Director's Message

Twelve years ago, Bill Gates Sr. visited the Johns Hopkins Bloomberg School of Public Health (JHSPH), and in time that visit led to the birth of the Gates Institute. In 2008 he visited us again, and our network of individual and institutional partners had the opportunity to meet with him and hear the urgency in his messages about reproductive health and family planning. But the visit accomplished something else—it inspired us to reflect on the important ways in which our projects and collaborations intersect, and the ways in which our work extends into so many facets of discovery while creating “social vaccines.”
So, what is the thread that connects social vaccines, youth populations and national development?

Since our inception, the Institute’s motto has been “Scholarship and Science for Social Change.” When we talk about “change,” we talk about enduring change in scientific learning—the kind of change that results from wide-reaching scholarly efforts, the kind of change that comes on the heels of newly acquired knowledge and skills, the kind of change that empowers and protects. We all understand the concept of a vaccine: an injection of weakened viruses teaches or enables immune systems to form antibodies that inoculate the body against the disease. At the Institute, we work to deliver social vaccines. Instead of using syringes and pharmaceuticals, we use knowledge and information. The antibodies that we provide are cognitive and analytical skills, and self-reliance. This is how we inoculate individuals, families and communities from adverse outcomes such as poverty, unwanted pregnancy and poor reproductive health.

Social vaccines work best when the inoculation happens early in life. That’s why, when we “immunize” a community from the negative consequences of sexual and reproductive risks, we prioritize reaching youth in low-income settings. Nearly all sub-Saharan countries have young populations, with 40 percent of the total citizenry under the age of 15. But while other regions are experiencing population stabilization, Africa’s youth population is growing rapidly—in fact, it has yet to peak. High fertility drives this growth. And here’s where the concept of youth dependency burden becomes important. In developed nations, there are 3.9 adults for every young person under the age of 15. But in Ghana, for example, there are only 1.5 adults for every young person. With this kind of youth dependency burden, which is likely to prevail for extended periods of time, most African countries face significant challenges in meeting youths’ needs to acquire the knowledge and skills for socially and economically productive livelihoods. Healthy starts for today’s youth—through the widespread application of social vaccines—will positively shape their futures and those of generations following them. To build the base of knowledge for discovery of other social vaccines, the Gates Institute is working with partners around the world in organizing an international conference on youth development to be held in Abuja, Nigeria, in April 2008.

This brings us to the demographic dividend, which is the economic benefit gained by an increase in the ratio of working-age adults to young dependents. When fertility levels decline, the number of working-age adults begins to outnumber youth in the population. Under the right market and social conditions, this shifting balance can fuel economic growth through increased productivity, greater household savings and lower costs for basic social services. The burden of dependent youths on working-age adults is tremendous in Africa. That burden can be mitigated in the future by averting unwanted pregnancies, of which there are many in the continent. Family planning is the key to helping couples achieve their reproductive intentions. Yet there is a contraceptive gap in sub-Saharan Africa. One of every four couples seeks to space or end pregnancies but does not practice contraception. This gap is significant, and it has been systematically neglected. Protecting the preconceptional health of mothers who wish to space births and use contraception is an investment in individual and national development that warrants strong support by political leadership. Moreover, protecting the health and well-being of today’s youth as tomorrow’s adults is an immediate investment that neither society nor leadership can afford to ignore or delay. Youth will deliver our future.

Amy Ong Tsui
Professor and Director