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Exploring philanthropy, non-profits and socially motivated business, from the Gates Foundation to your donation. A fresh look at the economy of good intentions.

July 30, 2009 at 2:15 PM

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Two words missing from Gates Foundation vocabulary

Posted by Kristi Heim

Technology holds the key to solving problems of health, education and poverty, Bill Gates made a point of saying in his recent visit to India.

The wholehearted embrace of technology comes as no surprise from the chairman of the world's largest software company. But in the context of philanthropy, perhaps he should have added the words "when appropriate."


Indian President Pratibha Patil, left, hands the Indira Gandhi Prize for Peace, Disarmament and Development to Bill Gates as Prime Minister Manmohan Singh, second left, applauds.

Gates touted the benefits of computers to help rural people access video lectures in villages without schools, and mobile devices to help doctors examine patients remotely. Slum dwellers in Bangalore can use mobile phones with SMS messaging and GPS to find jobs as day laborers through a Gates Foundation-supported program called LabourNet. Technology can reduce government corruption if citizens can use mobile phones and public computer terminals to give feedback on public services, he said.

"I am a 24-hour technology person," Gates said.

He visited India to assess the foundation's programs and receive the Indira Gandhi Prize for Peace, Disarmament and Development on behalf of the foundation. His appearances seemed to be a mix of the foundation's work and Microsoft's mission. Gates said Microsoft would like to partner with the Indian government in a project to provide each of India's 1.17 billion citizens with a unique identity number and biometric card.

The visit came after recent suggestions that the Gates Foundation's Avahan program has not lived up to its goals of curtailing the spread of HIV/AIDS. The $258 million initiative has been led by highly paid business consultants rather than people with public health experience. After the Indian government balked at taking on what has become one of India's largest health programs, the Gates Foundation increased its funding by $80 million.

In health and development, high-tech solutions don't always work. They can even make things worse if applied in the wrong way, by diverting resources from more fundamental programs or missing the root cause of a problem, for example.

Sometimes the most appropriate technology is none at all. Ironically this point was made best by one of the Gates Foundation's biggest grantees: PATH.

Its name stands for Program for Appropriate Technology in Health, and the idea behind that was reflected in a speech by Margarita Quintanilla earlier this year in Seattle.

Quintanilla, PATH's country leader in Nicaragua, got her start working at the ground level as a community health coordinator teaching basic concepts as washing hands to avoid diseases and getting regular pap screenings. She realized that technology could not overcome one of the biggest obstacles to health: gender-based violence and its effects, contributing to the spread of diseases like HIV/AIDS, unwanted pregnancy and other problems, all of which are common in India. Her approach was to build projects to teach life skills and health education to pre-adolescent girls and promote respect for women in families.

The more PATH's work grew, the more Quintanilla realized it would have to include "both technical and social approaches to increase the country's capacity to ensure better health," she said.

"We have to be wise and intelligent in our solutions. We have the responsibility of promoting change in the right way."

About 800 people listened to Quintanilla, but billions listen to Gates. As one of the world's most respected voices, he has a unique opportunity to call attention to social issues that no technology alone can solve.

UPDATE: Nicholas Kristof and Sheryl Wudunn analyze the links between gender discrimination and poverty, child mortality, global health issues and other problems in this excellent magazine series.

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