Bill & Melinda Gates answer '10 toughest questions' in annual letter

In their 10th annual letter for the Bill & Melinda Gates Foundation, co-chairs and trustees Bill and Melinda Gates addressed the 10 questions they are asked most frequently. The questions range in topic from how they maintain their optimism in today's world, to if their efforts to save children lead to overpopulation, to whether they feel as if they are imposing their own values on other people and countries.

In their 2018 annual letter, the couple notes what drives their unwavering optimism is not only knowing that life for millions of people across the world has improved during the past decade or century, but "knowing how life can get better."

"Although we see a lot of disease and poverty in our work — and many other big problems that need to be solved — we also see the best of humanity. We spend our time learning from scientists who are inventing cutting-edge tools to cure disease. We talk to dedicated government leaders who are being creative about prioritizing the health and well-being of people around the world. And we meet brave and brilliant individuals all over the world who are imagining new ways to transform their communities," the annotated letter reads.

Here are four additional excerpts from the Gates' 10th annual letter.

1. On the decision to make accessible vaccines a primary issue for the foundation: "Take vaccines. We assumed that since it was possible to prevent disease for a few cents or a few dollars at most, it was being taken care of. But it turned out that we were wrong, and tens of millions of kids weren't being immunized at all. We've spent $15.3 billion on vaccines over the past 18 years. And it's been a terrific investment. Better immunization is one reason why the number of children who die has gone down by so much, from almost 10 million in 2000 to 5 million last year. That's 5 million families that didn't have to suffer the trauma of losing a daughter or a son, a sister or a brother."

2. On how they use their foundation to support climate change initiatives: "Even breakthrough technology can't stop the weather from changing. So the world needs to adapt to what's happening now and what we know is coming. That's why our foundation's work, especially in global agriculture, is increasingly focused on climate issues. Hundreds of millions of people in developing countries depend on farming for their livelihoods. They had almost nothing to do with causing climate change, but they will suffer the most from it. When extreme weather ruins their harvest, they won't have food to eat that year. They won't have income to spend on basic necessities like healthcare and school fees. For smallholder farmers, climate change is not just an ominous global trend. It is a daily emergency."

3. On whether they're imposing their own values on other cultures: "On one level, I think the answer is obviously no. The idea that children shouldn't die of malaria or be malnourished is not just our value. It's a human value. Parents in every culture want their children to survive and thrive. … We're acutely aware that some development programs in the past were led by people who assumed they knew better than the people they were trying to help. We've learned over the years that listening and understanding people's needs from their perspective is not only more respectful — it's also more effective.

4. On whether saving children's lives leads to overpopulation: "When more children live past the age of 5, and when mothers can decide if and when to have children, population sizes don't go up. They go down. Parents have fewer children when they're confident those children will survive into adulthood. Big families are in some ways an insurance policy against the tragic likelihood of losing a son or a daughter. … When more children live, you get one generation that's relatively big. Then, when families decide to have fewer children, the next generation is much smaller. Eventually, a country ends up with relatively more people in the labor force producing economically — and relatively fewer dependents (very old or very young people). That's a recipe for rapid economic development, especially if countries take advantage of it by investing in health and education."

To read the Gates' full letter, click here.

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