the.world.is.flat-第75章

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is　the　subject　he　wanted　to　talk　about　most　and　addressed　with　the　most　passion。　
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〃No　one　funds　things　for　that　other　3　billion；〃　said　Gates。　〃Someone　estimated　that　
the　cost　of　saving　a　life　in　the　U。S。　is　5　or　6　million…　that　is　how　much　our　society　
is　willing　to　spend。　You　can　save　a　life　outside　of　the　U。S。　for　less　than　100。　But　
how　many　people　want　to　make　that　investment？　
〃If　it　was　just　a　matter　of　time；〃　Gates　continued；　〃you　know；　give　it　twenty　or　thirty　
years　and　the　others　will　be　there；　then　it　would　be　great　to　declare　that　the　whole　
world　is　flat。　But　the　fact　is；　there　is　a　trap　that　these　3　billion　are　caught　in；　
and　they　may　never　get　into　the　virtuous　cycle　of　more　education；　more　health；　more　
capitalism；　more　rule　of　law；　more　wealth　。。。　I　am　worried　that　it　could　just　be　half　
the　world　that　is　flat　and　it　stays　that　way。〃　
Take　malaria；　a　disease　caused　by　a　parasite　carried　by　mosquitoes。　It　is　the　greatest　
killer　of　mothers　on　the　planet　right　now。　While　virtually　no　one　dies　of　malaria　
today　in　the　flat　world；　more　than　1　million　people　die　from　this　disease　each　year　
in　the　unflat　world；　about　seven　hundred　thousand　of　them　children；　most　of　them　in　
Africa。　Deaths　from　malaria　have　actually　doubled　in　the　last　twenty　years　because　
mosquitoes　have　become　resistant　to　many　antimalarial　drugs；　and　commercial　drug　
companies　have　not　invested　much　in　new　antimalarial　vaccines　because　they　believe　
there　is　no　profitable　market　for　them。　If　this　crisis　were　happening　in　a　flat　country；　
noted　Gates；　the　system　would　work：　Government　would　do　what　it　needed　to　do　to　contain　
the　disease；　pharmaceutical　companies　would　do　what　they　needed　to　do　to　get　the　drugs　
to　market；　schools　would　educate　young　people　about　preventive　measures；　and　the　
problem　would　be　licked。　〃But　this　nice　response　works　only　when　the　people　who　have　
the　problem　also　have　some　money；〃　said　Gates。　When　the　Gates　Foundation　issued　a　
50　million　grant　to　combat　malaria；　he　added；　〃people　said　we　just　doubled　the　amount　
of　money　＇worldwide＇　going　to　fight　malaria　。　。　。　When　the　people　who　have　the　need　
don't　have　the　money；　it　takes　outside　groups　and　charities　to　get　them　to　the　point　
where　the　system　can　kick　in　for　them。〃　
Up　to　now；　though；　argued　Gates；　〃we　have　not　given　these　people　a　chance　＇to　be　in　
the　flat　world＇。　The　kid　who　is　connected　tothe　Internet　today；　if　he　has　the　curiosity　
and　an　Internet　connection；　is　as　＇empow380　
ered＇　as　me。　But　if　he　does　not　get　the　right　nutrition；　he　will　never　play　that　game。　
Yes；　the　world　is　smaller；　but　do　we　really　see　the　conditions　that　people　live　in？　
Isn't　the　world　still　really　big　enough　that　we　don't　see　the　real　conditions　that　
people　live　in；　the　kid　whose　life　can　be　saved　for　80？〃　
Let's　stop　here　for　a　moment　and　imagine　how　beneficial　it　would　be　for　the　world；　
and　for　America；　if　rural　China；　India；　and　Africa　were　to　grow　into　little　Americas　
or　European　Unions　in　economic　and　opportunity　terms。　But　the　chances　of　their　getting　
into　such　a　virtuous　cycle　is　tiny　without　a　real　humanitarian　push　by　flat…world　
businesses；　philanthropies；　and　governments　to　devote　more　resources　to　their　


problems。　The　only　way　out　is　through　new　ways　of　collaboration　between　the　flat　and　
unflat　parts　of　the　world。　
In　2003；　the　Gates　Foundation　launched　a　project　called　Grand　Challenges　in　Global　
Health。　What　I　like　about　it　is　the　way　the　Gates　Foundation　approached　solving　this　
problem。　They　didn't　say；　〃We；　the　rich　Western　foundation；　will　now　deliver　you　the　
solution；〃　and　then　issue　instructions　and　write　some　checks。　They　said；　〃Let's　
collaborate　horizontally　on　defining　both　the　problem　and　the　solutions…let's　create　
value　that　way…and　then　＇the　foundation＇　will　invest　our　money　in　the　solutions　we　
both　define。〃　So　the　Gates　Foundation　placed　ads　on　the　Web　and　in　more　conventional　
channels　across　both　the　developed　and　the　developing　worlds；　asking　scientists　to　
respond　to　one　big　question：　What　are　the　biggest　problems　that；　if　science　attended　
to　them　and　solved　them；　could　most　dramaticallychange　the　fate　of　the　several　billion　
people　trapped　in　the　vicious　cycle　of　infant　mortality；　low　life　expectancy；　and　
disease？　The　foundation　got　about　eight　thousand　pages　of　ideas　from　hundreds　of　
scientists　from　around　the　world；　including　Nobel　laureates。　It　then　culled　through　
them　and　distilled　them　down　to　a　list　of　fourteen　Grand　Challenges…challenges　where　
a　technological　innovation　could　remove　a　critical　barrier　to　the　solving　of　an　
important　health　problem　in　the　developing　world。　In　the　fall　of　2003；　it　announced　
these　fourteen　Grand　Challenges　worldwide。　They　include　the　following：　How　to　create　
effective　single…dose　vaccines　that　can　be　used　soon　after　birth；　how　to　prepare　
vaccines　that　do　not　require　refrigera

tion；　how　to　develop　needle…free　delivery　systems　for　vaccines；　how　to　better　
understand　which　immunological　responses　provide　protective　immunity；　how　to　better　
control　insects　that　transmit　agents　of　disease；　how　to　develop　a　genetic　or　chemical　
strategy　to　incapacitate　a　disease…transmitting　insect　population；　how　to　create　a　
full　range　of　optimal　bioavailable　nutrients　in　a　single　staple　plant　species；　and　
how　to　create　immunological　methods　that　can　cure　chronic　infections。　Within　a　year；　
the　foundation　received　sixteen　hundred　proposals　for　ways　to　meet　these　challenges　
from　scientists　in　seventy…five　countries；　and　the　foundation　is　now　in　the　process　
of　funding　the　best　proposals　with　250　million　in　cash。　
〃We're　trying　to　accomplish　two　things　with　this　program；〃　explained　Rick　Klausner；　
a　former　head　of　the　National　Cancer　Institute　who　now　runs　the　global　health　programs　
for　the　Gates　Foundation。　〃The　first　is　＇to　make＇　a　moral　appeal　to　the　scientific　
imagination；　＇pointing　out＇　that　there　are　great　problems　to　be　solved　that　we；　the　
scientific　community；　have　ignored；　even　though　we　pride　ourselves　in　how　
international　weare。　We　have　not　taken　our　responsibilities　as　globalproblem　solvers　
as　seriously　as　our　self…identity　as　an　international　community。　We　wanted　the　Grand　
Challenges　to　say　these　are　the　most　exciting；　sexy；　scientific　things　that　anyone　
in　the　world　could　work　on　right　now　。　。　。　The　idea　was　to　fire　the　imagination。　The　
second　thing　is　to　actually　direct　some　of　the　foundation's　resources　to　see　if　we　
could　do　it。〃　
Given　the　phenomenal　advances　in　technology　in　the　last　twenty　years；　it　is　easy　to　
assume　that　we　already　have　all　the　tools　to　address　some　of　these　challenges　and　


that　the　only　thing　lacking　is　money。　I　wish　that　were　the　case。　But　it　is　not。　In　
the　instance　of　malaria；　for　example；　it　isn't　just　the　drugs　that　are　missing。　As　
anyone　who　has　visited　Africa　or　rural　India　knows；　the　health…care　systems　in　these　
areas　are　often　broken　or　functioning　at　a　very　low　level。　So　the　Gates　Foundation　
is　trying　to　stimulate　the　development　of　drugs　and　delivery　systems　that　presume　
a　broken　health…care　system　and　therefore　can　be　safely　self…administered　by　ordinary　
people　in　the　field。　That　may　be　the　grandest　challenge　of　all：　to　use　the　tools　of　
the　flat　world　to　design　tools　that　work　in　an　unflat　world。　〃The　most　important　
health…care　system　in　the　world　is　a　mother；〃　
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said　Klausner。　〃How　do　you　get　things　in　her　hands　that　she　understands　and　can　afford　
and　can　use？〃　
The　tragedy　of　all　these　people　is　really　a　dual　tragedy；　added　Klausner。　There　is　
the　individual　tragedy　of　facing　a　death　sentence　from　disease　or　a　life　sentence　
of　broken　families　and　limited　expectations。　And　there　is　the　tragedy　for　the　world　
because　of　the　incredible　lost　contribution　that　all　these　people　still　outside　the　
flat　world　could　be　making。　In　a　flat　world；　where　we　are　connecting　all　the　knowledge　
pools　together；　imagine　what　knowledge　those　people　could　bring　to　science　or　
education。　In　a　flat　world；　where　innovation　can　come　from　anywhere；　we　are　letting　
a　huge　pool　of　potential　contributors　and　collaborators　slip　under　the　waves。　There　
is　no　question　that　poverty　causes　ill　health；　but　ill　health　also　traps　people　in　
poverty；　which　in　turn　weakens　them　and　keeps　them　from　grasping　the　first　rung　of　
the　ladder　to　middle…class　hope。　Until　and　unless　we　can　meet　some　of　these　grand　
challenges；　much　of　that　50　percent　of　the　world　that　is　still　not　flat　will　stay　
that　way…no　matter　how　flat　the　other　50　percent　gets。　
TOO　DlSEMPOWERED　
There's　not　just　the　flat　world　and　the　unflat　world。　Many　people　live　in　the　twilight　
zone　between　the　two。　Among　these　are　the　people　I　call　the　too　disempowered。　They　
are　a　large　group　of　people　who　have　not　been　fully　encompassed　by　the　flattening　
of　the　world。　Unlike　the　too　sick；　who　have　yet　even　to　get　a　chance　to　step　onto　
the　flat　world；　the　too　disempowered　are　people　who　you　might　say　are　half　flat。　They　
are　healthy　people　who　live　in　countries　with　significant　areas　that　have　been　
flattened　but　who　don't　have　the　tools　or　the　skills　or　the　infrastructure　to　
participate　in　any　meaningful　or　sustained　way。　They　have　just　enough　information　
to　know　that　the　world　is　flattening　around　them　and　that　they　aren't　really　getting　
any　of　the　benefits。　Being　flat　is　good　but　full　of　pressure；　being　unflat　is　awful　
and　full　of　pain；　but　being　half　flat　has　its　own　special　anxiety。　As　exciting　and　
as　visible　as　the　flat　
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Indian　high…tech　sector　is；　have　no　illusions：　It　accounts　for　0。2　percent　of　
employment　in　India。　Add　those　Indians　involved　in　manufacturing　for　export；　and　you　
get　a　total　of　2　percent　of　employment　in　India。　
The　half　flat　are　all　those　other　hundreds　of　millions　of　people；　particularly　in　
rural　India；　rural　China；　and　rural　Eastern　Europe；　who　are　close　enough　to　see；　touch；　


and　occasionally　benefit　from　the　flat　world　but　who　are　not　really　living　inside　
it　themselves。　We　saw　how　big　and　how　angry　this　group　can　be　in　the　spring　of　2004　
Indian　national　elections；　in　which　the　ruling　BJP　was　surprisingly　tossed　out　of　
office…despite　having　overseen　a　surge　in　India's　growth　rate…largely　because　of　the　
discontent　of　rural　Indian　voters　with　the　slow　pace　of　globalization　outside　the　
giant　cities。　These　voters　were　not　saying；　〃Stop　the　globalization　train；　we　want　
to　get　off。〃　They　were　saying；　〃Stop　the　globalization　train；　we　want　to　get　on；　but　
someone　needs　to　help　us　by　building　a　better　stepstool。〃　
These　rural　voters…peasants　and　farmers；　who　form　the　bulk　of　India's　population　
just　had　to　spend　a　day　in　any　nearby　big　city　to　see　the　benefits　of　the　flat　world：　
the　cars；　the　houses；　the　educational　opportunities。　〃Every　time　a　villager　watches　
the　community　TV　and　sees　an　ad　for　soap　or　shampoo；　what　they　notice　are　not　the　
soap　and　shampoo　but　the　lifestyle　of　the　people　using　them…the　kind　of　motorbikes　
they　ride；　their　dress；　and　their　homes；〃　explained　Indian…born　Nayan　Chanda；　editor　
of　YaleGlobal　Online。　〃They　see　a　world　they　want　access　to。　This　election　was　about　
envy　and　anger。　It　was　a　classic　case　of