Beyond Binary

Describing both the need for improvements in global health and the technologies that could create those gains, Bill Gates on Tuesday characterized himself as an "impatient optimist."

For those that know him, both terms describe him well.

Bill Gates talks about efforts to fight Malaria as part of a broad global health speech on Tuesday.

(Credit: CNET News)

In the 15 months since he left full-time work at Microsoft, Gates has focused on his philanthropic efforts--which focus on areas where there is great suffering as well as the means to alleviate that suffering through attention and increased resources. But, too often, change is not coming quickly enough.

"When it comes to global health, Bill and I are optimists--but we're impatient optimists," Melinda Gates said in a statement ahead of a speech on Tuesday. "The world is getting better, but it's not getting better for everyone, and it's not getting better fast enough."

Melinda Gates pointed to a program in South Africa where antiviral treatments are helping those living with HIV, but she said that for every two getting the treatment, there are five others that are missing out.

"That's the kind of thing that makes us impatient optimists," she said.

In the Washington, D.C. address, which is being carried live over the Internet, the Gateses spoke of areas where change is taking place, pointing to some of the "Living Proof" success stories that his foundation has highlighted on its Web site recently.

In his speech, Bill Gates noted that the U.S. government has increased its spending on global health each of the last 10 years and said that the investment is paying off.

"We're here to say two words you don't often hear about government programs," Bill Gates said. "Thank you."

He pointed to what he called the most beautiful picture he had ever seen--a chart of childhood deaths worldwide that shows death falling by more than half since 1960, when 20 million kids a year died annually.

But, he said, even the current level of 9 million childhood deaths a year is too many. Gates called on policymakers to commit to reducing by nearly half the number of children that die each year, from the present level of 9 million per year to less than 5 million by 2025.

"U.S. support has already helped to reduce deaths of young children by more than 50 percent in the past 50 years," Bill Gates said in a statement ahead of the speech. "If we keep up our commitment, it's possible to cut child mortality in half again--just 15 years from now. What's more, we can do it with proven interventions that already exist."

Despite the global economic challenges, the foundation has increased its own spending this year.

In particular, the Gateses advocate a focus on fighting malaria, vaccinating 90 percent of children against preventable diseases, providing basic health services to three quarters of the world's pregnant women and newborns, and treating diarrhea and pneumonia.

"A few interventions make a dramatic difference," Bill Gates said, showing computer modeling that shows that work in those areas alone could allow the number of global childhood deaths to drop below five million per year. "This is well within the realm of possibility."

Melinda Gates noted the development of a vaccine against rotavirus--a major global health threat, but one that remained invisible because it wasn't a factor in developed countries such as the United States.

"It's a fantastic success," Melinda Gates said. "We've created a vaccine for the poorest children on the planet and it's just beginning to reach them."

One of the challenges, though, is that the vaccine needs to be refrigerated throughout its journey from manufacture to delivery to those being immunized.

In the speech, Melinda Gates told the story of a young HIV-infected girl who went from very ill to robust after a year on retroviral treatment and brought out a Namibian a capella group that tours the country with songs that educate people about HIV. Bill Gates talked about some of the methods being used to fight Malaria and other diseases.

But he also saved some of his words to answer those skeptical of his efforts, worried that the aid was only fueling corruption or actually holding back long-term self sufficiency.

"The goal here is to help countries become self-sufficient," Gates said, noting that onetime aid recipients like Thailand and Brazil are now net contributors. "Aid done properly can help a country unleash their potential."

Not all of the criticisms are myths, though, Melinda Gates said. She noted that very little progress has been made in some areas, such as protecting the health of new mothers and newborns. Roughly half a million women in poorer countries die during childbirth, while one in 32 children in the developing world die in their first month of life.

Bill and Melinda Gates spoke earlier on Tuesday on ABC's World News Tonight, talking about the role that just a couple of new vaccines can have in saving millions of lives.

And, while most of his time is going toward his foundation work, Bill Gates said he still spends time at his other job--at Microsoft.

"I love the work that Microsoft does," Bill Gates said in an excerpt of the interview posted to ABC's Web site. "I love the magic of software."

Here is one of the foundation's Living Proof videos: