Melinda Gates warns on aid cuts
Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, speaks to the FT's Vanessa Kortekaas about progress in tackling poverty and disease, and the risk of regression as countries – including the US – rethink their commitment to foreign aid.
Produced by Vanessa Kortekaas. Filmed by Nicola Stansfield. Still images by the Bill & Melinda Gates Foundation and Getty.
The Bill and Melinda Gates Foundation has just released a wide-ranging report about how much progress has been made to tackle global poverty and disease over the last few decades. But they also warn that progress is at risk, because some countries are rethinking their commitment to development. I'm joined now by Melinda Gates.
Melinda, can you tell us what are the key areas where you've seen the most progress, for example child mortality rates, and was key to that success?
Sure. We've made huge progress as a world on cutting childhood mortality in half, and maternal mortality almost in half. And the key to that is the fact that we had a goal, and a blueprint, and countries were learning from one another. Those primary health care systems are starting to be set up. And we were actually able to reach children with vaccines, and parents wanted to come into clinics for vaccines. All of those pieces have to come together. But when they do, it's magic. And kids getting vaccines mean that they stay alive.
One thing that really struck me in the report is that you said the commitment to fighting global poverty and disease is in jeopardy. Why are you concerned about this?
Well we're concerned any time there is talk about cutting funds, because we know that the funds the world has committed is what has allowed these countries to make progress. And if we cut the funding to these programmes, children will literally die. They won't receive vaccine. Adolescence won't get HIV/AIDS drugs. Moms won't get family planning tools. It takes money to make this progress. And so we're concerned any time governments talk about cutting funds.
And specifically, we know in the US that funding was cut to the UN population fund this year. And in the UK, there's a lot of discussion as you know, of course, about the foreign aid budget. But because the US is such an important global leader in development, are you worried that under the Trump administration that that leadership and progress is at risk?
Well, I think that the current administration budget that was put forward, yes it shows many cuts across the board in global health. And so it's going to be up to Congress to come forward and keep the funding up in foreign aid in the United States. And that's true in Europe, as well. Just as you said, the UK has made deep investments over many, many years. When I travel out to the developing world, it's those investments that are allowing children to eat, and get nutritious meals. And so yes, any time a budget is proposed to be cut, or you hear that the public is concerned about foreign aid, it's our job to get the message out that, no, in fact these sets of programmes that are happening are highly effective. And it's why children, and moms and dads are staying alive.
What do your findings tell us are the biggest barriers to progress? Is it cultural, for example, when it comes to family planning, or maternal health? Or is it just a matter of funding?
Sure well one of the things that has been so great in the last decade, is that we are actually breaking through those cultural barriers. One of the things we point out in this report, just as one example, is Senegal. So Senegal came together with a country-wide plan to say, we believe in family planning. And even though it's been a taboo subject in the past, we're going to talk about it. They put it on TV, on radio, in the newspapers, and in posters. The moms started to talk about how the Koran allows for family planning, and how they should talk about it as the right thing for families to do.
So it's those two pieces coming together, funding and cultural barriers, that are being broken through. And I could give you example after example of where that's happening around the world, and it's why this progress is happening.
And another point I want to touch on that's related to those cultural issues is digital financial inclusion. How key do you think access to financial services is for empowering women in achieving gender equality? Now we have research that shows that when a woman has access to finances, it changes everything in her family.
That word, that tricky word, we call empowerment, we always say, well what does that actually mean? Financial services is one of the things that leads to empowerment. So the way a woman is perceived in her family, in India by her mother-in-law, in Africa, by her husband or her teenage son. If she has assets, she spends them on her family, and she starts to plan. And she not only has dreams and hopes, she actually starts to have goals, and can achieve those goals. And that's what empowerment is. And so even if she's only saving a few rupees a day, or a few dollars here or there, over the course of a year it adds up.
And so when a child needs those fees, that come due to put her next child in school, guess what? She has them. And it changes everything about how she's seen in her family, in her community. I hear it over, and over, and over again, when I travel, from the women themselves. And now the research supports that.
And finally what is the one take-away you're hoping people will get from this report?
We have the largest cohorts of adolescents coming up across the continent of Africa. And if we make the investments in these adolescents, we give young women access to family planning tools, it allows her to get herself educated. It allows her to get a job, and have children when she wants them to. If we make the investments, continue to make the investments in HIV/AIDS drugs, which saves their lives, they will go on to be a generation that lifts their own country up.
And the converse side of that, if we don't make the investments, is a very bleak and sad story. And I think we need to say to the world, these are the right investments, because the world will change. This is the generation that will change the world. And they already are, we just need to keep believing and investing in them.
Thanks for your time Melinda.