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Some days or decades, everything in the world seems to be getting worse. Global warming is unstoppable. Political polarization is tearing us apart. Women’s rights are backsliding in Afghanistan and, American liberals might argue, in the U.S. as well. European energy costs are skyrocketing, China is heading into recession, Ukraine is locked in existential war, and many African countries face a growing food crisis.
The list of sorrows goes on and on. So what is there to be optimistic about?
Today, the Bill and Melinda Gates Foundation released its Goalkeepers Report on global progress. Seven years ago, 200 world leaders agreed to 17 development goals, including the elimination of deep poverty and world hunger by 2030. The report finds that although the world is on track to achieve “almost none” of its ambitious goals, the planet is still better off than it was 30 years ago in almost every category.
“In 2015, when we set those goals, we didn’t expect a pandemic or a war in Ukraine,” Bill Gates told me in an interview about the report last week. “And yet, because of the progress before the pandemic and because of the innovations like mRNA, I remain optimistic when I think of the 10-to-20-year time frame.”
Since 1990, poverty and hunger have declined dramatically while life spans have increased on every continent. According to the report, the share of global smokers has declined by about 20 percent; children are roughly 30 percent less likely to be malnourished or stunted; rates of tuberculosis have similarly declined by about one-third; maternal deaths per live births have declined by 40 percent; the prevalence of neglected tropical diseases such as dengue and leprosy has declined by roughly 70 percent; and the share of the global population with access to toilets and safe plumbing has increased by 100 percent. The quality of data collection varies by category and country. But overall, it is hard to argue that human progress is some sort of sales pitch from the pathologically optimistic. Progress is simply a fact.
The report also contains deeper lessons about how sustained focus on the poor can dramatically improve the world. Consider the decline in AIDS-related deaths, which is one of the great underappreciated triumphs of the 21st century. Decades ago, public-health experts projected that about 5 million people would die of AIDS in 2020. In 2003, President George W. Bush announced a new policy, nicknamed PEPFAR, to combat the HIV epidemic around the world. At the same time, other countries and global-health organizations distributed millions of antiretroviral drugs throughout Africa, where cases were rising fastest. As a result, the number of global AIDS deaths has declined every year since 2005 to roughly 500,000 in 2020, according to the Goalkeepers Report. That means nine in 10 projected deaths were prevented thanks to the hard work and ingenuity of governments and public-health advocates.
These lifesaving programs cost a fraction of a rich nation’s GDP. From a utilitarian standpoint, they represent some of the greatest bargains on Earth. “It would be easy, in face of all our challenges, like inflation, in rich countries, to turn away from thinking about Africa,” Gates told me. “But the level of generosity that’s considered great is roughly 0.5 percent of GDP, because those dollars are so impactful. [In many cases] we can save lives for $1,000 per life.”
Another bright spot in global health is the decline of deaths in children under the age of 5. In 1990, more than 8 percent of children died before their fifth birthday. But that figure fell to 3.6 percent in 2021. When I spoke with Gates, I called this the best piece of news on the planet. He didn’t correct me. “The biggest reason the number’s gone down is that we got vaccines out to almost all of the children in the world” for diseases like measles, Gates told me. Groups such as Gavi, which is partly funded by the Gates Foundation, help buy and distribute vaccines, which drives prices down and improves access. The WHO has estimated that measles vaccination has prevented more than 20 million deaths in Africa since 2000, with the benefits concentrated among children.
Finally, for hundreds of years, economists and philosophers have worried that overpopulation would deplete the world’s resources and lead to mass starvation. But that hasn’t happened. Thanks to scientific breakthroughs such as the Green Revolution, the number of famine victims in the 2010s was lower than in any decade on record. In the 1870s—one of the most famous decades in the history of scientific and technological development—142 people per 100,000 died of famine globally. Today’s rate of famine deaths is about 99 percent lower than that of the late 1800s, despite the world’s population being roughly five times larger. (It is hard to imagine more compelling statistical proof of material progress.)
Gates said he’s still not satisfied with the way we think about world hunger. Agricultural productivity has allowed countries such as Ukraine and the U.S. to grow enough wheat to feed the world. Today, Africa imports more than 70 percent of its wheat, and annual food assistance sent to struggling countries has grown to $57 billion annually. But Gates told me that he wants the world to spend more money on agriculture research (currently $9 billion worldwide) so that African farmers can expand their own output without relying on global trade and generosity.
Fourteen years ago, the foundation started supporting African crop researchers who were worried about rising temperatures destroying their harvest. Corn makes up 30 percent of all calories consumed in sub-Saharan Africa, but it struggles to grow when temperatures consistently exceed 85 degrees, as they are expected to in the next few decades. The African research team used selective crop breeding to create a hybrid maize that is more resistant to hot weather. But hybridizing magic seeds isn’t enough. “You’ve got to get through the country systems to get the seed approved,” Gates said. “You’ve got to get all the way out to the farmer with advice and then credit to buy the fertilizer. This has got to get all the way to adoption.”
Headlines about scientific breakthroughs in malaria vaccines, or cancer treatments, or nuclear power are always fun. These breakthroughs are magnificent news. But material conditions around the world aren’t waiting on moments of laboratory invention. Progress requires the hard and harder-to-headline work of deploying the technology that we invent.
Want to discuss more? Join The Atlantic’s Derek Thompson for Office Hours September 13 at 1 p.m. ET for a conversation exploring the next frontiers of cancer research. We dread the diagnosis of cancer, not only because of its threat to life, but also because the road to recovery comes with toxic therapies. But a cluster of medical breakthroughs offer real hope for better cancer outcomes in the future. Thompson interviews Eric Topol on the scientific frontier and the intersection of technology and health care. Register here and reply to this email with your questions. If you can’t attend, you can watch a recording any time on The Atlantic’s YouTube channel.