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  The most important thing I’ve learned since Melinda and I started our foundation is this: The money governments are spending on health and development is improving people’s lives every day.

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  This is the most beautiful picture I have ever seen. It shows that in the last 50 years, the number of children who die has gone down from 20 million to just over 8 million. That is a stunning accomplishment for humanity. There are many reasons for it, but one very important reason is the money donor countries have spent on foreign aid.

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  The European Union as a whole has provided more than 50% of global Overseas Development Assistance (ODA) for decades. In 2010, the EU reaffirmed the collective target of devoting 0.7% of its Gross National Income to ODA by 2015.

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  Of all health spending, the best investment might be vaccines. Vaccines are inexpensive, they are relatively easy to deliver, and they protect a child for a lifetime. They save lives. Vaccines are one of the major reasons why the number of children dying has dropped so steadily.

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  Vaccines made the eradication of smallpox possible. Fifty years ago, there were 10-15 million cases a year; now there are none. Vaccines have also brought us to the threshold of eradicating polio. Since 1988, the number of cases is down more than 99%. That is thanks to the commitment of many donor countries, impressive logistical efforts in countries where polio still existed, and a 13-cent vaccine that has been provided to billions of children. Finally, vaccines have reduced the number of children dying from measles by 93%, from diphtheria by 93%, and from tetanus by 85%.

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  Vaccines have the potential to do so much more because we can do a better job delivering them, and we can keep developing new ones. Pneumonia is one of the leading causes of child deaths. There is a new vaccine that can prevent many cases of pneumonia. Diarrhea is another leading cause, and there is now a vaccine that can prevent many cases of severe diarrhea as well.

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  This year, 1.4 million children will die from diseases for which there is a vaccine.

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  Three quarters of poor people in the world are small farmers. Their food and income depend on their agricultural productivity. So it stands to reason that if you want to help poor people work themselves out of poverty, the most strategic thing you can do is invest in small-scale agriculture.

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  History offers a stunning example of the power of agriculture.

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  In the 1960s and 1970s, investments in agriculture saved a billion people in Latin America, South America, and parts of Asia from starvation. But these investments never got to Africa. In Africa, average yields have been stagnant for decades.

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  The French research center CIRAD has working with partners and local farmers in Burkina Faso and Mali for a decade. In those countries, the typical farmer has a few hectares of land, mostly planted in sorghum or millet, the key staples. So the quantity and quality of the sorghum and millet farmers grow can make the difference between prosperity and starvation. CIRAD is helping to breed better varieties of these crops that have traits farmers want - whether that’s resistance to pests or the ability to grow in extreme heat. The project is also helping farmers organize into groups to disseminate the seeds.

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  The German development agency GIZ and development bank DEG are leading the “Cotton made in Africa” initiative. The innovative thing about this program is that it channels market forces so that they help the poorest people who are so often left out of markets. The typical cotton farmer in Africa, usually a woman, has just a few hectares of land to grow enough cotton to generate the income that will support her entire family. Thousands of miles away, retailers like Puma, REWE, and Tchibo are looking for new sources of high-quality, sustainably produced cotton for their products. The “Cotton made in Africa” initiative helps small farmers in Africa dramatically improve the quality and quantity of their cotton crops and then connect those farmers to international buyers. In one of the countries where the project is working, Malawi, yields are up 100 percent this year alone. Those farmers are earning an extra $250 this season. To put that in some perspective, the entire project costs less than $200 per farmer over four years.

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  When you add up many projects that are helping farmers increase their productivity across the world, you have the potential for enormous impact. According to a recent study, if sub-Saharan African farmers were to double their yields over the next 20 years, then poverty across the region would drop by 40 percent.

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  For years, many governments disbursed foreign assistance without measuring its impact. But in the past decade, donors have start to get clearer and more principled about the purpose of their assistance. However, there are still stories that raise the specter of corruption, like the recent new that some money awarded by the Global Fund to Fight AIDS, Tuberculosis, and Malaria was diverted.

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  Corruption costs lives. The Global Fund recognizes that, which is why it discovered, reported, and punished the corruption itself. Because the Global Fund tracks its results carefully, we know what it has achieved since it was created in 2002: 3 million people treated for HIV, 7.7 million treated for tuberculosis, and 160 million bed nets distributed.

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  This chart was developed by Hans Rosling, a global health expert and pioneer in creative ways of showing data. There is a very clear relationship between life expectancy and family size.

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  And life expectancy goes up, family size goes down. So saving children’s lives actually slows population growth. Over the long run, a smaller population helps countries address the needs of their people, including feeding, educating, and employing them—and protecting the environment they live in.

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  When aid is done well, it removes some of the key obstacles that prevent a country from developing. We’ve seen it happen before, in Asia, for example, where aid as a percentage of Gross Domestic Product (GDP) has been dropping steadily.

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  A country like Korea no longer receives any aid, and in fact now gives aid. A country like Thailand receives no net aid. And even countries that still get aid, such as India, are much more self-sufficient. In India, for example, development assistance as a percentage of GDP is 10 times less than it was 40 years ago.

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  I am an impatient optimist. I believe the world is getting better, but not fast enough, or for enough people. In the spirit of impatient optimism, here are some of the things aid can help the world accomplish. If all 15 countries that pledge .7 reach that level, they would be able to fund all of the following: The full course of vaccines for every infant in the 72 GAVI countries, plus treatment for every person in the world with (non-drug resistant) TB, plus 375 million bed nets; Clean water for 250 million people; A tripling of the income of 4 million farm households in sub-Saharan Africa, lifting 20 million people out of poverty and education for 69 million children, the total number who are currently not in school.

Living Proof: The Presentation

The proof according to Bill Gates

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Bill Gates has been traveling around Europe to meet with world leaders and convince them that the money they spend on aid is money well spent. These are the same charts, images, graphs and words he uses to make his argument. If you're interested in using any of these slides, they are also available for download at in our Media Library.

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