As co-chair of the foundation she started with her husband Bill, Melinda Gates is the leading woman philanthropist. In an exclusive interview, she tells Joeanna Rebello Fernandes how tech innovations can save lives and why she remains optimistic about India:

Eradication of poverty is one of the UN's Sustainable Development Goals. UP and Bihar, where the Gates Foundation concentrates its work, have sizable populations below the poverty line. If you could present to both governments a three-point plan of action to achieve this goal, what would it be?

It would be to first and foremost, focus on health. Any kind of progress depends on people being able to live a healthy life. Then they need to invest in making sure that everybody is educated. Third, that people have the right financial structure so they can go on to live a productive life. Like what the government is doing in the mobile phone area to make sure people have access to bank accounts. And fourth, people need to eat, they must have access to technology in agriculture to make sure it is done right.

Recently, more than 60 kids died because of a reported disruption in oxygen supply in a UP hospital. Does news like this dishearten you?

I did read about that and my heart is broken for the families that have lost children. I think the great thing about India though is the free press and the fact that that news is out there. Now what India needs to do is look at these facilities and make sure they're high quality in every single place. That means well-trained people with the right equipment that's functioning properly . I was saddened, but I am also optimistic, because I know that India responds and whenever there's a tragedy they ask, what else do we need to do.

The Gates Foundation champions the use of cost-effective technology in development. The Fecal Sludge Treatment Plants in Telangana -a complete sanitation value chain -are such an example. Of all the innovations, what excites you most?

This is one of the reasons Bill and I are so excited about India. The world will not make its Sustainable Development Goals without India making progress. And India is absolutely poised to make that progress. You see it in the fact that India is polio-free. That has been used in the rest of the world to say that we can do it. India has so much incredible innovation. MenAfriVac is a vaccine that was created in India and has brought meningitis down substantially across the Meninge belt in Africa. The way India is leading financial services on the phone with the Aadhaar system,other countries would love to have that. India can become a model for the world and that's how we can get to those SDGs and bring the death rate down.

Part of your approach to bridging the gap between goals and outcomes in rural societies is to integrate local customs and beliefs into the solution. How does that work in India?

You can bring the best innovations to people but culturally if they will not accept them, you don't make that kind of progress. One of the fantastic things I see in India are self-help groups led by women. They're helping explain, culturally, to young women why things like exclusive breastfeeding are important. And they're bringing the mothers-in-law along, because she is often a key decision-maker. The mother-in-law may say it's hot outside, you can't possibly have enough milk, we need to supplement with more water or goat's milk. And the head of that self-help would say, 'No, No. The right thing to do is immediate and exclusive breastfeeding. Or whether it's telling them to go to a health clinic. Those front line health workers in India - the ASHA workers - accompany the women to the clinics and see that they get those services. That's an innovation in itself that quite honestly I wish we had in many other countries.

Originally, when I used to travel to India over 15 years ago, I would go to villages in UP where there was no discussion about taking a woman to a clinic. The whole discussion was about how do we do the best with helping her give birth at home. We helped women overcome some of the cultural practices - one was, often the mother-in-law would hire somebody, a lower caste member, to come in and tend to the birth, which was considered a very polluting event, and that person's job was to scrub and clean the baby. They'd scrub all the vernix off and would leave the baby aside in the cold until they dealt with the mother because they were afraid culturally that the placenta would rise up and choke the mom. And so we had to explain that shouldn't leave the baby aside because they get cold. Keep the baby warm, put it on the mom's chest. Kangaroo care promotes breastfeeding and reduces cases of pneumonia.

The Indian government's refusal last year to renew FCRA (Foreign Contribution (regulation) Act) licenses of NGOs has affected organizations like the Gates-funded Public Health Foundation of India (PHFI). How has this impacted your work in India?

So far our work hasn't been affected. We're always working with NGOs that are approved to work with the government. There's no other way for us to work in India and that's how we want to work quite frankly. - TOI 


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