Bill Gates says today’s global children’s health crisis is tomorrow’s economic catastrophe

Since then, with the help of wealthy nations and charities, much has been gained in the global effort to improve the health of the world’s children. Between 2000 and 2020, for example, infant mortality was reduced by 50%, as was the prevalence of infectious diseases. The areas that have suffered the most, including sub-Saharan Africa, have seen the most improvement.

But attention was diverted – and with it help. Now, progress is stubbornly blocked, according to a new report released today by the Bill & Melinda Gates Foundation. And the children pay the price.

UNICEF estimates that more than 400 million children – two-thirds of the world’s children – are at risk of malnutrition, meaning that even those children who have access to food may not be getting enough nutrients from what is available to them.

Malnutrition has devastating consequences for children. It increases the likelihood of developing common infections and increases the risk of dying from them. Malnutrition can lead to blindness, soft bones, stunted growth and is responsible for half of all deaths in children under 5. Malnourished children do not thrive in school, ultimately earn less than well-nourished peers, and are less likely to escape poverty.

And climate change will only make the problem worse, as the foundation points out in its annual Goalkeepers report, which tracks progress towards the UN’s sustainable development goals.

More than half of all child deaths occur in sub-Saharan Africa, and the number of people living in extreme poverty there continues to rise. However, the share of total aid given to Africa has fallen to its lowest level in 20 years.

The report calls for the restoration of global health aid and a special focus on child malnutrition. There are several “scalable” solutions, including agricultural technologies that will result in cows producing more nutrient-rich milk, fortifying everyday foods like salt and flour, and increased access to prenatal vitamins.

In an interview with wealthGates explains why he calls malnutrition “the world’s worst child health crisis.” He also discusses the economic impact of poverty, as well as his ideas on how to get the world to pay more attention.

WEALTH: Can you expand on the link between nutritional deficits and financial deficits? What are the economic consequences of malnutrition?

Bill Gates: There’s a thing called the poverty trap, where if you’re poor enough, you can’t invest in roads and better seeds and fertilizers, and your child’s diet is so limited, both in terms of lack of vitamins. .protein they need, that their physical and mental capacity is far below its potential. And in Africa, you have countries where 40% of children – because of limited brain development caused by malnutrition, even if you invest in their education – cannot contribute economically.

It’s very generational. The child you don’t feed today is your worker tomorrow. It’s not like when you improve your diet, you know, six months later your economy starts growing. Because, unfortunately, if you’re malnourished before the age of 5, you never recover. If you are stunted at age 5, you will be stunted for life.

This is the key asset of the future. What the foundation sees is that by helping with health in many ways—vaccines, whatever, and malnutrition was a very big part of that—you can break the poverty trap. You can make these children healthy. And that’s why help can help you get rid of it.

Bill and Melinda Gates Foundation

FORTUNE: Why has aid to Africa collapsed so drastically?

Bill Gates: From the year 2000 until the start of the pandemic, I would say that the community – we’re just a part of it – really did a great job of addressing food shortages in Africa and health challenges in Africa, including malaria, on the agenda . President Bush of the United States created PEPFAR (to address the global AIDS epidemic), which also led to the creation of the Global Fund. At the turn of the century, aid levels went up… and we kind of kept it up.

Will it go down or up? It probably depends to some extent, but we were able to get those vaccines to children in poor countries and reduce the under-5 mortality rate from 10 million a year to 5 million a year. And now we wake up, “Wow, why are we on this set?” Well, the pandemic, the fact that it interrupted these things, is understandable. But we also find ourselves with these African countries heavily in debt and paying very high interest rates, so their very limited tax collection goes more towards interest payments than the combination of health and education. So that stands in the way of the magic formula that we talked about the last time this happened, at the turn of the century: there was debt relief, and Africa was the biggest beneficiary of that debt relief.

Can we get on the agenda… do this again? I don’t know if we can. We should. And you know, it’s going to take a broad civil society. The Gates Foundation is just a small part of it. There is a movement among voters to take the moral imperative here and be willing to return to that 1 to 2 percent of the budget for these relief causes, including stopping health care and debt relief, and even some for education that we really? need?

WEALTH: In the report, write about the need for the world to recommit to the work that drove progress in the early 2000s. How will you get the rest of the world on board?

Ports: When things are over in Africa, they are very far away. And if the way you start that message is, “Boy, we’re going to make you feel bad about how bad things are in Africa,” you know, it’s not that engaging. It’s this balanced message where you say, “We’ve made huge strides,” that you know, kids are surviving a lot longer. And, the money was very, very well spent and people should feel very proud of that. And yet, there is still much to do.

The rich world’s budgets are more out of date because you have this willingness to spend more on defense and more on the health of the elderly and more on pensions because of the age structure. You want to spend more on almost everything. And so even though only 1 to 2 percent saves lives, you know, for a 1,000 of what you spend per country to save a life, it’s not as well represented, because it’s far away. And if civil society has other issues that exclude this from the agenda, then we can, without much visibility, see cuts.

FORTUNE: What’s your pitch for getting the world over?

Ports: It’s hard in a pitch with lift. Hit people with a “Do you care about the death of children?” Well, that’s a bit of a stretch. Do you have pictures of children dying? I haven’t tried this yet, but I doubt it would work.

What are the angles that might work? If you are a health care worker, (maybe it is) the idea that some children are not getting a measles vaccine. A death from measles is a truly horrible death. If you are a religious person, does it impress you that the poorest should get help? Sometimes the stars get involved, which is helpful. When I was in Nigeria, I was there with Jon Batiste. We think the logic is strong, but it’s a very, very crowded environment in terms of what people care about.

This interview has been condensed and edited for clarity.