Bill Gates on health and poverty in Africa

Bill and Melinda Gates believe poor people’s live will change rapidly in the near future.

Read an edited excerpt of Bill and Melinda Gates’ annual letter, titled ‘Our Big Bet for the Future’

Green: You’ve made a big bet: that the lives of people in poor countries will improve faster in the next 15 years than at any other time in history. But you admit that a handful of the worst off could continue to struggle. Which in your opinion are the worst off African countries and why?

Gates: It’s hard to predict if you go fifteen years out which ones will still be in a very tough situation. Today you know Somalia, Mali, the Central African Republic, DRC: quite a few where the strength of the government and the basic stability and therefore the ability to build infrastructure and have any type of government, roads, education, … is extremely difficult and what some people call ‘failed states’. You know there are many countries in Africa which are moving up and getting better. Typically, although Somalia is kind of the exception, the sea board countries, because they can engage in trade and build up infrastructure they tend to do better than landlocked countries.

Green: In terms of HIV, the hope is that the number of people on treatment will outstrip the number of new infections, especially in sub-Saharan Africa. In your opinion will we reach this tipping point by 2030?

Gates: Yes, I’m optimistic that we will. The challenge with HIV which is that right now we need to keep you on lifelong treatment and so as we’re improving the survival rates, the total number of people living with HIV; those count for a lot. So the financial cost to the government of providing the drugs and the services that just gets larger and larger. So we need to have less people being infected so we’re not growing the size of that pool. And then the real dream, that we don’t have, is what’s called a functional cure, where you give people a set of drugs that are powerful enough that then subsequently they don’t need to keep taking drugs. And there’s a lot of research in that area and there’s a good chance that by then we’ll have a functional cure.

Green: You’ve predicted, in your newsletter, that the continent can achieve food security in fifteen years. In your opinion is this only possible if Africa embraces genetically modified foods?

Gates: It’s like medicine. Each different type of crop you’ll look at it and you’ll say OK here’s the benefits of this and here’s the risks. In fact GMOs, all the ones that are used today, there have been no safety problems. And the EU just agreed that individual countries could decide to adopt GMOs. If you look at the crops that are adopted to climate change like dealing with very heavy heat and drought and salinity – the most productive ones there probably will involve GMO techniques. But I think the benefits are such that a lot of countries will decide to embrace it.

M&G’s Health reporter Amy Green speaks to Bill Gates

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