Save the World Better than Billionaires Larry Ellison and Bill Gates on Five Dollars Extra a Day

Good morning, Live Better than a Billionaire-a-Holics!

Are you feeling motivated this morning? I certainly hope so.

Yesterday's Wall Street Journal reported that billionaire Larry Ellison, CEO of Oracle Corporation, is in the process of giving $115 million to the Harvard School of Public Health to establish an institute that will have five professors in it. These professors will "monitor the return on investment in different medical programs" to improve global health. "Mr. Ellison said the program would publish a journal and employ statisticians to monitor public, private and philanthropic investments."

Ironically, one of the areas that will be measured will be the billions being spent by the Bill and Melinda Gates Foundation, which has been funded by one of the founders of Microsoft Corporation, a key software rival of Oracle Corporation.

I have read extensively on this subject and Mr. Ellison certainly has a point. Much of the money spent on health care improvement doesn't yield much in the way of results. Some spending, in fact, is counterproductive . . . causing health care to decline. An example in some countries has been the sometimes ill-advised effort to provide "free" powdered infant formula to mothers who do not have access to clean water. Many of the infants sicken and die on the tainted combination while they would have remained healthy on breast milk.

I have also read about efforts to clean up the water . . . which have failed when no one was trained to maintain the equipment that cleans the water. All of the money was wasted after the equipment stopped working.

Even where there is clean water, many people don't know about germs. They don't wash their hands with soap, feeling that rinsing in water is enough. Major outbreaks of illness follow.

Where they do wash with soap, the soap often pollutes the only available water supply because they don't understand about pollution and how it affects their health.

The solution to the water supply pollution differs from one area to the next. In a desert area, you have to keep the water and reuse it . . . but there's no source of energy to make that possible. Simple solar concentrators that cost pennies to make can solve the problem. In a rainy, wet area, you have to keep from contaminating the wetlands which means that sanitary facilities can only be located in certain areas. And so on.

Working on health without working on education and how to select and maintain the right local solutions is largely a waste of time.

And if the local government is corrupt, the "health" solutions will simply be siphoned off into the black market or for bribes.

If the people cannot earn a living, they won't obtain the food they need to have the nutritional foundation for good health.

Without a good living, they won't have the shelter they need to stave off many sources of disease such as the mosquitoes that bring malaria.

Without an understanding of how AIDS is transmitted, a whole population may be destroyed by a single disease through simply following established cultural habits of promiscuity.

And I could go on.

Interestingly, solutions designed by poor people in underdeveloped to solve these problems work much better than those designed in and supplied from the "advanced" countries. You can read about some of these solutions in C.K. Prahalad's recent book, The Fortune at the Bottom of the Pyramid. One of my favorite examples comes from India where cataract surgery is performed at a cost of less than $50 which would cost thousands in an "advanced" country . . . yet the Indian solution compares favorably in terms of the rate of complications and the resulting visual acuity.

So let's think about this. In terms of low-cost innovation, a dollar in the hands of a poor health innovator in an underdeveloped country is probably worth a million dollars spent to work on the same problem in an "advanced" country. In fact, that dollar might create value that's as great as ten million dollars because the low-cost solution will be delivered by people who will work for extremely low wages.

So, if you provide $300 for health care innovation in the next year to the right person in an underdeveloped country, your gift can do more good than Larry Ellison's. Think about that!

The Live Better than a Billionaire on Five Dollars Extra a Day might look like this:

Spend $150 a year to establish a Web site that publishes articles about low-cost, effective solutions to health care issues that have been developed by poor people in underdeveloped countries.

Set up a nonprofit organization to receive tax-deductible gifts to fund more research by such health care innovators. Ask attorneys and accountants to volunteer their services to create and maintain this organization.

Solicit funds on the Web site to finance research and development of the best ideas proposed by poor people in underdeveloped countries. Give grants to the best ideas proposed on the Web site.

Publish the results of these programs on the Web site. Seek publicity in underdeveloped countries for these results by sending press releases by e-mail to the leading print and television media in underdeveloped countries.

If you did all of this, the effect of your efforts and modest spending would probably exceed what all the billionaires in the world accomplish in the next ten years . . . unless of course they stop acting like billionaires and learn to live better than a billionaire on five dollars extra a day.

I welcome your improvements to this line of reasoning.

Donald W. Mitchell, Your Dream Concierge

Copyright 2005 Donald W. Mitchell