A child falls into an abandoned well and an entire nation holds its breath. Cable news outlets descend upon the small town. Brave firefighters and volunteers assemble for the frenzied dig. The frantic mother becomes a national icon. As the rescue efforts continue, the short hours turn into long days. Yet on each day of the rescue attempt, 15,000 children around the world die from causes that could have been easily prevented. Each of those children has a face we do not see and grieving parents we will never know. Their passing goes unnoticed.

The hard-wired human tendency to live in the micro—to connect with individual people and their particular stories—both empowers and shapes our enormous capacity for giving. This might be one reason why 98 percent of American philanthropy ends up in America. We invest financially where we connect emotionally. The little girl trapped in a well in the American Midwest moves us in ways that an unseen 15,000 children simply cannot. We respond to what we see.

Or what we choose to see.

Can we choose to see that countless lives might be saved in developing countries using techniques that have been commonplace in America for decades?

Can we choose to see that even in the most technologically advanced nation, millions are still left on the other side of the digital divide?

Can we choose to see that even in the wealthiest nation, a generation of young people are falling behind academically and are left unprepared by their huge, bureaucratic high schools for the responsibilities of adulthood, work, and citizenship?

Can we choose to see how different our lives would have been had we been born only a few times zones in one direction or another, or a few degrees closer to the equator?

Location, location, location
You might have been born under a bad government—in a nation lacking the simple social infrastructure of laws, freedom, fair play, and rudimentary education that allow a culture of enterprise to develop. The very worst governments bring political purges, ethnic cleansing, or even man-made famine.

If your birthplace is tropical, the issue becomes mere survival against a host of conditions, including malaria, diarrhea, and others. Blessed with a wealth of natural resources, many of these countries have the potential to develop thriving economies. But that potential will never be realized when so many have to fight just to survive.

Yes, the world is getting smaller, in a sense—making it easier to travel, easier to be exposed to other cultures. But that has merely revealed the vast differences in outcomes across the globe. The world-changing advances of the past century—technology, medicine, communications—have only reached a portion of the world, leaving the majority of humanity behind in a cycle of poverty, disease, and privation. When measuring the differences between us, the world has gotten much larger.

Viewed up close, the big statistics behind our worst problems take on a human face. Every one of the thousands lost every day to preventable disease is a child with a face and a family and a future that could have been great. Every child lost is an incalculable tragedy, whether in an AIDS ward in the heart of Africa or in an abandoned well in America’s heartland. Each demands action. Sympathetic feelings are not enough. Good intentions are not sufficient.

Don’t reinvent the wheel. Make it roll.
The Bill & Melinda Gates Foundation addresses the fundamental inequities of health and opportunity by helping developing nations gain access to health advances long taken for granted in wealthier countries. Within the United States, the foundation extends education and learning opportunities to the underserved, with a special eye to improving the quality of life for challenged families closer to the foundation’s home in the Pacific Northwest.

The real heroes of this story are our grantees who have dedicated their lives to solving the world’s toughest problems. By finding and funding intellectual and moral genius, the foundation places resources in the hands of the people best able to use them.

The foundation clusters its funding around four project areas:

• Global Health, to ensure that lifesaving advances in health are created and shared with those who need them most.
• Education, to foster students prepared for citizenship through academic rigor and personal attention.
• Libraries, to close the digital divide by ensuring access to knowledge through public libraries.
• Pacific Northwest, to effect positive change for the region’s most vulnerable residents.

2002 was a year of big steps forward. In this report, you will read some of the incredible stories:

• Health initiatives throughout the developing world fight our most intractable challenges—HIV/AIDS, malaria, polio, and others.
• Education reform transforms the learning experience—one small school at a time.
• Families in the Pacific Northwest now have new options for living and learning that were not available before.
• In late 2003, we’ll reach the finish line with our U.S. Library program, having brought the Internet and information technology to low-income and isolated communities in all 50 states. And now libraries need sustained community and national support to increase public access to information technology.

The pending completion of the U.S. Library program recalls an important point: With continued diligence, some challenges can be met.

In the end, the big steps taken by our grantees are really just the determined application of many smaller steps. Some of the world’s biggest problems can be solved with incredibly simple measures. It costs only 25 cents to vaccinate a child for measles. Oral dehydration to save a child’s life from diarrhea costs only 33 cents. For $4, a bed net can prevent a case of deadly malaria.

The challenges of equity in global health, education, and other opportunities are enormous, but not intractable. Good solutions are available. For most of the world, they’re out of reach, but they’re not out of sight.

This world can be different. With concerted effort and cooperation, we’re making it better.