The NPHR on the Gates Foundation Letter 2016

By Claire Vernon, PhD Candidate

Editors’ notes: The impact of the Gates foundation on public health will only be sufficiently appreciated through the hindsight of posterity. Beyond the enormous financial contribution of Bill and Melinda Gates, research from the Gates foundation is providing new and innovative ways to think of global health. Each year the gates foundation releases an annual letter to share new thoughts and evaluate their journey so far. This year’s letter is both rich in ideas and inspirational in aspirations. We provide a brief summary of the highlights below.

Time and energy are the focus of the annual Gates Foundation letter. In their 2016 letter, Bill and Melinda Gates highlighted the value of these resources and presented the case that we must reduce energy poverty and time disparity if we want to reduce poverty and inequality.

“Sure, everyone wants more time and energy. But they mean one thing in rich countries and something else entirely when looked at through the eyes of the world’s poorest families.

Poverty is not just about a lack of money. It’s about the absence of the resources the poor need to realize their potential. Two critical ones are time and energy.”

While the larger discussion of energy and time as essential resources for combating poverty is important and worthy discussion, these resources also impact health. Access to energy is a particularly critical component to improving public health. As Bill points out:

“[E]nergy…means you can run hospitals, light up schools, and use tractors to grow more food.”

In the NPHR’s Winter 2015 Issue, Drs. Halley Aelion and Amul Tevar showed how efficient, accessible energy is key to improved public health. They presented examples of how both policy change and technological innovation contribute to increasing energy access, thereby directly improving community and individual health.

Drs. Aelion and Tevar explored the direct relationship between energy access and health—such as new technologies to treat water—yet energy access also impacts people’s lives in indirect ways. Examples of this are energy-powered plumbing and stoves, which simplify necessary daily tasks like obtaining clean water and cooking food. In this way, access to energy indirectly affects health by giving people—particularly women, who often carry a disproportionate burden of unpaid work—the limited resource of time. Melinda discusses how unequal gender distribution of un-paid work affects communities by specifically hindering the potential of women and girls:

“[E]very society needs it [unpaid work] to function. You can think of unpaid work as falling into three main categories: cooking, cleaning, and caring for children and the elderly.

Now, this work has to be done by somebody. But it’s overwhelmingly women who are expected to do it, for free, whether they want to or not.”

As a concrete strategy to address this “limited time resource” dilemma, Melinda advocates a solution where unpaid work becomes recognized as work and is redistributed equally between men and women, thus allowing everyone to contribute to bring solutions to reduce the time burden that inefficient work represents for communities. Melinda continues:

“Housework comes first [before homework], so girls often fall behind in school. Global statistics show that it’s increasingly girls, not boys, who don’t know how to read.

… In poor countries, moms are usually responsible for their kids’ health. But breastfeeding and traveling to the clinic take time, and research shows that health care is one of the first tradeoffs women make when they’re too busy.”

It is logical that community health would suffer when adults are too busy with essential life tasks to allocate time to breastfeeding or taking children to be vaccinated against preventable diseases, tasks that are arguably also essential. The more nuanced connection, perhaps, is how a community is hurt when its girls to grow up without an education. Certainly education is essential for all children, but when girls are specifically tasked with more unpaid work than boys are, they pay a greater time debt. The time debt could be paid with hours taken from sleep, or from homework, or from school itself. None is a great option.

Literacy is a critical door through which adults are empowered to learn more on topics ranging from health to economics, and illiteracy can severely hinder a person’s agency and opportunity. When large proportions of communities are burdened with illiteracy, such as when women are not literate, it is not simply the woman herself who is impacted. Her family, friends, and neighbors lose the benefit she could bring to their community were she to be educated. Our own Osefame Ewaleifoh has presented a more thorough look at the myriad ways in which education improves health through increased autonomy and agency.

In this year’s letter, Bill and Melinda Gates draw much needed attention to this topic: Time and energy are essential resources and we should recognize them as such. If our goals are to reduce poverty and improve health, two goals which are deeply intertwined, we must work towards a world with easy access to clean, safe energy, and we must “recognize, redistribute, and reduce” the time burden of unpaid work. In doing these things, we can open communities up to greater opportunity.

Photo by Pixabay via Pexels: Creative Commons

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About NPHR Blog (184 Articles)
The is the blog of the Northwestern Public Health Review journal. The blog and journal are both student run and contain research articles, opinions, interviews and other content pertaining to public health.

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