Bill Gates, "Giving Back: Finding the Best Way to Make a Difference”

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SCHANER: Good morning. I've been given the honor of introducing our speaker. My name is Simon Schaner, and I'm a PhD candidate in the Department of Economics. Earlier this morning, several of us students were privileged to show Mr. Gates examples of our research. Mine focuses on the use of malaria diagnostic tests and anti malarials among low-income households in Africa.

Public health issues such as malaria are among the many problems tackled by the Bill and Melinda Gates Foundation in a quest to help all people lead healthy and productive lives. At MIT, we share the foundation's ambition to confront big problems with big solutions, as we pursue our mission to serve the nation and the world.

Mr. Gates has long been a friend to the Institute, and his work toward the betterment of humankind continues to inspire us. We are honored that he was chosen to visit us as part of his college tour. Please welcome Bill Gates.

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GATES: Thank you. Thank you. Well it's great to be here. When I dropped out of college, I promised my dad I'd go back, and so I'm doing it a day at a time to work off that debt that I've got. This is the first college set of visits I've done since switching to work full time for the Gates Foundation. And it's a little bit different than the kind of talks I gave when I was coming out focused on software, focused on Microsoft.

I'll talk a bit about technology and how it's an enabling factor, but mostly, I want to talk about a question that fascinates me and that is are the brightest minds working on the most important problems? And to the degree that they're not, how could we increase that, which I think would make a huge difference. Now this is a question that we'd like to be as precise as possible, but I think it'll be tough to be too numeric on it.

After all, if we think about what do we mean by the brightest minds? You could have a range of definitions of that, but I think any definition would include the people who get to attend the world's top 20 universities. And so everyone here would fit into that category.

Also, if we take a phrase like important problems, I think there would be a different lists that people would come up with. I think there's some things that would be in common. The problems in poor countries, the health problems, sanitation problems, governance problems, inability to do savings, get loans, all of those problems that make life so much more difficult for the bottom 2 billion, versus particularly, the richest 1 billion would belong on that list. And there'd be five or six really big things that we haven't put enough attention into that would make a huge difference.

We'd also have in the list, some problems that are more global in nature. For example, the problem of education. It's not something that even the world's richest country, the United States, has managed to improve and make equitable and make available to everybody who should want it. Or we'd have the problem of energy, where getting energy to be lower and lower cost is very important for everybody, and now we have a new constraint that we have to do that in a way that eliminates the environmental negative effects, including that CO2 emission.

You might have on the list the difficulty of feeding the world, where you don't have much more acreage you can put under cultivation, and yet both the population increase, a factor of 1.5, and the dietary change you get as people get richer mean that we're going to have to have about three times the agricultural output and the only trick that we have for that is increased productivity. And so a huge challenge, also one with significant environmental constraints.

So those are the kinds of things I think about when I think about the important problems. And for many of these problems, the amount of work that's been done on very essential questions, it always stuns me how few bright minds have worked on those things. How little effort and energy and investigation there is on those things, and it makes me wonder how we might change that. How we might make these things more exciting.

I was thinking about this. About three weeks ago, I was with some friends just goofing around on the weekend, and they had a couple topics that their incredible minds had really focused on, and were thinking in this rich, deep way, where they knew the history, they knew the strategies, they know the outputs. The two topics were first, NCAA March Madness and what was going to happen in basketball. I don't remember anyone mentioning them MIT team in those discussions, but that's okay.

And they really had studied these problems. They had those brackets and they were talking about which was going to be best and a wonderful debate about those topics. And the second thing was discussing of investments. Who had pick good stocks, what had happened in the mortgage market, what was going to happen with the investment banks, what kind of derivatives were there, and did various people understand what you might choose to do in investing in those things.

And all that IQ, including lots of IQ that goes off to Wall Street and just works on those topics is there full time thing. So we have lots of talent that could be shifted, at least to some degree, from sports, entertainment, investing, even in the areas of innovation, a great science that's it's done here and other places. A lot of that focuses on the needs of the rich. There's a lot of great work on baldness drugs.

Now, I'm not talking about a complete shift, because I still want to have some movies, I like movies, and I certainly know people that would be easier to look at if they'd use the baldness drug. But how could we have a shift of, both people who work on these issues on a full time basis, and perhaps even more importantly, people who although it's not their full time focus, that they're engaged in these things. They picked one or two, and their time, their donation, their political voice is involved in these things.

I think if you look at the trend over the last 15 years or so, there has been an increase, and places like MIT have been very good in taking leadership on this. If you look at the visibility of issues like malaria and AIDS, it is much higher today than any time in the past. And that is resulting in more government donations, more scientists working on those things. Still, if you take malaria, it's a pretty small set.

There's less than 100 scientists who work on the key problems of malaria. Kills a million children a year, should it have more than that, maybe so. So we've seen a change. My generation was not that aware of poverty and what was going on. I don't know whether it was the Cold War or what the distraction was, but it was not as visible, not as clear as it starting to be.

Now I see this shift in many ways. I see it in terms of what the students here are going into, I have a project up in Seattle, which is about using software to model diseases. And a MIT graduate, [INAUDIBLE] is working on that. And she could make 10 times as much money working on something else, but this idea of modeling malaria, and other diseases, and testing out the tactics and using actually this Monte Carlo simulation, which is a technique from physics applying it to that in this very rich way. Now, that problem has drawn her in, and we've got this team of amazing people doing that.

We have some exemplars. People like Paul Farmer, who people aspire to do the kind of work that he does, and it's not just the global issues, also on education and Teach for America is a new phenomena. Here at MIT, there were 96 people in the graduating class who applied for Teach for America, and that's 7.5% of the class, and that's pretty amazing, because every one of those kids would have had other opportunities that would have been far more renumeration.

So there is this increased visibility. I myself, did not go through some rational process of picking what I wanted to work on based on either economics or it ranking high on some list I wrote down great problems. I fell into what I ended up doing as my full time career. I was 13, there was computer, it confused the teachers, it was fun to figure it out, and that became my fanatical involvement, was thinking, how could software improve?

How could it be better? Trying to meet people who had done more and getting them to critique what I'd done. And then eventually, starting a company around that idea. And I feel good that you can say through happenstance, that work actually led to a broad industry, personal computing, internet, software, that has been incredibly empowering. Has had, both in a direct sense, but also as a tool to be used for these other problems, it has been fantastic.

And so I don't look back on that with any regret. It what it did work out, but I didn't know what was going on in the world I was in my 40s. Before in terms of my travels, I started really having an awareness of how tough health conditions were. And I remember in particular reading an article about disease in poor countries and seeing there was a disease I've never heard of called rotavirus that was killing a million kids-- half a million kids a year-- and thinking, well, boy, there must be a lot of scientists working on that.

One fact, at that time, there are about 10 scientists working on that. Not well-funded, and just an obvious thing. And so I thought, wow, the world is not that rational. It is not these things. And in a way, that was good news for me, personally, it meant there were some very clear things that as I was taking the Microsoft resources and giving them back to society and trying to have impact, there were some low hanging fruit that hadn't been picked.

I wasn't going to be-- if the world was rational-- my marginal dollars would have far less utility than if there were these things that really had been missed. But I want to do is take two problems, including that one of childhood deaths, and talk about what's going on, and some of the things that need more bright minds, and given a sense of the very deep need on many of these, and yet the great opportunity. The chance of success.

I think if you took and tried to give the world a report card, one of the things you'd have very strongly, even if you only pick 10 measures, would be the number of childhood deaths. Some have there's an effort now that we've funded called the Millennium Development Goals, so they're trying to benchmark where different countries are in the progress, and set fairly ambitious goals for improving metrics.

And one of those is this under five childhood death number, and the milestone for those goals as 2015, and we'll make pretty good progress. We want to achieve them all, but it has had a very positive effect. So this is a very interesting metric, and I actually have one chart. I'm only going to show you one, but it's my favorite chart in the world, and that's one that shows the progress over time in reducing these childhood deaths.

If you go back to 1960, over 20 million children died that year. If you come up to the last year, which was the most recent measurement we have on this, it was under 9 million children. And there's about a 40% increase in the size of the birth cohort, so the actual rate reduction you've got is actually even better than the factor of two you see here in the absolute number.

And so you might say, how did that happen? What is it? Is it cancer drugs? What kind of science did it? And the answer is although some of it is just nutrition and income levels, the general advance of GDP per person and the living conditions you're under. By far, most of that is vaccines. Measles vaccine alone is over a million of that reduction.

Smallpox vaccine that led actually to the first eradication of a disease altogether is a huge part of this reduction. Well over a million death reduction per year because of that. And so vaccines, which get less than 1% of the focus on medical spending, goes into that area. They are responsible for a really incredible amount of health benefit. Even in rich countries it's a underappreciated element of why things work.

And they're very cheap. The manufacturing cost comes down over time to most a few dollars you can deliver them. As a group, you don't need trained medical personnel to do it. And even in a country like Somalia, where you essentially, have no government, we have quite high vaccination rates. Actually much better than we have in northern Nigeria, northern India, where you have a dysfunctional vaccination system that's only getting to 30% in some of those areas.

So it's a huge problem we have to fix, while at the same time, we add in these new vaccines. When you think about the inequities of the child to death-- I always think about how is the way you can state that that is the most clear? One that I think is interesting is to say, other people who are born the same year you were, your birth cohort, how old were you before 20% of you had died?

And in a rich country in the United States, you'd get past age 60 before 20% had died. In a poor country, the poorest, you wouldn't get past age four before 20% had died. So you had a very dramatic difference. The thing that was mind blowing when I found out about this is the effect that improved health has on population growth. The first thing our foundation did actually was invest in reproductive health, because we said, okay, whatever the problems you're interested in, not having too many more people, whether it's jobs, education, food, environment, to not have sort of Malthusian growth levels like 3%, 4%, 5% a year, which we fortunately, only have in a few places now, that is a primary problem.

And I wasn't sure how to think about health interventions, because are you schizophrenic? Do you want more people or less people, and wouldn't that be the first class effect? Well, the answer is no. Paradoxically, the biggest intervention that reduces the family size that people want to have is improving Childhood Health. There's some others like female literacy and things that can be done.

Hans Rosling, who's from Karolinska, has a presentation on the web. A Ted presentation, a number of others, where he really articulates there's only two kinds of countries, there's high population growth countries with terrible health, and there's low population growth countries with reasonable health, and there's no in between because this effect is so powerful that as you improve Childhood Health, parents who are trying to have a few kids survive into adulthood choose not to have as large a family size.

So what you get is as soon as you start to improve health, all these other things become tractable, and you have many countries that we used to think of as poor and received aid-- even South Korea 30 years ago got aid-- now, it's quite a generous aid donor. So it's a complete turnaround from recipient to giving within a 40-year period, but it's true of China, Brazil, lots of countries.

So now we're down to what Paul Collier calls the bottom billion, maybe a billion and a half or so that are in this poverty trap that we still need to better on. And the good news is that despite the complexities and difficulties of these things, something like vaccinations can be delivered anywhere. So inventing those, getting them to be cheap, getting them out, getting a slightly better distribution system will allow us to go from that slightly under 9 million that we're at today, down to 5 million down to 2.5 million, and it has this huge, huge effect.

The other problem I want to take as an illustrative example is education. And education economists of all the things that's known for sure, investing in education, primary, secondary, college level, doing that in quality way is the thing that really allows a country to improve its standard of living. So both that at macro level, but also at the individual level.

We all know from our personal experience that education is what makes our life interesting, gives us opportunity, and so we should want it to be broadly available. If you look-- and I was absolutely blown away at the statistics, I had no idea of how poorly the education system in the US is working. Over 30% of kids drop out of high school. If you're a minority, over 50% drop out of high school. Even the ones who complete, many of them have had a really, really poor education.

And so they sign up for college, they get into a remedial math class, and half of those kids never get any degree. So they've got loans they're paying off, they've got this negative experience, they put time into it, and it hasn't worked for them at all. And so this education system is quite poor, and it's been covered up, hasn't been that visible.

What we have now is a trend that because of the way state budgets are allocated, a great education is going to be more and more out of reach, that is, the tuition is more expensive. And so we literally will have a situation where less people are getting college educations unless we do something fairly dramatic to improve the efficiency. Make some type of breakthrough.

So I'd say there's two things that are very important. One is to take the quality of teaching, and this is particularly in K through 12, and find out what the best practices are, and how to spread those best practices. And it blows my mind how little work has been done on that to identify, now that we know some teachers are wildly better than most teachers, you make over two years of progress in math if you get a top quartile teacher, and you make zero years of progress if you get a bottom quartile teacher.

So what's going on? Is it seniority? We know it's not. Is it having a PhD in math? Actually, we know it's not that either. That has a very little affect on it, although people are focused on it. There's huge differences of how the kids are being drawn in, and yet we don't study that. We don't invest in spreading it around. We don't measure teachers, give them feedback, it's a system, where there's a huge opportunity to improve, so that's important.

And the other thing I think is using technology. And here's a case where MIT has absolutely been at the forefront. OpenCourseWare, there's great numbers in terms of how much it's being used by millions of people. I'm a super happy user. I retook physics with Walter Lewin, I took Professor Sataway's course and loved that. I recommended it to everybody.

Eric Lander, biology, refresher on differential equations, actually of the 33 that they have videos, I've taken 11. And I just last night spotted two new ones that I need to take, so just for me, it's a good thing. But this is just the beginning. And MIT did spark a lot of people to do similar things, but the percentage of people using these things and the difficulty of finding something and testing their knowledge.

Really bringing the best of video, the best professors in the world, have interactive experiments, interactive ways of testing your knowledge, even accreditation. Have a way that if you have gathered this knowledge instead of that all coming bundled with a degree where you had to be somewhere for four years, fairly expensive, say, quarter million. Actually have the accreditation piece be separated out, so you can have innovation, in terms of how people acquire the knowledge, and separate it from place based learning.

Now the exact path to this is not clear. There's some schools like Rocketship, who even at the middle school level, are using online courses and mixing that in with live teaching. It's an area that needs to be tried, and you have to keep the kids motivated, you have to help when they get confused, some of that will be face-to-face, but there's online innovation there too.

Right now, it's all pretty fragmented. Different universities doing different courses. It's kind of hard to find things. Academic growth has a little bit of an aggregation there, but that this can improve very substantially. I was talking with Victor Xu about how we take speech recognition and bring that in. We were talking about making it more modular if you just want to learn different concepts.

So we are just scratching the surface, and the need to take this and have teachers be able to learn how to teach better, to assign kids who are ahead, to assign kids who are behind, or to have self-motivated people going and use this and have it be a worldwide resource that's very clear who should use what, that's something that needs get done. And again, it's what's been done so far has had very modest funding. This is an area we need more resources, more bright minds, and certainly one that I want to see how the foundation can make a contribution to this.

So if you look at the two issues, childhood deaths, education, or if you look at the other ones. Savings, where the cell phone can bring down the transaction costs, sanitation or advanced physics and chemistry you really can do that in a different way. Energy may be the toughest one of all, but again, one where MIT is marshalling its resources to make a strong contribution as it can.

These important problems, there's reasons to believe we can't make progress, but that rate of progress will be somewhat proportional to how we draw people in. Draw them in full time, draw them in part time on these issues. So it does leave this, almost meta question of how to get the brightest people more on to these big problems. Why don't they work on them? Well, the economic rewards aren't totally in line with these problems. That's interesting, we can think about what would change that.

The visibility, getting the success stories out, how can we do that? My dream is that, say a few years from now, I'll go off and I'll have a weekend, and instead of talking about March Madness and stock prices, we'll have these brackets about the best teaching and which ideas have been tried, team teaching, online, and we'll be comparing which has really come out with the best outcomes.

And then we'll talk about food and the best seeds, the new agricultural practices that are increasing this productivity, and we'll have that same excitement and understanding that we have about other topics. I don't think that specifically is going to be easy to achieve, but it's kind of the high bar of why aren't these topics as interesting, as engaging as those other things.

And if we really did that, yes, we might delay the invention of a new financial product by a few years, we might even delayed that baldness drugs by a few years. But if it helps on the important problems, I think it's a good thing. Thank you.

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Great. Well, the rest of time is for Q&A. I think the way it's set up, there's the two mics. There's one here and one there. And just go to the mics and ask a question. Just say your name and what area you're studying in. Give me a little bit of context, that'd be great, so go ahead here.

CHAN: Mike and I are actually here to ask the same question. My name is Grace Chan, and I'm a member of a student initiative here at MIT called Leaders in Global Health Transformations, or LIGHTs. We're composed of undergraduate students, graduates, and business students from across campus. Now, as the world's foremost supporter of technological solutions to global health, you know better than anyone that in order to produce a new technology that has a large global impact, not only is there a need for inventive scientists and engineers to build the technology, but also a need for great entrepreneurs to disseminate the technology and build value.

A need for people who understand delivery and operations on the ground, and a need for rigorous evaluation and systems analysis. Here at MIT, we have the world's best minds in all of these areas, and many of these experts are currently engaging in various projects in global health. Results of a survey rewrite, we recently distributed through the provost's office revealed that over 40 MIT faculty are engaged in some global health research, and 17 student groups have an interest in this area.

However, these efforts are currently very isolated, with little collaboration between the different sectors. We believe that if these efforts are better coordinated, MIT as a whole, would be very well positioned to play an important role in solving poverty in global health. So our questions to you are threefold. First, would you be--

[LAUGHTER]

--would you be supportive of a centralized administrative led initiative, committed to supporting global health at MIT, much like the initiative that already exists for energy. Two, how do you think this initiative might be implemented? And three, how would the Gates Foundation be interested in partnering with such an initiative? Thank you.

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GATES: Well, I definitely applaud the work that's going on. And I do think MIT is an exemplar of this. One of the things we're trying to get is the institutions in the developing countries, particularly in Africa and India, more involved in this and transfer some of the expertise and skills, so that they, where the needs are, actually are more capable of doing some of the elements, including policy, measurement, things of that kind.

The idea of how universities organize, now, it's not a deep expertise that I have, and so the question of whether there should be a minor or some new thing that pulls us together, I think that's definitely worth looking at. I'd encourage you if you do it, though, to not just take health by itself. I'd say broaden it to international development, because the issues of agriculture, savings, there's quite a few issues, and I'd say the awareness and MIT of the health issues is ahead of some of those other issues. And yet, the kind of expertise is equally applicable to those things.

And once we improve health, we still want to work on those things. Today, what we've done with MIT is we take particular projects like the measurement and evaluation, and we fund that. Bruce Walker does a lot of the best work on AIDS, and we fund a lot of his activities. Whether a particular things should be done at a single university level here or there's some other missing thing, I'm not sure.

I did see a few things today where people are doing medical instruments, where I said, okay, we should make sure that the needs. What are they using, what are the problems, what they're using, what is the gap there that we really do a survey so people are picking the right thing. So that's a particular one, but we'll have a dialogue about whether a minor an Institute makes sense, and whether that's value added or how that can help. Thanks.

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GOLDBERG: Hi my name is Michael Goldberg, and I'm a postdoc in the Cancer Center. Really, I just want to say thank you for coming to speak with us today. And on behalf of MIT and really everyone in the world, thank you for the work you've done, you do, and will continue to do.

GATES: Thank you.

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MENCHACA: Hi. My name is Alejandra Menchaca. I work on energy efficiency in buildings, and my question has to do with population growth. In my field, we try to reduce, or at least where I work on, we're trying to reduce demand in order that we don't have to work too hard on the supply side. In terms of population, it's a hard issue to tell people whether to have a certain number of kids or not, but clearly, population growth is clearly a problem, in terms of supplying, as you mentioned earlier, the food, and the energy, and everything staying sustainable.

Do you think we will ever get to a point in which population will be controlled in a more legal way, or something like that, or it's something that will never be touched? I know I wouldn't like to be told, you can't have more than a certain number of kids, but at the same time, it is a problem. So how do you see that issue?

GATES: Yeah, the miracle here. If you go back to 1970, the estimates were that world population would reach about 20 billion, and that's because people didn't understand this effect of how health would have an impact. And so they lowered it to 18 to 16 to 14, and now the consensus is about 9.2 billion peak global population in about 2050.

Now on a global basis, that's probably okay, and we won't do much. Maybe we could get it to be 8.5 or something, the problem is that population growth is exactly where we have the least resources. The least good government, the least infrastructure, the least education, the least food capability, and all of the increase from the current 6.2 billion that we're at today to that around 9 billion plus or minus, is going to come in poor countries in urban cities. That a lot of the births will be in the rural areas, but net, it's going to be in these mega cities that are somewhat dysfunctional.

And so our reproductive health program is able to substantially lower birth rates because there's unmet demand that is, if you just go out to women and tell them, okay, there's a shot They can take that works for 90 days, or there's an implant that works for three years. We're going to be able to bring the price of those supplies down very dramatically. And it's an area that was ridiculously not funded.

In fact, the US government completely pulled out of the UN population group because of this issue that some of these groups are involved in voluntary abortion, and so the US didn't want to be connected in any way with that piece. Now, that rule, the so-called Mexico City gag rule was eliminated by President Obama. So for the first time, the US is back funding some of the delivery activities. But the innovation here, there's a lot that can be done.

As you bring the price of these things down, the injections, the implants, as you get the word out, the demand is there. So it's all completely voluntary. Women want to have a smaller family in all of these high population growth areas, and so there's no need to worry about coercive things. In fact, back in the 60s, the Club of Rome people who were these doom and gloom people we're saying that we had to have coercive techniques, and they just didn't understand.

So you have a very positive view of this. People want to have smaller families, the advances are coming that will make that easier. It won't come soon enough in a way, take Tanzania, it's a population of 42 million now. Even with a modest birth rate, it'll get to 90 million because they have the age structure as such, you have all these young people, that when they go and have their children, will all about double the population.

One of the ironies in population is that the rich countries are shrinking. The US is the only rich country that has population growth. Japan, Italy, Germany are shrinking. Mexico, even at their middle income level, is actually shrinking. And yet, you think, oh, we should have more immigration. We should take all these young people and keep our age structure reasonable, but politically, that's fairly difficult to do.

Even in India, this is an amazing thing, in the south of India in Kerala there below, which is the part of India with really good health care, it's subjectively the best, they're actually below replacement rate, whereas, in the same country you go up to Uttar Pradesh, that's 3.5% growth year, so one of the highest population growth in the entire world. The two highest population growth areas are actually northern Nigeria, northern India, which is also where you don't have good vaccination.

And so in a way, it's good news because you do the interventions with the reproductive health and the vaccines and the childhood care all in the same places, and it's very focused where you go and do that work.

BRYAN: My name's Alan Bryan. I am in the Health Sciences and Technology. I have a PhD in Bioinformatics. I'm a medical student, and so I'm now going to work in medical informatics. My question is single, but with two applications. You spoke of particularly vaccines and an improving education methods. In both, there's a two-part problem. One, is how to find what works better, and the second is how to get what works better out to people who need it.

In both cases, which do you find harder? So for vaccines, is it harder, and this is based on your past experience talking to people and then their future projections. Is it harder to do the research to find the vaccine, or to establish the cold chain that gets it out to people. And likewise, in education reform, is it harder to figure out what best practices really are that are transferable and are not innate to some organization, or some teacher's personal patterns of action or something. Or is it harder to talk through the accreditation process, and schools of education, departments of education, so forth, to get it integrated into the system?

GATES: Yeah, that's a very good question. And the answer is different for the two different domains. In the case of vaccines, we are science limited. That is, an AIDS vaccine is very tricky and we're having to learn basic things about molecular shape space, immunology, it is interesting, but it's taking us a lot longer because we haven't gotten lucky on that one. So that is science limited.

Malaria vaccine it's criminal that we didn't work on it, because probably the science of the 80s or 90s were good enough to do a malaria vaccine. They were not good enough to know an AIDS vaccine. Even if we'd been working super hard, we just don't have the fundamental understanding. Most of the diseases we work on, the vaccines aren't that hard, it's just there wasn't money put into it, and so now it's moving at full speed now.

And the delivery thing, we're going to have to raise money, billions, but you're talking about saving lives for less than $2,000 invested that is funding vaccination it saves lives for less than $2,000. And because in the US we'll spend $2 million or $20 million to save a life, then you say, okay, are these lives really less than 1,000 times as valuable? I mean, maybe there are 400 as valuable, but 1,000, that's getting kind of extreme.

I mean, even in the Constitution, slaves were worth what? 3/5 of the vote or something like that. So in terms of discrimination, numerically, this is pretty extreme stuff if you fail to fund the vaccines, which right now, in the budget crisis, we're having challenges with that, but in the long run, we won't. On cold chain, there's this great science of these super thermoses that should avoid us having to use electrification, which is very tough because if it goes out, the vaccines spoils, and electricity policies in these countries are so bad that using a solution that's passive energy to get the cold basically ice in a super or in a Dewar's type thing, we think we can replace cold chain.

But even if we have to use refrigerators, we can do it. You have to over buy the vaccines because of the fact that some of the most will spoil. So that one is science limited. The education one, even though we don't know-- it's mind blowing how little we know about what good teachers do and how you would invest in spreading that around, I think that will finally get some good work going on.

The field needs about 50 times as many people working on it, we need the schools of education to show up and get serious about this. We need some of the methodologies of real measurement to be applied to it. The hardest thing there, even once we know what to do, is going to be convincing people to do it. In fact, we have an existence proof. Kipp is a charter school that there's 82 of these schools that runs for less than the cost of public schools, and is able to take inner city kids, the poorest kids, and get over 95% of them to go to college and get a four year degree, and it doesn't take numbers.

If you walk into a Kipp school, you know you're in a very different place. Within 15 minutes of being in there, they have some amazing teaching being done there, and it's a different personnel system, it's a long school day, it's just very different than a public school. So here, the limiting factor absolutely is taking current practice, which is a I'm doing God's work, don't measure me. Seniority is good stuff type system that there are many great practitioners in that system, but there's no real effort to spread that.

We have five sites in the US that we've given $400 million to where the union and the district signed up to have teacher measurement. So we put webcams in so you can see the video, you don't have people walking into the classroom, it's very disruptive. We do teach students surveys, we do peer surveys, we look at the test data coming in and going out a variety of measures that we were going to try to get a consensus.

Four years from now, that in these five sites a teachers can say, hey, I like this. They got rid of the right people, it helped the rest of us here do better. It was not capricious, it was not high overhead, and I really like this. If that can happen in the five sites, and they can tell everybody else, that would be good. If you say, what's the riskiest thing the foundation is doing? It's that teacher personnel's activity because the status quo is immensely powerful there.

When we invent vaccines, no group, I won't name who it is, can uninvent the vaccine. If you do good education, there are groups that can send you back to square zero, and that has happened in many cases.

DENMON: Hello. My name's Matt Denmon, and I'm a PhD in Nuclear Engineering, and I was wondering, you mentioned the importance of low carbon energy to the world's future. Can you take a couple of minutes to talk about the role of nuclear power to provide that energy given that you're investing in nuclear reactor designs at third tier power.

GATES: Well, energy problems, one of these incredible problems and the progress of civilization you can almost measure it as is the price of energy goes down, so many great things happen. We have a civilization that's based on very cheap power, and it's great, we need to continue that. If you look at what technologies could really provide the electricity demand, say, 40 years from now, there are very few.

And most the ones that are kind of cute and cuddly have two big problems. I'm talking about solar PB, solar thermal, solar chemical, the very solar approaches, or the wind approach. Those two have one, it's energy farming, and so the density, the acreage involved, the watts per square meter of those things, it makes it very hard. And when you do farming, you get wind, you get snow, you get your capital equipment isn't in a coal plant that's protected from the elements, it's large, widespread.

So that's very hard, but even if you get passed that, there's the intermittency problem, where you can't on a 24-hour period, or when the clouds screw you up or the wind doesn't blow, you have this storage problem. And you can ask-- I think-- reasonable researchers, will there be in the next 40 years the ability to store, say, the amount of energy that the US uses over a 24-hour period in, pick your favorite technique. Battery, water storage, thermal storage, there aren't many choices, and it's not clear. We should work on that.

Professor Sataway, a lot of people are looking at radical battery technology that could, in terms of cost and capacity, get us in a very different space than even the lifting and learning curve will get us to. So you don't want to just bet on those because the costs are hard, because it's farming, and the intermittency thing. Once you get above say, 20% from intermittent sources, you've got a problem. It's cute, it works well up to about 20% where you ask the baseload guys, which today those are the hydro coal, natural gas, nuclear guys, you ask them to suck it up when the wind doesn't blow.

Anyway, nuclear, in some ways, is the coolest of all because you put the plant near the demand, and you don't care if there's sun or not. There's lots of countries that don't have sun and wind much at all, and so you have to say, are they willing to have the political risk of having their energy coming from, say, Libya and over some big transmission infrastructure.

Anyway, nuclear has the advantage that the amount of energy per atom is about a million times better than coal or natural gas. You start with this huge advantage, and yet given the complexity of the plants and the things you have to do, you more than wipe out your million for one advantage, and today's nuclear plants are fairly expensive. At least the way they're built outside of China they're quite expensive.

China is actually building them in three years and competitive with coal, so they're pushing the state of the art, and they're standardizing designs and things like that. Anyway, so nuclear is one of the directions that we should innovate in. Nuclear innovation stopped in the 1970s, we basically have this sub design thing that was put into shipping port for the first power generator, and we basically built 400 of those that are all custom, but not many interesting way. They're all LWRs and PWRs.

And the industry did not innovate much at all. There's this third generation passive safety P 1000, but except for that, it didn't do much. The question is, can we get 1,000 bright minds with 20 different ideas and we're starting to see that. I don't happen to believe in modular reactors, but some people do. That's great. Some people like these molten salt reactors, that's a little bit tricky.

The crazy group I'm backing, we use U238, depleted uranium. And because we have fast neutrons, we have this neutron budget that's very different. Now, our main problem is a material science problem. Is these damn neutrons degrading, the cladding and everything, and we don't have a predictable way of saying, over a 40-year lifetime, how various materials deal with that.

If you look at the fusion guys, they're neutrons are 1,000 times worse than our neutrons, but even ours or are-- those guys have 14 NPV neutrons, good luck to them. But some people should work on that. That is not an easy thing, in terms of the economics. So nuclear, in terms of [INAUDIBLE] is incredible, and if you use this approach we're talking about, it is infinite, that is you can filter out of the sea very cheaply enough, uranium to run this thing for as long as the sun will shine.

So in that sense, is it quote, "renewable" quote, well it's infinite. You don't worry about the amount of uranium. So anyway, I think it's one of the approaches that a ton more should be done in. We need more money in material science, we need more money in batteries, we need more money in transmission, this is an underinvestment area where if the government actually does raise trading money or carbon tax money. Some of the bills that have been proposed, don't actually fund R&D at a reasonable level, so it's a tragic thing that, hopefully, if we get a revenue source, that we can take the energy, R&D, and get it up maybe a factor of three or four more.

There's a few good things going on like [INAUDIBLE], but that doesn't work for nuclear. But I love I love nuclear. It does this radiation thing that's tricky, but--

[LAUGHTER]

--they're good solutions. It was interesting, recently in Connecticut, this natural gas plant blew up 11 guys. Just blew them up, actually, I think killed 506. If that had been a nuclear plant everybody would know about that. Coal mines, yeah, China did a good job last year, they went from 3,300 guys dying in coal mining accidents, to 2,600. Very impressive, don't you think?

But if nuclear had killed those 2,600 people, I mean, we would just be-- kiss the whole industry goodbye. It's interesting, deaths per megawatt, nuclear is the minimizer--

[LAUGHTER]

[APPLAUSE]

--these things, but it's got a lot of challenges. But it's great. I'm glad there's this Renaissance of people going into it. We have this company, and everybody in the company is either over 60 because they have done something, or they're in their 20s or 30s because they're open minded and optimistic. So it's an interesting bimodal, we don't have anybody in the 40s and 50s, because that was the nuclear shut down period is when those people would have would have been trained. Go ahead.