Bill Gates’ onion

This is a nice illustration of a set of nested problems (a.k.a. “The Onion“) in development from Bill and Melinda Gates’ philanthropic work.

Often – most of the time? – the technical solution is only a small part of a whole system needed to bring about change. See also The Wrapper.

… In the case of global health, I thought that the research piece and the breakthrough of say new vaccines or drugs was the only missing piece. Sadly, the delivery mechanism in many countries, the primary healthcare system, was also very very poor, and it was kind of shocking that we for that diarrhoeal disease – rotavirus – we found out that the rich world had a vaccine, and it wasn’t getting out to the kids who needed it most. So that’s this deep irony that the kids who are least at risk of dying are getting the vaccine and the kids who are most at risk are not.

And I admit, for a year or two, I thought “Gosh, isn’t someone else going to solve this financing and quality of delivery problem, and eventually got convinced that no, it wouldn’t be solved and so it would be almost pyrrhic to invent more new vaccines that wouldn’t get financed and wouldn’t get delivered.

Bill Gates on Masters of Scale – How to Accelerate History Part 2 (21 December 2019)

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