At the fifth Ramnath Goenka Memorial Lecture held in Delhi this month, Bill Gates, Co-chair & Trustee – Bill & Melinda Gates Foundation, philanthropist, author, investor & technology founder, spoke on the significant role that India can play in overcoming global challenges such as climate change, healthcare besides commercial viability of research and significance of AI in today’s times. Gates was in conversation with Anant Goenka, Executive Director, The Indian Express Group. On what’s holding us back from making faster innovations We certainly have a challenge. The places where you have the resources and the ability to give money or use science to solve these problems, are often very distant from where the problem is. For example, the suffering of malaria. If the people literally lived near you who had those problems, you would probably buy bed nets for them. You would try and advocate for a research programme to bring that horrible disease to an end, which hopefully, we will. Even within India and the places with the toughest challenges, are far away from where you have the most sophistication. I’d always hoped that digital tools would essentially shrink distance and make us understand what people are doing, and have more humanity. We’ve seen some of that. We’ve also seen that you get drawn into your ideas and so it’s also been a force for polarisation. And you have this struggle to find what’s going wrong with our fellow men and see what’s going well. On global vs customised solutions Well, it’ll certainly be a mix. Key technologies like the green way of making cement, steel, and powering jet planes with hydrogen instead of hydrocarbons will get invented and compete on a very global basis. There’s not a country that’s not talking about green hydrogen as something that they want to bring into their economy because it actually solves a lot of these different climate things. But the path to go about it will have to be local. For example, in case of this gigantic green grid for India, you’re actually kind of blessed because you have a fair bit of wind and sun. So you’ll solve it in a certain way. Fora country like Japan, it’s difficult. They don’t have the same landmass. Hopefully, some form of nuclear power will be both economic and safe, and acceptable. On problems of sustainability stemming from the West’s vision of development I don’t think we can count on people living impoverished lifestyles as a solution to climate change. Meat consumption in India will be less. That’s good for your health. Will all Indians become vegetarians? Will all Americans become vegetarians? I wouldn’t want to count on it. Anybody who wants to evangelise that, they’re welcome to, I won’t resist in any way. Yes, in the climate movement, you can kind of say we’d been consuming too much and maybe we shouldn’t travel anymore. In the US in particular, we could use half as much energy per person. But if we said to India, to stay at its current level, that would be completely unjust. Most of the demand for more energy, cement, and steel is coming from middle-income countries like India, where, even if you stop at a quarter of American energy intensity, climate change is very dramatic. I’m not saying, to consume as much as possible. But we ought to give people that option. For example, air conditioning. If you’re tough, don’t buy it. It’s good for the climate. But as India gets warmer, I’m betting that the demand for air conditioning is going to skyrocket. As it gets hotter, demand is more for electricity, which if it’s not green, then you’re in a positive feedback loop. On commercial viability of research and innovation vis-a-vis exploitative solutions in healthcare In healthcare, we do have a solution that’s kind of ideal, which is that the return that allows drug companies to have profit comes to them primarily from their sales in rich countries and somewhat from middle-income countries. For lower-income countries, the price should be just what is the cost to make the medicine because these countries either don’t enforce the patents or don’t file the patents. Pharmaceutical companies understand the expectation. The foundation (Bill and Melinda Gates Foundation) has helped create a patent pooling mechanism. We were talking to the generic drug manufacturers here in India who go to that and actually make incredibly low-cost medicines. We help them. Their profit margins are low enough that sometimes we have to grant them money or guarantee them volume so they can afford the investment to bring the price down. For most climate technologies, market competition will make the price higher as people are seeking volume from these things and it’ll make the price very low. But if there’s some key climate technology that only one person has, then the political process about which country should really pay for this and have that intellectual property, something will kick in. I don’t think our priority says that the market won’t solve these things. If the market isn’t driving the availability of great solutions, then yes, the government will step in. On Big Pharma’s need for a brand makeover in developing countries Big Pharma has done a lot of incredible inventions. I’m not going to stick up for everything the Big Pharma does. Some of the pricing stuff is complicated. But they run $500 million in Alzheimer’s drug trials, but all of which have been failures to this point. And yet, there they are, continuing to try. I wouldn’t want to get rid of the profit motive in medical innovation. On nuclear energy Unlike computers, where the prices kept going down, the complexity of the nuclear reactors kept going up. By the time they got to what we have today, what we call the third generation, they really priced themselves out of the market. Then cheap natural gas came in and made it very tough. So the nuclear industry didn’t invent a new design. What’s necessary is to start from scratch. I’m very biased on this. I have over a billion dollars in a company doing this and it could fail. I’m not doing it to make money. I’m doing it because it may contribute to the climate issue. So there’s nuclear fission. There’ll be a new generation of designs that will be dramatically cheaper and safer. Then there’s nuclear fusion. I'm an investor at a lower scale in four of about 16 companies that seem to be making some progress there. We can’t count on it. There are a few of them that say in 10 to 15 years, if everything went perfectly, they think they could make cheap electricity. We have to keep an open mind on whether nuclear fission will solve its problems, and whether nuclear fusion come into existence. It would be great for humanity if those solutions worked well. On AI and if the world is ready for it We may never be ready. For somebody who grew up thinking about software and what software could not do, AI was always the dream. How is it that humans are so good at recognising images and speech? Even five years ago, things like image recognition, or speech recognition had become very good. For peripheral senses, the machine was at human or even slightly better levels. But it could not read. It could memorise the document. But if you said, pass this complex biology test about this biology textbook, it just couldn’t do it. Large language models that are called general predictors can now read and write. They’re not perfect. For anybody who’s even played with ChatGPT-3, you will sometimes get answers that are stunning about how stupid the thing is. I'm playing with something even better than that and believe me, it’s even spookier. Mostly in a positive way. People are surprised that now I can write poems, songs, and greetings that are written very well. We’re at the beginning of computers that help in ways that they never could before. I think the pace of innovation will be very rapid. I've gone to full-day meetings where we sit and talk about healthcare, how we use this to find more drugs or to give advice to patients. This is the biggest thing happening in tech. Yes, we have 3D glasses and everything. But this is way more profound. Because the productivity of even white-collar jobs will now be greatly enhanced over the next two or three years. QUICK QUESTIONS What gives you more joy, earning money or giving it away? I’m worth less every year so I hope I enjoy giving it away. I’m voluntarily giving it away so I’m having a blast. I had fun making it too. When was the last time you used ChatGPT and what did you type? I was telling it to write things in Hindi last night. Of course, I have no idea what it was writing, but I play around with it. Whenever I have friends over, we joke around. Which authoritarian regime is a better hub for innovation — Russia or China? The degree of innovation in China is quite significant. Nothing like the US levels. Russia has lower population and people who are very good in mathematics. But beyond that, they never really learned how to scale things up. They completely exited from medical innovation, even though 50 years ago, they were very good. I feel sorry for the young generation there, which should be contributing to health advances and IT advances now. That’s going to be largely blocked from them. Some of them are leaving the country because of that. Free speech is at the centre of innovation. A lot of people in India talk about why can’t we be like China or because people think about moving to Dubai or Singapore. The Western democracies and India have set a great example for the world with their openness, including free speech and a press that can push back on political leaders. We need that more now. It shouldn’t blind us to the fact that China, even in a system that you might think, would hold these things back. There are some significant innovative things that happened in China. They study what we do well. We should study what they do well. Chung Hua is a top university. Microsoft has a research group in Beijing, which is every bit as good as the one in Bangalore, Cambridge, UK, Seattle or Boston. So the human capacity to innovate is pretty universal. You have to have a pretty bad regime to completely suppress that. You’re one of the smartest, richest people alive. When was the last time you felt helpless? I’ve had a lucky life. There was an antitrust lawsuit against Microsoft. The US government was a thousand times more powerful. I had moments of helplessness. But I’m not asking anybody to feel sorry for me. The one thing you’ve learned from Steve Jobs. I learned a lot from Steve. We were utterly different. He never wrote a line of code. But his sense of design and marketing, and his intuitive feel for who was a good engineer was great. Steve was such a unique person and was able to get a lot out of people. He sometimes would overwork people, it wasn’t a perfect thing. But Steve was amazing. I learned a lot from him. Do you believe there’s life on other planets? I’m doubtful. There’s this thing called the Drake equation where you look at the probability — what it took for life to come on this planet. As you get to more complex life forms, it looks like that it wasn’t that probable. But this is one of those things that you may have to have a sense of faith in. But during my lifetime, we’re unlikely to answer the question. VOICE BANK Rudra Pratap Founding Vice Chancellor, Plaksha University You have addressed several problems — health, climate, and sustainability. I haven’t seen as much effort from you on improving education. What do you think about the current state of education and what would you like to change? The Gates Foundation spends over $500 million a year on education and about 80 per cent of that is focused in the US. When I started the foundation, I thought we were going to do education in the US and study the best teachers and show the others how to do what the great teachers do. It’s helping but it will take a long time. It was the other way around with health work. It was quick and we got new vaccines and started to see results, even though it was in some of the countries with challenging environments. In education, we’ve had some results where we improve the curriculum and train teachers in a better way. Some governments run a personnel system where great teachers are identified and rewarded. It’s an area where we’ve had some good results. I’m optimistic because I think the experiments we’re doing with the AI are where the student can play around and get a lot of really good feedback on their papers. If you improve education, you improve a lot of things, including, being a good citizen. Dr Krishna Ella Founder & chairman, Bharat Biotech You have Covid data of more than a billion people. How can that data be used and further digitalised for the healthcare of this country? I was over at the health ministry today and saw the control centre they used, which is a great piece of software, worked on in India, that helped get the vaccination coverage up. It was a great achievement. The government’s goal, under Ayushman Bharat Digital Mission (ABDM), of digitising the health system, has some incredible initiatives, many of which we’re helping supercharge with the grants. I think it’s going to all come together. So the quality of healthcare is much better when you get outbreaks. It’s another case that India always wants to do things on economical basis. It may be as a set of health system software that like the digital infrastructure is valuable to other countries. The US does some things really well and everybody should learn from our health system. But in some cases, it’s complicated and expensive. We need places like India to make such contributions.
