Why 2035? The year Bill Gates predicted (almost) no more poor countries

Earlier this week, Bill Gates issued his annual letter and one of the main take-aways that got attention was his prediction that by the year 2035 the traditional distinction we make between rich and poor nations – developed vs. developing – will no longer be meaningful.

CNBC Bill Gates: There will be no poor countries by 2035

Independent No poor countries by 2035

NPR Almost no poor countries by 2035

Why pick the year 2035? And what exactly will happen to make nearly every nation rich or middle income? As we noted yesterday in our annual review of Bill’s annual letter, the overall wealth of a country is not necessarily the best measure of whether or not life is better for individuals. And Gates doesn’t exactly explain how all nation boats will rise on this tide. He just extrapolates from the trajectory of progress seen so far and says:

Almost all countries will be what we now call lower-middle income or richer. Countries will learn from their most productive neighbors and benefit from innovations like new vaccines, better seeds, and the digital revolution. Their labor forces, buoyed by expanded education, will attract new investments.

Technological improvements in health, agriculture, communications and more/better education are critical to ending poor nation states by 2035. Sounds a bit kitchen sinkish.

But earlier in the letter, Gates points to what the philanthropy has long believed is one of the most critical drivers of progress in Africa at least – health. Without the massive gains made on the health front in sub-Saharan Africa (especially in curbing the devastating impact of HIV/AIDS), it would be hard to imagine much progress achieved on other fronts.

Put simply, Gates believes improving health is one of the most powerful – maybe the most powerful – means of fighting poverty. And he’s backed up by data.

Dean Jamison

Dean Jamison

“People argue about how much, but there’s no question having healthier people contributes to economic growth,” said Dean Jamison, an economist at the University of Washington and co-author with Harvard’s Larry Summers of a ground-breaking new report entitled Global Health 2035: A World Converging Within a Generation.

The report, which was partly funded by the Gates Foundation, is stunning in both its economic analysis and its ambitious prescription for the future.

As The Guardian noted in its story on this report, published in The Lancet in early December, Jamison, Summers and their team of two dozen other experts determined that key health investments in low- and middle-income countries could, if done right, contribute to 25 percent of economic growth.

“We estimate that with new annual investments of around $60 to $70 billion per year, by 2035 the economic improvements obtained will create what we are calling the Grand Convergence,” Jamison said.

In the mid-1800s, he noted, there wasn’t much difference between rich and poor nations in terms of either health indicators or per capita average income. Eventually, due to industrialization and also some basic health and hygiene infrastructure improvements, a Grand Divergence took place – widening the gap between the nature of life in rich or developed nations as compared to poor or ‘developing’ ones.

“Rich countries saw a vast improvements in health, while poor countries saw very little improvement,” Jamison noted.

The Global 2035 report – conceived initially as a follow-up to an earlier, highly influential World Bank report published in 1993 (which also made the case that health is perhaps the most powerful ‘wedge’ against poverty) – sets out a fairly specific strategy for investing in health as a means to reduce poverty. Even in 1993, Jamison said, few could see light at the end of the tunnel in terms of closing the gap between rich and poor countries. Today, some say they do see the light.

“We have this generational opportunity to affect this convergence, to invest in a strategy that over the course of the next two decades could significantly reduce global inequity,” Jamison said.

It sounds like a lot of money, Jamison acknowledged, but looked at in the proper context it’s a bargain. Putting aside the millions of lives saved by improving health in poor countries, he said even the most bloodless, emotionally void economic analysis will attest to the global gains that would reverberate in every nation if we could truly get rid of the costly impact of our current First-Third, developed-developing world economies.

“We could make it happen,” Jamison said.

So that is perhaps the most likely reason Gates picked the year 2035. He doesn’t say so in his letter and he hasn’t yet returned my calls to confirm. But it’s a good bet.

Tomorrow, Humanosphere explores in more detail what the Global 2035 analysis calls for and how the controversial concept of ‘universal health coverage’ fits into the plan for achieving this Grand Convergence.

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Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at]humanosphere.org or follow him on Twitter @tompaulson.