Bill Gates: Mosquitos, malaria and education

A passionate techie and a shrewd businessman, Bill Gates changed the world while leading Microsoft to dizzying success. Now he's doing it again with his own style of philanthropy and passion for innovation. *Why you should listen Bill Gates is the founder and former CEO of Microsoft. A geek icon, tech visionary and business trailblazer, Gates' leadership -- fueled by his long-held dream that millions might realize their potential through great software -- made Microsoft a personal computing powerhouse and a trendsetter in the Internet dawn. Whether you're a suit, chef, quant, artist, media maven, nurse or gamer, you've probably used a Microsoft product today. In summer of 2008, Gates left his day-to-day role with Microsoft to focus on philanthropy. Holding that all lives have equal value (no matter where they're being lived), the Bill and Melinda Gates Foundation has now donated staggering sums to HIV/AIDS programs, libraries, agriculture research and disaster relief -- and offered vital guidance and creative funding to programs in global health and education. Gates believes his tech-centric strategy for giving will prove the killer app of planet Earth's next big upgrade. Read a collection of Bill and Melinda Gates' annual letters, where they take stock of the Gates Foundation and the world. And follow his ongoing thinking on his personal website, The Gates Notes. His new paper, "The Next Epidemic," is published by the New England Journal of Medicine. *Transcript I wrote a letter last week talking about the work of the foundation, sharing some of the problems. And Warren Buffet had recommended I do that -- being honest about what was going well, what wasn't, and making it kind of an annual thing. A goal I had there was to draw more people in to work on those problems, because I think there are some very important problems that don't get worked on naturally. That is, the market does not drive the scientists, the communicators, the thinkers, the governments to do the right things. And only by paying attention to these things and having brilliant people who care and draw other people in can we make as much progress as we need to. So this morning I'm going to share two of these problems and talk about where they stand. But before I dive into those I want to admit that I am an optimist. Any tough problem, I think it can be solved. And part of the reason I feel that way is looking at the past. Over the past century, average lifespan has more than doubled. Another statistic, perhaps my favorite, is to look at childhood deaths. As recently as 1960, 110 million children were born, and 20 million of those died before the age of five. Five years ago, 135 million children were born -- so, more -- and less than 10 million of them died before the age of five. So that's a factor of two reduction of the childhood death rate. It's a phenomenal thing. Each one of those lives matters a lot. And the key reason we were able to it was not only rising incomes but also a few key breakthroughs: vaccines that were used more widely. For example, measles was four million of the deaths back as recently as 1990 and now is under 400,000. So we really can make changes. The next breakthrough is to cut that 10 million in half again. And I think that's doable in well under 20 years. Why? Well there's only a few diseases that account for the vast majority of those deaths: diarrhea, pneumonia and malaria. So that brings us to the first problem that I'll raise this morning, which is how do we stop a deadly disease that's spread by mosquitos? Well, what's the history of this disease? It's been a severe disease for thousands of years. In fact, if we look at the genetic code, it's the only disease we can see that people who lived in Africa actually evolved several things to avoid malarial deaths. Deaths actually peaked at a bit over five million in the 1930s. So it was absolutely gigantic. And the disease was all over the world. A terrible disease. It was in the United States. It was in Europe. People didn't know what caused it until the early 1900s, when a British military man figured out that it was mosquitos. So it was everywhere. And two tools helped bring the death rate down. One was killing the mosquitos with DDT. The other was treating the patients with quinine, or quinine derivatives. And so that's why the death rate did come down.Now, ironically, what happened was it was eliminated from all the temperate zones, which is where the rich countries are. So we can see: 1900, it's everywhere. 1945, it's still most places. 1970, the U.S. and most of Europe have gotten rid of it. 1990, you've gotten most of the northern areas. And more recently you can see it's just around the equator. And so this leads to the paradox that because the disease is only in the poorer countries, it doesn't get much investment. For example, there's more money put into baldness drugs than are put into malaria. Now, baldness, it's a terrible thing. (Laughter) And rich men are afflicted. And so that's why that priority has been set. But, malaria -- even the million deaths a year caused by malaria greatly understate its impact. Over 200 million people at any one time are suffering from it. It means that you can't get the economies in these areas going because it just holds things back so much. Now, malaria is of course transmitted by mosquitos. I brought some here, just so you could experience this. We'll let those roam around the auditorium a little bit. (Laughter) There's no reason only poor people should have the experience. (Laughter) (Applause) Those mosquitos are not infected. So we've come up with a few new things. We've got bed nets. And bed nets are a great tool. What it means is the mother and child stay under the bed net at night, so the mosquitos that bite late at night can't get at them. And when you use indoor spraying with DDT and those nets you can cut deaths by over 50 percent. And that's happened now in a number of countries. It's great to see. But we have to be careful because malaria -- the parasite evolves and the mosquito evolves. So every tool that we've ever had in the past has eventually become ineffective. And so you end up with two choices. If you go into a country with the right tools and the right way, you do it vigorously, you can actually get a local eradication. And that's where we saw the malaria map shrinking. Or, if you go in kind of half-heartedly, for a period of time you'll reduce the disease burden, but eventually those tools will become ineffective, and the death rate will soar back up again. And the world has gone through this where it paid attention and then didn't pay attention. Now we're on the upswing. Bed net funding is up. There's new drug discovery going on. Our foundation has backed a vaccine that's going into phase three trial that starts in a couple months. And that should save over two thirds of the lives if it's effective. So we're going to have these new tools.But that alone doesn't give us the road map. Because the road map to get rid of this disease involves many things. It involves communicators to keep the funding high, to keep the visibility high, to tell the success stories. It involves social scientists, so we know how to get not just 70 percent of the people to use the bed nets, but 90 percent. We need mathematicians to come in and simulate this, to do Monte Carlo things to understand how these tools combine and work together. Of course we need drug companies to give us their expertise. We need rich-world governments to be very generous in providing aid for these things. And so as these elements come together, I'm quite optimistic that we will be able to eradicate malaria. Now let me turn to a second question, a fairly different question, but I'd say equally important. And this is: How do you make a teacher great? It seems like the kind of question that people would spend a lot of time on, and we'd understand very well. And the answer is, really, that we don't. Let's start with why this is important. Well, all of us here, I'll bet, had some great teachers. We all had a wonderful education. That's part of the reason we're here today, part of the reason we're successful. I can say that, even though I'm a college drop-out. I had great teachers. In fact, in the United States, the teaching system has worked fairly well. There are fairly effective teachers in a narrow set of places. So the top 20 percent of students have gotten a good education. And those top 20 percent have been the best in the world, if you measure them against the other top 20 percent. And they've gone on to create the revolutions in software and biotechnology and keep the U.S. at the forefront. Now, the strength for those top 20 percent is starting to fade on a relative basis, but even more concerning is the education that the balance of people are getting. Not only has that been weak. it's getting weaker. And if you look at the economy, it really is only providing opportunities now to people with a better education. And we have to change this. We have to change it so that people have equal opportunity. We have to change it so that the country is strong and stays at the forefront of things that are driven by advanced education, like science and mathematics.When I first learned the statistics, I was pretty stunned at how bad things are. Over 30 percent of kids never finish high school. And that had been covered up for a long time because they always took the dropout rate as the number who started in senior year and compared it to the number who finished senior year. Because they weren't tracking where the kids were before that. But most of the dropouts had taken place before that. They had to raise the stated dropout rate as soon as that tracking was done to over 30 percent. For minority kids, it's over 50 percent. And even if you graduate from high school, if you're low-income, you have less than a 25 percent chance of ever completing a college degree. If you're low-income in the United States, you have a higher chance of going to jail than you do of getting a four-year degree. And that doesn't seem entirely fair. So, how do you make education better? Now, our foundation, for the last nine years, has invested in this. There's many people working on it. We've worked on small schools, we've funded scholarships, we've done things in libraries. A lot of these things had a good effect. But the more we looked at it, the more we realized that having great teachers was the very key thing. And we hooked up with some people studying how much variation is there between teachers, between, say, the top quartile -- the very best -- and the bottom quartile. How much variation is there within a school or between schools? And the answer is that these variations are absolutely unbelievable. A top quartile teacher will increase the performance of their class -- based on test scores -- by over 10 percent in a single year. What does that mean? That means that if the entire U.S., for two years, had top quartile teachers, the entire difference between us and Asia would go away. Within four years we would be blowing everyone in the world away. So, it's simple. All you need are those top quartile teachers. And so you'd say, "Wow, we should reward those people. We should retain those people. We should find out what they're doing and transfer that skill to other people." But I can tell you that absolutely is not happening today. More transcript please see: http://www.ted.com/talks/bill_gates_unplugged/transcript?language=en#t-577000