In 2006, Warren Buffett donated $31 billion of his fortune to the Bill and Melinda Gates Foundation, which focuses on solving global issues and eradicating poverty worldwide. Ten years later, Bill and Melinda Gates wrote a letter to their friend to let him know just how they were using his money, “the biggest single gift anyone ever gave anybody for anything.”
The letter, available to read on Gates Notes (aka Bill Gates’ blog), covers not only the Gates Foundation’s triumphs, but also the work they have yet to do. As the Gateses put it, “Philanthropy isn’t like business. We don’t have sales and profits to show you. There’s no share price to report. But there are numbers we watch closely to guide our work and measure our progress.” The numbers they share come mostly from their global health work and tell the story of how the foundation has put Buffett’s generous donation to work.
They begin with the positives: 122 million children’s lives saved since 1990. Basically, fewer children are dying before age 5 than ever before. As Melinda puts it, “Saving children’s lives is the goal that launched our global work.” And ensuring that children live longer has positive effects across society. She goes on to write that “Virtually all advances in society—nutrition, education, access to contraceptives, gender equity, economic growth—show up as gains in the childhood mortality chart, and every gain in this chart shows up in gains for society.”
Their attack on childhood mortality begins with vaccines. Thanks to the efforts of the Gates Foundation and its partner organizations, 86 percent of children worldwide receive basic vaccines, the highest percentage in history. It’s an effort that requires coordination between non-governmental organizations and both wealthy and poor countries, which has led the Gateses to create Gavi, the Vaccine Alliance, which “connects companies who develop vaccines with wealthy governments that help with funding and developing countries that get the vaccines to their people.”
But despite their huge accomplishments, Bill and Melinda Gates aren’t ready to rest yet. As they tell Buffett (and all the other people reading the letter), there are still plenty of problems that require solving. One million babies die the day they are born. Of childhood deaths, 45 percent are linked to malnutrition. And while the Gates Foundation has helped raise the number of women in developing countries using modern contraception to 300 million, there are still nearly that many women who get pregnant without wanting to.
It’s a constant quest for answers. The Gates Foundation has been closely studying Rwanda, which has managed to cut its newborn mortality rate by 30 percent through simple changes, like hygiene, breastfeeding and having trained birth attendants present. They’re working on increasing the amount of foreign aid that goes towards solving malnutrition—and at only 1 percent, there’s nowhere to go but up. As for the contraceptives, Melinda writes that “Public advocates are important, which is why I’ve taken on that role. But nothing can take the place of a trusted voice in the community.” By improving contraceptive technology, sharing stories of those whose lives were or could have been improved by contraceptives, and supporting women’s self-help groups in India, the foundation hopes to help give another 120 million women access to birth control by 2020.
What the Gateses stress most is the need for optimism. A recent survey showed that only one percent of people knew that extreme poverty had been cut in half since 1990. They want to change that notion. As they wrote to their friend, “We’re trying to channel your empathy, add your optimism, mix in technology, apply strategy, and work with partners to save more lives. That’s how we’re spending your gift.”