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          蓋茨夫婦如何改變數十億人的生活?

          黎克騰 2019年04月28日

          蓋茨基金會正改變數十億人的生活,但如果沒有背后蓋茨夫婦獨特的愿景,這個基金會不會有今天如此強大的力量。

          2018年3月,比爾·蓋茨又一次站在講臺前。過去幾個月里他發表了一場又一場演講,在舊金山敦促制藥商關注影響窮人和富人的疾??;在印度安得拉邦宣揚小農場的價值;在阿布扎比建議王儲和太子黨繼續支持全球醫療行動;在克利夫蘭建議投資建更好的學校。

          此刻,這位排名全世界第二的富豪,也是最積極為窮人爭取利益的蓋茨身處尼日利亞阿布賈,演講的主題也一以貫之:投資“人力資本”的必要性。會議中心位于總統府附近,在場者包括尼日利亞總統穆罕默杜·布哈里,政府部門也幾乎全員出席,從立法官員到各州領導再到商界領袖。大家都準備好聆聽這位通過名下基金會向尼日利亞慷慨捐助16億美元的人演講。

          兩個月前,比爾和梅林達蓋茨基金會走了非同尋常的一步,決定幫尼日利亞償還欠日本的7600萬美元債務,尼日利亞借該筆資金是為了消滅脊髓灰質炎。進展十分驚人。2012年,該國的骨髓灰質炎導致癱瘓病例占全世界一半以上,之后該數字已降至零。

          但蓋茨的演講內容并非關于“繼續做好工作”。相反,他告訴尼日利亞,雖然該國在非洲最富有,人口也最多,但仍有1.9億人生活在危險邊緣。蓋茨表示,尼日利亞正面臨“慢性的營養不良流行病”,尼日利亞兒童有三分之一長期營養不良,而且產婦死亡率排名全球第四高,也由此成為“世界上生孩子最危險的地區之一”。尼日利亞超過一半的農村兒童讀寫能力欠缺?;鶎俞t療系統“千瘡百孔”。

          蓋茨的話還沒完。他表示,從人均國內生產總值來看,石油資源豐富的尼日利亞“正迅速接近中上收入水平,如巴西、中國和墨西哥”。但從有意義的衡量標準來看仍然更像貧窮國家,人均壽命僅有53歲,比隔壁收入更低的撒哈拉以南非洲國家還低9歲。尼日利亞正走向危險的未來,除非改變路線,開始為提升人民健康、教育和經濟機會大筆投資。

          “你們一直對我很客氣,這么直言不諱也許不太禮貌?!鄙w茨向聽眾表示,他將事先準備好的演講稿稍微改動了一點。但他解釋說這從尼日利亞商人和億萬富翁阿利科·丹格特身上“吸取的教訓”。丹格特曾告訴他:“‘我獲得成功可不是因為假裝銷售我并沒有的水泥?!疑钜詾槿?,禮貌可能更容易,但面對現實也很重要,這樣才能進步?!?/p>

          第二天的頭條新聞顯示,該演講讓政府“震動”。全球疫苗免疫聯盟(GAVI)主席,曾擔任兩屆尼日利亞財政部長的恩戈齊·奧孔約·伊維拉說,可能也只有比爾·蓋茨才能做到。幾年前,蓋茨還在微軟擔任首席執行官時,就曾直言不諱地挑戰政府領導人,例如上世紀90年代美國政府針對微軟的反托拉斯案中。1975年,蓋茨與保羅·艾倫共同創立微軟公司。

          如今蓋茨已遠離微軟時代,但仍然堅持坦誠風格?!八谀崛绽麃嗊@次就是,還是直言不諱的風格,” 奧孔約·伊維拉說,不過現在坦率的態度中融入了別的東西,一種明確目的驅動的感覺,相對溫柔的熱情。

          近來人們說起63歲的比爾·蓋茨,熱情一詞頻頻出現。就在上世紀后幾十年,他還經常被嘲笑是個傲慢又沒有靈魂的企業掠奪者。

          It was March 2018, and once more Bill Gates found himself behind a podium. In the previous few months, he had given one keynote address after another—in San Francisco, he’d urged drugmakers to focus on diseases that affect the poor as well as the rich; in Andhra Pradesh, India, he had preached the value of smallholder farms; in Abu Dhabi, he’d enjoined the Crown Prince and other princelings to continue their financial support for global health initiatives; in Cleveland, he’d promoted investment in better schools.

          Now the world’s second-richest man and foremost itinerant advocate for the poor was in Abuja, Nigeria, talking about the same theme that had underlain all of these speeches: the need to invest in “human capital.” Among those gathered at the conference center, in the shadow of the Aso Rock Presidential Villa, was the Nigerian President himself, Muhammadu Buhari, and what seemed like the entire seat of government, from legislative mandarins to a full house of governors and business leaders—all primed to hear from a man who had, so far, lavished the country with $1.6 billion in grants through his eponymous foundation.

          Two months earlier, the Bill & Melinda Gates Foundation had taken the unusual step of absorbing a $76 million IOU Nigeria owed to Japan, for money Nigeria had borrowed to fund a polio eradication effort. The progress there had been striking. In 2012 the country had more than half of the worldwide cases of this paralyzing disease; that number had since been cut to zero.

          But Gates wasn’t there to deliver a keep-up-the-good-work speech. He was there to say the opposite: to tell his hosts that their nation—Africa’s richest and most populous, with 190 million residents—was on a knife’s edge. The country was facing an “epidemic of chronic malnutrition,” with one in three Nigerian children chronically malnourished, Gates told his audience. Nigeria had the fourth-worst maternal mortality rate on the planet, making it “one of the most dangerous places in the world to give birth.” More than half of rural Nigerian children could not adequately read or write. The primary health care system was “broken.”

          The harsh litany went on. On the basis of per capita GDP, oil-rich Nigeria was “rapidly approaching upper-middle-income status, like Brazil, China, and Mexico,” Gates said. But by every meaningful measure, it still resembled an impoverished nation: Life expectancy was a meager 53 years—nine years lower, on average, than its low-income neighbors in sub-Saharan Africa. Nigeria was headed for a perilous future—unless it changed course, that is, and began to substantially invest in the health, education, and economic opportunity of its people.

          “It may not be polite to speak so bluntly when you’ve always been so gracious to me,” Gates told the gathering, veering a bit from his prepared remarks. But, he explained, he was “applying a lesson” he’d learned from Nigerian businessman and fellow billionaire Aliko Dangote, who told him: “?‘I didn’t get successful by pretending to sell bags of cement I didn’t have.’ I took from that, that while it may be easier to be polite, it’s important to face facts so that you can make progress.”

          It was a speech that “rattled” the government, according to the next day’s headlines. And it could have been given only by Bill Gates, says Ngozi Okonjo-Iweala, chair of GAVI, the international vaccine alliance, who twice served as Nigeria’s finance minister. Years earlier, when Gates was CEO of Microsoft, the company he cofounded with Paul Allen in 1975, he’d had no trouble speaking bluntly to government leaders—vigorously challenging, for one notable example, the U.S. government’s antitrust case against the company during the 1990s.

          The post-Microsoft Gates was still unabashedly candid—“He did that in Nigeria, and he didn’t mince words,” says Okonjo-Iweala—but the frankness was now infused with something else: a driving sense of purpose. A more tender kind of, well, passion.

          That’s a word that’s used quite a bit these days to describe Bill Gates, 63, who in the waning decades of the 20th century was often pilloried as a brash—and sometimes soulless—corporate predator.

          一位朋友回憶說,在孟加拉國首都達卡,政府極盡熱情歡迎蓋茨夫婦。然而夫婦二人只想聽當地普通民眾說話。圖片來源:Courtesy of Bill & Melinda Gates Foundation/Prashant Panijar

          雷·錢伯斯是一位很有影響力的美國慈善家,現在擔任世界衛生組織全球戰略大使,也曾擔任聯合國秘書長瘧疾問題特使數年。他說,蓋茨對全球醫療領域不管什么“問題的熱情”,以及“對病患的同情”都很強烈。醫生海琳·蓋爾曾在蓋茨基金會工作五年,負責艾滋病、結核病和生殖健康計劃,現任芝加哥社區信托公司首席執行官。她特別指出“堅定”一詞,認為“該描述并不準確,太缺乏想象力。實際上應該是介于堅定和熱情之間。蓋茨這個人肩負使命,而且‘無所畏懼’”。

          如果你想知道如此長久的熱情動力何在,主要原因其實藏在基金會的名字里,不過是除了蓋茨的另一部分:梅琳達·蓋茨。

          如果說比爾的超能力是敢于向強權說真話,梅琳達的超能力可能傾聽弱者的心聲,而且能消化并分享秘密,往往都是殘酷壓抑的智慧。她語氣溫和,卻又如教堂鐘聲一樣振聾發聵。了解她的人都說她真正不可思議的本領其實是傾聽的能力。

          梅琳達今年54歲,曾在蓋茨基金會工作的蓋爾回憶起2000年代初與梅琳達前往印度,會見了受到艾滋病毒影響嚴重的群體,都是從事性交易的女性。梅琳達像往常一樣,坐在地板上傾聽?!八麄儺斨性S多人常年受周圍人們輕視和羞辱,”蓋爾回憶說,“她靜靜聽在場女性講述自己的故事,了解她們的生活,為什么淪落到用性換取基本的生存,還有外界人的傾聽,聽她們的故事,愿意擁抱她們,按照正常人的尊嚴平等對待她們意味著什么,當時的場景非常非常感人,”她說。

          在莫桑比克情況也一樣。蓋茨夫婦前往偏遠的農村地區,聽當地婦女談論對子女的期望,“以及對無法供養照顧子女的擔憂,” 蓋爾說?!懊妨者_會坐在地上,跟女性談論母親關心的事情。她就是有跟每個人聯系起來的超凡能力?!?/p>

          洛克菲勒基金會的首席執行官拉吉·沙赫也曾在蓋茨基金會工作,經常與創始人一起旅行,但有一次比較特別:2005年12月前往孟加拉。政府竭盡所能歡迎這對著名的夫婦到訪達卡,還把巨大的兩人頭像貼在機場路邊廣告牌上。然而,蓋茨夫婦只想參觀著名的國際腹瀉病研究中心,或者人們常說的“霍亂醫院”湖北11选5走势图。

          該醫院成立于20世紀60年代,在幫助腹瀉兒童生存的研究方面成果頗豐湖北11选5走势图?!爱敃r湖北11选5走势图,”沙赫回憶說,“爆發了霍亂湖北11选5走势图湖北11选5走势图,我們也正好路過。不知道你見沒見過霍亂病床,都比較高湖北11选5走势图,中間有個洞湖北11选5走势图,上面有藍色的防水布,原因很明顯湖北11选5走势图?!泵繌埿〈采纤粋€孩子湖北11选5走势图?!昂⒆觽儾煌8篂a,”沙赫說湖北11选5走势图?!安〈蚕路胖敖优判刮?。母親坐在孩子旁邊,不停地喂口服液,一般是加鹽和其他電解質的純凈水?湖北11选5走势图!边@種叫ORS的口服液可以防止孩子在腹瀉期間脫水甚至死亡。

          梅琳達坐在一位母親旁邊,幫忙用勺子喂孩子。這兩位女性一個出生在達卡,另一個出生在達拉斯的中產階級家庭湖北11选5走势图,通過翻譯談論晚飯吃的東西。就在那一刻,沙赫意識到梅琳達真的能做到跟任何人建立聯系湖北11选5走势图。他在談話中停頓了片刻:“我記得可能不夠準確。但我只記得她說:‘哦湖北11选5走势图,我家里人也吃了米飯和豆子!’她就是這樣,人們能以很特別的方式跟她產生聯系『?1选5走势图湖北11选5走势图!?!-- cend -->

          Ray Chambers, an influential American philanthropist who is now the World Health Organization’s Ambassador for Global Strategy and who for several years served as a UN Secretary-General’s Special Envoy for Malaria, says Gates’ “passion for the subject”—whatever that might be in global health—“and his compassion for the victim” are equally striking. Physician Helene Gayle, who spent five years with the Gates Foundation, overseeing its HIV, TB, and reproductive health programs and who is now CEO of The Chicago Community Trust, singles out the word “determined” before saying, “that’s not quite right—that’s too pedestrian. It’s somewhere between determined and passionate. I mean this guy is on a mission, and he is—the word is ‘undeterred.’?”

          And if you’re wondering what drives this perpetually refueling zeal, a big part of the answer can be found on the other side of the ampersand in his foundation’s name: ?Melinda Gates.

          If Bill’s superpower is speaking truth to the mighty, Melinda’s may well be hearing the truth of the unmighty—and then internalizing and sharing that secret, often brutally repressed wisdom. For a generally soft-toned speaker, her voice has the command of a church bell. But those who know her say her truly uncanny talent is simply the ability to listen.

          Gayle recalls one trip with Melinda, now 54, and Bill in the early 2000s to India, meeting with a group that was particularly hard-hit by HIV, women in the commercial sex industry. Melinda—as was often the case—sat on the floor with the women and listened. “Many of them were despised and stigmatized in their own communities,” recalls Gayle, “and having her listen to these women’s stories and hear the lives that they led—why they ended up having to trade sex for basically survival, and what it meant to them to have people from outside come and listen to them, listen to their stories, be willing to hug and embrace them, and treat them like human beings with equal value—was a very, very moving moment,” she says.

          In Mozambique, it was the same. The ?Gateses would travel to a remote rural area, talking with women about their desires for their children—“and their fears that they wouldn’t be able to provide for their children and care for them,” says Gayle. “And Melinda would sit on the ground, talking woman to woman about the things that mothers care about. She has this remarkable ability to connect with everybody.”

          Raj Shah, the CEO of the Rockefeller Foundation, has likewise worked at the Gates Foundation and traveled frequently with its founders, but there is one trip that stands out: Bangladesh, December 2005. The government had pulled out all the stops in welcoming the famous couple to Dhaka, putting their giant faces on billboards lining the highway from the airport. The Gateses, however, just wanted to visit the famous International Center on Diarrheal Disease Research—or, as everyone called it, the “Cholera Hospital.”

          Established in the 1960s, the hospital had long been a pinnacle of research on ways to help children with diarrhea survive. “At the time,” recalls Shah, “there was a cholera outbreak, and we were walking through. And I don’t know if you’ve ever seen a cholera cot, but basically it’s a raised cot with a hole in the middle, and they have a blue tarp over it, for obvious reasons.” On each cot was a child. “And the kids just have constant diarrhea,” says Shah. “There are buckets under the cot to capture all that. And the mothers sit next to their kids and constantly give them a combination of oral rehydration, salts mixed with purified water and some other electrolytes.” That ORS, as it’s called, keeps the child from dehydrating and dying during the diarrheal episode.

          Melinda sat down beside one mother and began helping to spoon-feed her child, as the two women—one born in Dhaka; the other, in a middle-class home in Dallas—talked through a translator about what they ate for dinner. It was a moment when Shah realized that Melinda could bond with anyone. He pauses for a moment in the conversation: “I could be wrong in all my recollections. But I just remember her saying that ‘Oh, my family ate rice and beans also!’ It’s just who she is: People connect with her in a very special way.”

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