If you’re looking for reasons that Warren Buffett delegated much of his philanthropy to the Bill & Melinda Gates Foundation, there’s the imam looking at Islam’s view of frequent pregnancies, the Peruvian president preventing stunted children and the Ethiopian government minister encouraging women to have babies in health facilities instead of at home.
Such descriptions of change are recounted in the first edition of Goalkeeper, a report that the Gateses plan to issue each year through 2030.
The report tracks progress toward 18 “sustainable development goals,” adopted by the United Nations in 2015, which “are fundamental to people’s health and well-being,” the Gates report said, with projections to 2030.
Buffett, the chairman of Berkshire Hathaway Inc., has said he wants his wealth to tackle problems that might otherwise go unresolved.
The Gates Foundation’s targets include childhood deaths and malnutrition; diseases including HIV-AIDS, malaria, tuberculosis and tropical maladies; poverty; maternity deaths; excessive pregnancies; smoking; sanitation; and poor education, among others.
Among the first-person stories in the report:
» Kesete Admasu, former health minister of Ethiopia, said the country’s 40,000 health extension workers reach the 85 million people who live in the country’s rural areas, passing along basic health information and bed nets to keep away disease-bearing insects.
To establish the personal relationships necessary to persuade women to give birth at health facilities instead of traditional home birthing, the government recruited the 3 million-member Women’s Development Army.
Women in one region wanted religious leaders to be present at births, so those leaders agreed to go to health facilities. Women didn’t want to be carried on stretchers because often people who left a village on stretchers never came back. The programs designed a new stretcher just for pregnant women.
The overall result: The proportion of women giving birth in health facilities rose from 20 to 73 percent, lowering the maternity death rate substantially.
» Fatimata Sy, a director with the Ouagadougou Partnership in Senegal, said culture dictated that women have lots of children, despite the health risks of frequent pregnancies.
Senegal developed a national action plan for family planning, endorsed by religious leaders, community advocates, youths and others. A yearlong public awareness campaign aimed at ending the taboo of discussing the subject.
A revamped supply chain now delivers enough contraceptive supplies to meet the rising demand for reproductive health services.
» Moussé Fall’s mother died when she was 43 after having eight children. “We realized that the main cause of her death was pregnancies that were too close together,” he said.
Now an imam and founder of the Islamic Network on Population, Fall said that even though many religious authorities oppose family planning, the Koran, Islam’s holy book, does not, citing references to the duty women have to breast-feed children for two full years.
Fall’s network works with local doctors and influential imams, so far training more than 3,000 imams about Islam’s views on family planning.
» Rohini Pande, a public policy professor at Harvard’s Kennedy School, said social norms in India see women working outside the home as shameful, and men whose wives work are considered bad providers. Family wages generally go to the husband, even if the wife works.
By depositing women’s wages directly into their new low-dollar accounts, the families saved more and worked more, adding to the economy and taking advantage of women’s talents.
» Stunted physical and cognitive growth due to malnutrition causes lifelong social and economic problems.
Milo Stanojevich, director of CARE in Peru, said a new program by U.S. AID improved nutrition, food security, water and sanitation in 1,200 communities, reducing chronic malnutrition by 10 percentage points.
The resulting Child Malnutrition Initiative gained political support for reducing stunting among children under age 5 by 5 percentage points within five years. When Alan Garcia was elected president, he pledged to reduce stunting by 9 percentage points and achieved that goal.
“We just kept the pressure on and kept the support through three different administrations,” Stanojevich said, “and the government made it happen.”
Despite much progress, the Gateses wrote, today “there is more doubt than usual about the world’s commitment to development,” such as cuts in foreign aid by the U.S. Congress and “retrenchment” in other countries.
“The decisions we make in the coming years will have a big impact on whether millions of people conquer disease and lift themselves out of extreme poverty,” the report said. “Most developing countries need to do more to prioritize the welfare of their poorest citizens.”
Yet another observer, analyst Sarah DeWitt of JPMorgan Chase & Co., says Greg Abel, head of Berkshire’s energy division, is the likeliest successor to Buffett as Berkshire’s top executive.
DeWitt also wrote that Buffett “shows no signs of slowing and could possibly be at the helm for another decade in our view.”
Buffett hasn’t said whom he would recommend to take on his executive role but assures shareholders that Berkshire’s board of directors discusses the topic regularly and has a candidate in mind if need be.
The Omaha World-Herald is owned by Berkshire Hathaway Inc.