WASHINGTON, D.C. -- In the experience of Bill Gates, there are few problems technology cannot solve, and few areas of the world that technology cannot reach to improve the lives of people.
In his post-Microsoft career as head of the Bill & Melinda Gates Foundation, Gates has been pursuing the improvement of global health care the way he sought market share for the Windows operating system. But technology in health care is not the goal, only a means to an end -- and only in certain cases.
Technology has made a huge impact on improving health care, in terms of research and fighting disease, Gates said Tuesday at the 2010 mHealth Summit in Washington, D.C., during an on-stage interview with Microsoft executive Dr. Kristen Tolle, director of Microsoft's Natural User Interactions team. Although Gates supports efforts to push mobile technology into health care, there are many hurdles left to clear.
"In the case of the cell phone, there is a chance to go beyond that, and actually be there with the patient, there in the clinic that might not be staffed with a fully trained staff," Gates said. "So, there are some opportunities. We have to approach these things with some humility though. There are not Internet and data connections out there [wherever they may be needed]."
Gates pointed out that he sees a few areas where mobile devices can make a big difference in health care. They can serve, and currently do in many studies, to remind patients to take medications. They can be valuable in the practice of tracking drugs through the global supply chain, and they can help with registering vaccines and performing diagnoses.
But beyond technology as a tool to improve health care, countries, companies and whole economies must confront some critical misunderstandings about where to attack the global health care crisis.
For instance, are the efforts to improve health care in the poorest countries merely exacerbating an already unwinnable situation? Gates explained how his efforts through his foundation began with a focus on reproductive health. But it was discovered along the way that that improving reproductive health and addressing the problems of overpopulation really required improving children's health care first, he said.
"The key and most important fact is that as you improve health, as you save lives of children under [the age of] five, that is the thing that reduces population growth," he said. "That sounds paradoxical, if I have seven children and seven of them survive. The point is that within a decade of improving health outcomes, parents decide to have [fewer] children."
In the case of the cell phone, there is a chance to go beyond that, and actually be there with the patient, there in the clinic that might not be staffed with a fully trained staff.
Bill Gates, founder, Bill & Melinda Gates Foundation
Such thinking informs many of Gates' views on global health. Raising awareness doesn't necessarily change behavior, as a human immunodeficiency virus, or HIV, education program in South Africa his foundation sponsored didn't change the rates of infection. "It's a time-horizon thing," he said, adding a bit of sardonic humor: "If AIDS were to kill you immediately, things would get better because you'd see these piles of bodies outside bars … and people would get suspicious."
Conversely, he said, better health care eventually will improve rates of education and ultimately, lifestyles.
In Gates' view, the future of medical technology after mobile is in robotics. "Computers, it's learning to see, it's learning to talk, it's learning to listen, it's learning handwriting, and it's learning to move around," he said. "Ambulatory [functions have] really improved a lot. Dexterity is about five years behind."
But Gates envisions more robotic devices that can handle everyday tasks in such areas as home health care, citing the example of lifting an elderly person. In addition, as basic computing power evolves, so will "biological knowledge," he said -- and with that the ability to construct drugs and vaccines that will take human kind to the next level of health care.
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