Many Many Moments of Lift

More than 122 million lives saved. Hundreds of millions people lifted out of extreme poverty. Over the course of its existence, The Bill & Melinda Gates Foundation has helped drive massive positive outcomes like that by focusing on what it calls “actionable measurement” – aka a commitment to collecting and analyzing data about its activities and interventions, and then using this information to adapt and refine its efforts.

As Bill Gates noted in the Foundation’s 2013 Annual Letter, the digital revolution has played a key role in increasing the organization’s ability to measure which approaches are working and which aren’t. “Thanks to cell phones, satellites, and cheap sensors,” he wrote, “we can gather and organize data with increasing speed and accuracy.

But it’s not just that the Foundation has been effective at aggregating and analyzing the “whos,” “whats,” “wheres,” “whens,” and “hows” of huge global challenges like childhood mortality. What struck me when reading Melinda Gates’ new book The Moment of Lift, is how committed and adept the Foundation has also been in understanding the "whys" – a question that even the most finely tuned sensors can't always offer much insight into. 

Still, anyone who wants to improve the world at scale knows how important it is to ask why. Until you deeply grasp why people do the things they do, you won't know where the most promising opportunities to introduce new ways of doing things exist.

Or, as Melinda puts it in The Moment of Lift, “If you don’t understand the meaning and beliefs behind a community's practices, you won't present your idea in the context of their values and concerns, and people won't hear you.”

This key principle is one that many would-be change-makers – be they product managers or philanthropists – overlook.

Melinda has been extremely successful in both these roles. In the late 1980s, she began her career at Microsoft as a product manager and helped turn Word, Encarta, and Expedia into consumer mainstays. In 2000, she co-founded The Bill & Melinda Gates Foundation, which has since grown into the world's largest private charitable organization.

The path from “product manager” – and the sense of impersonal authority that title conveys – to “philanthropist” – which can be defined as “lover of humanity,” may seem unlikely. But it makes perfect sense to me. After all, great product managers are typically great user understanders. They’re always looking for more context. They’re always looking for more ways to project themselves into the lives of the people they hope to serve.

When Melinda and Bill started their foundation, their goal was highly ambitious, entrepreneurial in spirit, and also fairly open-ended. As Melinda describes it in The Moment of Lift, they set out to “discover the huge missed ideas that would allow a small investment to spark massive improvement.”

That led them to “go where there was the most harm,” and consequently, The Gates Foundation’s first global initiative involved reducing rates of under-5 mortality in parts of the world where millions of children were dying from diarrhea and other preventable conditions and diseases each year.

But while the Foundation initially believed that increasing distribution of basic vaccines would be the best way to make an impact in this realm, a conversation Melinda had with a young mother in Malawi led to a new realization.

“What about my shot?” the woman asked her, referring to the long-acting birth control injection Depo-Provera. “Why do I have to walk twenty kilometers in this heat to get my shot?”

As a result of this conversation and others, Melinda began to understand how improving access to contraceptives could lead to substantial reductions in under-5 mortality rates. “When women in developing countries space their births by at least three years, each baby is almost twice as likely to survive their first year – and 35 percent more likely to see their fifth birthday,” she writes.

In the years that followed Melinda's encounter with that young mother, she continued making trips to Africa and other developing regions in the world, and listening and learning from the people The Gates Foundation intended to serve. And eventually these conversations led to the huge missed idea that would help guide the Foundation's efforts: Namely, that “if you want to lift up humanity, empower women.”

As Melinda recounts in The Moment of Lift, this fundamental but overlooked truth was at the root of so many of the issues the Foundation had been working on. Reduce childhood deaths? Increase access to contraceptives in countries where death rates are high. Improve agricultural productivity? Make sure researchers working on new seeds and fertilizers talk to female farmers as well as male ones, because the former do much of the agricultural work in developing countries.

“Whenever you include a group that's been excluded, you benefit everyone,” Melinda writes. “And when you’re working globally to include women and girls, who are half of every population, you’re working to benefit all members of every community. Gender equity lifts everyone.”

So while empowering women in pursuit of a more equitable society, with equal rights and equal participation, is obviously the right moral path to pursue, it’s also an economically productive one. Indeed, as Melinda notes, “No country in the last fifty years has emerged from poverty without expanding access to contraceptives.”

Even when your strategy has a clear path to scale, achieving lasting structural doesn't happen by simple decree. Instead, it tends to be an iterative process that hinges on the development and implementation of what Melinda describes as “delivery systems,” or “getting tools to people who need them in ways that encourage people to use them…”

In other words, as much as the Gates Foundation emphasizes scientific research and new breakthrough products, it’s not just enough to develop effective solutions. In addition, even a robust distribution network doesn’t necessarily guarantee success, if that network doesn't actually reach the people you want to reach or engage them in a way that make them receptive to what you're offering.

To get people to adopt new practices, protocols, and tools that are unfamiliar to them, and perhaps even contrary to their existing beliefs and values, you have to be transparent about your intentions. And you have to present your solution in a way that reflects their concerns and desires.

That requires empathy. Indeed, at one point in her book, Melinda talks about the “empathy barriers” that sometimes characterize change-making efforts, where outsiders come to a community with good intentions but show little interest in why the people there do things the way they do, and sometimes don’t even bother to explain why they think something should change.

Sound familiar? While Melinda was writing about development efforts in Senegal, she could just as easily have been talking about Silicon Valley.

Here, entrepreneurs and technologists often believe so strongly that the projects they’re working on will create such positive outcomes for the world that they think everyone else should just step aside and let them do their magic.

When “disruption” is regularly posited as the fastest path to progress, empathy may seem more like a bug than a feature. But as Melinda shows with great clarity and grace in The Moment of Lift, a commitment to empathy has been a defining feature of The Gates Foundation for the last 20 years, and one of the main reasons it has been able to drive such massive improvements in global health and well-being during this time.

Over the next 20 years, the opportunities to pursue change at scale will be vast, as we strive to keep improving global health, mitigate climate change, create new sources of renewable energy, produce enough food for a growing global population, and figure out how to productively implement powerful new technologies like driverless cars, AI, robotics, and synthetic biology. Philanthropists and product managers alike should look to Melinda’s experience for inspiration and guidance.