Why I Am Optimistic About 2023

As 2022 came to an end, I’ve had a lot of opportunities to speak with our key partners and others about the challenges the world is facing. Acute polycrises spanning health, economics, hunger and peace sit alongside the acceleration of longer-term trends like shifts in production, technology and the workplace.??

These conversations, as you can imagine, often begin in a negative place. In my work, what I see is that even though very few crises originate among the poorest people in the world, they are often the hardest hit.?

African countries contribute only 3% of the emissions leading to climate change, for example, and yet 16 of the 20 countries most vulnerable to climate change are in Africa, and East Africa has now missed four consecutive rainy seasons while West Africa has endured historic levels of flooding. The war in Ukraine has caused food and fertilizer prices to spike in many places, but it’s the biggest problem for people in poor countries in the Global South, where families spend a greater portion of their household income on food – sometimes upwards of 50% in some parts of Africa and South Asia.

It is a serious time. More than ever, we need the resources, the motivation, and the cooperation to solve big problems.?

• First, and most obvious, we have a problem with resources. Even though most of these investments pay for themselves many times over, today’s financial pressures make it difficult to fund even the most important things. We’re seeing this now with European governments cutting assistance to Africa because of spending for Ukraine. We’re increasingly having to think outside of traditional public finance, whether that’s private funding, new initiatives from development banks, or other sources.
• The second is motivation. For a long time, being seen as an international leader was a positive in most countries. Now, many leaders are facing public pushback on showing global leadership as opposed to domestic focus, and nationalist leaders are emerging more and more - most recently in Italy in September.
• The final one is cooperation and trust. The foundation measures trust regularly, and currently it's incredibly low. Some of this was a result of the COVID response, but more thought needs to be put into how to build trust back up from historic lows .?

However, I am optimistic that we will make progress on all three in 2023.??

First and foremost, I believe the problems we face are solvable. A few weeks ago, the Gates Foundation held its yearly strategy review meetings – and coming out of them, I don’t think I’ve ever been as excited about what’s possible. I heard over and over again about how we can dramatically improve the world: from drought-resistant seeds, to new protections against malaria, to digital public infrastructure improvements that make it easier for everyone to access capital. These are innovations that are not only reactive to the crises we face today, but build a stronger, more resilient world for generations to come. Bill’s annual letter this year cites a few, including an inexpensive phone-based ultrasound technique and gene therapy approaches to curing sickle-cell disease and AIDS.

Second, I believe in the people who are at the forefront of solving them. I feel lucky to see great leadership all the time: whether it’s a government leader taking a bold decision to refund the Global Fund, or women entrepreneurs and influencers on the African continent, or scientists working across borders to accelerate locally appropriate innovations. It’s one of the greatest privileges of my position that I get to meet and learn from so many of them. That’s where a better world comes from, and our job as a funder is to help these leaders change the world as quickly as they can.

And finally, I believe that a good enough cause can rally the world together, no matter what. The world today has challenges, yes – but no more than at the height of the Cold War in the 1960s and 1970s, when the U.S. and U.S.S.R. came together with WHO to eradicate smallpox, still the only human disease to ever be globally eradicated. And even last year, country after country pledged their recommitment to the Global Fund against HIV, TB and Malaria, resulting in the highest-ever replenishment for a multilateral health initiative, and allowing the Global Fund to continue work that has already saved 50 million lives.

Cooperation like this isn’t easy, but with the right cause, the right science, and the right advocates, it is possible. We can ensure that vulnerable women and children have access to the nutrition they need, and that small-scale farmers are resilient to the worst impacts of climate change. We can learn from the COVID-19 pandemic to build stronger health systems and a corps of emergency first responders for future epidemics. And we can make smart reforms to international finance, especially development banks, to address the debt crisis and unlock desperately needed funding.

There’s a brighter future ahead — and I’m proud to work with all of you to help realize it.