Today, I'd like to talk with you about something that should be a totally uncontroversial topic.
But, unfortunately, it's become incredibly controversial.
This year, if you think about it, over a billion couples will have sex with one another.
Couples like this one, and this one, and this one, and, yes, even this one.
(Laughter) And my idea is this -- all these men and women should be free to decide whether they do or do not want to conceive a child.
And they should be able to use one of these birth control methods to act on their decision.
Now, I think you'd have a hard time finding many people who disagree with this idea.
Over one billion people use birth control without any cgeorge@example.com.
They want the power to plan their own lives and to raise healthier, better educated and more prosperous families.
But, for an idea that is so broadly accepted in private, birth control certainly generates a lot of opposition in public.
Some people think when we talk about contraception that it's code for abortion, which it's not.
Some people -- let's be honest -- they're uncomfortable with the topic because it's about sex.
Some people worry that the real goal of family planning is to control populations.
These are all side issues that have attached themselves to this core idea that men and women should be able to decide when they want to have a child.
And as a result, birth control has almost completely and totally disappeared from the global health agenda.
The victims of this paralysis are the people of sub-Saharan Africa and South Asia.
Here in Germany, the proportion of people that use contraception is about 66 percent.
That's about what you'd expect.
In El Salvador, very similar, 66 percent.
Thailand, 64 percent.
But let's compare that to other places, like Uttar Pradesh, one of the largest states in India.
In fact, if Uttar Pradesh was its own country, it would be the fifth largest country in the world.
Their contraception rate -- 29 percent.
Nigeria, the most populous country in Africa, 10 percent.
Chad, 2 percent.
Let's just take one country in Africa, Senegal.
Their rate is about 12 percent.
But why is it so low?
One reason is that the most popular contraceptives are rarely available.
Women in Africa will tell you over and over again that what they prefer today is an injectable.
They get it in their arm -- and they go about four times a year, they have to get it every three months -- to get their injection.
The reason women like it so much in Africa is they can hide it from their husbands, who sometimes want a lot of children.
The problem is every other time a woman goes into a clinic in Senegal, that injection is stocked out.
It's stocked out 150 days out of the year.
So can you imagine the situation -- she walks all this way to go get her injection.
She leaves her field, sometimes leaves her children, and it's not there.
And she doesn't know when it's going to be available again.
This is the same story across the continent of Africa today.
And so what we've created as a world has become a life-and-death crisis.
There are 100,000 women [per year] who say they don't want to be pregnant and they die in childbirth -- 100,000 women a year.
There are another 600,000 women [per year] who say they didn't want to be pregnant in the first place, and they give birth to a baby and her baby dies in that first month of life.
I know everyone wants to save these mothers and these children.
But somewhere along the way, we got confused by our own conversation.
And we stopped trying to save these lives.
So if we're going to make progress on this issue, we have to be really clear about what our agenda is.
We're not talking about abortion.
We're not talking about population control.
What I'm talking about is giving women the power to save their lives, to save their children's lives and to give their families the best possible future.
Now, as a world, there are lots of things we have to do in the global health community if we want to make the world better in the future -- things like fight diseases.
So many children today die of diarrhea, as you heard earlier, and pneumonia.
They kill literally millions of children a year.
We also need to help small farmers -- farmers who plow small plots of land in Africa -- so that they can grow enough food to feed their children.
And we have to make sure that children are educated around the world.
But one of the simplest and most transformative things we can do is to give everybody access to birth control methods that almost all Germans have access to and all Americans, at some point, they use these tools during their life.
And I think as long as we're really clear about what our agenda is, there's a global movement waiting to happen and ready to get behind this totally uncontroversial idea.
When I grew up, I grew up in a Catholic home.
I still consider myself a practicing Catholic.
My mom's great-uncle was a Jesuit priest.
My great-aunt was a Dominican nun.
She was a schoolteacher and a principal her entire life.
In fact, she's the one who taught me as a young girl how to read.
I was very close to her.
And I went to Catholic schools for my entire childhood until I left home to go to university.
In my high school, Ursuline Academy, the nuns made service and social justice a high priority in the school.
Today, in the [Gates] Foundation's work, I believe I'm applying the lessons that I learned in high school.
So, in the tradition of Catholic scholars, the nuns also taught us to question received teachings.
And one of the teachings that we girls and my peers questioned was is birth control really a sin?
Because I think one of the reasons we have this huge discomfort talking about contraception is this lingering concern that if we separate sex from reproduction, we're going to promote promiscuity.
And I think that's a reasonable question to be asked about contraception -- what is its impact on sexual morality?
But, like most women, my decision about birth control had nothing to do with promiscuity.
I had a plan for my future.
I wanted to go to college.
I studied really hard in college, and I was proud to be one of the very few female computer science graduates at my university.
I wanted to have a career, so I went on to business school and I became one of the youngest female cgeorge@example.com.
I still remember, though, when I left my parents' home to move across the country to start this new cgeorge@example.com.
They had sacrificed a lot to give me five years of higher education.
But they said, as I left home -- and I literally went down the front steps, down the porch at home -- and they said, "Even though you've had this great education, if you decide to get married and have kids right away, that's OK by us, too."
They wanted me to do the thing that would make me the very happiest.
I was free to decide what that would be.
It was an amazing feeling.
In fact, I did want to have kids -- but I wanted to have them when I was ready.
And so now, Bill and I have three.
And when our eldest daughter was born, we weren't, I would say, exactly sure how to be great parents.
Maybe some of you know that feeling.
And so we waited a little while before we had our second child.
And it's no accident that we have three children that are spaced three years apart.
Now, as a mother, what do I want the very most for my children?
I want them to feel the way I did -- like they can do anything they want to do in life.
And so, what has struck me as I've travelled the last decade for the foundation around the world is that all women want that same thing.
Last year, I was in Nairobi, in the slums, in one called Korogocho -- which literally means when translated, "standing shoulder to shoulder."
And I spoke with this women's group that's pictured here.
And the women talked very openly about their family life in the slums, what it was like.
And they talked quite intimately about what they did for birth control.
Marianne, in the center of the screen in the red sweater, she summed up that entire two-hour conversation in a phrase that I will never forget.
She said, "I want to bring every good thing to this child before I have another."
And I thought -- that's it.
That's universal.
We all want to bring every good thing to our children.
But what's not universal is our ability to provide every good thing.
So many women suffer from domestic violence.
And they can't even broach the subject of contraception, even inside their own marriage.
There are many women who lack basic education.
Even many of the women who do have knowledge and do have power don't have access to contraceptives.
For 250 years, parents around the world have been deciding to have smaller families.
This trend has been steady for a quarter of a millennium, across cultures and across geographies, with the glaring exception of sub-Saharan Africa and South Asia.
The French started bringing down their family size in the mid-1700s.
And over the next 150 years, this trend spread all across Europe.
The surprising thing to me, as I learned this history, was that it spread not along socioeconomic lines but around cultural lines.
People who spoke the same language made that change as a group.
They made the same choice for their family, whether they were rich or whether they were poor.
The reason that trend toward smaller families spread was that this whole way was driven by an idea -- the idea that couples can exercise conscious control over how many children they have.
This is a very powerful idea.
It means that parents have the ability to affect the future, not just accept it as it is.
In France, the average family size went down every decade for 150 years in a row until it stabilized.
It took so long back then because the contraceptives weren't that good.
In Germany, this transition started in the 1880s, and it took just 50 years for family size to stabilize in this country.
And in Asia and Latin America, the transition started in the 1960s, and it happened much faster because of modern contraception.
I think, as we go through this history, it's important to pause for a moment and to remember why this has become such a contentious issue.
It's because some family planning programs resorted to unfortunate incentives and coercive policies.
For instance, in the 1960s, India adopted very specific numeric targets and they paid women to accept having an IUD placed in their bodies.
Now, Indian women were really smart in this situation.
When they went to get an IUD inserted, they got paid six rupees.
And so what did they do?
They waited a few hours or a few days, and they went to another service provider and had the IUD removed for one rupee.
For decades in the United States, African-American women were sterilized without their consent.
The procedure was so common it became known as the Mississippi appendectomy -- a tragic chapter in my country's history.
And as recently as the 1990s, in Peru, women from the Andes region were given anesthesia and they were sterilized without their knowledge.
The most startling thing about this is that these coercive policies weren't even needed.
They were carried out in places where parents already wanted to lower their family size.
Because in region after region, again and again, parents have wanted to have smaller families.
There's no reason to believe that African women have innately different desires.
Given the option, they will have fewer children.
The question is: will we invest in helping all women get what they want now?
Or, are we going to condemn them to some century-long struggle, as if this was still revolutionary France and the best method was coitus interruptus?
Empowering parents -- it doesn't need justification.
But here's the thing -- our desire to bring every good thing to our children is a force for good throughout the world.
It's what propels societies forward.
In that same slum in Nairobi, I met a young businesswoman, and she was making backpacks out of her home.
She and her young kids would go to the local jeans factory and collect scraps of denim.
She'd create these backpacks and resell them.
And when I talked with her, she had three children, and I asked her about her family.
And she said she and her husband decided that they wanted to stop having children after their third one.
And so when I asked her why, she simply said, "Well, because I couldn't run my business if I had another child."
And she explained the income that she was getting out of her business afforded her to be able to give an education to all three of her children.
She was incredibly optimistic about her family's future.
This is the same mental calculus that hundreds of millions of men and women have gone through.
And evidence proves that they have it exactly right.
They are able to give their children more opportunities by exercising control over when they have them.
In Bangladesh, there's a district called Matlab.
It's where researchers have collected data on over 180,000 inhabitants since 1963.
In the global health community, we like to say it's one of the longest pieces of research that's been running.
We have so many great health statistics.
In one of the studies, what did they do?
Half the villagers were chosen to get contraceptives.
They got education and access to contraception.
Twenty years later, following those villages, what we learned is that they had a better quality of life than their neighbors.
The families were healthier.
The women were less likely to die in childbirth.
Their children were less likely to die in the first thirty days of life.
The children were better nourished.
The families were also wealthier.
The adult women's wages were higher.
Households had more assets -- things like livestock or land or savings.
Finally, their sons and daughters had more schooling.
So when you multiply these types of effects over millions of families, the product can be large-scale economic development.
People talk about the Asian economic miracle of the 1980s -- but it wasn't really a miracle.
One of the leading causes of economic growth across that region was this cultural trend towards smaller families.
Sweeping changes start at the individual family level -- the family making a decision about what's best for their children.
When they make that change and that decision, those become sweeping regional and national trends.
When families in sub-Saharan Africa are given the opportunity to make those decisions for themselves, I think it will help spark a virtuous cycle of development in communities across the continent.
We can help poor families build a better future.
We can insist that all people have the opportunity to learn about contraceptives and have access to the full variety of methods.
I think the goal here is really clear: universal access to birth control that women want.
And for that to happen, it means that both rich and poor governments alike must make contraception a total priority.
We can do our part, in this room and globally, by talking about the hundreds of millions of families that don't have access to contraception today and what it would do to change their lives if they did have access.
I think if Marianne and the members of her women's group can talk about this openly and have this discussion out amongst themselves and in public, we can, too.
And we need to start now.
Because like Marianne, we all want to bring every good thing to our children.
And where is the controversy in that?
Thank you.
(Applause) Chris Anderson: Thank you.
I have some questions for Melinda.
(Applause ends) Thank you for your courage and everything else.
So, Melinda, in the last few years I've heard a lot of smart people say something to the effect of, "We don't need to worry about the population issue anymore.
Family sizes are coming down naturally all over the world.
We're going to peak at nine or 10 billion.
And that's it."
Are they wrong?
Melinda Gates: If you look at the statistics across Africa, they are wrong.
And I think we need to look at it, though, from a different lens.
We need to look at it from the ground upwards.
I think that's one of the reasons we got ourselves in so much trouble on this issue of contraception.
We looked at it from top down and said we want to have different population numbers over time.
Yes, we care about the planet.
Yes, we need to make the right choices.
But the choices have to be made at the family level.
And it's only by giving people access and letting them choose what to do that you get those sweeping changes that we have seen globally -- except for sub-Saharan Africa and those places in South Asia and Afghanistan.
CA: Some people on the right in America and in many conservative cultures around the world might say something like this: "It's all very well to talk about saving lives and empowering women and so on.
But, sex is sacred.
What you're proposing is going to increase the likelihood that lots of sex happens outside marriage.
And that is wrong."
What would you say to them?
MG: I would say that sex is absolutely sacred.
And it's sacred in Germany, and it's sacred in the United States, and it's sacred in France and so many places around the world.
And the fact that 98 percent of women in my country who are sexually experienced say they use birth control doesn't make sex any less sacred.
It just means that they're getting to make choices about their lives.
And I think in that choice, we're also honoring the sacredness of the family and the sacredness of the mother's life and the childrens' lives by saving their lives.
To me, that's incredibly sacred, too.
CA: So what is your foundation doing to promote this issue?
And what could people here and people listening on the web -- what would you like them to do?
MG: I would say this -- join the conversation.
We've listed the website up here.
Join the conversation.
Tell your story about how contraception has either changed your life or somebody's life that you know.
And say that you're for this.
We need a groundswell of people saying, "This makes sense.
We've got to give all women access -- no matter where they live."
And one of the things that we're going to do is do a large event July 11 in London, with a whole host of countries, a whole host of African nations, to all say we're putting this back on the global health agenda.
We're going to commit resources to it, and we're going to do planning from the bottom up with governments to make sure that women are educated -- so that if they want the tool, they have it, and that they have lots of options available either through their local healthcare worker or their local community rural clinic.
CA: Melinda, I'm guessing that some of those nuns who taught you at school are going to see this TED Talk at some point.
Are they going to be horrified, or are they cheering you on?
MG: I know they're going to see the TED Talk because they know that I'm doing it and I plan to send it to them.
And, you know, the nuns who taught me were incredibly progressive.
I hope that they'll be very proud of me for living out what they taught us about social justice and service.
I have come to feel incredibly passionate about this issue because of what I've seen in the developing world.
And for me, this topic has become very close to heart because you meet these women and they are so often voiceless.
And yet they shouldn't be -- they should have a voice, they should have access.
And so I hope they'll feel that I'm living out what I've learned from them and from the decades of work that I've already done at the foundation.
CA: So, you and your team brought together today an amazing group of speakers to whom we're all grateful.
Did you learn anything?
(Laughter) MG: Oh my gosh, I learned so many things.
I have so many follow-up questions.
And I think a lot of this work is a journey.
You heard the discussion about the journey through energy, or the journey through social design, or the journey in the coming and saying, "Why aren't there any women on this platform?"
And I think for all of us who work on these development issues, you learn by talking to other people.
You learn by doing.
You learn by trying and making mistakes.
And it's the questions you ask.
Sometimes it's the questions you ask that helps lead to the answer the next person that can help you answer it.
So I have lots of questions for the panelists from today.
And I thought it was just an amazing day.
CA: Melinda, thank you for inviting all of us on this journey with you.
Thank you so much.
MG: Great.
Thanks, Chris.
Alright.
I have a close, tight-knit circle of friends.
We're all in different cities and we're all in different areas, from local news to city government to law, financial services ...
And despite those different areas, we seem to share similar stories of workplace drama.
Now, I define workplace drama as an annoyance that adds additional stress to the job.
So again, it's when people get on your nerves, not the job itself.
So as we're going through these stories, I'm realizing there has to be a better way for us to coexist with our coworkers without this much drama.
So I created a few steps that have been working for me, and I'm happy to share them with you guys today.
Step 1: rewind and reflect, also known as, "What did I do?"
I want you guys to all replay your most recent workplace drama situation in your head like a movie.
Ignore all of the emotion and just focus on you.
But for now, let's just think about this hypothetical: say you're on a group project, you each have your own individual assignments and then you all divide up the work.
But then someone becomes unresponsive -- not answering calls, they go ghost.
Then you or someone else has to now pick up that additional slack.
So in a brief, small, very tiny lapse in judgment, you vent to the nearby coworker.
Then all of a sudden, your ghost comes back, and they surprisingly know everything you just said.
(Laughter) Now, what did I do in this situation?
I vented to someone who was not my confidant.
Why would I do that?
Sometimes we create this unspoken bond with people that only exists in our heads.
They don't owe me their discretion.
I just assumed it was there.
So we're not going to go down a rabbit hole, trying to figure out why they did that.
It doesn't matter.
They did it.
But the goal in this step is self-reflection.
We need to focus on what did we do so we can avoid it in the future.
Step 2: come back to reality, also known as, "It needs to stop."
(Laughter) So you guys ever think about problems before you get to work?
Oh -- it's just me?
(Laughter) Well, I'm guilty of it.
I think about all of these situations in my head, and then I get mad just thinking about it.
So I'm telling myself, "No, you're just being prepared, Stacy."
(Laughter) "You are just making sure that you can handle whatever they're about to cgeorge@example.com."
But you're not.
What you're really doing is setting yourself up and creating this anxiety in your head that doesn't exist.
Then we also have to be careful about listening to other people's made-up scenarios.
Here's what I mean.
Let's say you're in the break room, and you're talking to some coworkers.
Then, all of a sudden, another coworker comes in.
Now, they seem to just be in deep thought -- not overly cheerful, but they're not rude.
They come in, they walk out.
Then the coworkers over here begin to diagnose what they feel is wrong with that person.
They're saying things like, "Oh, they're just mad they didn't get the job."
Or they're saying, "Oh, no, no, no -- during this season, they're just always upset."
And you're sitting here like, yep, that must be it.
You're listening to this as if this is facts.
Meanwhile, this coworker can be in deep thought about literally anything.
They could have just opened a pack of Starburst, got four yellows back-to-back, and they're just trying to figure out what happened.
(Laughter) (Applause) But you're over here listening.
And you're listening to their made-up scenario that now can impact how you choose to interact with that person throughout the day.
Whether we're creating fake stories in our head or listening to other people's made-up stories, it needs to stop.
The goal in this step: stop stressing over things that haven't happened.
Alright.
Step 3: vent and release.
It's good to have a vent buddy.
This is your coach, your cheerleader, your therapist, whatever you need them to be in the moment.
This is not like that person in Step 1 that just happened to be in earshot.
You have an established relationship with your vent buddy.
Now, here's another scenario.
You're getting ready to tell a customer or a client something that they just don't want to hear.
So, as you're in the middle of this spiel, up comes another coworker, and they interrupt you and then says the exact same thing you were saying.
You can't make a scene in front of a customer.
So you just have to sit back, "Mm-hmm," and just listen as they do this.
And you're burning up inside.
So what do we do?
We go to our vent buddy.
We talk about it.
We get mad.
And that's the time for that.
Get mad.
Get angry.
Curse, scream, do whatever you need to do to get it out.
Now here's the hard part: you then have to switch that tone to positivity.
I truly believe in positive and negative energy, and it has a way of controlling our moods throughout the day.
You've got to think of things like, "OK, where do I go from here?
What can I do differently?"
And then, if you're the vent buddy, it's your responsibility to lead your friend back to the positive.
Now, the other hard part: you have to then apply those learnings to the situation.
You can't carry that resentment around.
If you do, that one-off situation now becomes a pattern.
Pattern behavior is harder to ignore than a one-off situation.
The goal in this step is, "Let's turn our vent session into a productive conversation."
Step 4: learn a new language, also known as, "We need to talk."
Guys, I personally don't like to pick up the cgeorge@example.com.
I just don't.
I feel like whatever you need to say to me can be an instant message or an email.
That is my work language.
(Laughter) The only problem with that, you can't hear tone through an email.
I read emails the same way I speak, so I'm pretty sure I've misinterpreted some tones before, unless I know you.
So here's an example.
I'm going to show you guys an email, and I want you to read it, and then I'm going to read it out loud.
Alright, that was fast enough, you should have read it.
(Laughter) "Stacy, Thank you for reaching out about my group.
At this time, we will not need any additional support.
Going forward, if I feel we need help, I'll ask, you won't have to reach out.
Per my last email (attached below), I've outlined what I do, and what you do, so we can avoid this in the future.
As always, thank you for your partnership!!"
Guys ...
(Laughter) That's how you read it?
(Laughter) Guys, there are certain words in there that if you hear or if you see in an email, it is safe to assume they typed it with their middle fingers.
(Laughter) I didn't know it then.
I know it now.
(Laughter) I think I messed up some people's emails.
They're correcting them.
(Laughter) With all of that said, you have to know when it is time to pick up the phone.
You have to know when it is time to have a face-to-face.
And these face-to-face conversations are not easy.
They are difficult, but they are necessary.
The goal is to try to understand the other person's perspective.
So you'll start the conversation with things like, "OK, you got upset when I ..."
Or you'll say things like, "OK, you already had the situation handled, and then I ..."
So that way, you can see exactly where they're coming from.
Also, don't try to make people like you.
We all have our own upbringings.
We all have our experiences.
And we all have our own communication styles.
As the new generations are entering the workforce, we're also adapting to it.
Meetings are now emails.
Emails are now texts.
Off-sites are now Skype.
So as we're adjusting to that, we need to at least try to understand what type of style of communication they use.
The goal in that step is to really understand their work language and accept the fact that it may be different than yours.
Step 5: recognize and protect, also known as, "We need to take a walk."
So here's my last scenario from one of my teacher friends.
You're about to have a meeting with a parent, and prior to it, you and a coworker, you kind of discuss it, and the coworker tells you, "It's alright, I got your back.
I'm going to agree with your recommendations."
So you're kind of side-eyeing them because they've burned you before, but you've had the "we need to talk," so you're like, "We're in sync now, I'm going to trust them."
You go through the meeting, the parent disagrees with you, and like clockwork, the coworker agrees with the parent in front of you, making you look ridiculous.
Again, we can't make a scene in front of people, right?
So you've got to hold it in.
And then, after the meeting, that same coworker has all the audacity, comes up to you and says, "Crazy meeting, right?"
(Laughter) Yeah.
They're testing you now.
It's a test.
(Laughs) So that's the perfect time to just go off, right?
This is a repeat offender.
(Laughter) You walked away, and they came back with it.
But we're trying to avoid workplace drama, not take a cannonball leap into it, so we have to walk away.
You lead that conversation by taking the first available exit.
You're not doing this for them.
You're doing this for you.
You have to protect your energy.
Don't try to figure out why they would do this, and no more coming-to-Jesus conversations.
It is what it is, they did what they did, and given the opportunity, they'd probably do it again.
But you now know that.
You now recognize that.
So that way, you can act accordingly.
We typically try to set expectations -- our expectations -- on other people, and then get disappointed when they don't follow through.
We have to learn to accept people where they are and adjust ourselves to handle those situations.
The goal in this step is to recognize when it is time to professionally walk away from someone.
Guys, I realize these steps may come off as saying, "Take the high road."
And people always say it.
"Just take the high road."
And they describe it as some elegant path of righteousness filled with rainbows and unicorns.
It's not that.
It's embarrassing.
It's humiliating.
It leaves this knot of resentment in the pit of your stomach.
And as you're traveling down this amazing high road, you see billboards of things you shoulda said and things you shoulda did.
You go over there and you look at the easy road, and they're chillin', not worried about a thing.
But I have to admit, the more I travel down this road, it does get a little easier.
Petty situations, they don't bother me as much.
I learn little nuggets here and there.
And as I continue down this path, there seem to be more opportunities waiting for me.
I have like-minded people who want to connect with me, projects that people want me on, leaders reaching out because they heard about me through someone else.
And the best part?
The need to even look at the easy road is no longer there.
Guys, we're not going to change the way adults act in the workplace.
We are not.
And for that reason, there will always be workplace drama.
But if we stick to these steps and put in the work that comes with it, we can learn to avoid it.
Guys, thank you for being my vent buddies.
(Laughter) And thank you so much for your time.
(Applause)