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  • I thought in getting up to my TED wish

  • I would try to begin by putting in perspective what I try to do

  • and how it fits with what they try to do.

  • We live in a world that everyone knows is interdependent,

  • but insufficient in three major ways.

  • It is, first of all, profoundly unequal:

  • half the world's people still living on less than two dollars a day;

  • a billion people with no access to clean water;

  • two and a half billion no access to sanitation;

  • a billion going to bed hungry every night;

  • one in four deaths every year from AIDS, TB, malaria

  • and the variety of infections associated with dirty water --

  • 80 percent of them under five years of age.

  • Even in wealthy countries it is common now to see inequality growing.

  • In the United States, since 2001 we've had five years of economic growth,

  • five years of productivity growth in the workplace,

  • but median wages are stagnant and the percentage of working families

  • dropping below the poverty line is up by four percent.

  • The percentage of working families without health care up by four percent.

  • So this interdependent world which has been pretty good to most of us --

  • which is why we're all here in Northern California doing what we do

  • for a living, enjoying this evening -- is profoundly unequal.

  • It is also unstable.

  • Unstable because of the threats of terror,

  • weapons of mass destruction, the spread of global disease

  • and a sense that we are vulnerable to it in a way that we weren't not so many years ago.

  • And perhaps most important of all, it is unsustainable

  • because of climate change, resource depletion and species destruction.

  • When I think about the world I would like to leave to my daughter

  • and the grandchildren I hope to have,

  • it is a world that moves away from unequal, unstable, unsustainable

  • interdependence to integrated communities -- locally, nationally and globally --

  • that share the characteristics of all successful communities:

  • a broadly shared, accessible set of opportunities,

  • a shared sense of responsibility for the success of the common enterprise

  • and a genuine sense of belonging.

  • All easier said than done.

  • When the terrorist incidents occurred in the United Kingdom a couple of years ago,

  • I think even though they didn't claim as many lives as we lost in the United States on 9/11,

  • I think the thing that troubled the British most

  • was that the perpetrators were not invaders, but homegrown citizens

  • whose religious and political identities were more important to them

  • than the people they grew up with, went to school with,

  • worked with, shared weekends with, shared meals with.

  • In other words, they thought their differences

  • were more important than their common humanity.

  • It is the central psychological plague of humankind in the 21st century.

  • Into this mix, people like us, who are not in public office,

  • have more power to do good than at any time in history,

  • because more than half the world's people

  • live under governments they voted in and can vote out.

  • And even non-democratic governments are more sensitive to public opinion.

  • Because primarily of the power of the Internet,

  • people of modest means can band together and amass vast sums of money

  • that can change the world for some public good if they all agree.

  • When the tsunami hit South Asia, the United States contributed 1.2 billion dollars.

  • 30 percent of our households gave.

  • Half of them gave over the Internet.

  • The median contribution was somewhere around 57 dollars.

  • And thirdly, because of the rise of non-governmental organizations.

  • They, businesses, other citizens' groups, have enormous power

  • to affect the lives of our fellow human beings.

  • When I became president in 1993,

  • there were none of these organizations in Russia.

  • There are now a couple of hundred thousand.

  • None in India. There are now at least a half a million active.

  • None in China. There are now 250,000 registered with the government,

  • probably twice again that many who are not registered for political reasons.

  • When I organized my foundation, and I thought about the world as it is

  • and the world that I hope to leave to the next generation,

  • and I tried to be realistic about what I had cared about all my life

  • that I could still have an impact on.

  • I wanted to focus on activities

  • that would help to alleviate poverty, fight disease, combat climate change,

  • bridge the religious, racial and other divides that torment the world,

  • but to do it in a way that would either use

  • whatever particular skills we could put together in our group

  • to change the way some public good function was performed

  • so that it would sweep across the world more.

  • You saw one reference to that in what we were able to do with AIDS drugs.

  • And I want to say that the head of our AIDS effort,

  • and the person who also is primarily active in the wish I'll make tonight,

  • Ira Magaziner, is here with me and I want to thank him for everything he's done.

  • He's over there.

  • (Applause)

  • When I got out of office and was asked to work, first in the Caribbean,

  • to try to help deal with the AIDS crisis,

  • generic drugs were available for about 500 dollars a person a year.

  • If you bought them in vast bulks,

  • you could get them at a little under 400 dollars.

  • The first country we went to work in, the Bahamas,

  • was paying 3,500 dollars for these drugs.

  • The market was so terribly disorganized

  • that they were buying this medicine through two agents

  • who were gigging them sevenfold.

  • So the very first week we were working,

  • we got the price down to 500 dollars.

  • And all of a sudden, they could save seven times as many lives

  • for the same amount of money.

  • Then we went to work with the manufacturers of AIDS medicines,

  • one of whom was cited in the film,

  • and negotiated a whole different change in business strategy,

  • because even at 500 dollars, these drugs

  • were being sold on a high-margin, low-volume, uncertain-payment basis.

  • So we worked on improving the productivity of the operations

  • and the supply chain, and went to a low-margin, high-volume,

  • absolutely certain-payment business.

  • I joked that the main contribution we made

  • to the battle against AIDS was to get the manufacturers

  • to change from a jewelry store to a grocery store strategy.

  • But the price went to 140 dollars from 500.

  • And pretty soon, the average price was 192 dollars.

  • Now we can get it for about 100 dollars.

  • Children's medicine was 600 dollars,

  • because nobody could afford to buy any of it.

  • We negotiated it down to 190.

  • Then, the French imposed their brilliantly conceived airline tax

  • to create a something called UNITAID,

  • got a bunch of other countries to help.

  • That children's medicine is now 60 dollars a person a year.

  • The only thing that is keeping us from basically saving the lives

  • of everybody who needs the medicine to stay alive

  • are the absence of systems necessary to diagnose, treat and care

  • for people and deliver this medicine.

  • We started a childhood obesity initiative with the Heart Association in America.

  • We tried to do the same thing by negotiating industry-right deals

  • with the soft drink and the snack food industry to cut the caloric

  • and other dangerous content of food going to our children in the schools.

  • We just reorganized the markets.

  • And it occurred to me that in this whole non-governmental world,

  • somebody needs to be thinking about organizing public goods markets.

  • And that is now what we're trying to do,

  • and working with this large cities group to fight climate change,

  • to negotiate huge, big, volume deals that will enable cities

  • which generate 75 percent of the world's greenhouse gases,

  • to drastically and quickly reduce greenhouse gas emissions

  • in a way that is good economics.

  • And this whole discussion as if it's some sort of economic burden,

  • is a mystery to me.

  • I think it's a bird's nest on the ground.

  • When Al Gore won his well-deserved Oscar

  • for the "Inconvenient Truth" movie, I was thrilled,

  • but I had urged him to make a second movie quickly.

  • For those of you who saw "An Inconvenient Truth,"

  • the most important slide in the Gore lecture is the last one,

  • which shows here's where greenhouse gases are going

  • if we don't do anything, here's where they could go.

  • And then there are six different categories

  • of things we can do to change the trajectory.

  • We need a movie on those six categories.

  • And all of you need to have it embedded in your brains

  • and to organize yourselves around it.

  • So we're trying to do that.

  • So organizing these markets is one thing we try to do.

  • Now we have taken on a second thing, and this gets to my wish.

  • It has been my experience in working in developing countries

  • that while the headlines may all be -- the pessimistic headlines may say,

  • well, we can't do this, that or the other thing because of corruption --

  • I think incapacity is a far bigger problem in poor countries than corruption,

  • and feeds corruption.

  • We now have the money, given these low prices, to distribute

  • AIDS drugs all over the world to people we cannot presently reach.

  • Today these low prices are available in the 25 countries where we work,

  • and in a total of 62 countries,

  • and about 550,000 people are getting the benefits of them.

  • But the money is there to reach others.

  • The systems are not there to reach the people.

  • So what we have been trying to do,

  • working first in Rwanda and then in Malawi and other places --

  • but I want to