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Speaker 1: Gates Foundation CEO Mark Susman says the way wealthier countries

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Speaker 1: responded to the pandemic stoked mistrust with countries let's struggle

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Speaker 1: with poverty. In a wide ranging conversation, Susman talks about

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Speaker 1: the growing gap between what's known as the Global South

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Speaker 1: and the global North, and his latest peace in Foreign Affairs,

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Speaker 1: the roots of the Global South's new resentment, and he

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Speaker 1: spoke with Bloomberg's Jennifer Zabasajah.

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Speaker 2: Mark, thank you so much for being here.

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Speaker 3: I want to start first with this abed that you

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Speaker 3: wrote in the Foreign Affairs and specifically a quote that

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Speaker 3: you touched on. You said, wealthy countries need to take

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Speaker 3: concrete steps towards repairing the trust deficit or the rift

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Speaker 3: will grow with a lot of African countries.

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Speaker 2: Can you talk about.

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Speaker 4: That, yes, so very specifically, whether it comes to the

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Speaker 4: discussion about climate, whether it discussions to discussion around the

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Speaker 4: COVID response, whether it comes now to the discussion around

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Speaker 4: critical issues like the debt crisis. There is a huge

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Speaker 4: amount of rhetorical commitment, a lot of which you will

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Speaker 4: hear in meeting after meeting here in Marrakesh, about what

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Speaker 4: could and should be done. But when you actually look

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Speaker 4: at where the follow up is, is there actually money

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Speaker 4: resources policy being implemented that support the countries of the

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Speaker 4: Global South, and particularly supporting the low income countries that

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Speaker 4: are facing the greatest pressure. Sadly, we have not yet

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Speaker 4: seen very much.

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Speaker 3: Are you seeing steps taken towards reversing that though?

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Speaker 2: This week?

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Speaker 5: Yes, well that is absolutely the hope.

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Speaker 4: So I think a Jabanga, as the new head of

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Speaker 4: the World Bank, has put forward an ambitious agenda. There's

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Speaker 4: some very exciting proposals both around bigger issues about how

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Speaker 4: you might use and expand hybrid capital around critical issues

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Speaker 4: like the energy transition, but and also how we might

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Speaker 4: reinvigorate instruments like IDA, which is the International Development Associations,

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Speaker 4: the pool of World Bank resources that the low income

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Speaker 4: countries draw from. And so again there's a lot of

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Speaker 4: good things being said, but what we really need to

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Speaker 4: see is that translate into actual commitments, both into there's

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Speaker 4: currently a crisis window that's open requesting resources for EIDA

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Speaker 4: that we'd like to see high income countries contribute to.

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Speaker 5: This week, have a big.

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Speaker 4: Commitment about what's going to come in the forthcoming cop

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Speaker 4: The Conference of parties that are on climate that we'll

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Speaker 4: have in the UAE, and to make sure again that

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Speaker 4: there's a big focus on topics like adaptation currently adaptation,

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Speaker 4: which is really how countries deal now with the consequences droughts,

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Speaker 4: floods related crises, where the countries of the global South,

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Speaker 4: particularly in the tropics, are by far the most affected

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Speaker 4: in real time, especially farmers and communities like that. But

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Speaker 4: so far, roughly only about a tenth of the resources

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Speaker 4: to go to climate go into those kinds of investments,

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Speaker 4: and so for all of those, there's some great proposals

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Speaker 4: on the table, both here this week and for the

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Speaker 4: coming Climate Summit, and we very much hope that this

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Speaker 4: comes apart so we will see a real shift in

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Speaker 4: momentum and energy and attention. But the test will be

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Speaker 4: do the resources follow.

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Speaker 3: And we've heard from the African Union as well sort

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Speaker 3: of make their own calls, especially something that you've echoed

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Speaker 3: MDB reforms in particular, is the Gates Foundation aligned with

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Speaker 3: what the African Union is calling for?

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Speaker 2: Do you want to take it even a step further

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Speaker 2: than what dy'd ask.

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Speaker 4: No, we're very aligned, and actually we'll be hosting some

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Speaker 4: meetings today and tomorrow that work, particularly with a group

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Speaker 4: of African finance ministers and other partners, to make sure

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Speaker 4: there is a strong aligned voice coming from Africa specifically,

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Speaker 4: but the Global South more broadly around the steps that

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Speaker 4: need to take place and the expectation that the multilateral

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Speaker 4: Development Banks and when you talk about MDB reform, will

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Speaker 4: still keep a firm focus on the primary mission of

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Speaker 4: investing in poverty reduction and in health and education and

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Speaker 4: other core human capital investments, and that as we tackle

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Speaker 4: the very critical issue of climate that does not come

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Speaker 4: at the expense of those core investments, but it really

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Speaker 4: is additional.

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Speaker 5: It's a both and set of investments.

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Speaker 3: And if that doesn't happen, you mentioned the rift will grow.

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Speaker 3: What does that mean, I mean, what does that look

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Speaker 3: like in today's terms, Well, the.

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Speaker 4: Rift has very concrete consequences in terms of the impact

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Speaker 4: on people. Already, there are over sixty countries in the

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Speaker 4: Global South, very many of them on the continent of Africa,

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Speaker 4: who are paying more in debt service than they are

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Speaker 4: in health and education. That clearly is not the right

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Speaker 4: kind of prioritization that we need if we're going to

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Speaker 4: be investing in the continent of the future, and so

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Speaker 4: we need to have a set of steps which include

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Speaker 4: we haven't mentioned the debt relief, but some steps of

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Speaker 4: debt relief, some forms of new concessional capital coming in

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Speaker 4: that are in exchange for countries prioritizing these sets of

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Speaker 4: investments in their own people. And if you don't have

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Speaker 4: it first and foremost, what you'll see is a widening

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Speaker 4: poverty gap, a widening incombat, a wide health gap. Already,

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Speaker 4: COVID has had a much bigger impact than most people realize.

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Speaker 4: Not through it COVID directly, but we'd seen a halving

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Speaker 4: of extreme poverty in the world, including on the continent

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Speaker 4: of Africa, in the first two decades of the twenty

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Speaker 4: first century. That has stalled in the last three or

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Speaker 4: four years, and we've actually seen poverty increase and median

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Speaker 4: incomes are not going up. We'd seen a harving of

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Speaker 4: child mortality, preventable child mortality on the continent of Africa

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Speaker 4: and in the world in the.

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Speaker 5: First two decades that has stalled.

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Speaker 4: Vaccination rates are still not back to where they were

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Speaker 4: in twenty nineteen. We've seen massive setbacks in education. This

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Speaker 4: is a very real time human crisis that is then

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Speaker 4: exacerbated by the climate crisis. So it's not just that

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Speaker 4: the rift will grow, and the rift is real with

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Speaker 4: the political resentment from the global South that their needs

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Speaker 4: are not being met, but it has very real human

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Speaker 4: consequences on the people that need those critical investments and.

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Speaker 3: On the contrary, I mean, the Gates Foundation also had

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Speaker 3: their annual meetings as this year this week in Dakar

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Speaker 3: and Senegal, and you guys announced a number of investments

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Speaker 3: into vaccinations and really increasing vaccinations for this part of

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Speaker 3: the world. Can you talk about whether or not we're

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Speaker 3: expecting anymore in investments.

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Speaker 2: I think it was about forty million that was announced.

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Speaker 4: Right, yes, So to put it in perspective, you know

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Speaker 4: our annual budget, we are by far the largest grant

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Speaker 4: making foundation in the world. Our budget is around eight

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Speaker 4: billion dollars a year. The vast balka that goes into

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Speaker 4: health is our biggest ara of investment.

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Speaker 5: We also work in agricultural development.

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Speaker 4: Financial inclusion related activities, all focused on providing, you know,

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Speaker 4: ways to help save lives from preventable deaths and provide

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Speaker 4: opportunities for the poorest and most vulnerable. Specifically, the event

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Speaker 4: that we had this week in Dakar and Senegal is

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Speaker 4: what we call our Grand Challenges program. That's where we're

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Speaker 4: looking at research and development into new tools and opportunities

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Speaker 4: that could disproportionately affect the poorest and most vulnerable. And

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Speaker 4: there we made two specific sets of additional comitments. One

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Speaker 4: was around the expansion of specific technology, which we've helped

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Speaker 4: pioneer with a company called Quantum around vaccine mRNA manufacturing.

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Speaker 4: The mRNA being the key vaccines that helped address the

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Speaker 4: COVID crisis, and we hope and believe in the future

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Speaker 4: will be critical for diseases like malaria, tuberculosis, HIV, even

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Speaker 4: potentially cancer. And so we had announced some very concrete

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Speaker 4: partnerships with both the South African company BioVac, Senegalese company

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Speaker 4: the Institute Paste da Car and we're looking for other

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Speaker 4: African countries where we'll do that. And then we had

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Speaker 4: a second set of investments really looking at artificial intelligence.

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Speaker 4: And there's so much discussion about AI generally, but there's

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Speaker 4: not a lot looking at the potential application of AI

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Speaker 4: to really provide services, enhanced services for the poorers.

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Speaker 5: And so for.

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Speaker 4: Example, we have a handheld device which you can use

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Speaker 4: a cell phone, which uses an AI algori of them

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Speaker 4: can actually help in low resource health settings get the

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Speaker 4: gestational age of a baby. It's the equivalent of an

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Speaker 4: ultrasound that has an amazing impact in terms of reducing

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Speaker 4: preventable maternal and child mortality. There are new tools in education, healthcare,

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Speaker 4: other areas, and so those with the two sets of

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Speaker 4: enviouncement that they're complementary. We need the research and development

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Speaker 4: investments that are going to be building the tools for

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Speaker 4: the future. And then it's the doubling down on the

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Speaker 4: tools that we have already, the vaccines, the basic health services,

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Speaker 4: the digital financial infrastructure that can help people.

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Speaker 3: Now, well, when you mentioned the two companies where the

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Speaker 3: I think it's five million going to each, where are

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Speaker 3: the rest of those funds going to be allocated?

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Speaker 2: Are you still looking for partners across the continent.

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Speaker 5: Yes, so we're in discussions with a number of countries.

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Speaker 4: We convened a number of African countries recently at the

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Speaker 4: UN General Assembly.

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Speaker 5: This is also technology.

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Speaker 4: While we're focusing these resources on Africa, this is a

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Speaker 4: public good for the world.

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Speaker 5: We've been working with countries like Brazil or in the need.

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Speaker 5: You're also looking at how you can use the technology.

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Speaker 4: And by the way, this is not just putting mRNA

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Speaker 4: technology for the sake of it. This is a cheaper,

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Speaker 4: more effective, more reliable version than what we've seen for

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Speaker 4: the COVID vaccines. And again, our investments are helping me

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Speaker 4: create that as a public good for the continent.

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Speaker 3: And how do you see that aiding in I think

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Speaker 3: it was Bill Gates this week who said it's these

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Speaker 3: investments are the first step right in sort of achieving

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Speaker 3: health equity.

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Speaker 2: What do you see as the next step?

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Speaker 3: Because there still is a billions of dollar health equity

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Speaker 3: gap in Africa.

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Speaker 4: Yes, so will you need a combination across all that

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Speaker 4: you need? First, African countries themselves need to keep prioritizing

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Speaker 4: health and education. We combine the two as human capital

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Speaker 4: investments as core priorities, which.

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Speaker 5: Many of them are.

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Speaker 4: But that's challenging in the constrained financial circumstances we talked about.

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Speaker 4: Without debt relief and other tools, we need institutions like

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Speaker 4: the World Bank really doubling down on its own support

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Speaker 4: and it was recently convening in Tanzania around human capital,

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Speaker 4: which the Gates Foundation participated in that the Bank was

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Speaker 4: leading around how they can help generate and do that.

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Speaker 4: And so it's making sure that those pools of resources

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Speaker 4: that the Bank generates and that we're hoping we'll unlock

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Speaker 4: through MDB reform both expand we need that pie to

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Speaker 4: expand and then remain prioritized on some of those core

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Speaker 4: investments in health and development. And then there are other

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Speaker 4: partners like the World Health Organization, like the GAVI Vaccine Alliance,

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Speaker 4: the Global Fund to Fight AIDS, TB and malaria. We're

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Speaker 4: significant funders in all of those, but those need to

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Speaker 4: be able to continue to do their work and then

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Speaker 4: we'll see a repeat, we hope, of those massive reductions

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Speaker 4: in mortality that we had in the first two decades

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Speaker 4: of the twenty first century that have stalled this decade.

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Speaker 2: Optimistic about the end of this week seeing some of

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Speaker 2: those Well.

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Speaker 4: We're always optimistic. That's our sort of calling card at

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Speaker 4: the Gates Foundation. We believe things can be done because

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Speaker 4: they have been done in the past. We believe progress

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Speaker 4: can be accelerated. We believe the political will is there

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Speaker 4: that as always, the proof, as I wrote in my article,

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Speaker 4: is got to be in actually providing the resources, having

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Speaker 4: people put their money where their mouth is and then

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Speaker 4: seeing it implemented. So yes, I'm hopeful this week will

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Speaker 4: be an important step and we'll see some successful investments

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Speaker 4: and announcements. But this has got to be part of

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Speaker 4: a through line that goes through the climate discussions, that

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Speaker 4: goes through next year, because this is not a one

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Speaker 4: off set of steps. This is a multi year poly

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Speaker 4: crisis that we're in the middle of, and it's going

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Speaker 4: to take a multi year set of commitments in investments

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Speaker 4: by all of us if we're going to get out

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Speaker 4: of it and create the kind of opportunities for the

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Speaker 4: future that we want.

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Speaker 1: That's Gates Foundation CEO Mark Susman speaking with Bloomberg's Jennifer Sabasaga.

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Speaker 1: Subscribe to the Bloomberg Talks podcast now to hear more

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Speaker 1: conversations like this one. I'm Charlie Pellett, and this is

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Speaker 1: Bloomberg