Gates Package — page 1082

The drop in family size has led to a remarkable fact: The world recently passed what Hans called "peak child"--that is, the number of children under five hit its maximum and is going down. The benefit? As the United Nations Population Fund explains on its website, "Smaller numbers of children per household generally lead to larger investments per child, more freedom for women to enter the formal workforce, and more household savings for old age. When this happens, the national economic payoff can be substantial."11 So: Health is improving nearly everywhere, with big dividends for human welfare. The global health gap is still large, but it is narrowing. As dramatic as this story is, it's only the background for what we need to know now. What caused these changes? And how can accelerating them also help prevent pandemics? Trying to explain a decades-long global phenomenon involving billions of people is a risky endeavor. Entire books have been written on single aspects of the decline in child mortality and the march toward global health equity, and I'm covering the subject in just one chapter. I'm going to focus on the factors that are most directly relevant to the problem of preventing pandemics, with the understanding that I'm leaving out a host of others, including agricultural yields, global trade, economic growth, and the spread of human rights and democracy. It is no accident that many of the tools used against COVID have their roots in global health. In fact, at virtually every step in the COVID response, there is an essential tool or system or team that exists only because the world has invested in improving health for the poor. The fingerprints of the global health movement are all over the COVID response. Here's a list--and just a partial list at that--of ways that the two overlap. Understanding the virus