蓋茨在演講中呼吁人們重視非洲。瘧疾每年造成了大量的兒童死亡，二十世紀(jì)初時，瘧疾曾經(jīng)是一種全球性的疾病，后來人們發(fā)現(xiàn)用奎寧可以治療瘧疾，到了二十世紀(jì)70年代，這一疾病在溫帶地區(qū)基本被消滅。但是，非洲國家對此沒有引起應(yīng)當(dāng)?shù)闹匾暎矝]有足夠的資金來開展這樣的項目。?

每年全世界大約有超過270人死于瘧疾，其中75%是非洲兒童。盡管瘧疾已經(jīng)在大多數(shù)國家絕跡，不過這種病毒仍然在貧窮的非洲及亞洲國家蔓延；這些國家主要是熱帶或亞熱帶氣候。比爾及梅林達(dá)·蓋茨基金會"去年曾捐款1.5億美元幫助解決找到抗瘧疾病毒的疫苗。?

I wrote a letter last week talking about the work of the foundation, sharing some of the problems. And Warren Buffet had recommended I do that -- being honest about what was going well, what wasn't, and making it kind of an annual thing. A goal I had there was to draw more people in to work on those problems, because I think there are some very important problems that don't get worked on naturally. That is, the market does not drive the scientists, the communicators, the thinkers, the governments to do the right things. And only by paying attention to these things and having brilliant people who care and draw other people in can we make as much progress as we need to.

So this morning I'm going to share two of these problems and talk about where they stand. But before I dive into those I want to admit that I am an optimist. Any tough problem, I think it can be solved. And part of the reason I feel that way is looking at the past. Over the past century, average lifespan has more than doubled. Another statistic, perhaps my favorite, is to look at childhood deaths. As recently as 1960, 110 million children were born, and 20 million of those died before the age of five. Five years ago, 135 million children were born -- so, more -- and less than 10 million of them died before the age of five. So that's a factor of two reduction of the childhood death rate. It's a phenomenal thing. Each one of those lives matters a lot.

And the key reason we were able to it was not only rising incomes but also a few key breakthroughs: Vaccines that were used more widely. For example, measles was four million of the deaths back as recently as 1990 and now is under 400,000. So we really can make changes. The next breakthrough is to cut that 10 million in half again. And I think that's doable in well under 20 years. Why? Well there's only a few diseases that account for the vast majority of those deaths: diarrhea, pneumonia and malaria.

So that brings us to the first problem that I'll raise this morning, which is how do we stop a deadly disease that's spread by mosquitoes?

Well, what's the history of this disease? It's been a severe disease for thousands of years. In fact, if we look at the genetic code, it's the only disease we can see that people who lived in Africa actually evolved several things to avoid malarial deaths. Deaths actually peaked at a bit over five million in the 1930s. So it was absolutely gigantic. And the disease was all over the world. A terrible disease. It was in the United States. It was in Europe. People didn't know what caused it until the early 1900s, when a British military man figured out that it was mosquitoes. So it was everywhere. And two tools helped bring the death rate down. One was killing the mosquitoes with DDT. The other was treating the patients with quinine, or quinine derivatives. And so that's why the death rate did come down.

Now, ironically, what happened was, it was eliminated from all the temperate zones, which is where the rich countries are. So we can see: 1900, it's everywhere. 1945, it's still most places. 1970, the U.S. and most of Europe have gotten rid of it. 1990, you've gotten most of the northern areas. And more recently you can see it's just around the equator.

And so this leads to the paradox that because the disease is only in the poorer countries, it doesn't get much investment. For example, there's more money put into baldness drugs than are put into malaria. Now, baldness, it's a terrible thing. (Laughter) And rich men are afflicted. And so that's why that priority has been set.