From our studios in new york city, this is charlie rose. Bill and Melinda Gates are here. Their foundation has donated more than 31. 6 billion globally since its inception 15 years ago. Their primary goals internationally are improved health care and to combat poverty. Their focus in the United States is to expand Educational Opportunities and access to technology. This week they will publish their annual letter. In it, they say the progress weve seen so far is exciting so exciting that we are doubling down on the bet we made 15 years ago in picking Ambitious Goals for whats possible 15 years from now. Our big bet that lives in poor countries will improve faster in the next 15 years than in any other time in history and their lives will improve more than anyone elses. Im pleased to have bill and Melinda Gates back on this program. Welcome. I want to talk about the big bet, and i also want to bring in a remarkable speech you guys gave this report is full of optimism. 40 years ago you had a big bet that turned out to be successful, the idea that you could reduce inequity and you are doubling down on that bet now. Why are you believing that this is doable . Weve been lucky enough to get a chance to go out to the countries to meet with the scientists to understand the nature of the problems, how can we bring malaria down . How do you get Teaching Online so that it helps kids out . Everything we predict is based on that experience. Innovation is on our side, the fact that people care and well be able to inform them about progress in a better way, and people should know its really a great thing that we want them to join in with. Are there also things that you have learned in the last 15 years that will improve the way you achieve your goals in the next 15 years . Absolutely. As an organization we continue to learn and hopefully iterate on everything we have learned. We have learned how to get vaccines out in a much reduced amount of time. It used to take 2025 years when a vaccine would come out in the United States. Now we have gotten that down to 13 years in the developing world. With the specific strains for pneumonia, for example, there are specific strains for Different Countries in africa. We learn to bring the price of the vaccine down across the board. When you have failed to achieve what you thought you might, what has been the reason . I think sometimes we have gone into an area and maybe looked at the problem in slightly the wrong way. For example, in the Pacific Northwest we wanted to end homelessness. We thought one way was to build transitional housing, and we started down that path and built about 1700 units. But thats not really the way to end homelessness. You have to go upstream and figure out how you keep families from dropping into that situation . Can they move in with somebody else . Can you keep them in that apartment longer and surround them with what they need . We need to ask the question a different way and come up with a different solution. We have learned from that. You said it is fair to ask whether the problems we are predicting we can achieve, the results will be stifled by Climate Change. And you dont know. You have a 15 year window. The impact of Climate Change in the next 15 years fortunately, is not dramatic. What is dramatic is the effect over time if we dont invest and employ new ways of generating electricity and doing transport. It is not a nearterm disaster. The rich world needs to put more into r d, put more into conservation. In the meantime, we know that the co2 we have already emitted will cause warming. The biggest problem there is what that does to agriculture. Inventing better seeds that can deal with drought and flooding that is the way to mitigate these things. We need two things. We invest in private companies that are energy innovators, to reduce emissions, and then through the foundation, we invest in agriculture advances which give you the resilience so that even in the face of Climate Change, farmers will have more nutrition, be able to feed their kids and escape poverty. Knowing the two of you, we have talked about fertilizer its how you have discovered this significance especially in africa of farming and fertilizing. I grew up in the city, so i didnt understand much about different crops and harvest and seeds, all these things. Yet if youre going to care about the poorest, youve got to learn about agriculture. Over 60 of the poor people in the world are people who farm. Most of what they eat is what they grow themselves. So you have to raise their productivity. Every country that has come out of poverty started by getting their Agricultural Sector to be very productive. There are some good lessons about how to do that. How the green revolution helped asia a lot. Better seeds. Africa has a lot of climate ecosystems, a lot of different crops. But can you adapt it for africa now . Thats what weve gotten into now. It was very underfunded, so we have come in as one of the great funders there. Our optimism comes from looking at what can be done with those seeds, both with conventional breeding and gmo breeding are giving us much better seeds. In the meantime, we have seeds that are better than what the farmers are using. Our business is getting them out to them, and fertilizer is too expensive in africa. Not easy to get. Fertilizer alone will often double your output. Its really that lack of knowledge, lack of credit standing in the way of this. We predict africa will be able to feed itself. Today it imports 50 billion of food a year. Its ironic, you have a continent where 60 of the people are farmers, importing food from a country where 2 of the people are farmers. Another thing you talk about is that it is agriculture and health. Health is the precursor. If you dont grow up and lead a healthy life, you cant really participate in the economy. If a family is dealing with three or four cases of malaria in their family a year, it takes you out of the workforce. We look at, do the children reach their fifth birthday . Is the mother not dying in childbirth . Then you can go on to give them seed and fertilizer and training so they are getting more income off of their farm. A 2030 increase in yield is huge because not only are they healthy and they can feed their family, they can put that crop on the market and get that income. They can then deal with the Health Shocks that come and they can educate their kids. You also talk about polio malaria, and hiv. Are we expecting breakthroughs in the next 15 years . Absolutely. We are saying we will get polio done, and we had a good year last year, everywhere except pakistan. Pakistan we have a lot of cases, but knowing that the focus is on there now, the government is starting to do the right thing. The army and the government have a lot of distractions there between floods, political things, and really going into the area where the taliban were preventing vaccination from being done, that really meant we couldnt succeed. Now that the army has gone in there, they are controlling those territories. We need their cooperation to get primary health care working. The dialogue, the resources i predict they will get into line. Nigeria, now that we have gone six months, its likely we wont have more cases. We will get other diseases in the next 15 years. All we can say for the big killers, malaria, hiv, is that is when we will build the breakthrough tools. Is it still 600,000 deaths per year . Yes, from malaria. We have a pipeline of better diagnostics, drugs, and vaccines. 15 years from now, the roadmap for eradication will be clear. We will have gone to local areas and shown how to do it. We will need the next 15 years to be sure we get that one completely finished. You have to be not dealing with an episode of malaria to be able to participate in the economy. But think about a mom or dad who are dealing with malaria and having to get their child to a clinic. They are not out working their farm or participating in the economy in the local area. Another breakthrough is in banking. Tell me what you hope will happen there. Clearly that is a technology issue. We are seeing hundreds of millions of cell phones all over places like bangladesh and africe. Africa. People are using their cell phone to save small amounts of money. Then they dont have to pay the transport fees to go into the city. They dont have to go into the bank where they will tell you they are unwelcome. They can stay out on the farm and save one dollar a day or two dollars a day. If there is a health shock in the family, then they have the money to deal with it. They have actually saved it on their phone. Then they can use their phone for all kinds of other things. Is it worth me going to the market today to take my farm goods in . They are participating in the economy by having that banking on the phone. And education is the final breakthrough we talked about here in this report. The key is the software. 15 years ago, people said we can tape great lectures, video them and put them out on the web for free. But that didnt have much impact. It wasnt connected to a degree. If you got confused, you have no way of getting straightened out. So the last 15 years, people have been playing around with it. We have been the biggest funder of these online courses, they are improving a lot. Quizzes, personalized learning you have coaches. Imagine that other people are doing all the other subjects over the next 510 years, they will put out free learning software. Even a young kid who you want to learn the alphabet or a little bit of math, the mother can hand the kids the phone, it will work at their level and personalize at their level and personalize it to exactly the pace they want to go. In terms of being a supplement for families of kids that are motivated, it makes the idea of having a library available. It is way beyond that. It is the software and the fact that the phone or a bigger screen tablet device will be pretty pervasive in the timeframe we are talking about. Where are we on to as the projects that are not so much a part of the report, the big history project . Explain what it is. Big history is a way of teaching science and history so that its all integrated. You start at the beginning of time and see how planets got formed, single cell life farming. Its a way of creating a knowledge map so that instead of thinking, these things are not very connected, or how much is there . It gives you the framework that all your knowledge fits in. Here is why the egyptians were interesting. Here is why the dinosaurs were interesting. It all is in your understanding. Are you getting any pushback on this at all . We have it now in a few thousand schools. It is quite novel, new courses being taught in high school are coming along. There are coding courses catching on, and there is big history. It is a pretty big investment, and of course its all free to whoever wants to use it. I predict that this will be a widely used course. We have already gotten over 50,000 students to give us their feedback. One brilliant teacher led a bunch of people pulling it all together. He goes around the world and explains, and he has done an amazing job. Common core. What youre hearing from teachers jeb bush is supporting it. He is very much an outspoken supporter of common core. It is basically a set of standards against which we know if a student is learning math in secondgrade or fourthgrade or 10th grade, that they are learning the right things to advance them to the next grade level. That means if a student moves from vermont to new york or texas, they are learning everything they need to learn at each place. It also means that instead of standards, you can teach from the english curriculum, you can use the scarlet letter, madame bovary, but you are teaching things that kids need to know in english language arts. It opens up the possibility that a lot of additional people can come in with great digital lessons. Teachers can use those and personalize those around the things they want to learn about, but they are learning the right things and are then prepared to go on to college. Why is the American Federation of teachers opposed to this . They have looked at various states and said, have you given the teachers enough training, or you are trying to roll this out too quickly . There are a lot of concerns about the personnel system. Theyre coming in to give teachers more feedback. If youre changing the curriculum, should you be putting in the personnel system at the same time . Those are two important things and it will be decided locally what those rollouts will look like. Overall, its more of the implementation issues where, from time to time, they have said lets slow down or finetune it. The ones that have had time to work with the common core and build out their lesson plans are saying they see the difference it makes in their classroom. They are saying, i was nervous when i came in, i didnt know if i would have enough time to plan it, but i am seeing the difference in outcomes. We have 127 billionaires signed up now to the giving pledge. We are almost at the five year anniversary. The neatest thing about it has been the learning coming from one another. Whether its how you measure and figure out whether your money is having impact, everybody is benefiting from the conversations we get to have about what things we are learning and how we are going about doing the work. It has been beneficial to us, as other people introduce us to areas they are thinking about that are different from ours. You two gave the speech together, and you began saying i love optimism on the stanford campus. You two are more optimistic now than ever. Optimism is essential, you make that point. And you talk about the fact about going to africa in 1997. In order to talk about the Digital Divide and to see if you can minimize the Digital Divide, right . Right. What happened in soweto . The idea that a computer is relevant to the problems they were dealing with, where getting enough food, having decent health, even any electricity, a reasonable place to live. I thought it was neat a kid should have access, but they had to rig up a special generator just to do this one demo, and they borrowed that generator. The idea that there was a hierarchy of need, and our next focus together, that we would get at those very basic issues while in addition still believing in digital empowerment, but not at the top of the list. That was pretty eyeopening to me. I kind of got that i need to drill down to it. This was the first sort of searing impact of poverty on you. Thats right. Touring through africa, simply as a vacation, and we got to see people really dealing with the basics. So it has been a learning process ever since. We often call each other when we are on the road, almost every day. But it was a different call, because bill was really quite choked up on the phone. He had seen firsthand how awful it is to have that disease. It is a death sentence to go into that hospital because of the amount of tb that they just were not able to treat in there. He said this just cannot be. He knew the difference, if you lived in the United States, how the Health Care System would be dealing with it. When you see those moments of heartbreak, that is what propels the work. How can i help not just the 100 people in the hospital, but how can i help thousands and millions . You said in the speech, i told her i had been somewhere i had never been before. This particular hospital is called king george v. You only went in if you had drugresistant tb. The few drugs that work at that point had horrific side effects. There is one that gets rid of your hearing. There is one that makes you a little crazy. The hospital is not well staffed. There are young kids in there. There was thinking that, do we educate them or not, because they are going to die . The staff themselves were getting infected, so not many wanted to work there. It was just as bad as it could be. There those people were, and i knew that most of them would never, ever come out of it. How did we get to the point where in parts of the world, if that was a problem new york city actually had a drugresistant tb problem about 15 years ago, put a lot of money into it, and solved it. But here, its just going on, and unless innovation and delivery money shows up, its going to stay as kind of a piece of hell. I get from this, especially the sense that to accomplish, to eliminate poverty, which you say can be done, and disease, which you say can be done, its going to take a combination of brainpower you have often talked of putting enough iq on the problem but also heart. I think you have to go to these places and let your heart break. You have to say, what if i was born in these circumstances . What if i was born in a rural, remote place in tanzania. What would life be like for me as a mother or father . What lengths would i go to to feed my children . When you can put yourself on the other side of the map, when you talk with local villagers, if i was in those circumstances, what would i want the west to do . What would i tell them . When you let your heart break and consider what it would be like to have a child dying of malaria, you have to say, we have to save not just that child but 600 million. 600,000. You let your heart break and you come home and you see what the great innovations are coming and you start to figure out, how do i deliver those means to these difficult, remote settings. Not just how to do the great science, but also how to deliver it in these remote, rural settings. You tell the story of a woman who said, please take my two children. Then she said, please take one. I could see she had a tiny little house. I could see her husband inside. He had been injured. She said he has no job anymore. You can see the land, we have no farm. How am i going to feed my children . She is pushing these little boys under the age of four, take my two boys home with you. And when i couldnt, she said, ok, please just take one of them. She doesnt know who i am, she just knows i am a woman from the United States. She knows the chance for those two children to grow up and reach their potential is so much higher in the United States than in her village in africa. Like all mothers, her first idea is the best that can happen for her children. Absolutely. I was out with a group of u. S. Senators in africa a couple of years ago. We were visiting ethiopia and tanzania. We talked to a female farmer and she was talking about this new corn seed she got. She was getting 30 more yield from her farm. She was talking about the extra income she was getting