In his fifth annual letter (22 pages, HTML or PDF), Bill Gates, co-chair of the Bill & Melinda Gates Foundation, argues for setting clear goals and developing ways to measure progress toward improving the human condition. The letter also includes a sidebar by Melinda Gates, co-chair of the Gates Foundation, about initial challenges in obtaining baseline and historical data for a collaborative effort to expand access to contraceptives.

In the letter, Gates points to the United Nations Millennium Development Goals as an example of how setting clear and concrete goals can bring focus to high-priority efforts aimed at improving the lives of the world's poorest people. At the same time, Gates acknowledges the difficulty of measuring results accurately and creating an environment where problems, and what is and isn’t working, can be discussed openly. “[A]ny innovation — whether it's a new vaccine or an improved seed — can't have an impact unless it reaches the people who will benefit from it,” Gates writes. “[I]nnovations in measurement are critical to finding new, effective ways to deliver these tools and services to the clinics, family farms, and classrooms that need them.”

In the area of polio eradication, a top priority for the foundation, just three countries — Nigeria, Pakistan, and Afghanistan — have failed to eradicate the disease. Gates describes how in northern Nigeria, specially trained staff working independently of foundation-sponsored vaccination campaigns created more accurate maps by walking through every high-risk area and using high-resolution satellite images, enabling them to more efficiently identify unvaccinated children. The measurement systems put in place by the global polio eradication initiative “will be invaluable for other healthcare activities, including routine vaccination of infants,” Gates adds — activities that have far-reaching benefits beyond polio eradication.

Gates also makes the case for measurement in the field of education reform, based on the foundation’s Measures of Effective Teaching (MET) project, which concluded in a January 2013 report “that there were observable, repeatable, and verifiable ways of measuring teacher effectiveness,” including student surveys and reports by trained evaluators. “[T]he most critical change we can make in U.S. K-12 education is to create teacher feedback systems…that are properly funded, high quality, and trusted by teachers,” Gates writes. “These measurement systems need to provide teachers with the tools to help support their professional development. The lessons from these efforts will help us improve teacher education programs.”

In terms of the outlook for the next fifteen years, Gates lists two concerns: ongoing reductions in government assistance for international health and development projects, and challenges in aligning the international community around clear goals and efforts to help the world’s most vulnerable populations. While many developing countries are seeing economic growth, Gates argues, aid remains critical to innovation in delivering solutions. “[N]ow that we're more precisely measuring indicators like child mortality, people are able to see the impact aid has in stark terms — that it's the difference between putting people on HIV treatment or letting them die. When framed this way, aid has a better chance of becoming a priority for people.”