Bill Gates On the Importance of Measurement in Global Health #BillsLetter

Every year Bill Gates, the Co-Chair of the Bill and Melinda Gates Foundation, writes an annual letter laying out his vision for the future of global health and poverty eradication. This year’s letter, which can be read at, espouses the critical importance of measurement in saving more lives. In fact, Gates uses measurement in business as an example of its parallel importance in global health programs and delivery to those in most need.

Gates writes about global health and education programs that have used measurement as a key driver of their work. For example, using MDGs as a framework and by learning from the successes of the Indian state of Kerala in health delivery to its most vulnerable communities,  Ethiopia has subsequently been able to successfully lower its rate of child mortality. As Gates writes, “Ethiopia’s effort on health has lowered child mortality over 60 percent since 1990”. Ethiopia was able to achieve a proven decrease in child mortality with the implementation of 34,000 female frontline health workers who are in charge of 15,000 health posts scattered throughout the country. These health workers provide health care for those in their communities where previously health care was relegated to those who were near hospitals and health centers. Now, using Ethiopia as an example, Nigeria, Malawi and Rwanda are in the process of creating their own country-wide models for frontline health workers and better health care delivery to its citizens.

Gates also shares the prolific work India did in conjunction with Rotary International to eradicate polio from the country. This year marks the second year India is polio-free. This is thanks in large part to the work of health workers as well as robust geographic assessments that showed parts of the country that were not being reached for routine polio vaccine coverage. When measurements and changes were put into place, polio was eradicated from the country. Now polio is only found in Afghanistan, Pakistan and Nigeria.

Melinda Gates, Co-Chair of the Bill and Melinda Gates Foundation, wrote a section in the annual letter that discusses her family planning efforts and the critical need for precise measurements in order to provide more family planning options for women who live in the world’s poorest countries.

“I didn’t feel I had an accurate picture of how many women currently have or lack access to contraceptives, or what could realistically be done to drive improvement,” Gates wrote.

Through her work leading the London Summit on Family Planning last year data was sifted through in order to clearly determine that 120 million women need access to family planning services.

In all, Bill Gates’ push for more measurement in global health programs is sure to help save millions more lives in the coming decades because the more everyone knows the more can be done.

To read Bill Gates’ full annual letter visit or you can download it as a PDF. Additionally if you would like to share your hope for the 2030, visit the Gates Foundation Facebook page where you can have your voice heard on the My Hope for 2030 app. 

Photo: Gates Foundation

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