There's an old joke about a delusionary business plan: "Lose money on every sale, but make it up in volume."
I was reminded of this by an October 28, 2009 statement posted on Bill and Melinda Gates' Foundation Center web site about their vast plans to cut disease, particularly among children, with lavish spending,:
"In a joint speech to lawmakers, administration officials, and foreign policy experts as part of the foundation's new Living Proof Project, the Gateses noted that U.S. spending on global health has increased significantly in recent years, from $1.5 billion in 2001 to $7.7 billion in 2009. Although that figure represents less than one-quarter of 1 percent of the federal budget, the nation's investments in global health have achieved impressive results. For instance, since 2003 the President's Emergency Plan for AIDS Relief has helped save an estimated 1.2 million lives. 'U.S.-supported global health programs are saving and improving the lives of millions of people, at a remarkably low cost,' said Bill Gates. 'All Americans should be proud of this success.' [Bill and Melinda Gates Call on U.S. Policy Makers to Continue Support of Global Health Initiatives]
Doubtless many lives are saved by these efforts—at least temporarily. The Gates' business, Microsoft, certainly knows how to reach millions and its volume has grown to be huge.
But is this program ignoring the facts on the ground in too many countries?
Since 2003, Mr. and Mrs. Gates, 1.2 million lives may have been saved—but the net number of humans added to the planet since then is about 400 million, many of them in countries which have serious health, resource, and stability problems.
Every child born potentially adds to the cumulative ills facing these poor countries. And these translate into conditions where immigration to other places often becomes imperative for many—that, or joining an indigenous militant group.
Since April, I have been to four countries in Africa—Ethiopia, Egypt, Ghana, and Zambia. And, in decades of overseas travel prior to these trips, my wife and I have witnessed to the same continuing urgent need: for more family planning, but also for programs that empower the producers of babies, namely women.
Many NGOs working in this field are getting that job done—but always with inadequate resources.
For example, Ethiopia (to the surprise, I bet, of many) is now Africa's 2nd largest country. Its population has risen from 35 to 85 million in just 25 years. In a private interview, we were told by Ethiopia's President that his government has embraced Pathfinder International's Takamol clinic method which is being pursued in both Ethiopia and Egypt. Establishing attractive small, modern clinic centers with local governance in areas which encompass both rural and urban populations has brought women into leadership positions on critical issues such as child spacing, contraceptive choices and related reproductive services.
PF's constant operational mantra, "Building capacity", can hopefully produce a continuing successful program even when PF is no longer there. What a good move to establish functioning, local community-based democracies that encourage such a powerful sense of community ownership in the local clinic staff and their customers.
As The Population Reference Bureau, which has been a Gates Foundation grant recipient, has just reported in one of its authoritative policy briefs:
"Family planning is one of the most cost-effective health interventions in the developing world. For decades, research has shown that for a relatively modest investment, family planning saves lives and improves maternal and child health. However, there have been relatively few studies that shed light on how family planning also lifts families out of poverty. Now, a new study on Bangladesh provides evidence that long-term investment in an integrated family planning and maternal and child health program (FPMCH) contributes to improved economic security for families, households, and communities through larger incomes, greater accumulation of wealth, and higher levels of education."
[Family Planning and Economic Well-Being: New Evidence From Bangladesh]
Too bad the Gates Foundation's leaders are not heeding PRB's suggestion to fund more similar programs.
The Gates Foundation's October 28, 2009 statement went on:
"The Gateses also urged policy makers to commit to reducing child deaths worldwide by nearly 50 percent — from about nine million per year to five million — by 2025, noting that U.S. support of global health initiatives has already helped reduce deaths of young children by more than 50 percent in the past fifty years. Citing new projections by Johns Hopkins University researchers, the Gateses highlighted four strategies that could be combined to achieve that goal: immunizing 90 percent of the world's children against measles, rotavirus, pneumococcal, and other illnesses; providing malaria prevention tools to 90 percent of people at risk of the disease and effective malaria drugs to 75 percent of those in need; providing basic health services to at least 75 percent of pregnant women and newborns; and ensuring that at least 75 percent of children receive treatment for diarrhea and pneumonia.
"'When it comes to global health, Bill and I are optimists — but we're impatient optimists,' said Melinda Gates. 'The world is getting better, but it's not getting better for everyone, and it's not getting better fast enough.'
But the birth explosion occasioned by the introduction of penicillin in the 1940's raised world population 2.5 times. And now we find the world a much more dangerous place.
Mrs. Gates, you are repeating this pre-WWII process with your programs. Except that the planet can't handle with another multiplication like that—a theoretical increase in world population to over 15 billion, which would insure a complete planetary disaster.
I impatiently wait your enlightenment.
The Gates program is great PR. But much of the world loses ground with every new birth. Did anyone in the Gates' large audience of important leaders listening to their statement rise to make this point?
When I related those Ethiopian population growth numbers to a friend living in Falls Church, VA, a Washington suburb, she exclaimed, "My God, our neighborhood is loaded with Ethiopians."
No surprise, and there are plenty of other immigrants there too, generated by this same overseas population growth.
"As of the 2000 census there were in Falls Church 10,377 people, 4,471 households, and 2,620 families residing in the city. There were 4,725 housing units at an average density of 2,379.5/sq mi (916.8/km²). The racial makeup of the city was 84.97% white, 3.28% Black or African American, 0.24% Native American, 6.50% Asian, 0.07% Pacific Islander, 2.52% from other races, and 2.43% from two or more races. 8.44% of the population were Hispanics or Latinos of any race. Eden Center, a large mall of Vietnamese specialty stores, is located in Falls Church, and draws Asian consumers from the region. "
The city also has a very significant population of ethnic Salvadorans.
Just more Microsoft customers, I guess.
The US has added 50 million immigrants and their offspring since 1970.
More are coming, you may be sure.
What is the Gates Foundation doing about that?
Donald A. Collins [email him], is a freelance writer living in Washington DC and a former long time member of the board of FAIR, the Federation for American Immigration Reform. His views are his own.