The right technologies
In most cases we're talking about delivering technology in tough conditions - in places where the climate, the lack of electricity, the lack of skilled workers and the lack of transportation make it so that no one will know how to repair the tool if it breaks down, and they won't be able to afford to replace it.
So while the science and engineering that lead to innovations can be very complex, the reality on the ground is that it's got to be very straightforward - very easy to use - and that requires a lot of ingenuity.
A great technology can be the sticker that tells somebody when a vaccine has been compromised by heat and is no longer effective. Heat-sensitive stickers prevent millions of doses of good vaccines from being discarded and millions of doses of spoiled vaccines from being administered futilely.
Technology can also look like a debit card. In Malawi, women have difficulty opening their own bank accounts; many are illiterate and can't sign their names. At the same time, social custom allows in-laws to take possession of a wife's assets if her husband dies, which happens often, of course, because so many are dying of AIDS.
So one of our grantees has a debit card with a fingerprint reader that helps a woman who opens an account prevent others from using it. Thus, it protects her from financial ruin if her husband's family is trying to get those assets. We've heard that women in Malawi are doing a great job letting newlyweds know about this, because it's so empowering.
In areas where there's no infrastructure for banking, we have grantees using satellite technology to help people borrow money, get insurance and deposit their savings.
Technology can also look like a new seed, modified to produce a safer and more nutritious cassava plant. Cassava is a staple food in parts of Africa and South America. It's cheap and abundant and rich in starch and calcium, but it also has toxins, including a precursor of cyanide. People who depend on cassava are at risk of poisoning or undernutrition, and seed technology can make it a safer and a better food.
Technology can look like a water-treatment unit that uses ultraviolet light to kill bacteria, viruses and parasites like cryptosporidium - all sources of some of the diarrheal diseases that kill millions of children. Our foundation is supporting a venture that uses this technology to provide safe drinking water for less than a penny per person a day.
Getting involved
But no foundation alone can solve the health problems of the developing world. We need businesses and governments as partners. That means we need to get these issues on the political agenda, and we need to tap into market forces to get the private sector involved. It means we all need to embrace a broader definition of responsibility.
We must be willing to look at the failure of collective action and see how we can change it. Because these problems are so complex, government has to be involved in solving them.
The Gates Foundation accounts for 1 percent of the giving in America. If we spent all of our endowment on education, it would amount to just half of what the state of California spends on education each year. If we used it to fill the gap between the amount of money that's available for health in developing countries and the amount that's needed, it would barely last one year.
But as soon as we say not just that we won't accept these diseases in our neighborhood or in our country, but that we won't accept them in our world, then we start the wheels of collective action turning. We start by giving our governments permission to spend more on these challenges. And that will unleash the potential for sweeping change.
Our foundation has learned a lot since we began our work. One thing I hope more people learn is that giving, meeting smart people, and thinking through these problems can be immensely fun. It's a lot like running a successful company, and it draws on some of the same skills.
It's an incredible privilege, and of course we'll make mistakes, so it's often very humbling as well. Ultimately, solving these problems comes down to all of us. Those of us in the rich world have the chance to improve the lives of billions of people around the world. I can't think of anything that's worth more of our time and effort.
