In letter to philanthropic partner Warren Buffett, the Gates define achievements from vaccines to lives saved – while still pushing for gains in infant mortality

How Bill and Melinda Gates helped save 122m lives – and what they want to solve next

It was the biggest philanthropic gesture ever, the billionaire investor equivalent of Batman and Superman joining forces to fight world crime.



Ten years ago, Warren Buffet, chairman of Berkshire Hathaway and the world’s second richest man, pledged to give most of his fortune to the only man in the world richer than him – Bill Gates. The gift was worth around $30bn at the time.



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The aim was to scale up the efforts of the Bill and Melinda Gates Foundation to save children’s lives in the developing world, in the belief that, as Gates has it, “all lives have equal value”.



The relationship has always been close, they say. The Gates take a holiday every January with Buffett and his wife, and their annual letter – in the form of a report to Buffett on the 10-year anniversary of his massive gift – is peppered with billionaire jokes: how Buffett eats Oreos for breakfast, and once pulled out coupons in Hong Kong to pay for dinner in McDonald’s.

But between the jokes is the data. Bill and Melinda Gates sum up what has been achieved with their combined billions over the past decade in a series of big numbers, and end with the hope of reaching the magic zero – no more disease.



122m: the number of children’s lives saved since 1990



This was well before the launch of the Gates Foundation in 2000, but progress in global health towards the Millennium Development Goals has largely been measured from that date.

The couple do not claim that they have saved 122 million lives, “but if you look at the decline in child mortality, the acceleration of new vaccines getting out to children like pneumococcus and rotavirus are absolutely responsible for most of that acceleration and so the fact that in 2000 and 2001 we with amazing partners helped create GAVI for vaccines and the Global Fund for HIV, TB and malaria – I don’t think that would have happened without the two lead governments and ours getting behind it,” said Bill.

86: the percentage of children who receive basic vaccines worldwide



Coverage for the basic package of vaccines is now the best it has ever been, and they are the biggest reason for the drop in children’s deaths, says Melinda.



Bill adds that for every $1 spent in childhood immunisation, there is a $44 return in economic benefits. That includes the income parents would have lost when unable to work when their child was sick.

300m: the number of women in the developing world who use modern forms of contraception

This has been a major focus for both Gates and Buffett. In the past 13 years, the numbers are up 100,000.



“Warren, you’ve compared your philosophy of investing to Ted Williams’s science of hitting,” said Bill in the letter. “Williams waits for the right pitch, and you wait for the right deal. This is the right deal, Warren. Like vaccines, contraceptives are one of the greatest lifesaving innovations in history.”

In the negative side of the ledger ...



1m: the number of babies who still die on the day they are born

Half of those deaths are due to sepsis, or blood-stream infections, asphyxia which is lack of oxygen at birth and being premature and therefore small and fragile. “For decades now, health experts have been struggling to treat or prevent these conditions, with disappointing results,” writes Melinda.

They turn to Rwanda for a lesson on what works – breastfeeding in the first hour and exclusively for six months, cutting the cord in a hygienic way to avoid infection, and kangaroo care, where the mother keeps the newborn next to her skin to raise and maintain the baby’s temperature. Rwanda also doubled the percentage of births involving a skilled worker. It brought its death rate down by a third between 2008 and 2015.

45: the percentage of deaths related to malnutrition

Bill talks of trying to guess the ages of children he saw in African villages and always getting it wrong. They were smaller than they should have been because of poor nutrition. That can mean poor cognitive development too.



“Nutrition is the biggest missed opportunity in global health,” he writes. “It could unleash waves of human potential – yet only 1 percent of foreign aid goes to basic nutrition.”

And the ambition...

0: the number of cases of deadly diseases the Gates are aiming for



As Bill Gates says: “We want to end our letter with the most magical number we know. It’s zero. This is the number we’re striving toward every day at the foundation. Zero malaria. Zero TB. Zero HIV. Zero malnutrition. Zero preventable deaths.



“Zero difference between the health of a poor kid and every other kid.”

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