Is Bill Gates wrong about polio?
Bill Gates and his huge foundation are under fire these days for his unrelenting focus on eradicating polio.
Critics are urging him to pull back from the zero-case goal. Eradication is impossible, they say, and is pulling dollars away from other life-threatening diseases. Gates should accept reality and invest in controlling the disease, not wiping it out.
Well-meaning though they might be, these critics miss the point. Gates is right to set an audacious goal and take it to the finish line. In doing so, he has decided to convert what many see as an intractable problem into one that is solvable.
This is the core challenge facing anyone engaged in changing the prevailing wisdom that rules the world. It is the same obsession that drives all social breakthroughs. As I write in my new book, Driving Social Change, success is not about settling for half a loaf or even 90 percent of a loaf, but altering the basic notion that the world can only be so much better.
The prevailing wisdom always fights change--after all, that is how it remains the prevailing wisdom. It criticizes new ideas, plants seeds of doubt and argues that problems such as poverty and disease are an inevitable byproduct of progress. Even when great breakthroughs occur in moments of national concern, the prevailing wisdom is always ready for a return to power when complacency sets in.
The prevailing wisdom about global health is surely right that polio is almost impossible to eradicate. Polio is a pernicious disease, especially in less developed countries where vaccinations involve multiple doses over relatively long periods at $2 to $3 per contact.
Moreover, Gates' polio campaign may indeed be diverting needed funding from other priorities. As the editor of the Lancet, a highly respected medical journal, recently tweeted, Gates' "obsession with policy is distorting priorities" even in other areas that the Bill and Melinda Gates Foundation has targeted. "Global health does not depend on polio eradication."
Gates has made the case that eradicating polio will save the world billions, and is also no doubt right. But his case would be stronger if he focused on the broader purpose of his effort.
Even if we fail, he could say, we should aim for a fundamental and permanent shift toward cure, not comfort; eradication, not control. Yes, we should invest in the most effective treatments for polio, which has a habit of popping up in unexpected places such as the Minnesota Amish community. Yes, we should acknowledge the enduring frustration in achieving eradication.
But these familiar realities have not stopped other efforts to change the status quo. Great social movements demand great ambition. Imagine if the civil rights movement had promised just half as much discrimination, the environmental movement just half as much toxic waste, the hospice movement just half as many painful deaths, the food movement just half as many hungry children, or the Egyptians just half as much the oppression.
By accepting nothing less than absolute eradication, social movements not only inspire their forces to persevere against the odds, they challenge the notion that some problems are just too hard to solve. Are they naïve? Are they arrogant? Are they immune to doubt? Perhaps so. But their drive for change is not only admirable, even heroic, but essential for reminding the world that it doesn't have to accept the status quo as the only alternative.
Thinking big is ultimately about creating a very different vision of the future and holding to it when the status quo demands compliance. Instead of saying "Yes, we can" when others say "Yes, we might" or "No, we can't," Gates is saying "Yes, we will"--and actually means it. He understands that change does not begin with compromise, but with a grand expectation of impact.
If Gates had said "Yes, we might" when he launched Microsoft, he wouldn't have the money now to change the world. Nor would he have the confidence to fight for a healthier world. He simply refuses to believe that polio is an intractable problem. His critics should adopt the same stance, whether in attacking disease or creating a more just, tolerant, enlightened and equitable world.
February 4, 2011; 11:30 AM ET |
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