We want to welcome Bill Gates. Joining us to discuss what is the goalkeepers report for 2024, the title of which is The Race to Nourish a Warming World. Now, in this report, you talk of a global health boom that we all experience from the year 2000 to 2020. That has come to a screeching halt. And in particular, you single out the worst child health crisis being malnutrition. Why is malnutrition such an issue? Yeah. So the incredible progress we made since the turn of the century until the start of the pandemic, you know, really should be celebrated. We brought our child to death down from over 10 million a year to under 5 million. And then it plateaued. It plateaued, you know, because the interest costs for the poor countries and the pandemic itself. But we want to get back to that rapid improvement. We do need to make progress on

malnutrition to do that, because if you don't get the right food when your before you're born and in your early years, your brain and your body never develop. And so your mental and physical capabilities are far, far short of what they should be, which is not only a tragedy for you, but your country, where the young people are the key driver for their economic growth. They get into a poverty trap when they have very, very high malnutrition. The long-term implications for the individual. Claire, can you paint the economic impact of this? Have you risen the data on it? Yeah. So the a whole generation that's malnourished, you know, then as they grow up, your investments in educating them aren't going to work as well. Your ability to move to higher-paying activities, you know, it gets stalled. And without that engine of productivity, you don't get the tax collection that lets you put even more into the school.

system. And so that's where you get trapped, particularly in Africa, where the conditions are challenging. The population growth makes it more challenging. And then climate change, which is affecting the ability to grow food, has its most negative effect, particularly near the equator and in poor countries. I think a figure of some $3 trillion in productivity is lost. But sort of the irony of all of this, bill, is that in many ways the solutions aren't rocket science. It's about giving prenatal nutrients to mothers in the form of but a bit of folic acid or vitamins to be enriched. What else could be done, though, to more seriously impact and reduce this malnutrition? Well, in the last ten years, we've gained a deep understanding of what goes on, that if you don't get the right food directly, your stomach gets inflamed and then you can't absorb the food that

you're eating. And that's partly because you're not getting the right vitamins. You know, we can help with that by making sure that during pregnancy your mother gets those vitamins and then later that the food you eat is fortified in the right ways. And that can be done very inexpensively. And so cheap solutions that are ready to scale address almost half of this problem. And then we have a pipeline of innovation that'll go after the rest of it. But it's clear what we need to do to enable these kids to achieve their potential. Can you talk about that pipeline of innovation a little bit more? What excites you that. Well, what we've seen is that the microbiome, which is the term for all the bacteria growing in your gut, can get into a bad state. And so we want to get it back to that non-inflamed state. And when I approach that, we're trialing

is actually to eat a probiotic. We're actually the good bacteria. Get into your stomach and outcompete the bad bacteria. We think that would be quite beneficial. You know, we have that out in countries to see the effects and then we'd have to drive the price of that down so that it can join these other tactics as proven ways to help out all of these kids. The innovation is obviously something we lean into when we think ultimately of Bill Gates. You're the guy who's every other question at the moment, I'm sure, is about generative AI. Is there anything within these new developments that the whole world is obsessing about that is helping in practical ways for malnutrition and for world health? Well, he, you know, malnutrition in some ways to see, you know, such a basic thing. You know, so we do need to raise money to get resources for this so that the poor countries, you know, get out of the

poverty trap and then are self-sufficient. The innovation is going to accelerate. Tools like A.I. are helping us understand the God, the immune system. You know, how to design vaccines in a very deep way. And, you know, the key thing that the foundation has, my innovation, is making sure it's not just helping the rich countries, but it's helping the poorest. And so, you know, can they get medical advice in their native language, on their cell phone? Can they have their diseases that are so ignored, like malaria? Can we use it to develop ways to not only reduce that, but eventually eradicate it? And so, you know, that's where the foundation is looking at the innovation and making sure that it's benefiting those most in need. The Foundation Talking with global leaders often, I'm sure global leaders of wealthy developed nations who are preoccupied right now with their own

political instabilities, their own worries about the cost of living. Will you get the help you need from developed nations, do you think? Now? That's a very good question. You know, the dream is that even in the face of huge budgetary challenges that all countries have, that they would be willing to have one or 2% that go to help the poorest, to help these countries move forward. And these are things where you're saving a life for less than $1,000 per life saved. So, you know, very catalytic. Very well measured. You know, I wouldn't be putting my money in unless I knew that it was extremely well spent. And so we're trying to keep this on the agenda to continue that miracle that took place where we made so much progress, getting rid of childhood death. You talk of that miracle. And I've got to ask you, as someone who, you know, almost sees us taking those

steps ahead, and then it feels as though something gets in the way. Call it a war, call it a global epidemic. And we take what feels like two steps back. Do you ever just lose confidence? Do you ever feel that this is a fight that can't be won? Well, I will say that when we set the current goals, the United Nations, which are called the Sustainable Development Goals, we didn't anticipate a pandemic. We didn't anticipate the financial difficulties that the African countries would find themselves in, paying more in interest than they can for health and education. And we didn't anticipate the wars that have broken out, both Ukraine and in several others, including the Middle East. And so the goals we set for 2030. You know, you look back and, you know, it feels a bit naive, but, you know, every life saved really counts. You know, here we're talking about millions of lives.

We're talking about making these countries stable, having health systems so that if there are potential pandemics getting started, they can stop it before it spreads globally. So, not only the moral benefits, but the global benefits are pretty strong. And yes, it's harder today than it was a few years ago to get through the noise level to get this cause to be heard. But, you know, because it's about helping other humans, I think we'll succeed. You know, we're very committed to it. Well, thank you for talking us through accelerating the progress towards the global goals. Appreciate it. Bill Gates, thank you for your time. Thank you.

Bill Gates on Fighting the Nutrition Crisis With Cows

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