WIRED: The Human Element—Melinda Gates and Paul Farmer on Designing Global Health

Paul Farmer and Melinda Gates have a lot in common. They’re both Duke University alums, and they’re both devoted to improving health around the world, especially in places with few resources. As cochair of the Bill & Melinda Gates Foundation, Gates is particularly dedicated to empowering women and girls, which in turn benefits the health and prosperity of entire communities. Farmer splits his time between Boston (where he runs the Department of Global Health and Social Medicine at Harvard Medical School), Haiti, and Rwanda. He’s founding director of Partners in Health, an international nonprofit that delivers health services to the rural and urban poor in a dozen countries. Gates and Farmer don’t often work together, but their work certainly unites them. In New York City for UN meetings, the two friends talked to WIRED about the best ways to improve health all over the world.

WIRED: What innovation do you think is changing the most lives in the developing world?

MELINDA GATES: Human-centered design. Meeting people where they are and really taking their needs and feedback into account. When you let people participate in the design process, you find that they often have ingenious ideas about what would really help them. And it’s not a onetime thing; it’s an iterative process.

How does that work in practice?

PAUL FARMER: In Haiti I would see people sleeping outside the hospital with their donkey saddle under their neck — they’d been waiting there for days. And no one was asking them, “What are you eating while you’re waiting? What is your family eating while you’re gone?” We have to design a health delivery system by actually talking to people and asking, “What would make this service better for you?” As soon as you start asking, you get a flood of answers.

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