The Bill & Melinda Gates Foundation recently launched its second annual Goalkeepers Data Report.
The report pointed to demographic trends that could stall unprecedented progress in reducing global poverty. It said about one billion people may have lifted themselves out of poverty over the past 20 years, while there is rapid population growth in the poorest countries, particularly in Africa, a situation which “puts future progress at risk”. According to the report, poverty is concentrating in Africa in just a handful of very fast-growing countries. By 2050, for example, it said more than 40 percent of the extremely poor people in the world will live in just two countries – Democratic Republic of Congo and Nigeria, saying the poverty will be rooted in violence, political instability, gender inequality, severe climate change, and other deep-seated crises. The report mentioned other problems, including high rates of child mortality and malnutrition. On the way out, it stressed the need for Nigeria to invest in human capital now to avoid a scenario where 152 million Nigerians will live in extreme poverty by 2050 when the country’s population is expected to expand by 239 million people. Despite the sobering projections, however, Bill and Melinda Gates, in the report, expressed optimism that today’s growing youth populations could help drive progress, adding that investing in the health and education of young people could unlock productivity and innovation, leading to a “third wave” of poverty reduction, which follows the first wave in China and the second in India. To launch the report, Bill Gates held a call press conference with selected journalists across countries. Sunday Vanguard participated in the exercise.
Excerpts:
Goalkeepers Report Well, we are excited about the Goalkeepers event, which, of course, we do the same week as the U.N. General Assembly. We view it as a unique opportunity to get together people who are committed to making the improvements that are talked about in the Sustainable Development Goals. But the kind of work that goes on there often can be ignored or not get much attention because the key to the success is gradual progress bringing down malaria deaths, reducing the number of people in poverty. It’s an ongoing effort in many countries. The opportunity we have is to talk about where things are going well, to highlight whether it’s new science or heroes in the field, but also be quite frank about where things are not going well and talk about what we should do to get back on course. The world’s done a great job on many of the issues we’re working on. For example, the extreme poverty number came down by a billion over the last 20 years, and, interestingly, if you look at the world as a whole, the actual number of births in the world is quite flat. But underneath that, you see there’s a shift of the births from some of the richer countries into a lot of the more developing countries. So, if you just take Africa, even though it’s only 14 percent of the population of the world, it’s 24 percent of the births already. And over the century, it lights up and becomes half of the births. So, you actually have a lot of population growth in Africa, even though the globe as a whole, the growth isn’t that dramatic. On all these things, we partner the International Health Metrics and Evaluation Group at the University of Washington, and, every year, we go through the 18 key figures, and then look underneath what’s going on to understand the best practices and innovation and actually do our forward focus where we look at both positive developments like a new tool or more resources or negative developments where less funding comes available. We have a lot of great examples where the progress was amazing. Brazil is an example of nutrition, Indonesia for family planning. Vietnam is a very interesting case of being a big positive outlier in terms of the quality of the education they give. You know, the world in education focused a lot on access, which was super important, and, in most countries, made huge progress on gender-equal access and kids overall being in school. But now there needs to be a focus on the quality of what’s going on there, and Vietnam is held out as an example where that’s being done very, very well. The particular challenge of the population growth in Africa leads to a simple idea that the world should help Africa invest in its human capital, and that means both the health and the education of this young generation coming up in Africa. And if those investments are made in the right way, you get two kinds of amazing effects. One is those kids are able to contribute fully and drive a lot of economic growth, and then further, the patterns of behavior on a voluntary basis would be that the level of population growth would actually diminish, just like it has in so many other countries. And, you know, if we’re really highlighting this human capital challenge and how that can be done well, it’s sort of a centrepiece of this report. So, you know, we’re very optimistic that by bringing attention to these things, talking about the heroes and the best practices, and making sure that even though this stuff is not in the rich capitals in the world, and there’s a lot of issues that can distract from it, that in fact those people are committed to staying involved and we drive the innovation and the delivery as fast as we possibly can. You mentioned reproductive health and choice is key to unlocking human capital in this report.
What is the foundation doing to step up and fill some of the gap left by the gag rule in terms of reproductive health services? And why has the foundation not considered or reconsidered funding abortion directly?
Bill:Well, we’ve chosen to be super active in reproductive health, tools of contraception, but not to be involved in abortion. And that’s just a choice that we’ve made in terms of what our role is and where we think we can make progress. Some of the people that we work with do that differently, but that’s the position we’ve chosen to be in. The gag rule, which is also called the ‘Mexico City Rule,’ is complicated because this is the first time that the declaration that any organization that gets U.S. money has to commit that they’re not involved in discussing or providing abortion. It was applied far more broadly this time than ever before, so it applied to people getting U.S. money for HIV and malaria. You know, it’s actually not all that visible how much more difficult or what sort of impact that’s had. You know, we certainly have said that we think the rule doesn’t make sense, but it’s very much in place, and people have adjusted to try to minimize the negative impact of that. So, our funding for innovation is new tools of contraception and getting the message out, and that includes both women who want to face their births or women who decide that they don’t want to have any more children, but all on a completely voluntary basis.
You visited Nigeria in March 2018 and essentially you counselled the leaders to invest in human capital rather than infrastructure. Six months down the line, what is your assessment of the situation?
Bill: I think the key point that I made when I was in Nigeria is that the overall level of government tax collection is the lowest in the world. And so that the resources that are available to invest look to be much lower than you need across the various functions of government. And, of course, I highlighted what that means in terms of primary health care, which we are very involved in Nigeria trying to help improve that primary health care system and reduce the very, very high level of childhood deaths that’s still there. And it wasn’t so much a statement against infrastructure. In fact, I believe infrastructure is very important. You’ve got to have roads and electricity, whether it’s even for a subsistence farmer to get the inputs in and the outputs out. But the overall level and you know, in infrastructure, Nigeria — whether it is roads or electricity — there’s a lot that needs to be done. But the overall resource level isn’t enough to do the education and the health. And so, I was pleased that this discussion of why is the tax collection, revenue collection by the government so low? At least it did trigger some discussion. There has not been a substantial change, but perhaps the various parties will look at suggestions on how to get more revenue. Of course, they have to have the taxpayers believe that the money will be spent well and the works will be hired to do those jobs and they’ll be the trained workers. So, you have to both raise the revenue and raise the quality in order to get the impact.
With the last year’s report on foreign aid, do you think there has been a change and now First Lady Melania Trump, the US First Lady, is heading to Africa, for the first time in October. Can visits like that help build awareness among elected officials?
Bill: In terms of trips, absolutely, it’s fantastic when we can get as many people who are thinking about these issues or who can bring visibility to these issues to visit Africa. You know, so recently, Angela Merkel, Theresa May, President Macron have all been down in Africa. Whenever those trips are taking place, we do our best to make sure that some of the challenges and the progress get highlighted. I don’t know the specifics of the First Lady’s trip, but I imagine groups we work with are giving input on where good places to visit would be. In terms of the overall funding level for foreign aid that you said was a theme in last year’s report, we still have a lot of concerns about that. In the United States, we are very thankful that the Congress has maintained these things as priorities, despite the executive branch recommending very substantial cuts. On quite a bi-partisan basis, the U.S. foreign aid giving was maintained. It’s also been maintained in the U.K. It’s gone up in Germany, so we’re hoping to keep it at that level. France has made a commitment to keep going up. So, overall, there isn’t a big aggregate increase, but GAVI, Global Fund, a lot of the agricultural things and key agencies are getting about the same level of funding.
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