The World Is Flat (54 page)

But while I am a technological determinist, I am not a historical determinist. There is absolutely no guarantee that everyone will use these new technologies, or the triple convergence, for the benefit of themselves, their countries, or humanity. These are just technologies. Using them does not make you modern, smart, moral, wise, fair, or decent. It just makes you able to communicate, compete, and collaborate farther and faster. In the absence of a world-destabilizing war, every one of these technologies will become cheaper, lighter, smaller and more personal, mobile, digital, and virtual. Therefore, more and more people will find more and more ways to use them. We can only hope that more people in more places will use them to create, collaborate, and grow their living standards, not the opposite. But it doesn't have to happen. To put it another way, I don't know how the flattening of the world will come out.

Indeed, this is the point in the book where I have to make a confession: I know that the world is not flat.

Yes, you read me right: I know that the world is not flat. Don't worry. I know.

I am certain, though, that the world has been shrinking and flattening for some time now, and that process has quickened dramatically in recent years. Half the world today is directly or indirectly participating in the flattening process or feeling its effects. I have engaged in literary license in titling this book The World Is Flat to draw attention to this flattening and its quickening pace because I think it is the single most important trend in the world today.

But I am equally certain that it is not historically inevitable that the rest of the world will become flat or that the already flat parts of the world won't get unflattened by war, economic disruption, or politics. There are hundreds of millions of people on this planet who have been left behind by the flattening process or feel overwhelmed by it, and some of them have enough access to the flattening tools to use them against the system, not on its behalf. How the flattening could go wrong is the subject of this chapter, and I approach it by trying to answer the following questions: What are the biggest constituencies, forces, or problems impeding this flattening process, and how might we collaborate better to overcome them?

Too Sick

I once heard Jerry Yang, the cofounder of Yahoo!, quote a senior Chinese government official as saying, “Where people have hope, you have a middle class.” I think this is a very useful insight. The existence of large, stable middle classes around the world is crucial to geopolitical stability, but middle class is a state of mind, not a state of income. That's why a majority of Americans always describe themselves as “middle class,” even though by income statistics some of them wouldn't be considered as such. “Middle class” is another way of describing people who believe that they have a pathway out of poverty or lower-income status toward a higher standard of living and a better future for their kids. You can be in the middle class in your head whether you make $2 a day or $200, if you believe in social mobility-that your kids have a chance to live better than you do-and that hard work and playing by the rules of your society will get you where you want to go.

In many ways, the line between those who are in the flat world and those who are not is this line of hope. The good news in India and China and the countries of the former Soviet Empire today is that, with all their flaws and internal contradictions, these countries are now home to hundreds of millions of people who are hopeful enough to be middle class. The bad news in Africa today, as well as rural India, China, Latin America, and plenty of dark corners of the developed world, is that there are hundreds of millions of people who have no hope and therefore no chance of making it into the middle class. They have no hope for two reasons: Either they are too sick, or their local governments are too broken for them to believe they have a pathway forward.

The first group, those who are too sick, are those whose lives are stalked every day by HIV-AIDS, malaria, TB, and polio, and who do not even enjoy steady electricity or potable water. Many of these people live in shockingly close proximity with the flat world. While in Bangalore I visited an experimental school, Shanti Bhavan, or “Haven of Peace.” It is located near the village of Baliganapalli, in Tamil Nadu Province, about an hour's drive from downtown Bangalore's glass-and-steel high-tech centers-one of which is aptly called “The Golden Enclave.” On the drive there, the school's principal, Lalita Law, an intense, razor-sharp Indian Christian, explained to me, with barely controlled rage in her voice, that the school has 160 children, whose parents are all untouchables from the nearby village.

“These kids, their parents are ragpickers, coolies, and quarry laborers,” she said as we bounced along in a jeep on the potholed roads to the school. “They come from homes below the poverty line, and from the lowest caste, the untouchables, who are supposed to be fulfilling their destiny and left where they are. We get these children at ages four and five. They don't know what it is to have a drink of clean water. They are used to drinking filthy gutter water, if they are lucky enough to have a gutter near where they live. They have never seen a toilet, they don't have baths... They don't even have proper scraps of clothing. We have to start by socializing them. When we first get them they run out and urinate and defecate wherever they want. [At first] we don't make them sleep on beds, because it is a culture shock.”

I was typing frantically in the back of the jeep on my laptop to keep up with her scalding monologue about village life.

“This 'India Shining' thing [the slogan of the ruling Bharatiya Janata Party, BJP, in the 2004 election] irritates people like us,” she added. 'You have to come to the rural villages and see whether India is shining, and you look into a child's face and see whether India is shining. India is shining okay for the glossy magazines, but if you just go outside Bangalore you will see that everything about India shining is refuted... [In the villages] alcoholism is rife and female infanticide and crime are rising. You have to bribe to get electricity, water; you have to bribe the tax assessor to assess your home correctly. Yes, the middle and upper classes are taking off, but the 700 million who are left behind, all they see is gloom and darkness and despair. They are born to fulfill their destiny and have to live this way and die this way. The only thing that shines for them is the sun, and it is hot and unbearable and too many of them die of heatstroke.“ The only ”mouse“ these kids have ever encountered, she added, is not one that rests next to a computer but the real thing.

There are thousands of such villages in rural India, China, Africa, and Latin America. And that is why it is no wonder that children in the developing world-the unflat world-are ten times more likely to die of vaccine-preventable diseases than are children in the developed flat world. In the worst-affected regions of rural southern Africa, a full one-third of pregnant women are reportedly HIV-positive. The AIDS epidemic alone is enough to put a whole society into a tailspin: Many teachers in these African countries are now afflicted with AIDS, so they cannot teach, and young children, especially girls, have to drop out either because they must tend to sick and dying parents or because they have been orphaned by AIDS and cannot afford the school fees. And without education, young people cannot learn how to protect themselves from HIV-AIDS or other diseases, let alone acquire the life-advancing skills that enable women to gain greater control over their own bodies and sexual partners. The prospect of a full-blown AIDS epidemic in India and China, of the sort that has already debilitated southern Africa, remains very real, largely because only one-fifth of the people at risk for HIV worldwide have access to prevention services. Tens of millions of women who want and would benefit from family-planning resources don't have them for lack of local funding. You cannot drive economic growth in a place where 50 percent of the people are infected with malaria or half of the kids are malnourished or a third of the mothers are dying of AIDS.

There is no question that China and India are better off for having at least part of their population in the flat world. When societies begin to prosper, you get a virtuous cycle going: They begin to produce enough food for people to leave the land, the excess labor gets trained and educated, it begins working in services and industry; that leads to innovation and better education and universities, freer markets, economic growth and development, better infrastructure, fewer diseases, and slower population growth. It is that dynamic that is going on in parts of urban India and urban China today, enabling people to compete on a level playing field and attracting investment dollars by the billions.

But there are many, many others living outside this cycle. They live in villages or rural areas that only criminals would want to invest in, regions where violence, civil war, and disease compete with one another to see which can ravage the civilian population most. The world will be entirely flat only when all these people are brought into it. One of the few people with enough dollars to make a difference who has stepped up to this challenge is Microsoft chairman Bill Gates, whose $27 billion Bill and Melinda Gates Foundation has focused on this huge, disease-ravaged, opportunity-deprived population. I have been a critic of some of Microsoft's business practices over the years, and I do not regret one word I have written about some of its anticompetitive tactics. But I have been impressed by Gates's personal commitment of money and energy to address the unflat world. Both times I spoke to Gates, this is the subject he wanted to talk about most and addressed with the most passion.

“No one funds things for that other 3 billion,” said Gates. “Someone estimated that the cost of saving a life in the U.S. is $5 or $6 million- that is how much our society is willing to spend. You can save a life outside of the U.S. for less than $100. But how many people want to make that investment?

“If it was just a matter of time,” Gates continued, “you know, give it twenty or thirty years and the others will be there, then it would be great to declare that the whole world is flat. But the fact is, there is a trap that these 3 billion are caught in, and they may never get into the virtuous cycle of more education, more health, more capitalism, more rule of law, more wealth... I am worried that it could just be half the world that is flat and it stays that way.”

Take malaria, a disease caused by a parasite carried by mosquitoes. It is the greatest killer of mothers on the planet right now. While virtually no one dies of malaria today in the flat world, more than 1 million people die from this disease each year in the unflat world, about seven hundred thousand of them children, most of them in Africa. Deaths from malaria have actually doubled in the last twenty years because mosquitoes have become resistant to many antimalarial drugs, and commercial drug companies have not invested much in new antimalarial vaccines because they believe there is no profitable market for them. If this crisis were happening in a flat country, noted Gates, the system would work: Government would do what it needed to do to contain the disease, pharmaceutical companies would do what they needed to do to get the drugs to market, schools would educate young people about preventive measures, and the problem would be licked. “But this nice response works only when the people who have the problem also have some money,” said Gates. When the Gates Foundation issued a $50 million grant to combat malaria, he added, “people said we just doubled the amount of money [worldwide] going to fight malaria... When the people who have the need don't have the money, it takes outside groups and charities to get them to the point where the system can kick in for them.”

Up to now, though, argued Gates, “we have not given these people a chance [to be in the flat world]. The kid who is connected to the Internet today, if he has the curiosity and an Internet connection, is as [empowered] as me. But if he does not get the right nutrition, he will never play that game. Yes, the world is smaller, but do we really see the conditions that people live in? Isn't the world still really big enough that we don't see the real conditions that people live in, the kid whose life can be saved for $80?”

Let's stop here for a moment and imagine how beneficial it would be for the world, and for America, if rural China, India, and Africa were to grow into little Americas or European Unions in economic and opportunity terms. But the chances of their getting into such a virtuous cycle is tiny without a real humanitarian push by flat-world businesses, philanthropies, and governments to devote more resources to their problems. The only way out is through new ways of collaboration between the flat and unflat parts of the world.

In 2003, the Gates Foundation launched a project called Grand Challenges in Global Health. What I like about it is the way the Gates Foundation approached solving this problem. They didn't say, “We, the rich Western foundation, will now deliver you the solution,” and then issue instructions and write some checks. They said, “Let's collaborate horizontally on defining both the problem and the solutions-let's create value that way-and then [the foundation] will invest our money in the solutions we both define.” So the Gates Foundation placed ads on the Web and in more conventional channels across both the developed and the developing worlds, asking scientists to respond to one big question: What are the biggest problems that, if science attended to them and solved them, could most dramatically change the fate of the several billion people trapped in the vicious cycle of infant mortality, low life expectancy, and disease? The foundation got about eight thousand pages of ideas from hundreds of scientists from around the world, including Nobel laureates. It then culled through them and distilled them down to a list of fourteen Grand Challenges-challenges where a technological innovation could remove a critical barrier to the solving of an important health problem in the developing world. In the fall of 2003, it announced these fourteen Grand Challenges worldwide. They include the following: How to create effective single-dose vaccines that can be used soon after birth, how to prepare vaccines that do not require refrigeration, how to develop needle-free delivery systems for vaccines, how to better understand which immunological responses provide protective immunity, how to better control insects that transmit agents of disease, how to develop a genetic or chemical strategy to incapacitate a disease-transmitting insect population, how to create a full range of optimal bioavailable nutrients in a single staple plant species, and how to create immunological methods that can cure chronic infections. Within a year, the foundation received sixteen hundred proposals for ways to meet these challenges from scientists in seventy-five countries, and the foundation is now in the process of funding the best proposals with $250 million in cash.