CARE International

May 10, 2007
Remarks by Melinda French Gates

Thank you, Helene. There's so much we miss about Helene at the Gates Foundation: her energy, her expertise, her dedication. Most of all, though, we miss her frequent flyer miles—because, as you just heard, I don’t think anybody works harder or goes farther on behalf of global health.

Helene always reminded us that the world does not need us to think small and accomplish easy goals. It needs us to think big and to strive for constant progress. That’s the same posture I see in CARE’s work. This is not an organization that is content to focus on nutrition or sanitation or education alone. CARE’s mission is to end poverty.

Helene joked that when she left the Gates Foundation to lead CARE it wasn’t just that she would be moving from Seattle to Atlanta, from one coast to the other. She was also moving from one side of the check to the other.

We’re just as happy that she’s still in the same business. Helene, thank you for this work.

This evening I want to take just a few minutes to talk about fighting inequity. For Bill and me, realizing the scope of inequity in our world is what really lit a fire under our philanthropic efforts.

I remember several years ago sitting with Bill and reading an article we’d been given. It was about the millions of children dying in poor countries every year from diseases we don’t think about much in this country . It focused on a disease called rotavirus, which kills about 600,000 children a year.

Bill and I read this article and we said, This can’t be, 600,000 children, one disease. How come we never hear about it? We take our children to be vaccinated. We read news stories. We don’t hear about it. We thought if a single disease were killing that many children, it would be front-page news.

But it wasn’t. How could we reach any other conclusion but this: Some lives in this world are seen as worth saving and others are not. That realization drives all the work that we do today and will continue to do throughout our lifetime. We believe that every human life has equal worth.

This premise has been affirmed to me over and over again in my travels. Whatever the conditions of people’s lives, wherever they live, however they live, they share the same hopes, the same dreams as you and I in this room. When I travel, people talk about how they want food, health, safety, shelter, all the things we care about. They care for their loved ones. They want to provide for their children.

They talk over and over again about the future of their children and educating their children. In so many places, those building blocks of dignity are unattainable. Those aspirations are unachievable. So our goal is really quite simple. It’s to give every person a chance to live a healthy and productive life.

So looking at a world where 11 million children die before their fifth birthday… one billion people live on less than a dollar a day...and one out of every eight people go hungry every single day...the toughest question for us was, “Where do you begin?”

We chose health as our point of entry because when health improves, life improves by every single measure, from higher literacy to better education, stronger economic growth and a more stable and prosperous society.

I think there’s a little bit of a misunderstanding about the foundation because people often say, “Well, you started in health, but didn’t you know there were these other problems?”

Of course we saw the other problems. But we decided to start with what we were good at and what was close to our hearts. For Bill and me, that’s technology. When I say technology, I mean bio-technology. We learned about the gap between vaccines that we were getting for our children in the United States but were not being delivered in the developing world. We’ve had these vaccines for 15 or 20 years.

How could that be?

It was a market failure. No one was working on vaccines for diseases like malaria or tuberculosis, because we don’t have those diseases in the United States. And, even though we’ve mapped the human genome, there was not a whole lot of progress on an HIV vaccine—again, because we can get the medications in our country.

But all you need to do is visit the places where our grantees are working to see that the cycle of inequity, of ill health, is both a cause and an effect. Immunizing children against a disease is a hollow promise if they don’t have enough to eat. That’s why for us health is neither a starting point nor an ending point. It’s an intervention point.

We started to look for other points of intervention. We had a very small group at the foundation looking at several different areas—clean water, agriculture, financial services, several others—where we were doing small amounts of work. We were asking what else could we do to make sure that if we gave a child a vaccine, she could also have some food and her family could lift themselves out of poverty?

We were already looking at these points of intervention when Warren Buffet announced last summer that he would be committing most of his wealth to our foundation and his children’s foundations. His extraordinary generosity gave us the opportunity to really accelerate some of this work that we were already studying. So we created a group at the foundation that is now called Global Development.

In the cycle of inequity there are so many points of vulnerability: hunger, economic opportunity, poor governance, the list goes on and on. But following the lead of an organization like CARE we’re starting to look at these areas of vulnerability and say, “But they’re amazing opportunities.”

Because we’re so blessed with resources at the foundation, I think people look at us and think we’ll be able to change these problems on our own. That could not be further from the truth. When you look at the scale of the problems we’re trying to deal with, it has to be governments and markets that solve these problems. Of all of America’s charitable giving, our foundation accounts for less than 1 percent. Last year, our Global Health Program made about $900 million in grants. By contrast, the budget of the National Institutes of Health is $28 billion every year.

So our work is really focusing on those places where if we pioneer a solution, governments and markets can dramatically expand those solutions. That’s what we think will transform the lives of a huge number of people.

Right now we’re looking at several areas we feel provide amazing opportunities to apply innovative models to people’s lives. I want to touch on two of them tonight: one in the area of agriculture and the other in the area of financial services.

No developing country has risen from poverty without first raising its agricultural productivity. That’s why it’s so distressing to know that Sub-Saharan Africa is the only place in the world where there is less food per person year after year.

Three quarters of the poorest people rely on agricultural survival. So when small farmers struggle, hunger quickly spirals into a sense of hopelessness. Malnutrition stunts children’s physical and mental growth, and it causes adults to miss work and, ultimately, lose income.

However, when small farmers can grow enough not only to feed their families but to have a surplus, then progress is possible. They can send their children to school. They can hire workers. They create markets.

We’ve seen it before. Back in the 1940s, the Rockefeller Foundation started to look at this problem. The world wasn’t keeping up with population growth. Half of the people in the developing countries were without enough food.

So the Rockefeller Foundation began some pioneering work with the help of a scientist named Norman Borlaug, who was with them at the time. They worked to spreading these farming innovations throughout Latin America and Asia with new seeds, better irrigation techniques, essential crops like wheat, corn and rice.

The farmers all became more productive. As a result, world food prices dropped. In Asia, real per capita income nearly doubled and the rate of poverty was cut nearly in half in Asia. Improvements in agriculture are credited with improving the health of 30 to 40 million preschool children. This process became known as the Green Revolution.

But for a variety of reasons, the Green Revolution never reached one crucial area: Africa. Today three quarters of African farmland is being cultivated without advanced seeds or fertilizer. Can you imagine if you were a farmer in the United States and were still using seeds from the 1940s? We hope to change that.

Together with the Rockefeller Foundation and partners in Africa, we recently launched AGRA. It’s the Alliance for Green Revolution in Africa, an organization that will be based in Africa, staffed by Africans. We believe that there can be a Green Revolution in Africa, but that it can learn from what happened in Asia.

In Asia there was criticism of the fact that the Green Revolution mainly benefited the most large-scale farmers. AGRA will focus on reaching small farmers, because the vast majority of the population in Africa have less than two and a half acres of land. AGRA will also learn from the criticism that fertilizer was overused in Asia—they want to be sure what they do in Africa is environmentally sensitive.

Great seeds that are created in Asia and America and Latin America need to reach Africa, but they need to be adapted by the Africans to what works for them—so they’re drought-resistant, they’re pest-resistant, and they’re the crops that the Africans want.

For instance, there’s a great kind of Asian rice that has higher yields, higher productivity, and higher nutrition than other types of rice. Some West African breeders have taken it to Africa, and they’re making a variety called NERICA: a NEw RIce for Africa. And it’s being adopted widely there. That’s exactly what needs to happen all across Africa.

We need more African crop scientists who are working on these specialized issues. We need to link small farmers to the markets so that they don’t get taken by middlemen and they know the market prices for their goods.

Our goal in the next five years is to have a hundred new varieties of rice, corn, and bananas introduced on the African continent that meet the nutritional needs of Africans. Through this kind of coordinated, far-reaching agriculture reform we can significantly improve food production and give hundred of millions of small farmers, many of them women, an essential tool for improving their lives and the lives of their families.

Another area where we see opportunity is financial services. Hundreds of millions of lives can be touched through financial services. I know many of you have heard of this area, particularly with Muhammad Yunus and the fantastic work that he’s done through Grameen Bank in Bangladesh.

Of all the people who survive on less than two dollars a day, only one in ten have access to affordable, high-quality financial services. In Africa, there is no micro-lending institution that’s at scale, not a single one.

Consider where you would be if you didn’t have a savings account, you couldn’t get a loan, you didn’t carry any insurance. These are the things that allow us to manage life’s risks.

In the developing world, without those services, you have no margin, no room for error for something of the unexpected. So a child falls sick and needs to get medical services. Your husband loses his job because of AIDS. Your cattle die for some reason. Absolutely no insurance. Without access to capital, entrepreneurial sparks are snuffed and small businesses don’t have a chance to take hold.

But with these kinds of services, people can begin to see a path out of poverty. I met a woman in Bangladesh last year who used a micro loan to purchase a sewing machine. She paid her original loan back in just a few months, and eventually she was able to get two more sewing machines and hire two workers. Now she’s got her own small business and she’s already sending her kids to school.

Imagine the societal change when we take a story like that and replicate it millions and millions of times over.

Financial tools can also be tools of empowerment. In much of the world, men control the finances, which means, of course, they also control the women. That’s especially true in a country like Malawi. Many women there are illiterate so they can’t sign their name to open a bank account.

One of the NGOs we’re working with in Malawi has come up with a reader so that a woman can use her fingerprints to identify herself on a bank account. This is incredibly important in Malawi because if her husband dies—which happens often because of AIDS—frequently her brother-in-law, his brother, will come and take over the family finances. This card lets the woman protect her money so no one can take it from her.

This has become such a popular item in Malawi that many of the women are talking about it at their wedding showers. I think that’s quite a change in society.

As we’re looking at other areas in global development, whether it’s access to information, or better sanitation and water, we’re hopeful that new ideas, new technology, and a new sense of a worldwide commitment can help us confront these old and lingering challenges. To us, global development isn’t just about better seeds, better food, or better access to capital. It’s about a better future.

I want to share one thought in closing. As I look around a room like this tonight, I think: We are all so incredibly lucky.

Many of us have achieved the positions we have by virtue of our intelligence, our talents, our hard work. Now I don’t want to diminish any of your success by saying this, but none of those things would have mattered if we didn’t live where we live.

Bill is the first to acknowledge that it was luck that got him where he was. He would not have been able to create a Microsoft if it were not for what he was afforded in this country.

Warren Buffett, who’s one of the world’s greatest investors, speaks publicly and privately about the fact that if he’d been born in a different country or a different time and place, there would have been no market for his talents.

As I travel around places like Africa, I think, if I were a woman living here who was lucky enough to have a small farm, I would not have picked Bill Gates or Warren Buffett to cultivate my land. I might send them out to check on the price of the goods or to negotiate for me, but I don’t think I would have them tilling the land.

I met a woman in Nigeria last fall who still sticks in my mind. She was a very sharp woman. She had been to see a man in the village, an esusu, an informal money lender.

I asked her a little bit about her business. She was buying coal in the city and then selling it out in the country because she could get a higher price in the country. I asked her, “Why did you move to this particular place?”

And she looked at me like I was completely dense—like I had two heads. She said, “Well, of course I picked up and moved here because the price of coal is higher.”

You know, if she were sitting in this room tonight, I think she would be working at an arbitrage hedge fund.

That’s the entrepreneurial spark that you see over and over again when you’re out in the developing world. That’s what we need to tap by just letting people have access to some of the basics that we have access to here today.

For me, it hits home perhaps even more closely because I’m a woman.

While the deck is stacked against everybody in the developing world, it’s stacked even higher against women. Sometimes when I take reporters with me to see what’s going on in the world, they’ll say, “You live so well. Here you are visiting the poorest of the poor. Isn’t it jarring?”

But I never look at it that way.

Whenever I go out to visit the developing world, and I’m welcomed with open arms by these women who are so incredibly generous, and I sit down in their home, on a mat on the floor, I always think: That could be me, sitting on the other side of that mat.

If I were in that situation, what would I do? What would I do for my children, for my family, for myself?

The answer is: I would do everything humanly possible. I’d work to exhaustion if that was the only opportunity. I would borrow or beg, if necessary.

And when I had done all of that, I would pray. I’d pray for change, for hope, for someone to see my struggle and offer a little bit of help.

That is why I’m here tonight. Because in the fight against inequity, in the struggle against poverty, that prayer finds an answer in an organization like CARE. Thank you.