 Good morning Hank, it's Tuesday, so I am very nearly 40, which as it happens means that I'm almost exactly twice as old as the median vlogbrothers viewer. When I was their age half my life ago, I was a sophomore in college, I'd just fallen in love for the first time I was taking my first creative writing class, I looked approximately like this. Of course my life was very different then, and the world was different then too, specifically it was worse. That year, 1998, more than 10 million children under the age of five died. Over 50% of kids in low income countries weren't vaccinated, and 30% of all humans lived in absolute poverty, meaning that they survived on less than $2 a day in current US dollars. Today 80% of kids in low income countries are vaccinated, fewer than 10% of people on earth live in absolute poverty, and this year fewer than 6 million children will die. Child mortality isn't just falling, the rate at which it's falling has been accelerating for two decades. And after very slow progress for most of the 20th century, and for that matter all of human history, the cycle of poverty is suddenly breaking worldwide. How did that happen, and what's left to be done? Well every year Melinda and Bill Gates release their annual letter on those topics. And for me it's kind of required reading every year, because like the news can tell me what happened yesterday, but reading the Gates letter allows me to zoom out a little and think about what's happening in the larger human story over time. This year's letter is written to Warren Buffett, another billionaire who's pledged almost all of his wealth to charity, but it begins by pointing out that most funding for global health initiatives comes not from private individuals, but from governments. Here in the US about $32 billion went to foreign aid last year, which is less than 1% of the federal government's budget, but it still goes a long way. And I know foreign aid has a reputation for not working, but in fact it is extremely effective, and I also strongly believe it's in our national interest. Like poverty and poor health are associated with an increased risk for conflict, and also microbes are not aware of national borders, so better healthcare systems around the world mean less disease risk for all of us. Okay, so as brilliantly explained in this video by Inna Nutshell, we know that when child mortality goes down families choose to have fewer children, which ultimately slows population growth. It also means that kids on average will be healthier and more likely to go to school, and that their parents will be more likely to work because they won't have to be home with sick kids. So reducing child mortality has huge benefits, not just for individual families, but for entire social orders, as Bill says saving children's lives is the best deal in philanthropy. For one thing it's often quite inexpensive, like many vaccines cost less than a dollar, and vaccination is the number one reason child mortality has declined so much. But still, most children who die do so only because they were born poor. That is not acceptable, and also we don't have to accept it. We need to continue to close the gap between rich and poor countries when it comes to vaccination. We need to improve healthcare for infants. 45% of child mortality now occurs within the first month of life. And we need to improve nutrition, not just preventing starvation, but ensuring that kids get all the nutrients they need. That's a really big deal, as Bill puts it, malnutrition destroys the most human potential on the planet. Because malnutrition can stunt not just physical growth, but also cognitive development, which just compounds the disadvantages that the poorest kids in the world face. This year's Gates letter also focuses on access to contraception. Melinda writes, when women are able to time and space their pregnancies, they are more likely to advance their education and earn an income, and they're more likely to have healthy children. And this is another place where what's good for individual families can also have really positive impacts on the community. As Melinda points out, no country in the last 50 years has emerged from poverty without expanding access to contraceptives. Hank, 20 years from now, when today's median vlogbrothers viewer is as old as I am now, it is genuinely possible that both absolute poverty and child mortality will be rare everywhere on earth. And I really believe that as a species, our success is best judged not by how the richest or the best connected among us live, but how the poor and the oppressed and the vulnerable live. And I know it may feel like absolute poverty and child mortality rates are beyond our control that only the Gates's and the Buffets of the world can move the needle. But in reality, it's up to all of us, like when my kids get through a diarrheal illness with just Pedialyte and Advil, it's up to me to remember and to prioritize the kids who die of the very same disease for want of rehydration solution. When we vote, when we talk to our friends about what matters to us, when we choose whose lives to pay attention to, we are deciding what our future will look like. Hank, you told me once that bad news usually happens all at once, while good news usually happens slowly, and that makes it hard to pay attention to the good news. But we still need the good news, maybe now more than ever. So I really hope you'll check out the Gates letter in the doobly-doo below. It's honest and level-headed while still being optimistic, which is what I want to be when I grow up. Hank, I'll see you on Friday.