Home / Specials / The Philanthropy Issue /  Bill Gates | With affluence comes responsibility

At the headquarters of our foundation in Seattle, each floor has a quotation etched in glass. On one of the floors is a saying attributed to Mohandas Karamchand Gandhi: “The best way to find yourself is to lose yourself in the service of others."

These words of the Mahatma have a featured place in our building because they get at something very basic about philanthropy. They remind us that any search for real purpose in life must take us outside of ourselves.

Perhaps this statement resonates with me because I grew up hearing versions of it at home. My mother and father spoke often about the importance of giving back to the community, whether through volunteer work or financial contributions. They never let us forget that our relative affluence came with a deep responsibility to assist those who had not been born so lucky.

What’s more, I could tell from a very early age that even as my parents gave, they received. It was clear that they derived real satisfaction and a sense of belonging from their advocacy work and their donations to various causes.

My wife Melinda also came from a family that emphasized the value of giving back to society. So when it came time for us to think seriously about how we might want to use the resources we had been so fortunate to attain, our thoughts turned to philanthropic giving.

Almost a decade-and-a-half ago now, we began our foundation. We had come out of the worlds of business and technology, so perhaps it makes sense that our approach to giving has emphasized measurable results; the accumulation of data; and an entrepreneurial approach to identifying and addressing needs that the market had overlooked.

From the start, these tendencies have led us to place a heavy emphasis on public health. Our foundation’s motto is “all lives have equal value", and it has long been clear to us that one of the fundamental drivers of human inequality is the prevalence of disease and malnutrition in the poorest parts of the world—and that we could achieve extraordinary gains in human well-being with relatively modest outlays.

So this is where our foundation has placed many of its bets—in vaccine development and distribution; in sanitation; in maternal and child-health programmes.

Inevitably, this work brought us to India. It is simply not possible to grapple meaningfully with global-health issues without addressing the challenges facing this vast nation of 1.2 billion people. For example, one of our foundation’s top priorities is the reduction of mortality among children under five years of age—and India alone accounts for 22% of the world’s under-five deaths.

But while India’s public-health problems can be immense, so are the strengths that this remarkable country can bring to bear against those problems.

One of these strengths is a deep-seated and growing tradition of philanthropy. There is the legacy of Jamsetji Tata, as well as the more recent example of leading philanthropists like Azim Premji, Ajay Piramal, Anu Aga, Hemendra Kothari and Rajashree Birla, most of whom have also contributed to this special edition.

Another important asset in India’s public-health campaigns is a recent history of impressive victories against widespread and deeply entrenched diseases. This history shows what a nation can achieve when government and philanthropy work in concert against even the most formidable public-health problems.

India was long considered the most difficult place to end polio. As recently as 2009, it was home to 50% of the world’s wild poliovirus cases. But by 2011, polio transmission had been interrupted, leading to this year’s certification of India as a polio-free country.

This triumph would not have been possible without the committed engagement of Indian government officials, at both the national and state levels. The Pulse Polio Programme was an excellent example of this. Philanthropies such as ours were honoured to contribute to the anti-polio effort in ways that played to the unique attributes of the non-profit sector.

For example, our foundation was able to provide sustained support to the Global Polio Eradication Initiative (GPEI), and could invest in non-traditional approaches, such as electronic mapping or GPS tracking, to monitor the movements of vaccination teams.

Another great Indian public-health success has been its national campaign against HIV and AIDS. Here too, government took the lead, with the philanthropic sector in support. Our foundation’s first investment in India, back in 2003, was a $200 million grant for an HIV prevention programme called Avahan, which focuses on sex workers and other high-risk populations.

As a result of a range of governmental and non-profit efforts, HIV infection rates in India have decreased by nearly half over the past decade, according to the National AIDS Control Organization, and the government of India has taken ownership of the Avahan programme, as originally planned.

One lesson to be drawn from these campaigns is that governments are without peer in their ability to generate resources at the scale necessary to defeat disease. Philanthropies—even one as large as our own—cannot duplicate this in any sustained way.

There is simply no substitute for robust government-funded health and development programmes, which is why I advocate so strongly for affluent nations to maintain and increase those programmes—and for India to boost its own health spending above its current very low level of 1.1% of gross domestic product.

That said, there is also a clear and distinct role for the philanthropic sector—notably, in identifying and supporting interventions that may be too speculative or uncertain for taxpayer-supported governments to pursue. In time, as those interventions become more proven, governments can increasingly apply their greater resources toward them.

Melinda and I have made a point of visiting India regularly; our most recent visit to the country was just last month. A centrepiece of our visit was the launch of the India Newborn Action Plan, or INAP. This plan reflects the Indian government’s admirable and far-sighted commitment to the health of mothers and children.

In this undertaking, the government’s job will be to maintain funding and accountability at the necessary levels. But philanthropists—especially those based right here in India—have their own tasks ahead of them: To identify the unsolved aspects of the problem; to invest in truly innovative solutions; and to collaborate intelligently with the government in ways that derive maximum leverage from the strengths of each sector.

As India’s own national experience has demonstrated, this is a proven formula for success. I have deep and growing faith in the governmental and philanthropic leadership of this country to apply that formula in ever more meaningful ways.

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