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Gates Package, p.1077 · gates:exh:00487
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Some of these diseases exist primarily in low-income tropical countries, which is why
they are often ignored by much of the world. During the past decade, when malaria has killed 4
million children in sub-Saharan Africa, it has killed fewer than 100 people in the United States.
A child born in Nigeria is about twenty-eight times more likely to die before her fifth
birthday than a child born in the United States.
A child born in the U.S. today can expect to live for seventy-nine years, but one born in
Sierra Leone can expect to live just fifty-five years.8*
In other words, health inequities are not rare. I think many people in rich countries were
shocked by the world's unequal response to COVID not because it was out of the ordinary but
because health inequities are not visible to them the rest of the time. Through COVID--a
condition the whole world was experiencing--everyone can see how unequal the resources are.
The point is not to depress you, or to wag a finger at the people who haven't dedicated
their lives to global health. The point is that all these problems deserve more attention. The fact
that most of the people who suffer from these diseases live in low- and middle-income countries
doesn't make them any less awful.
My dad had a beautiful way of elevating the moral dimensions of this phenomenon.
Years ago, in a speech to the United Methodist Conference, he put it like this: "People suffering
from malaria are human beings. They are not national security assets. They are not markets for
our exports. They are not allies in the war against terrorism. They are human beings who have
* Differences in health usually hold true within countries as well as between them. In the
U.S., Black women are three times more likely to die in childbirth than white women.