2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

On the afternoon of February 10, the Gates Foundation today released Gates’ 2020 letter. Bold innovation and strong global collaboration will allow us to respond more calmly to global health challenges, the foundation said. Here’s the full text of the 2020 Letter: This year’s letter comes at a time when we are experiencing a major public health challenge: the new coronary pneumonia outbreak.

To meet this challenge, the Foundation’s staff is working closely with partners in China and around the world to contain the spread of the epidemic, help countries protect the most vulnerable, and strengthen the development and system building of innovative tools in the long term.

We are convinced that bold innovation and strong global cooperation will allow us to respond more calmly to global health challenges. Therefore, on the one hand, through rapid and flexible funding, we help multilateral agencies and national public health departments to accelerate the detection, isolation and treatment of new coronavirus infections in order to stop transmission and control the outbreak; We also support research and development partners in China’s public and private sectors, as well as global partners such as the Alliance for Innovation in Epidemiological Prevention (CEPI), to develop vaccines, treatments and diagnostic tools to respond to outbreaks in the long term. We hope that the progress of innovation will serve those in need as soon as possible.

As Gates said in his annual letter, we will “continue to support advocates, researchers, government leaders, and those who are struggling on the front lines, and whose efforts make it possible for people in more places to lead healthy and productive lives.” “

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Twenty years ago, when we founded the Gates Foundation, 9/11 had not happened, the global economy had not yet undergone a massive recession, social media was still on the rise, and the world was no longer the same.

Yet there are many issues of concern in the world, both then and now, and there are good reasons to invest in any of them. We knew early on that we would donate most of the wealth we received from Microsoft to improve the lives of others. The challenge is how to give back in a meaningful and influential way.

We spent a lot of time talking to experts and reading a lot of reports in the search for the right charity direction. In the process, we recognize the need to focus more on the world’s poorest people and to meet their needs. The core idea of the Gates Foundation is that everyone should have the opportunity to live a healthy and productive life. Twenty years later, despite the many things that have changed, this remains the number one principle that drives our work.

As we enter the new decade, the world is still awash with many upheavals and uncertainties. Yet even at a challenging time, and in fact, it is a time when we need to continue to support advocates, researchers, government leaders, and those who are struggling on the front lines, whose efforts make it possible for people in more places to lead healthy and productive lives.

For the past two decades, the Gates Foundation has focused on improving global health and improving America’s public education system, which is key to a healthier, better, more equal world.

Disease is both a symptom of inequality and a cause of inequality, and public education is the driving force for equality.

We are well aware that philanthropy does not – and should not – take the place of government or the private sector. But we are convinced that philanthropy can play a unique role in promoting social progress.

In the best case, charity can take on risks that the government cannot afford and businesses are unwilling to take. The government needs to focus most of its resources on solutions that have proven to work, with companies entrusted to shareholders, and foundations like ours have the freedom to try ideas that they won’t try, some of which may lead to breakthroughs.

Our close friend Warren Buffett has a vivid account of this. He has always given us a lot of great advice. When he donated most of his wealth to the Gates Foundation and joined us in the charity work, he encouraged us to “do everything we can to give it a go.”

Many Americans know this from baseball. When you let go of a fight, you use all the strength of your body to hit the ball as far as possible. Although you know that the bat may swing empty and not touch the ball at all – but once you touch the ball, the rewards will be substantial.

That’s what we think about philanthropy. We cannot just pursue little-tat progress, but pour all our strength and all our resources into the big bets that, if successful, can save lives and improve lives.

It needs to be clear that the risks we take are not comparable to those of the real heroes who drive the world’s progress, such as medical workers who go deep into war zones to vaccinate their children, teachers who volunteer to work in the most challenging schools, and stand up in the world’s poorest areas. Women who rebel against stereotypes and traditional ideas that oppress them. What they do requires personal sacrifice, and we don’t need to – what we’re going to do is support and respect them and them, and hopefully one day our innovation will make life easier and more dignified for them.

Over the past two decades, the Gates Foundation has donated a total of $53.8 billion. Overall, we are excited about the results achieved. But does every dollar we spend have the desired effect? Not so. We were disappointed, frustrated, and surprised. But we believe that openness is important, whether it’s success or failure, and it’s important to share our lessons.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

In this year’s letter, we will talk about our work in the areas of health and education and how the risks we take will lay the foundation for future progress. We will also share the other two issues that became the focus of our work later – the climate crisis and gender equality – and how they will affect our work over the next two decades.

Several of the investments we made when we first started philanthropy were aimed at reducing inequalities in global health. So this letter begins here.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Global Health

Melinda: When we first started working on global health, we were shocked to find that many of the diseases that have long been prevented by the widespread use of vaccines in developed countries such as the United States continue to kill large numbers of children in low-income countries. This makes us acutely aware that poverty is closely linked to disease.

Neither the market nor the government can solve this problem alone, and we see an opportunity for charitable money to work.

We have worked with the World Health Organization, the World Bank and the United Nations Children’s Fund to create the Gavi Alliance for Vaccine immunization. Gavi called on governments and other agencies to work together to raise funds for vaccines and make them available to children in low-income countries.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Bill: After World War II, the world has set up a series of international organizations, hoping that the international community will increase economic and military cooperation, including the United Nations (UN), the World Health Organization (WHO) and the North Atlantic Treaty Organization (NATO), among others. Gavi is also promoting a similar type of collaboration to make vaccines available to more children.

We weren’t sure what we could do. Thanks to Microsoft’s experience, I learned about the risks of creating a new organization. To be sure, this is not the same risk we take with Gavi – we’re not launching new products to attract customers, we’re trying to prove to the world that an international partnership for vaccines is not only feasible, but necessary. If we fail, the government or other funders may stop investing in similar projects.

We faced a lot of problems at that time. Can we raise enough money to persuade manufacturers to offer vaccines at affordable prices in developing countries? Even if we raise it, can governments be persuaded to take on the difficult task of getting these new, yet underused vaccines for children?

For both questions, you can now answer “yes” loudly. By 2019, Gavi has vaccinated more than 760 million children and averted 13 million deaths. It has also succeeded in bringing more vaccines and supplies to the market at lower prices. For example, a dose of pentavalent vaccine, which can prevent five deadly infections, used to cost $3.65, but now it’s less than a dollar.

Melinda: Today, 86% of the world’s children have access to basic immunization, a higher number than at any time in history.

However, covering the remaining 14% is much more difficult than achieving 86%. These 14 per cent of children are among the most marginalized groups in the world.

Some of them live in countries with very weak infrastructure, and frequent conflicts have prevented the health-care system from functioning properly. Others live in remote rural areas. Most dishearted is that some children are only a few hundred metres from health facilities, but the health-care system ignores their presence (imagine the children of new immigrants living in the overcrowded slums of Nairobi or Rio de Janeiro). Gavi is now strengthening its cooperation with several countries to help children who are not vaccinated in specific areas with more targeted means.

Gavi is raising money for the next five years and we hope to inspire more funders to participate to further promote this success story for all children. More money will allow Gavi to save more lives. We believe that the strong investment in Gavi is one of the best decisions we have ever made – and we are excited about the return on this investment.

Bill: Our work on vaccines has something in common with another work we’ve been closely involved with since the beginning, which is AIDS.

At the beginning of the foundation, AIDS mortality in rich countries began to decline as a result of new medical measures. But like vaccines, life-saving health tools in high-income countries are not universal in low-income countries. In sub-Saharan Africa, the number of new infections was still soaring. I remember reading a terrible article in Newsweek that hiv could orphan an entire generation of children.

In response to the spread of AIDS and two other major disease killers, we funded a new organization, the Global Fund to Fight AIDS, Tuberculosis and Malaria, in 2002. The Global Fund shares a similar goal with Gavi: to introduce life-saving medicines, technologies and projects to low-income countries. For the same reason, the organization is taking similar risks.

But like Gavi, the global fund has been a huge success. In 2018 alone, nearly 19 million people in countries where the project was implemented will have access to hiv-resistant treatment.

Since the creation of the Global Fund, we learned that there are many programs around the world to use innovative technologies where they are most in need. As a result, the Gates Foundation has invested in the development of a range of new tools while supporting the Global Fund.

At first, we devoted much of our resources to AIDS prevention, which needs to be used every day. For a variety of reasons, this work has not achieved the results we had expected.

For example, we used to be optimistic about vaginal gels that could prevent infection, but it has proven to be effective in stopping the spread of the disease. Now although there is a daily oral preventive drug, as long as continuous use, prevention effectiveness of up to 99%, but the drug in low- and middle-income countries have not made much progress in the promotion, so the effectiveness of local AIDS prevention and control is limited. Local health programs are also trying to find ways to promote the drug, which needs to be taken orally every day, to make it both attractive and part of everyday life.

Now we are focusing on long-term preventive measures. Imagine that instead of taking medication every day, you’ll need to get a needle every other month, or have a subcutaneous implant on your arm, or even a single shot of the vaccine to completely eliminate the risk of HIV infection.

The Gates Foundation is also looking at long-term treatment options. Thanks to significant research, hiv-infected people today can achieve the same life expectancy as uninfected people as long as they receive treatment. But as with current preventive measures, (and so on) the need to take medication on a daily basis. We are looking for new treatmentoptions to reduce the frequency of medications and hope to extend the interval to one year.

Even if these long-acting treatments are achieved, many challenges will need to be overcome to truly reverse the epidemic.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Staff at the Guguletu Community Health Institute present edgtosers they have seen aids and tuberculosis in Cape Town, South Africa

Melinda: In 2003, we visited an AIDS clinic in Botswana, which was one of the largest on the African continent at the time. That visit gave us a deep understanding of the social structure behind the disease.

A Dutch doctor told us that he and his wife had hired a local woman in Botswana at home. One day, the woman told them she was going back to the village and never came back. Worried, the couple went to see her and learned that she had died of AIDS.

What shocked them was not that she had AIDS, but that she had never sought treatment in her life – even if she worked in a clinic, even though she could have had the best medical treatment. The stigma that is shrouded in AIDS is devastating and can even kill people.

We always remember the story. It makes us aware of the complexity of the disease and makes our actions clearer.

The fact is that in the fight against AIDS, medical intervention alone is not enough. We also need to look at what people with infected people really care about, what is stopping them from seeking prevention and treatment, and why treatments that work well in clinical trials don’t play their part in everyday life.

For example, as far as we know, adolescent girls and young women account for a fairly high proportion of new HIV infections in southern and eastern Africa. The reasons behind this are poverty, violence and gender constraints.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Although we think we know the girls well, there are still a lot we don’t know. We can look at their lives from our own perspective, but we can’t get enough data from their perspective. This makes it difficult for us to find the right way for them, whether it’s medical or otherwise.

Fortunately, research is catching up. Last October, I met a foundation partner in Johannesburg whose job was to fill this data gap and involve adolescent girls and young women in developing treatment and prevention programmes that better meet their needs.

The Gates Foundation also works with a U.S. government-backed project called DREAMS, an acronym for “firm, resilient, empowering, AIDS-free, guided and safe.” As the name implies, this project cuts into AIDS prevention from a broader perspective. It also focuses on financial literacy, entrepreneurship and the elimination of gender-based violence, all of which can help women and girls lead healthy, AIDS-free lives.

Over the past two decades, science and technology have made incredible achievements in tackling AIDS. The world’s understanding of how to use new technologies is also evolving, which is critical.

Bill: Global health has always been a core area of concern for the Gates Foundation. Climate change is making more and more people more vulnerable to illness, and the job will only become more important in the future. (I’ll add to this later in the letter.) )

In addition to our investments in vaccines and AIDS, we will continue to support progress in the prevention and control of other communicable diseases, such as malaria, tuberculosis and polio (of which polio is done primarily through a partnership with GPEI, the global polio eradication initiative). We will also continue to fund new initiatives in autonomous family planning, maternal and newborn health, and explore new ways to prevent malnutrition.

We do this because health improvements are essential to getting out of poverty. Only when people are healthy can their lives improve and the world will finally become a better and fairer place.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Public education

Melinda: Bill and I have always been very clear that the foundation focuses primarily on basic education (K-12) and higher education in the United States. To be successful in the United States is like a complex equation, with too many variables to consider, including race, gender, place of birth, income level of parents, and so on. Education is an extremely important factor in this equation.

Both of us have attended first-class schools and understand that this presents us with more opportunities. We also know that millions of Americans, especially students from low-income families and people of color, do not have access to the same opportunities.

Experts can certainly describe this reality in a more rigorous way. In 2001, I met with the educator Deborah Meier, and she had a big impact on me. Her book, The Power of Thought, made me understand that public schools are not only important social balancers, but also the driving force behind the revitalization of democracy. Democracy, she writes, requires the equal participation of every citizen. This means that if our public schools are not ready for students to participate fully in public life, they will not be able to serve our country well.

This passage often makes me think deeply. It really made me realize how important this job is.

If asked 20 years ago, we would say that global health is the most risky job the foundation has done, and American education is our surest choice. In fact, the two results are quite the opposite.

In terms of global health, there is much evidence that the world is on track, such as a significant reduction in child mortality. In contrast, American education has not yet met our minimum expectations. The status quo remains bleak for American students.

Imagine: U.S. elementary schools have an average of 21 students per class. Currently, 18 of them have graduated from high school with a diploma or equivalent certificate (a significant improvement from 2000), but only 13 of these 18 graduates will receive higher education within one year of high school. In the next six years, only seven will successfully complete four years of university studies and earn a degree.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

When you add race, it’s even worse. If all the students in this class are Latino, only 6 students in 6 years will complete four years of college education. If they were all African-American students, the number was only 4.

Progress is harder than we want, but that doesn’t mean we can give up. On the contrary, we believe that if we do not do our best to help students reach their full potential, the risks will be even greater.

We know, of course, that many people question the suitability of billionaire philanthropists to lead educational innovation or participate in education policy making. Frankly speaking, we have the same doubts. But Bill and I have always known that we don’t want to generate ideas for ourselves, but to support people who have worked in education for years to innovate, including teachers, administrators, researchers, and community leaders.

But the tricky thing is that even those who work in the field of education have difficulty reaching consistent conclusions about which methods work and what doesn’t.

In global health, we know that as long as children are vaccinated against measles, they will be immune to measles, which means higher survival rates. However, there is no consensus on the causalrelationship relationship between education. Is charter schools good or bad? Should school hours be shortened or extended? Which lessons on scores are better? Educators are also unable to give firm answers to determine which is the best practice.

It is also difficult to prove that any single initiative can change everything. It takes at least 13 years for a child to go to high school, with the participation of hundreds of teachers, education administrators, and local, state and federal policymakers. This is a slow cumulative process, and if the results are to eventually be changed, intervention is required at different stages in the middle.

Even so, we do see signs of progress. For example, we help to improve the curriculum, have some insight into preventing dropouts, and have a deeper understanding of what makes a great teacher and what makes a good teacher better. (Bill will then explain more reasons for optimism.) )

We are also proud of the Gates Millennium Scholars Program, which has offered full college scholarships to 20,000 students of color. We had the opportunity to meet some of the scholarship recipients, and it was always moving, and one of the students, Kaira Kelly, told me that she “never dreamed of going to college” before accepting the Gates Millennium Scholarship. When I met her, she was studying for a master’s degree in pedagogy and was ambitiously planning to repay our investment in her through work in the future.

Although the Gates Millennium Scholarship has made a huge difference to the lives of these 20,000 students, tens of millions of students have graduated from public schools in the 16 years since the scholarship was launched. This means that we are only exposed to a small part of it. Our goal is to make a huge difference for all American students, so we’ve moved most of our work from scholarships to places where we can influence more students.

It’s an unparalleled feeling to see young women like Kayla Kelly extort their potential. It further strengthens our commitment to supporting the public school system and ensuring that every student has the same opportunities.

Bill: How should we provide students with the tools they need to learn and develop ourselves? We found early in our education work that clear and consistent standards are needed for students to truly master what they learn every year.

We are betting heavily on a curriculum standard called Common Core. Within two years of the curriculum’s release, states have adopted it. But we soon discovered that it was not enough to adopt standards, which we should have expected. We thought that when the new standards were introduced in each state, the market would respond by developing teaching aids that were consistent with the new standards. But the reality is that it didn’t happen, so we started looking for ways to stimulate the market.

Some teachers told us that they had no way of knowing which textbooks met the new standards, so our foundation supported a non-profit organization called EdReports to compile so-called Consumer Reports for teaching aids. Now, each teacher can go up there to see how quality a textbook is and whether it meets the new standards. Schools will also use these evaluations to purchase materials that are more suitable for students. Accordingly, textbook publishers have begun to publish more and better materials.

In addition to textbooks, we need other ways to help teachers and students. For example, many teachers do not have access to the resources to meet their new expectations. So we look edatheted to provide them with training to help them adjust their existing teaching methods.

After two decades of hard work, what we have learned in the field of education is that it is very difficult to scale out these solutions. Much of our early work in education has hit the ceiling. Once these programs reach 100,000 grades of students, we will not be able to continue to achieve the desired results.

We are well aware that the impact of expanding education programs is not about replicating the same tools to everyone, but about tailoring them to the specific needs of teachers and students.

We have shifted the focus of our work on basic education to supportspecific solutions developed by some school networks for local situations. We hope that these Schools for School Improvements will help more African-American, Latino and low-income students successfully graduate from high school and continue their college education.

To date, we have funded $240 million from a network of 30 schools, many of which, not all, are geographically divided. Each network consists of 8 to 20 schools that target their own goals, such as helping backward freshmen keep up with the progress and graduate successfully.

The first year of high school is crucial. A new student who does not have more than one degree is four times more likely to graduate successfully than a student who has been a student of multiple departments. Judging students in this way whether they can graduate successfully is more predictable than using race, wealth, and even test scores.

In 2018, I visited North Grand High School in Chicago. Students at this school usually come from communities filled with violence, hunger and other problems. The school was once named one of the worst in Chicago.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Bill met with students at North Grand High School in Chicago.

North Grande High School later joined the School Improvement Network and gained data and experience from other schools on the network, changing the way it was taught to ninth graders.

If you’re a ninth-grader, on your first day of school, there’s a teacher who helps you develop organizational skills, develop college plans, and teach you how to do your homework on a school computer. You can view your scores every day using your on-campus network system. Every five weeks, a tutor sits down with you to learn about your recent situation and tell you where to go for help.

This method worked. By 2018, 95 percent of North Grande freshmen will be on track to graduate, and the school will be named one of the best in the city. Many schools in the network are implementing similar programmes and have made similar progress.

We want to create opportunities for schools to communicate and learn from each other, not to find a one-size-fits-all solution. The method applicable to North Grande High School is not available to all schools. It is important that other schools in other networks also share their successful experiences.

Melinda: Over the past two decades, we have continued to strengthen our commitment to continuing to advance global health and public education, and we have developed a strong sense of urgency on two other issues. Bill, it’s climate change. To me, it’s gender equality.

Looking ahead to the next two decades, we will also give up on these two issues.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Climate crisis

Bill: After the foundation was established, Melinda and I started going to low-income countries regularly to meet people there and get a direct look at the issues we’re involved in. We have been to some remote villages in Mozambique, such as Manchisa, to learn about malaria. We have also been to cities such as Lagos, Nigeria, to talk to local leaders about the AIDS crisis.

Although we go every time to understand the health situation, my attention is not always just on the disease. In many visits, I have noticed a problem: there is a serious power shortage in the area. Whenever the sun goes down, the whole village goes into darkness. I remember on the streets of Lagos, where there were no streetlights, people lit fires in old oil drums and huddled around them. I was thinking, we should do something.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

In Lagos, Nigeria, people gathered by fire.

I didn’t realize at that moment that this would be the beginning of my work on climate change.

What we observe is the so-called “energy poverty”, a real problem facing 860 million people around the world. Modern society is built on the power system. Without electricity, you’ll fall into darkness. So I started talking to the experts about the problem and what we could do.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Two facts quickly surfaced. First, the world will be richer, healthier and fairer if everyone has access to a stable and reliable electricity supply. Second, we need to find a way to achieve this without exacerbating climate change.

That was nearly fourteen years ago. Since then, I’ve spent a lot of time and resources exploring new ways to reduce greenhouse gas emissions and help people adapt to climate change.

When Warren Buffett encouraged Melinda and Me to give it a go many years ago, he was referring to the area the foundation was focusing on at the time, not climate change. But his advice also applies here. Without big bets, the world will not be able to solve the problem of climate change.

To combat climate change, the world needs unprecedented collaboration, innovation on an unprecedented scale in every sector of the economy, the widespread spread of clean energy sources such as solar and wind energy, and the need to work together to help the people most affected by global warming. It’s only after we decide what to do and what to do that can it all happen.

In other words, we need an action plan.

The good news is that we are full of ambition and clear goals. A series of bold moves on climate issues are the best evidence, including last autumn’s climate strike. As for the goals, we need to thank the Paris Agreement and all the countries, cities and regions that have made bold commitments to achieve zero CO2 emissions by 2050.

So what are the plans to achieve zero emissions? The answer is as complex as the problem we are going to solve. But simply put, two things: slowing and adapting.

Mitigation refers to reducing greenhouse gas emissions. Achieving this requires both further replication of existing solutions and a need for a lot of innovation to create and promote the cutting-edge technologies we so desperately need.

When people talk about tackling climate change, they usually focus on cutting emissions – which is certainly a good thing! Zero-emission alternatives are needed in every sector of the economy, but many industries do not. At present, mitigating climate change is the biggest challenge we need to address. It’s a pleasure to see so much resources invested in zero emissions (and I hope that innovation in this area will help power more people).

But mitigating climate change is not the whole problem, and we need to adapt to it.

People all over the world are affected by the warming climate. In the future, these effects will only get worse. Ironically, the world’s poorest people contribute the least to climate change, but the hardest.

The hardest hit are farmers who are struggling on the feeding line, relying on growing food to feed their families and already struggling on the brink of survival. They don’t have enough resources to withstand more droughts, floods, livestock plagues, or new pests that destroy crops. If global temperatures rise by 4 degrees Celsius, crop farming in most parts of sub-Saharan Africa will be reduced by at least 20%, which is only an average. In severely drought-stricken areas, the time it takes to farm is shorter.

The result is a further reduction in food, for self-sufficient farmers and others who depend on the sale of food for their livelihood. More children will suffer from malnutrition, and the gap between rich and poor will deepen.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Small farmers like this woman will be the hardest hit by climate change.

The Global Climate Adaptation Council, which I co-chair, recently released a report summarizing measures the government can take to support farmers in the coming decades. I also hope that the Gates Foundation’s work on agriculture will play a key role in helping farmers fight climate change. Ten years ago, we started funding research on drought-resistant crop varieties, such as corn and rice. These new varieties are already helping farmers in Africa and parts of India to harvest more. More and more crop varieties will emerge in the future that are adapted to the climates of different regions.

But even if we can increase food production, climate change will make it harder for many people to get the nutrients they need, making them more vulnerable to disease.

The best way to help people in poor countries adapt to climate change is to ensure that they are healthy enough to survive climate change. We need to reduce the number of malnourished children while increasing the chances of survival for the undernourished. This means ensuring that people not only have access to the nutrients they need, but also vaccines, drugs, diagnostics, and other interventions that are proven to be effective.

Organizations such as Gavi and the Global Fund can play a key role in improving health in the most vulnerable regions. If we want to prevent climate catastrophes, climate interventions and solutions alone are not enough. We also need to consider the indirect effects of climate change, such as how global warming will affect global health.

Climate change is one of the toughest challenges facing the world. But I believe that a climate disaster could have been avoided if we had taken steps now to reduce carbon emissions and find ways to adapt to global warming.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Gender equality

Melinda: In addition to the foundation’s 20th anniversary, I have often recently been thinking about another milestone this year: the twenty-fifth anniversary of the World Conference on Women in Beijing. (If you don’t remember the name of the meeting, you may have heard Hillary Clinton’s famous declaration at the conference: “Human rights are women’s rights, women’s rights are human rights.” “)

I remember reading about the conference and feeling that the world had laid an important foundation for women’s rights. But it took me many years to understand how to integrate gender equality into my own work.

After Bill and I started the foundation, I started visiting women in some of the poorest areas of the world. I have a lot to describe in my book, The Moment of Lift, because for me, these trips have changed everything.

I met a woman who asked me to bring her newborn baby home because she couldn’t afford to raise it. The sex workers I met in Thailand made me realize that if I was born in their environment, I would be willing to do anything to support my family. A community health volunteer I met in Ethiopia told me that on one occasion she had spent the night in a cave to escape her husband’s domestic violence when she was ten years old.

Each of them represents millions of women who have had similar experiences. What is even more difficult is that unless we act, these stories will continue to repeat themselves. If there’s one thing the world has learned over the past 25 years, it’s that these problems don’t go away out of thin air.

The data clearly shows that no matter where you were born in the world, as long as you are a girl, your life will be more difficult.

In developing countries, the lives of boys and girls have been sharply divided from adolescence. In sub-Saharan Africa, girls have an average of two years less years of education than boys. In developing countries, one in five girls will marry before the age of 18 and do not enjoy equal rights even within the family.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

In contrast, gender inequality is most pronounced in high-income countries. Although Women in the United States receive higher proportions of undergraduate and postgraduate degrees than men, they tend to focus on specific subjects and therefore receive relatively low job pay. Men are 70% more likely to become executives than women of the same age. Women of color are only worse off, and they are subjected to a combination of sexism and racial discrimination.

It is not a mystery why women’s quest for equality has been so slow. It is clear that, despite all the courageous attempts of activists, advocates and women’s rights movements, the world has not made gender equality a priority. Leaders have not made the necessary political and financial commitments to drive real change.

I hope that when the world gathers at the Generation Equality Forum this year to mark the 25th anniversary of the World Conference on Women in Beijing, it will also inspire unprecedented energy and attention on gender equality issues. But this time, we need to make sure that the energy and attention translate into real action.

If we miss the opportunity again and let the spotlight go out again, we may encourage the dangerous argument that gender inequality is inevitable. We need to tell the world loud and clear that these problems seem to be unresolved because we have never put in the necessary effortto solve them.

To make this time different, we need to boldly try new approaches and pry three levers to eliminate inequality.

First, help women get promoted quickly in key sectors such as government, science and technology, finance and health. When more women gain decision-making power in key positions, more decisions are made for all.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges

Melinda visits The Girls Garage in San Francisco. There, girls between the years and the girls between the years and the 17s can learn how to build and design their own projects.

But we can’t stop from top-down change, or focus only on women in certain fields, and we need to remove barriers that women from all backgrounds face in their daily lives. For example, the global labour force participation rate for women is 27 percentage points lower than that of men, or our economy is based on the large number of women’s unpaid work, or one third of the world’s women are victims of gender-based violence, one of the most common human rights violations in the world. Any one of these barriers will make it harder for women to realize their dreams and contribute their talents and ideas to the community.

Finally, since gender inequality touches on all aspects of society, any response needs to be broad-based. We need to carefully motivate our partners to work together to change the normality and expectations of society. We need to inspire not only social activists and advocates who have led the discussion, but also consumers, investors, religious leaders, entertainers, fathers and husbands.

I admit that when I first talked openly about gender equality, I thought it was an adventure. I know that the Gates Foundation was late in its involvement on gender issues. I am worried that my views will be at odds with the experts, and I am worried that I am the right speaker on this issue. But now I know that real progress requires each of us to speak up.

My first public issue was autonomous family planning. More than 200 million women in developing countries do not want to get pregnant, but no modern contraceptives are available. When women are able to decide for themselves the time and interval between pregnancy and childbirth, they are more likely to complete school, earn an income, and provide everything they need for their child’s healthy growth.

In addition to my involvement in autonomous family planning, I have led the Foundation in developing a strategy that prioritizes gender equality. Over the past few years, we’ve invested in closing the data gap, strengthening advocacy, and supporting the economic empowerment of women.

In order to increase the power and influence of American women, I set up a company called Pivotal Ventures. Last October, I announced that Pivotal Ventures will invest $1 billion over the next decade to accelerate gender equality in the United States. I hope this investment will be an inspiration to more philanthropists in the United States and around the world to make important commitments in solidarity with the experts and advocates who have worked these issues for years.

On the 25th anniversary of the World Conference on Women in Beijing, it is time for government leaders, business executives, philanthropists and everyone from all walks of life to act together to achieve their desire to make the world more equal.

I want to say very simple: equality, not to be treated.

Conclusion

Bill’s mother once said at our wedding: “The more resources, the more responsibility.” How to look at these enormous responsibilities that come with extraordinary resources will determine your life. “We have kept these words in mind and have been working hard to fulfill these responsibilities through our foundation for the past 20 years.

Just starting with charity work, we’re optimistic about the power of innovation to drive progress and excited about the adventurewe years we’re about to embark on – and we want to unleash the potential for innovation by taking risks.

Twenty years later, we are still optimistic and still choose to give it a go. But now we have a deeper understanding of how important it is to share the fruits of innovation fairly and impartially. If only some people in some places benefit from innovation, then others will fall further.

As philanthropists, we must not only take the risk of supporting innovation, but also work with our partners to meet the enormous challenge of distributing innovation. We believe that progress should benefit everyone in every corner.

That’s why we’ve done that over the last two decades, and that inspires us to move forward in the future.

Thank you

We dedicate this letter to all those who have contributed to the work of the Foundation.

First of all, we would like to thank our colleagues at the Foundation and the thousands of employees who have worked hard for the Foundation over the past 20 years. You are world-class advocates and experts, you have worked closely with partners around the world, and the success of the Foundation is inextricably linked to these efforts. We know that many of you started this work long before we did. We also believe that many people will continue to do the job after we leave. We are grateful to work with you and learn from you.

We also want to thank our partners – governments, institutions and individuals who are at the forefront of progress. We have benefited greatly from your insights and expertise. The courage shown by many of you has always inspired us because you have risked more than us to create a better future for your country and your community.

Finally, there’s a special person who keeps coming up in our review of the last 20 years, the old Bill Gates. Without you, the Foundation would not have achieved today’s results, and we would not be who we are. Still using baseball terminology as a metaphor, you are unique and insurpassable.

2020 Gates Letter: Innovation and Cooperation Can Address Global Health Challenges