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Why were the first three generations of reactor designs so uneconomical?

They weren’t uneconomical. If you take how much was spent on Gen 1 and Gen 2 reactors and look at how much power was turned out of those things, those are the deal of the century. You can only beat it with hydro. And for the guys like the French that wound up owning one of those things, the lifetimes were increased and are still being increased. They used to run them at like a 70 percent duty cycle. They have them up to around a 95 or 96 percent duty cycle. The price of uranium did not spike. Gen 1 and Gen 2 were the bargain of the century. Now Gen 3, because of all sorts of safety requirements and permit delays and various things, has proved very uneconomical, at least in Finland. But the statistic I love is that per atom you’re almost a million times better off than with hydrocarbons.

TerraPower is far out.

It’s very far out. It definitely needs to be categorized as a high-risk, wild thing, but the world only needs a few wild things to succeed to have two major benefits: cheaper energy, which the poor dearly need and would benefit everyone, and zero-emission energy. So it’s great, but as I say, you’ve got to get the pilot plant built, which is hard. You’ve got to have all the science and economics work the way they work on paper. And then you’ve got to get the manufacturers involved. And the numbers are pretty daunting, even in the Chinese electricity picture. Even though they’re building about half the nuclear plants and are going to move full speed ahead, they’re at 3 percent nuclear right now. Unless something that’s way better than they expect comes along, they won’t get to more than 15 or 20 percent nuclear.

You’ve said that nuclear has the best chance of being an energy miracle.

Well, it’s the one I’ve gotten involved in. I spend time at TerraPower. We’ve got a TerraPower phone call with partners today; I was over there on Monday. It’s a neat group of people, so I’ve gotten more personally involved. I don’t claim to be the person who’s surveyed all the possibilities better than anyone else. But I think solar thermal has a lot of promise, whether it’s [the California-based company] eSolar or dozens of other guys. Solar chemical: some people see the possibilities at the research level. The algae guys: I’ve actually got some money in some of those. That’s energy farming. That’s hard. But they’re seeing some results. Then there are crazy things like these high-wind kite guys. There’s a lot of energy out there. You really don’t want to rule anything out. If you’d said to somebody in 1890, “How are you going to solve the manure problem?” I don’t think they would have actually foreseen, “Well, we’re going to do it by creating this CO2 problem.”

Let’s talk about poverty. What is the minimum amount of energy that a person in a developing country should have access to for a reasonable standard of living?

Well, a level that’s about half of current European usage, which is a quarter of current U.S. usage. The room for efficiency–I’m saying it’s probably a factor of four. And then I’m saying the rest of the world should be allowed to live at that energy level. Now, the aggregate energy therefore for nine billion people, which is about what the peak population is expected to be, is dramatically greater than what we have today, and that’s why when you multiply that big E by the CO2 per E, that number better be pretty damn small, because you’re not just trying to stay where you are today; you’re trying to get 90 percent down from where you are today. So wow, that number has got to be approaching zero.

How much money should we spend to rebuild the social structures damaged by infectious diseases, by HIV and AIDS?

You know, we’ve got to stop the epidemic, and because we don’t have a cure, we’ve got to treat as many people as we can. I think in general when you help these societies, it’s not really specific to the AIDS epidemic. I mean, South Africa, they have made progress with their poor people. They still have so far to go. It’s not clear that the pathologies of the AIDS epidemic make your agenda for the poor people in South Africa different. The South African school system’s not very good. The electricity grid is really bad. They got dreamy thinking about some things coming on, they’ve got these huge power shortages, which is kind of ironic because they’ve got lots of coal. Now they have to raise power rates. That’s very tricky. I’m a big believer in investing in getting poor countries to be self-sufficient in terms of health improvement, which leads to reduced population growth. I don’t think there’s anything that’s unique to the AIDS-ravaged countries.

What has been the most important health-care innovation from the Gates Foundation? Of what are you most proud?

The biggest-impact thing we work on is vaccines–in particular, hepatitis B and Hib. [The Gates Foundation was instrumental in getting two vaccines into widespread use: one prevents hepatitis B, an infection that causes liver cancer in adults; the other prevents Haemophilus influenzae type B, a bacterial infection that causes meningitis and other life-threatening diseases during childhood.] In terms of saving lives, changing the rules, that’s probably number one on the list.

How many people is that expected to save?

Well, every year you get to add about another 300,000 lives.

That’s pretty cool.

It starts to add up. In vaccines, the effect is pretty incredible. The one that I hope to be able to add to that list which isn’t there yet is polio eradication. We’ve gotten very involved, we’ve put a lot of money in, and we’re fairly close. The last part is absolutely the hardest part. But the benefit to the world of that second disease eradication after smallpox, and the kind of energy that would create–it would free up money, it would energize the whole global health initiative. That’s a big one. There’s a couple of new vaccines that we didn’t invent, but we’re working on getting them to be low-cost and distribute them, get the culture right: the rotavirus and pneumococcus. Those together are about another 400,000 lives. Then you’ve got malaria, which is probably further down. There’s various interventions to help reduce the AIDs epidemic, but those aren’t there yet.

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