Big Bets

Make “big bets” to address the world’s biggest problems.

When people and organizations address issues such as poverty, public health, or environmental degradation, they tend to default to change in small increments. Too often, this approach can’t survive a problem’s complexities – challenges such as dealing with corrupt local officials, overcoming market barriers to the bulk production of medical supplies, or even coping with a lack of electricity or roads.

Instead of working in increments, you should identify and attack the root cause that underlies the problem you are attacking. Make a big bet.

Ask simple questions about complex issues.

Rajiv Shah joined the Bill and Melinda Gates Foundation in 2001, the year after it launched the Global Alliance for Vaccines and Immunization (Gavi). At the time, millions of children younger than five died each year of vaccine-preventable diseases. The Gavi initiative sought to immunize every child.

This ambitious project initially met with limited success. Bill Gates had posed a simple question: “What does it cost to immunize one child?” His question focused on a specific task – determining the cost of vaccinating...