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10 Breakthrough Technologies with Bill Gates

How the creator of the world’s biggest private foundation thinks about tackling some of the world’s biggest challenges.

March 28, 2019

Bill Gates, co-founder and former CEO of Microsoft, talks with Gideon Lichfield, MIT Technology Review's editor-in-chief, about the magazine's new list of 10 Breakthrough Technologies, which Gates curated.

The magazine has been publishing its list of 10 Breakthrough Technologies annually since 2001, as a way to highlight the recent advances that could have the biggest impact in the near future. Usually the list is assembled by the magazine’s expert editors and reporters, but this year Lichfield invited a special guest curator, Bill Gates, to share his own perspective on which emerging technologies could make the biggest difference for the largest number of people.

Gates stepped aside as CEO of Microsoft in 2000 to focus, in part, on running the Bill and Melinda Gates Foundation. With more than $50 billion in assets, the foundation supports programs to address global problems like poverty, child mortality, the spread of infectious disease, and limited access to healthcare and education. Befitting his practical outlook, Gates chose a few seemingly low-tech items for the list, such as better sanitation for cities without sewer systems and materials for sucking carbon dioxide out of the atmosphere. But he also included recognizably high-tech items like more dexterous robots, more conversational robots, and advanced fission reactor designs.




10 Breakthrough Technologies 2019

 Bill and Melinda Gates Foundation



Elizabeth Bramson-Boudreau: From MIT Technology Review. I’m Elizabeth Bramson-Boudreau, and this is Business Lab, the show that helps business leaders make sense of new technologies coming out of the lab and into the marketplace. This month here at MIT Technology Review we published our annual list of 10 breakthrough technologies. It’s meant to put a spotlight on the emerging technologies that we think will have the biggest benefits for humanity in the near future.

Elizabeth: We’ve been publishing this list every year since 2001 and it’s usually compiled by our expert editors and reporters. But this year, for the first time ever, we invited a special guest curator to tell us which technologies he thought should be on the list that guest was Bill Gates the co-founder and former CEO of Microsoft.

Elizabeth: These days, through his work at the Bill and Melinda Gates Foundation, Gates is basically a full-time philanthropist, focused on solving big problems like reducing child mortality preventing the spread of infectious disease expanding access to health care and improving education. So it’s no surprise that he had some strong opinions about which breakthroughs could make the biggest difference for the largest number of people. The areas he picked for our special issue include some things you might actually think of as low-tech, like better sanitation for cities without sewage systems, as well as others that absolutely do fit the high-tech mold, like smarter AI assistants, nimbler robots carbon capture techniques and lab grown meat for this special episode of Business Lab I’m going to turn the mike over to MIT Technology Review’s editor-in-chief Gideon Lichfield. Gideon went to Seattle recently to talk to Bill Gates and ask him what he thinks about the future and why he picked the technologies that are on this year’s list. So, here’s Gideon.

Gideon Lichfield: You’re famously optimistic, and you subscribe to the view of people like Hans Rosling and Steven Pinker that when you look at the important indicators, life has been getting better consistently for millions of people. How do you sustain that kind of optimism in a world in which climate change is accelerating, we have political polarization and disruption caused by social media, we have growing economic inequality, which is fueled at least in part by automation and AI. So, there’s a lot of worries about the technology having harmful effects. How do you retain your optimism?

Bill Gates: It’s great that people are worried about the problems, because they require action. You know, even take inequity. Globally inequity is down. That is, the poor countries are getting richer faster than the richer countries are getting richer. The bulk of humanity lives in middle income countries today. If you go back 50 years there were very, very few middle income countries. It was pretty bimodal where you had India and China Africa were poor, and then Europe, the U.S., Japan starting to be fairly well off, and not much in the middle. But today China’s at the high end of middle income, India’s at the low end of middle income, Brazil, Indonesia. It’s a phenomenal story and the ability of science to solve problems, clearly in the case of heart disease and cancer, make a lot of progress, some of the more chronic diseases like depression diabetes, I’m optimistic. Even obesity. You know, we’re gaining some fundamental understandings of the microbiome and the signaling mechanisms involved in these things. So yes, I am optimistic. It does bother me that most people aren’t optimistic. And you know, so, one of us is wrong and one of us is right.

Gideon: Do you think that you have maybe successful person’s bias? In other words, you’re some....

Bill: Of course. We have to factor that in.

Gideon: Right.

Bill: In my own life I’ve been extremely lucky. The country I was born in, the education I got to have, the business work I got to do. Even my foundation work is amazing and interesting work, but even subtracting out for my personal characteristics and personal experience I think the big picture is that it’s better to be born today than ever and it’ll be better to be born 20 years from now than today.

Gideon: So I want to talk about some of the individual technologies you picked for the list. One of them is lab grown meat, which is still very tentative, still very expensive. Why was that important enough to make the cut? And do you think that in a decade, two decades we could see lab-grown meat replacing a substantial proportion of animal-grown meat?

Bill: Yes I do. Part of the reason I picked it is to remind people that clean energy does not solve climate change. Every time you read about, oh, clean energy, that’s it, we just need clean energy. No, you don’t. Only about a quarter of the emissions come from electricity generation. So here you have a gigantic piece that is from beef production, and now this can be a substitute. So this is a category that people weren’t paying much attention to as a greenhouse gas problem, and yet I think the path to solve it is clearer than in say the cement or steel or other materials case.

Gideon: Right. Another technology you picked is AI, virtual assistants. So the reference there is to improvements in things like natural language processing. But these are still AIs that are basically very dumb machines.

Bill: Very dumb.

Gideon: They do one narrow task really well.

Bill: The computer is so stupid that when you present email, you don’t let it order it for you. You don’t trust it to have enough context to look at the material and understand the relationships and your calendar that it orders them for you. You pick which application to run, you pick which item to open. So it’s working at a very, very low level today. I do think that we’ll have executive assistant type capability in a five to 10 year period. Now you know I’ve known to be too optimistic about some of these IT things in the past, but generally they have progressed and it’s a huge priority project for companies like Google and Microsoft. And on some things like translation, the deep learning approaches are surprisingly good. And so I work on that a lot in my part time work with Microsoft, and I want one.

Gideon: Right. So I in that case it’s going to happen.

Bill: Absolutely.

Gideon: Let’s pick another of the technologies that you picked which I think is probably near and dear to your heart, which is the reinvented toilet. And you’ve explained this as the biggest advance in sanitation in 200 years. So tell us some more about.

Bill: Well, technologies are often decent enough that they stay the same. And so the idea of building sewers, using clean water, having a processing plant, that’s the paradigm in rich countries. Unfortunately, even in some middle income but certainly in low income countries the idea that you’re going to build that sewer system, the capital cost to do it is just unattainable. And yet the quality of life both in terms of disgust and disease, when you’re not taking the human waste and getting it out of an increasingly urbanized world—Africa will, although it’s the last place, it will be 50 percent urban 20 years from now. Will the kids there be healthy?

Gideon: But maybe just describe, briefly, what it does.

Bill: OK. Well it takes the human waste, the liquid and solid, and in some cases, it treats it as uniform, in most case it does some type of separation. The solids, you can essentially burn. The liquids you can filter. Now the cost of the equipment that does this reliably is a real challenge, and the net energy. Now burning the solid part, actually, you get energy. But whether you can make the balance—if you actually have to boil the liquid part that uses up a lot of energy. And, so, the technologies we have today work, but you know the cost per seat is over $5,000, and the maintenance that has to go into those things. To really get into those slums are going to have to get down to, the ultimate is the single-family household, wo the woman doesn’t have to go out at night. That we need to be less than $500. And so there are days when that’s kind of an intimidating target.

Gideon: Is there another technology like that which is you know something that has been around for so long and is so well established that nobody even thinks of innovating in it, but that actually, in the same way as the toilet, could be ripe for disruption?

Bill: There are cases where the sort of trickle-down approach of OK the rich world does something in some way, and now hey the poor world just learned to do it—in the rich world going to your doctors and getting regular medication sort of works. Actually, compliance isn’t that good. What we’d really like for the rest of the world is something like a drug depot, where it’s doing continuous release so that say you have to take six months of TB medicine, or you have to constantly have some HIV prophylactic drug in your body at a certain level. Drug depots would help the poor world application a lot. It’s not necessary for the rich world. And so there you have to challenge scientists to do something that if they just look at the rich-world target product profiles they won’t see it. Likewise keeping vaccines cold in place where you have lots of electricity reliably, stick it in the refrigerator, that’s fine. In Africa as we get out into rural areas we’ve had to challenge engineers to create new types of refrigeration. And that looks like it’s rolling out in a positive way. So trickle down works for a lot of things. Cell phones, chips, measles vaccine. But you’re going to miss a lot of potential innovation if you insist on that, and toilets is one where it’s even hard to see how some of these big Indian cities will ever deal with their waste, if all we have is sewer sanitation and large scale sanitation processing.

Gideon: Right. So you lead a $1 billion investment fund, Breakthrough Energy Ventures, which is investing in a whole bunch of different technologies, not all of them energy generation, but that are about limiting emissions. The question I have is, it feels like there are really a lot of technological solutions to climate change. And do we really need more of them, or is the biggest problem not political, about governments implementing them in creating the incentives for them to be taken up?

Bill: When you say to India, should you provide electricity to everyone, to have things we take for granted heating air conditioning, their path is to build more coal plants. That’s the cheapest form of electricity for them. And so yes, the rich countries are rich enough that if they chose to, they could pay huge premium prices for electricity. Now the reliability piece, you know you have seven days in Tokyo where you have no sun, no wind. The overall cost of electricity in Tokyo would be, for the entire year, would be more than doubled to have a 100 percent renewable solution. We don’t have ways of making cement, steel, meat that are zero-emissions, even at a doubled premium for those things. You know in France, they were asked to pay a 5 percent increase on their diesel price, and that was unacceptable. So the willingness to go for super expensive things whose only benefit is their reduction in greenhouse gas emission, it’s just not there. Politics is where you decide how much you’re going to put into basic research, or how you’re going to make things attractive for these innovative companies, or how you’re going to let things roll out when they’re in a less mature state. But no, if we froze technology today you will live in a 4 degrees C warmer world in the future, guaranteed.

Gideon: And you said recently that you want the U.S. to regain its lead, and you’re going to try to persuade the leaders of this country to regain the lead in nuclear power.

Bill: If we didn’t have climate change the quest to get broad acceptance of nuclear power wouldn’t be a priority for me. The general public attitude towards nuclear is a real challenge. And the economics are a real challenge. So if you can solve safety including the perception of safety and solve the economics that would be fantastic. It’s not easy. You also have to convince people that you’re not going to have a shortage of uranium, you’re not going to have proliferation, and that the waste isn’t going to be a huge problem. But the two big problems are the economics and the safety, and so daunting there are very few entities working on it even though the digital tools we have now, it’s insane that we’re not building a new reactor design. China is probably the place that’s most positive for nuclear energy. As you say, even there, the populace is asking questions about the safety and some of the reactors that have built did have cost overruns. And the way that that they’re balancing their power generation and their grid. They have some challenges there that are hurting the economics of all energy producers.

Gideon: So that gives us a nice segue to start talking about China. It has laid out these plans to be the world’s leading technology superpower within the next few decades. It’s got plans and bunch of specific areas. Do you think it can get there?

Bill: Well, it’s impressive what China has done. But China’s strength in digital areas, even in biology where they’re probably five years behind where they are in digital technologies, is very impressive. I mean Tsinghua is one of the top 10 universities in the world. And the number of science graduates and China is far greater than in other places. The real question I have to ask is innovation in China good for the world? If they cure some form of cancer, if they have seeds that are more productive, is that a good thing? In the realm of economics, it’s not zero sum. It’s really good. They only zero-sum game there is, is war. And I don’t think we should end up in a war with China.

Gideon: A trade war or any other kind of war.

Bill: Right. So, the idea that they’re starting to be innovative, that is good for the world. And like most countries in middle income status, they’re more willing to do big projects and upset the status quo. The U.S. in the ‘50s and ‘60s, you know Japan in the ‘70s and ‘80s, Korea in the ‘80s and ‘90s. There’s that middle-income state where your technological capability gets really strong and you’re willing, whether it’s your infrastructure or science, to go out and do very, very ambitious things. The U.S., it’s good to have a sense that, OK, we have to renew our edge. In fact, Japan was never going to overtake us in terms of scientific innovation. But I do think in the ‘70s and ‘80s when we were like, "Oh jeez, you know have they figured things out, we haven’t?," that we renewed our commitment to basic research. So post-World War II, it’ll be the first time that we have a broad technological competitor that actually uses the commercial market as the way they get their strengths. The Soviets had the problem that they didn’t have the commercial side. And so it meant that although their scientific understanding was very good, their ability to actually make things in an economic way fell way behind what we had. And so we had an incredible global uniqueness that’s kind of spoiled us, in a way. We won’t have as much uniqueness relative to China, even though we’re likely to stay at number one for a long time.

Gideon: Thank you very, very much Bill. That was a really fascinating conversation.

Bill: Yeah, great to talk to you.

Elizabeth: That’s it for this episode of Business Lab. I’m your host Elizabeth Bramson-Boudreau. I’m the CEO and publisher of MIT Technology Review. We were founded in 1899 by the Massachusetts Institute of Technology, and you can find us in print, on the web at dozens of live events each year, and now in audio form. To go deeper on all the technologies and trends that Gideon discussed with Bill Gates, please check out the March/April edition of MIT Technology Review or go to, where you can watch a video of the conversation or check out a full transcript. You’ll also find a special introduction to our Breakthrough Technologies issue written by Bill Gates.

Elizabeth: This show is available wherever you get your podcasts. If you enjoyed this episode we hope you’ll take a moment to rate and review us at Apple Podcasts. Business Lab is a production of MIT Technology Review. Our producer is Wade Roush with editorial help from Mindy Blodgett. Gideon’s interview with Bill Gates was produced by Daniel Lovering. Special thanks to our guest curator Bill Gates. And thank you for listening. We’ll be back soon with a new episode.


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