Bill and Melinda Gates —
For years, we’ve heard people question whether investments in the fight against global poverty have an impact. Clearly, we believe they do.
We are investing all our resources in that fight. But that doesn’t mean every dollar spent on development has maximum impact. And that must be our goal.
We are launching a report this year and will publish it every year until 2030 because we want to accelerate progress in the fight against poverty and disease by helping to diagnose urgent problems, identify promising solutions, measure and interpret key results, and spread best practices.
As it happens, this report comes out at a time when there is more doubt than usual about the world’s commitment to development. In our own country, Congress is currently considering how to deal with the big cuts to foreign aid proposed in the president’s budget. A similar mood of retrenchment has taken hold in other donor countries. Meanwhile, most developing countries need to do more to prioritize the welfare of their poorest citizens.
In 2015, the member states of the United Nations adopted the Sustainable Development Goals (or Global Goals), which together paint a picture of what we all want the world to look like in 2030. However, if we don’t reaffirm the commitment that has led to so much progress over the past generation, that world will remain out of reach. Leaders everywhere need to take action now to put us on the path we set for ourselves just two years ago.
Below are three of 18 data points from the report that help to clarify what our investments have committed to. We want people to understand the progress we’ve made, and what’s at stake. Child mortality, HIV, and family planning are three of the data points included in the SDGs that we believe are fundamental to people’s health and well-being.
Child Mortality — Melinda Gates
If I had to pick just one data point to focus on, it would be the children who die every year before the age of five. There’s so much packed into that one number. Child mortality is a proxy for overall well-being; it’s also a leading indicator of progress (or the lack of it). And when you talk to mothers who have experienced the death of a child, you understand what that number means in human terms. What is more fundamental than keeping children alive so they can thrive and build the future?
Close to half of the almost 5 million children who will die next year will die in the first 28 days of their lives. Most of them could be saved by a few simple interventions: for example, simple resuscitation if they can’t breathe, antiseptics that cost pennies to prevent infection, and breastfeeding to strengthen their immune systems.
Based on global child mortality data, the world is on the right track. In the more than 15 years we’ve been working in global health, the total number of child deaths has gone down every year. By a lot.
We know what it takes to give millions of children the opportunity to thrive. The question is, do we have the commitment?
HIV — Bill Gates
When you talk to people who worked in Africa around the turn of the millennium, when the AIDS epidemic was totally out of control, they say attending funerals was a routine experience, like cooking breakfast or commuting to work. The crisis was so horrifying that, starting in the early 2000s, the world made a huge investment to manage it. In the history of global health, there’s never been an increase of that magnitude in research and development or in getting products and services to people. That’s why that curve of AIDS deaths bends so sharply around 2004.
When you consider what would have happened if the curve had stayed on its original trajectory, the fight against AIDS also has to be counted among the world’s greatest successes. But it’s a success at risk: A 10% cut in funding for HIV treatment could cost the lives of an additional 5.6 million people.
Government budgets for AIDS treatment in both donor and developing countries have been flat and now there’s talk of cuts. I’m not advocating for a blank check, because I don’t think we need one. First, we can treat more efficiently. And the second key to solving the crisis over the long term is prevention.
By 2030, there will be more than 280 million Africans at the age when people are most at risk of contracting HIV. Compare that to 94 million people in 1990. If we only do as well as we’ve been doing on prevention, the absolute number of people getting HIV will go up even beyond its previous peak. So we have to do better. Part of that is more funding, not less.
If we invest more, if we are more efficient, if we share what we learn, if we show more leadership, then we will write the story of the end of AIDS as a public health threat.
Family Planning — Bill and Melinda Gates
Perhaps the best way to describe the importance of family planning is this: Achieving the family planning goal makes it more likely that we’ll achieve virtually every other Sustainable Development Goal. Poverty. Maternal mortality. Child mortality. Education. They all get better when women can plan their pregnancies so they are physically and economically ready when they have a child.
Senegal has established one of the most successful family planning programs. In 2012, Senegal launched a National Family Planning Action Plan and has seen a significant increase in prevalence of modern contraceptives.
But the norms around sex and family life are powerful. In many countries, families haven’t typically planned. The work of giving them options is not just technical – raising more funding, developing new products, and reparing broken systems. It’s also deeply cultural.
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The Goalkeepers report tracks 18 data points included in the SDGs.. To complement the data, we’re also telling the stories behind the numbers—about the leaders, innovations, and policies that have made the difference in countries where progress has been most significant.
The decisions we collectively make in the next couple of years are going to have a big impact on the shape these curves take. Of course, it’s not really about the shape of the curves. It’s about what the curves signify: whether or not millions or even billions of people will conquer disease, lift themselves out of extreme poverty, and reach their full potential.
This article was produced on behalf of the Bill & Melinda Gates Foundation by Quartz Creative and not by the Quartz editorial staff.