoft, I was tough with my colleagues. In some cases, it helped our success, but I’m sure that sometimes I went too far.

Therefore, it was great to see how young people in such difficult conditions work on this skill at a much younger age than me. They were passionate about the conversation and discussed good and smart questions with each other. They cope with serious difficulties surprisingly.

At the end of the session, I stayed to chat with them a little. We took selfies and joked about the Xbox vs PlayStation disputes. I said that everyone in our family loves the Xbox, which surprised no one.

This group has met in BAM for a year now, and it was visible. I was touched by the way they respected each other and how frank they were. I left, thinking: all classrooms in the world should give such a feeling.

6. There are nationalist arguments for globalism.


Countries such as the United States are investing in helping other countries, making the world more stable and secure.


Melinda : Nowadays, we increasingly hear the word “nationalism”. It is also one of the most multifaceted concepts in the politics of the 21st century. And although it can have different meanings for different people (with different shades and nuances), in essence, nationalism consists in the fact that a country must first take care of itself. And with some aspects of this concept, many of us can agree.

Bill and I love our country. We believe in its values. We agree that our leaders have an obligation to protect it. And for these reasons, we consider global action our patriotic duty.

And we are not alone. Twice, when the White House threatened to seriously cut its budget to help other countries, some of the most notorious opponents showed up in Congress and among US military leaders who claimed that these investments were vital to protect US interests.

The reason countries such as the United States invest in helping other countries is because it increases both stability abroad and home safety. Strengthening healthcare in other countries reduces the chances that deadly pathogens such as Ebola will become a global epidemic. And providing all parents around the world with the opportunity to raise educated and healthy children in safety reduces the chances that they will go out of despair in search of a better life.

The desire to put the interests of their country in the first place has nothing to do with the need to turn their backs on the rest of the world. In fact, the opposite is true.

Bill : we will prove this point again and again in the next couple of years, because now a critical moment has come to the global health issue, and the single player approach described by Melinda can lead to a regression.

In 2019, governments will need to return to funding the Global Fund [to Fight AIDS, Tuberculosis and Malaria], one of the largest healthcare projects in the world. And Gavi, the Global Alliance for Vaccines and Immunization, will need to raise money in 2020.

It is hard to overestimate the good deeds done by these projects around the world. Since 2002, the Global Fund with Partners has saved 27 million lives. Since 2000, Gavi has provided 690 million people with basic vaccines. This is comparable to vaccinating almost all Europeans.

In my opinion, these are amazing results. They demonstrate what can be done, understanding that we all have an interest in improving the health and well-being of the poorest people. It is also very cost effective: the richest countries spend about 0.1% of their budget on medical care.

But it bothers me that rich countries turn their backs on the world, and may come to a limited view of things, deciding that these attempts are not worth the cost. Or, for example, everyone will agree on the importance of assistance, but because of different political views, they will not take any action.

It will be a disaster. Today, more than 17 million people with HIV receive drugs from the Global Fund. Without them they will die.

This is one of the reasons Melinda and I always talk about successes. At a time when shocking incidents dominate the headlines, we want to remind people that life is getting better for millions of people in the poorest countries, thanks in part to smart investments in healthcare. Even if you care only about the health of your citizens, these investments will be an extremely smart investment. Progress benefits everyone.

7. When was the modern toilet with a drain tank patented?


Alexander Cumming patented a modern toilet with a flushing cistern in 1775, although he entered mass production only in the middle of the XIX century


Bill : Almost eight years ago, Melinda and I set the task of reinventing the toilet before engineers and scientists around the world. More than 2 billion people around the world do not have access to a normal toilet. Wastes from their livelihoods often end up in the environment, killing nearly 800 children daily. Exporting solutions from a rich part of the world will not help, because they need a sewer system that consumes a lot of water, which is very expensive to build.

Last year in Beijing, we organized a toilet fair, where I personally got acquainted with many next-generation toilet designs , and even performed on stage with a jar of human feces .

Some companies are already ready for production. Their inventions satisfy almost all requirements: they kill pathogens, keep pace with the rapid growth of cities, do not require sewers, external sources of water or the constant availability of electricity. So far they are losing only in value - therefore, our foundation invests in research and development to make them affordable for the poor.

So what does the next generation of toilets look like? At first glance, they are not much different. They do not look like a subject from science fiction.



All magic is hidden from view. Unlike today's toilets, toilets of the future are autonomous. These are tiny recycling stations that can kill pathogens and make waste safe on their own. Many even turn waste products into useful products, such as fertilizers for plants and water for washing hands.

Maybe these are not the most interesting inventions in the world, but the toilets of the future will save millions of lives.

Melinda : And they will also improve lives, especially for women. It’s hard for everyone to live without a toilet, but women and girls suffer the most.

Bill and I met with women whose kidneys were damaged because they did not go to the toilet at night to avoid the dangers associated with public institutions. We met with others who could walk mostly only in an open field, as a result of which they had to eat less and wait for darkness to not be in sight. There is also evidence that girls are more likely to skip school during menstruation if the school does not have decent toilets.

If you are like me, I think there are no toilets among your favorite topics for conversation. But if you advocate that girls can go to school, women participate more actively in the economy and are more protected from violence, then we will have to gain strength and talk about toilets.

8. Textbooks go out of circulation


The software finally changes the learning process


Bill : I've read enough textbooks in my life. However, this is a very limited way of learning. Even the best text cannot find out which concepts are clear to you and which ones you need help with. And he definitely cannot tell your teacher how well you understood your previous homework.

But now, thanks to software, a separate textbook is a thing of the past. Imagine that you study algebra in high school. Instead of just reading the chapter on solving equations, you look at the text online, a very engaging video that shows how to do it, and then play a game that reinforces the understanding of the concepts. Then you solve a couple of problems online, and the software creates new questions for the test specifically with those topics that you still do not fully understand.

All this is in addition to the work of teachers, and not a replacement. Your teacher receives a detailed report on what you read and looked at, which tasks you solved correctly, and which ones you did not cope with, and in which areas you need help. By your arrival in the classroom, the teacher already has a huge amount of specific information and tips so that he will spend time with you as efficiently as possible.

In our previous letters, we talked about such software in a theoretical manner. But now I’m ready to tell you that similar tools are already used in thousands of US classes, from kindergartens to high schools. Zearn, i-Ready, and LearnZillion are examples of digital textbooks used by students and teachers in the United States. More than 3,000 schools teach the Big History Free Digital Coursewhich I finance. He uses the software to immediately give students feedback on written work.

What's next? The same basic development cycle as for the rest of the software: we get voluminous feedback on existing products, collect data about what works well, improve products. This cycle is gaining momentum, as more and more states and regions are using digital textbooks more confidently. I hope that this trend will inspire more publishers of large textbooks who are in no hurry to offer such tools.

In the meantime, I had never heard anyone miss their hard and expensive textbooks.

Melinda: in addition to the ability to adapt to the knowledge of students, these tools also accelerate the advent of a new approach to learning, adapting to what the students themselves are.

In 2019, a college student is no longer a stereotypical teenager living in a hostel and graduating four years later with a break for a vacation somewhere in a warm place. Almost half of today's students are over 25 years old. More than half of them work. More than a quarter have their children.

These “non-traditional” students often do not have the time or resources to effectively master an ineffective and inflexible learning system designed not for them. That is why two out of every five students starting to get higher education either take a break or drop out of school.

Digital translation tools can help students deal with these issues and make college more accessible, convenient, and efficient.

One study found that using open courses allowed students on average to save between $ 66 and $ 121 per course. For the academic year, this can result in a saving of $ 1000, and this amount can just affect the decision whether to stay in school or drop it. Another found that students who used digital learning for introductory courses received better grades than students who studied the subject in the traditional way. And, of course, the first students had more options. The fact that students do not need to appear in the classroom at the appointed time is of great importance to them when they try to combine study, work and family responsibilities.

Putting it together, it turns out that students spend less money on more convenient courses at which they show better results. In short, we have got tools for such a change in education that meets the needs of modern students.

9. Mobile phones benefit the poorest women most


Mobile phones give women the opportunity to build a whole new life


Melinda : in rich countries, mobile phones facilitate the tasks that we already carry out - send an email instead of regular mail, navigate the world without fighting a paper map, catch a taxi without waiting for a car on the street in the rain. However, for the poorest part of women, a mobile phone not only makes life easier, it can help them build a whole new life. Connectivity solves this problem.

If a woman has never been to a bank, a mobile bank offers her a support in the formal economy and a chance for financial independence. If a woman is required to cook, clean, and monitor a child, her income is potentially increased, as she gets the opportunity to establish contact with clients, training courses, and professional organizations right from home. If she considers it shameful to buy contraceptives at a local clinic, delivery from an online store can help her regain control of her body and future.

In other words, women not only use mobile phones to access services and opportunities. They use them to change social norms, and challenge power structures that maintain gender inequality.



The problem is that the gender gap in the use of mobile phones and mobile Internet remains significant. A recent study of ten countries in Africa, Asia and South America showed that, regardless of age, education, income and location, the likelihood of using the Internet is 40% less for a woman than for a man.

The reasons for the existence of this gap are many. The main ones are cost, literacy (digital and conventional), social norms. In response to this, mobile operators, eager to connect to this market, create business strategies aimed at women. In Kenya and Nigeria, such programs are re-focusing on women's digital literacy training. We partnered with the initiative of the Harvard Kennedy School to begin testing solutions to the barriers to social norms.

When I think about why it is so important to give more mobile phones to women, I think about Nikma, the woman I met in Indonesia last October. Nikma told me that for years she had been trying to raise children, earning by selling vegetables, but she could not manage to make ends meet. Her situation became even worse when she had to leave her cruel husband.

Today, Nikma is one of more than a million Indonesians who make money with Go-Jek, a popular mobile platform for travel, food delivery, and other services. The application gives her access to a constant stream of customers and income, and she is paid through a mobile bank, so she completely controls her earnings. Now she can provide for her children without relying on her husband to abuse her. Using a telephone, she created a network of other women who engage in services, and together they collect money to support each other in the event of an accident or health problem.



Nikma told me: “Life is like a wheel. Sometimes you are from below, sometimes you are from above. " For women like her, who have spent most of their lives at the very bottom, mobile technology is creating new opportunities for fighting inequality and going up. We can help women seize on these opportunities by ensuring that inequality does not impede their access to technology.

And the last


Recently, we have been often asked whether our vision of the future remains positive. We say: of course. One reason is that we believe in the power of innovation. An even larger reason is that we see with our own eyes that for every task described in the letter there are people who devote their ideas, resources and even life to their solution.

When we feel that news headlines are oppressing us, we remind ourselves that none of us have the right to relax and expect the world to get better. We ourselves are obliged to push him in this direction.

In this sense, we have found that optimism can be a powerful call to action. And it has a multiplier effect: the more optimists work to improve the future, the more reasons to be optimistic.


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