It might surprise you, but Bill Gates believes the world is getting better

Bill Gates makes a point of talking about how optimistic he is, which can seem like madness when you look at the massive and complex problems he and wife Melinda have set out to solve. Through the work of their Gates Foundation, they want to cut carbon emissions to zero, drop childhood deaths in half from their 2015 levels (already sliced in half from 1990 levels), quadruple the access to contraception in the developing world (from 30 million today to 120 million by 2020), bring down the number of women who die in childbirth by 75% and wipe out entire diseases: TB, HIV, Guinea worm, polio, malaria. And while they’re at it, they intend to end malnutrition.

You could forgive them for tempering that optimism a bit lately. Governments at home and abroad have started looking inward, skeptical about the value of the kind of foreign aid that developing countries rely on for those health gains. In the U.S., the Trump administration has committed to cutting environmental protections, cast doubts about vaccines and reinstated Reagan-era “gag” rules that caused contraception availability in Africa to drop.

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