Setting clear goals and finding measures that will mark progress towards them is the key to improving the human condition, wrote technology billionaire Bill Gates in his foundation’s annual letter.
Gates wrote in the Bill and Melinda Gates Foundation’s fifth annual letter that while the concept of creating a goal and finding ways to measure it seems simple enough, he has been surprised how often it is not done and how hard it is to actually accomplish. As Gates explained, using these measures is the only way new advances in technology can have an effect.
“Any innovation — whether it’s a new vaccine or an improved seed — can’t have an impact unless it reaches the people who will benefit from it,” he wrote.
Gates cited the Millennium Developmental Goals (MDGs) created by the United Nations, and backed by 189 nations, in 2000 as an example of how measurement can work. The “spirit” behind this idea was Jim Grant of UNICEF’s work with vaccinations during the 1980s. Grant set a goal to deliver lifesaving vaccines to 80 percent of children worldwide, a goal that seemed out of reach during a time when the fax machine was the most advanced communications tool available.
While he did not reach his goal of 80 percent, the number of vaccinations increased from 17 percent in 1980 to 75 percent in 1990. Yet, as Gates noted, that number gradually slipped downwards as donor attention turned elsewhere.
The MDGs have taken Grant’s original ambitious goals and applied them to a global effort to improve the lives of the world’s poorest people. A date of 2015 was set to achieve these goals, and many countries are on track to meet these them. One of the countries is Ethiopia, which Gates cited as a strong example of how measurements help achieve these goals.
In the 1980s, the African country ranked near the bottom of every key health indicator, with child mortality among its most troubling statistic. Yet things started to change a decade ago when the country’s government made providing health care to every citizen a top priority. After it signed onto the MDG in 2000, Ethiopia listed a number of goals it wanted to meet, including reducing child mortality by two-thirds.
Gates said the country used measurement to figure out ways to achieve this and other goals. They used the Indian state of Kerala – which lowered its mortality rate and improved in other significant health care categories – as a way to measure its progress. With feedback from Kerala representatives, Ethiopia launched its own community health program in 2004.
“This is one of the benefits of measurement,” wrote Gates, “the ability it gives government leaders to make comparisons across countries, find who’s doing well, and then learn from the best.”
Ethiopia now has more than 15,000 health posts, staffed by 34,000 workers, delivering health care to a country that has more than 85 million people, according to Gates. These advances have played a part in the reduction of childhood mortality, particularly those under the age of five. There were 166 deaths per 1,000 live births in 2000; that number, as of 2011, is at 88 deaths per 1,000 live births.
Gates ended his letter by saying the measurement process he described — setting clear goals, picking the right approach, and then measuring results to get feedback and refine the approach continually — will help deliver tools and services to those that truly need them. Yet he acknowledged there are still problems that need to be faced.
“Though I am an optimist, I am not blind to the problems we face,” he wrote. “There are challenges we must overcome to speed up progress in the next 15 years. Two that worry me the most are the possibility that we won’t be able to raise the funds needed to pay for health and development projects, and that we won’t align around clear goals to help the poorest.”
The Bill and Melinda Gates Foundation was founded in 1994 to enhance healthcare and reduce poverty globally and, in America, to expand educational opportunities and access to information technology. The foundation had an endowment of $36.2 billion as of Sept. 30, 2012, according to its website.
You can read Gates’ full letter at http://annualletter.gatesfoundation.org/