Captioning sponsored by Rose Communications from our studios in new york city, this is charlie rose. Rose bill gates is here. He is, as you know, the chairman cofounder of the microsoft. His focus has been on philanthropic organizations since july of 2008 when he transitioned out of his daytoday role at the company to run the bill and Melinda Gates foundation, along with his wife. It is the Worlds Largest charity, devoted to improving Global Health and american education. The foundation is close to its target of eradicating the polio viking a goal bill gates is planning to achieve by 2018. I am pleased to have him back on the program. We come to you from the cbs news studio in new york. Welcome. Great to be here. Rose tell me this, the divisions in your life, which weve talked about before chairman of microsoft. Along with melinda, running the bill and Melinda Gates foundation. Theres a third thing. Whats the third thing, the catchall for the rest of the things you do . Well, innovation is what i love to work on, and so im spending time on Energy Innovation because we need cheap energy. We need clean energy. Im creating a New High School course because i think science and history can be brought together and made more interesting. Often, the money that lets you do the innovation is whats missing, and im lucky enough to have capital to whether its a new Nuclear Reactor or cheap solar, i can back some wild ideas so that i put time into that. And it lets me learn a lot of science, work with brilliant people. Rose i have in my hand the bill and Melinda Gates at annual letter from you from the foundation. Who is this directed to . Who are you who do you want to read this . Well, warren buff set sort of an ideal person id like to find it interesting because hes very busy doing his job, but he cares a lot about these issues. He knows i get to travel to africa. I get to see whats going on with budgets and science. Whats honestly taking place is there is the aid working . Wheres corruption blocking that . And so on a yearly basis, hed like to have me summarize where im optimistic, where we have setbacks, how should people think about the big causes education and the needs of the poorest. Rose whats interesting here, the theme of this is measurement. And you say thats crucial to have a goal and to be able to measure how well youre doing if youre going to reach the goal. Right. Its been stunning to me in the last year that the places weve done well are where were going and really be able to see whats going on. And, for example, if you want to get 90 of the kids vaccinated, then you better know within a month for this area, is it working . And if its working really well, what are they doing right . Why is it working here and not here . And the tools that let us measure sensors, satellitees, surveying people are much better. But idea of really bringing that to help the poorest, im stunned that that kind of thinking, systems feedback thinking is so rare. Soap i wanted to highlight that we have seen it work, and now we need to apply it a lot more than ever before. Rose you cite a book by a gay named William Rosen called, the most powerful idea in the world. And it was about steam engines. Right. So the world basically stayed the same in terms of livelihoods until the industrial revolution. And so the steam engine came along and it led to factories being able to make projects. Wool clothes became inexpensive. Cotton became available to everyone. And the question, what was the magic there . This books covered very well. And the point they make unless you can measure which engine is better than the others, all of these thousands of little small ideas dont get chosen. They dont add up. So without that feedback of whats better, whats going on, then progress doesnt happen. But once you have the measurement, then its obvious you discard this because its not as good and you pick this and then you make the next improvement. And that constant, welldirected feedback, once you have mum, it naturally emerges. Q. And technology makesmeasurem. Yes, business, technology, you know, becauseun youve got to pick whatever drives profit. If you dont pick tyou dont get to hire as many people. Companies disappear. In the private sector, the idea of measurement almost goes without saying. When you get to government, because they dont pick clear goals and they dont have training and measurement, its far more rare than it should be. Rose and i assume government in its aids programs are demanding more measurement because of the economic hard times and the stress on their budgets. Thats right. If were going to justify in very tight budget times taking this money that goes to the poor and making it a priority, people have to know that its not an image of the past where some dictator corruptly takes advantage of it, but rather that kids are getting malaria bed mat, and people are being kept alive on aids drugs. So the credibility of aid, which honestly in the past, some of it was misspent, we need to work on that or else it will be cut. Rose and you have made the point often that the problems in the world are too big for either n. G. O. S or foundations to do without significant government aid you cant conquer these problems. Thats right. Our Foundation Spends about 3 billion internationally with all the things we do. Overall, its 130 billion, and the u. S. Is about capitol hill 30 billion. Although having foundations like ours is a huge thing, the if the u. S. Cuts back in 10 , at least in dollar terms, youve cut out more than we bring. Rose in education, teachers sometimes object to be simply judged by teacher scores. This idea of measurement in eagle county, colorado, gave them a better way to evaluate performance. Thats right. You can say that teachers shouldnt be measured at all. Rose right. And the great ones are great and the average ones are average. Or you could say that they should be measured just by student test scores and i think neither of those is satisfactory at all. The test scores dont capture the whole picture. They actually dont tell you what that Teacher Needs to improve. So what were trying bring to this is the idea of surveying the students in a very smart way, asking them if the teacher uses time well, and which students they work well with, and using observationes, training both principals and teachers to go and sit down and be able to look for how you engage the class. And if we can train those evaluators well, then the teaching practice moves from thage up to the top car tile. That would make the u. S. System, which is now one of the worst in the rich world, absolutely the guest. Best. If we can fund it with 2 of the salary budget, it can be a phenomenal tool to make dication achieve the goals we have in mind. Rose jim grant is actually as important as henry ford, ford motor company, or tom watts orange the i. B. M. Company. What did jim grant do . Jim grant was the head of unicef, the United Nations organization thinking about children. And organizations like that, you know, talk about all the right things. But what he saw was that the vaccines werent getting out to all the kids. Only 25 of the worlds kids were getting vaccines. And he decided he would build a Measurement System this is in 1980. He built one that measured facts and coverage, and he would go and embarrass the political leaders whose countries had low numbers, praisethe ones who did it well. It was cheap snuff so incredibly impactful that he got vaccination from 25 up to over 70 . He saved more lives between 19 eighty and 1990 when he did that than anyone in all of history ever has, and yet, you know, hes not rose known by many people. Yeah, very obscure. When i went to buy the book about him, it was completely out of print. So its impress they have it was a Measurement System along with his moral correctness that let him achieve that dramatic result. Rose but the interesting thing, too swhen they stopped paying attention, it slid back down. Thats right. As soon as it wasnt there, and the political leader being told, hey, were falling behind these people. We need to get our vacinators to work harder or put more money into it, then it went down quite a bit. And a lot of new vaccines came along that didnt get out there to the poor children so the gap between a poor child and a rich child that gap actually grew after the jim Grant Campaign had closed it quite a bit. Rose so turning to the United Nations, speak of great goals, there they are for the millennium grants. And theyve set forecast for 2015, things that theyd like to achieve. How well have they done . And how do you measure that success as you define new goals for the next time . Well, its actually pretty rare for the United Nations to talk about measurements. They usually talk in terms of absolutes, like rights for all, no more poverty. Here, what they did is phenomenal. They picked goals, eight of them. Number 1 is about poverty, cutting poverty in half by 2015. Its already been achieved. They picked childhood death rates, the number of kids who die under five, which was 12 million back in 1990. Its on a path by 2015 to be under six million. So thats a 50 reduction, faster than any time ever. And so the goals for the first time got u. N. Agencies and donors thinking, another does our money really impact this measure . Which country is doing it well . So ethopia is a star because although they started from a bad situation, they cut their childhood death rate in twothird, and that was by looking at people who had done it well, and now theyve become the example for all of africa how by putting in cheap, primary health care you can achieve an amazing result like that. Rose so on balance you give them high marks for what theyve of theyve been able to achieve even though they didnt meet the goals that were set . Thats right. We achieved maybe half the goals. The other half we set the parhigh enough that were not there. These are unique in getting people to collaborate. Its kind of a good news story, you know, cut category childhood death in half that i dont think thats out there. People see a small disaster that might kill a few hundred, but we went from 12 million a year, and well get to less than 6 million. That thats great. In the next 15 years id like to see us get below three million. Rose you understand this letter, from time to time we should step back and celebrate the achievements that come with having the right goals, combined with political will, enerous aid and it has certainly deepened my commitment to this work your commitment is pretty deep as it was. What do you mean by that, deepening your commitment . There are a lot of cynics out there who talk about, hey, theres corruption. Why should we do this . Its far away. And sometimes you feel like, gosh, thats such a constant thing. Are we really going to make it . Is this really as important as i think it is. And only by seeing the progress does it reenergize you to say yes. H1n1 like any time in history, this inequity is being closed, and, you know, that matters to the fathers and mothersful africa. And in the long run it marts to humanitys ability to achieve big things. If we can eradicate polio, i think thats uplifting to all of our endeavors. Rose and all this got started because you and melinda were look at a pie chart, and you saw something called what was it . Rotovirus. It was killing 500,000 children a year. And i said to melinda, i never heard of rotovirus. Shed never heard of rotovirus. Is it some super difficult thing to get rid of . In fact, rich kids who have almost no risk of dying of it they might get a little sick they had a vaccine that worked super well. And the reason you had a half Million Deaths a year was because it wasnt cheap enough and it wasnt delivered to all the children of the world. And that sort of became the centerpiece of, okay, weve got to do the Foundation Work now instead of waiting. And then warren came along and doubled the resources we have. Rose but that pie chart changed your life. It became the centerpiece of how i was gog spend my postmace career. Rose what are the metrics of success for you . Well, i take this childhood death number and say thats a report card for all of humanity. Rose right. Because if you look at it, annual childhood death at that time was what, 20 million . You have to go back quite a ways to get to 20 million. In 1990, it was 12 million a year. Rose 12, okay. Today its what, 6 . 6. Sorry, just 6. 9 million so well get down below six. Rose but thats whats driving you, reducing young kids dying . Yeah, when theres science that we could do the invention and do the delivery to dramatically reduce that, its terrible that we dont. And yet, just capitalistic systems alone wouldnt get us to do that because these people have no money. And so what plans we can do is it can shed light on that and make sure the r d gets funded, that the deliver gets done. Rose one thing you decide me before is seeing what you have to do is show people whats going on around the world. It cant just be numbers. Has that experience changed you . I think to really commit yourself to this, you have to understand mentally, millions of kids, but you have to get your heart involved by going out to a malaria ward and see the parents of the children who are still dying, see it filled up with kids with cholera or rotovirus. And look at that and say, okay, this is what were trying to stop. Then every once in a while i go out and see there are less kids in those wards right now so you have that sense of progress. Its the individual cases. You know, like, i held in my hands a threeyearold girl who was one of the last in india to get polio, and she was smiling and happy. But she didnt realize that because her legs are paralyzed how thats going to make her life so much worse than it would have been if we had stopped polio sooner. Rose when you created the foundation the provision in the bylaws says youll spend all the money or the foundation will cease to exist 50 years after we changed that to 20 years. Rose 20 years after either you or melinda is no longer living. You both are dead. Exactly. Rose and because you wanted to make sure what by putting that in . We think we picked important causes for this era, and that all the resources that are independent foundation should be spent against those causes. Were sure that in the future there will be rich people. Theyll be more up to date about how to do things, how to execute things well. Theyll pick the right team and create visibility. But were sure we can make big progress in our lifetime. Rose you said you didnt like the implication that the problems were persist, despite the best efforts that you could make. Thats right. Rose you set the idea, we can accomplish this. And i dont want to hold back at all. I want all the resources to go against it because i know its important. And, you know, i dont think having the money way out there in the future will will be nearly as valuable as ending these disease. Rose so why is the eradication of polio so important that you consider it your most Important Mission . Well, the worlds put a lot into this. It started in 1988, when over 350,000 kids were being paralyze expected very quickly they got it down. And they spent billions and billions. In the year 2000, we looked like we were close. Were already giving and yet it turned out getting last few countries was very hard. There were some big setbacks in nigeria, the rumor that the vaccine sterilized women was a setback. Rose did people in the government start the rumor . Yes, somebody running for office in the north starte started that rumor. Now, later that very individual changed his mind and actually was publicly vaccinated his own children. But once a rumor like that gets out, its very hard to stop the damage. In fact, to this day, which is almost a decade later, in parts of northern nigeria, theres 20 of the households that the parents wont give the vaccine unless we bring in the religious leader and he really reassures them that, no, this is safe. The reputational vac ens are very fragile, and, you know, thats one of the big barriers. Rose but in the end, vaccines are your most important weapon. Theyre a magic tool. Polio will be eradicate bide the polio vaccine. Some day well have a malaria vaccine. Inventing and delivering vaccines, thats the biggest impact weve had so far. Rose im interested in the culture thing, too, because there are people who kill vacinators. Recently in the middle of december in pakistan, those going out to do the Vaccination Campaign were attending some were killed if you want north of pakistan, some down in karachi, and that is horrific. Its hard to understand why thats happening. No ones claimed credit. Weve gone a month now without much violence. We only have 250 cases last year in these three countries, and so the reason that were doubling down, erasing a big budget, making sure everybody is committed to this because its hard. Once you get to zero, you dent you dont have to buy more polio vaccines. All those resources get freed up to work on the next big challenge. Rose there are three countries left, afghanistan, nigeria, pakistan. Exactly. Rose and whats the percentage of polio casesem year now . The we had last year the lowest east was under 250. The majority were in nigeria, and the rest were in pakistan and afghanistan. So its minuscule and away are really, really close on this one. Rose is 2018 the number . Is that the date . Were committing we will get it done by then. You have to get to zero cases and wait two years for there not to be any cases. Rose but is the idea here, too, that you can win in the Global Health battle . Here is an example of what we can do . Absolutely. What were going to do to get rid of polio, that the systems were going to build to reach kids with other disease, that would cuttify it, but the victory of achieving good things will make it worthwhile. Rose if you get polio what disease are you saying you better watch out. Were coming after you next. I think as were close or at the polar eradication, then well step back and look at malaria, and well have new tools. And i think well put a agreement plan and go after that. Polio would be the second. So malayeria, hopefully, would be the third disease completely eradicated. Eradicated. Is there an appreciation of the need. The financial cases was a setback for so many things. Anything far away in distance or time, you know, when youve got problems here and now. They get less attention. So whether it