Raj Shah is the President of the Rockefeller Foundation and the author of a new book called Big Bets: How Large-Scale Change Really Happens. Dr. Shah has been part of big bets for 25 years, vaccinating nearly a billion children, helping countries fight Ebola and COVID, and now working to connect one billion people to electricity for the first time. Big Bets is a playbook for big change, full of inspiring stories and practical information you can use to achieve great things.
Doug Hattaway sat down with Raj Shah to talk about Shah’s book Big Bets, which explores the concept of making significant, transformative efforts to address global challenges rather than settling for incremental improvements. Shah shares examples from the book, including the global efforts to vaccinate children, fight hunger, and contain pandemics, emphasizing that such ambitious endeavors are achievable and crucial for social impact.
This conversation was edited for clarity and brevity.
Content Warning: This conversation mentions female genital mutilation.
Doug Hattaway: Raj, congratulations on the book. It’s really got a lot of insights and inspiration for people who want to make change in the world, and that’s what our listeners are all about. Thanks for joining us.
Raj Shah: Thank you, Doug. It’s great to be with you.
Doug: Let’s dive into it. It’s called Big Bets. What’s a big bet? How do you define that, and what’s an example from the book?
Raj: Well, big bets are our efforts to solve and not just make incremental improvements on some big challenges we face at home and around the world. I wrote the book because I think there’s so much negativity out there, and it convinces people that we can’t do these big things on behalf of social impact.
Can we vaccinate every child on the planet and reduce child mortality significantly? Can we fight hunger at scale and help hundreds of millions of people no longer be hungry? Can we fight pandemics and keep them contained before they spread into global catastrophes like COVID that disrupt entire societies and cause tens of millions of deaths?
I wrote the book because I believe the answer to all those is, We can. All three of those examples, we did, and they’re in the book, and they are big bets. They are efforts to actually tackle at scale some tough social impact problems.
Doug: Let’s dig into one of those. What’s a good example from the book that has lessons for folks?
Raj: Well, the effort to really immunize children around the world was—if I’m being honest—was how I learned about big bets. This was not necessarily a big bet I was in charge of. Bill and Melinda Gates had made a big bet after they read an article in 1999 that said that 600,000 kids would die of rotavirus, and those kids would be in mostly developing, low-income, and poor countries.
Actually, Merck was getting ready to roll out a vaccine in the United States, but no kids died of rotavirus in the United States, and when they learned that that vaccine wouldn’t be available to kids who were actually at risk of suffering and losing their life, they said, Well, this isn’t right. What would it take to make sure every child across this planet could be saved from a vaccine-preventable disease and a childhood death?
Over the next 20 years, we all collaborated around that with thousands of partners globally and achieved some amazing outcomes in protecting children from simple diseases.
Doug: Now, I know a lot of folks reading would say, well, when you’re Bill and Melinda Gates, you can afford to think big. One of your points is that you don’t have to be a billionaire or president to have what you call a big bet mindset. Tell us about that. What’s a big bet mindset?
Raj: Well, if I take that same example, to me the big bet mindset is saying, What would it take to vaccinate every child across the planet, as opposed to, how can we use this amount of money we might have to do a little bit of good right now? What I learned from working with Bill and Melinda in those days was the power of a simple question.
Bill would ask the question, What does it cost to vaccinate a single child? A lot of experts would say, well, you can’t answer that question so easily because it’s complicated. It’s always complicated to understand how human resources, how cold chains and refrigeration, whether countries had road infrastructure and the ability to deliver vaccines to communities in need, how all of that adds complexity, and that makes it hard to answer the question.
But he kept asking that simple question because he understood that if we could answer it, we would be able to identify how much resourcing was needed to vaccinate every child on the planet. Even though that was far in excess of the resources the [Bill & Melinda Gates] Foundation had at its disposal, it was a roadmap for the world to solve a big problem. Those roadmaps are necessary.
Doug: Yeah, it’s a good example, too, of how solving big problems usually takes systemic thinking. You have to think of all those aspects, like you said: the road infrastructure, the refrigeration technology, that thing. But a simple question, you said, is the technique to unpack all that complexity.
Raj: I learned that technique and used it time and again when I was at USAID [United States Agency for International Development] and led the Haiti earthquake response. The simple question was, Who’s in need, and what percentage of that need are we meeting today? Instead of saying, well, We’re feeding two million people in Port-au-Prince, you would say, Well, there are three and a half million people in Port-au-Prince who need emergency feeding, and we’re reaching 60% of that cohort. It’s a different way of thinking about what you’re trying to do. It’s not being satisfied with the data point, but rather asking yourself, What does it take to actually reach everybody?
Doug: Why do you think people are hesitant? What gets in the way of this thinking?
Raj: Well, in the book, I call it “the aspiration trap.” I feel like we’re so inundated with excuses, with reasons why our politics are too shattered, our institutions are too untrustworthy, our corporate leaders are too greedy. Whatever the excuse is, we read all day about reasons why something is unattainable, when in reality, these problems are, in fact, solvable. One of the chapters in the book is about the food crisis that happened in the aftermath of the 2008 financial crisis, and more than 100 million people were pushed back into a condition of hunger and malnutrition. It led to 47 episodes of political violence and upheaval around the world.
President Obama launched a big bet to fight hunger and to make sure that we revitalized agriculture in dozens of vulnerable communities to prevent hunger in the first place. That succeeded over time, but it succeeded because they aimed high. They said, the goal is to not allow this financial crisis to cause decades of downward pressure on the human development aspirations of vulnerable people.
Doug: You’re encouraging people to set big aspirational goals and not get trapped—fall in the aspiration trap—which is all the reason you might not be able to accomplish those goals.
Raj: Frankly, when you start buying into all those reasons, it’s also an excuse for inaction. One of my favorite examples, something the [Rockefeller] Foundation is working on right now and has for the last five or six years, is just child poverty in the U.S. One-quarter of all American kids are growing up in poverty.
If you ask people, they will say, Gosh, that’s too bad, but it’s a really complex issue. It’s got racial overtones and community equity issues, and the job market, and the economy. In reality, we saw in the last few years that one simple affordable policy, the refundable child tax credit, cut child poverty in America in half, virtually overnight. It was extraordinarily efficient and successful and could have been made permanent. It wasn’t politically made permanent, but we worked to build the political support to do that because we know that it would wipe out 50% of child poverty. These are solvable problems if we can overcome the natural instinct to wash our hands of responsibility.
Doug: I was going to ask: You talk in the book about lots of benefits to going big. What are those benefits to going big?
Raj: Well, I led USAID for a number of years, and I found that when we did small, incremental things, it was just as hard to secure the imaginations and commitments of partners in the private sector or on the other side of the political aisle. When we made big aspirational bets, we could tap into people’s hopes and dreams in a way that’s a little bit different.
I’ll give you one example. We at the [Rockefeller] Foundation have had a program that has worked on bringing renewable energy solutions to the billion people on Earth who live in the dark, without electricity. It’s called Energy Poverty, and it’s consuming less electricity than it takes to light one light bulb and to have a single household appliance per person per year.
We’ve been pioneering these solutions for a long time, and we finally started to find that these things could work at scale, mostly these solar mini-grids that we’re rolling out across India, the DRC [Democratic Republic of the Congo], Nigeria, and Ethiopia. Once we started to imagine a much greater scale and saying, Instead of reaching a few hundred thousand people in India, we actually think we can reach a few hundred million people across the planet, we were able to attract partners who said, Hey, that’s exciting. That’s something I want to be a part of because it’s big and it’s bold.
We put in $500 million, but so did the IKEA Foundation, the Bezos Earth Fund; two dozen other partners have now collaborated to create the Global Energy Alliance with $11 billion plus, doing this in 20 countries around the planet already. That’s the momentum you can get when you aim high and are willing to be bold in your aspirations.
Doug: People are more excited and intrigued to get involved in big bets. That’s interesting. We’ve been talking about big bets, global scale, and big resources. But I want to come back to this theme of “anyone can think this way.” Are there folks in the book who have a big bet mindset but are not billionaires or the president?
Raj: Absolutely. One of my favorite stories in the book is about a woman named Molly Melching. Molly grew up in Seattle, ended up as a student and then graduate student in West Africa. She started traveling in rural communities in West Africa and learned that a lot of the girls there were subject to a practice called female genital cutting. In addition to violating these girls, it was a horrific practice that really changed their life trajectories.
They’d drop out of school and all these things that would hold back entire societies. She started going to tribal leaders in village after village. She built a movement to protect the dignity and human rights of young girls and to end the practice of female genital cutting but also to invest in education for girls, to make sure girls were immunized against polio and other diseases that were pretty debilitating in that geography.
Over time, millions and millions of girls are leading much more whole, much more aspirational lives because of Molly’s big bet that she could change the mindsets of the communities in which these girls were growing up. I think she’s a wonderful example. I write about learning from her on trips to Senegal early in my career.
I think there’s so much to that story. That’s a big bet anchored in local ideas and local solutions. It’s a big bet carried out by someone who’s not famous, should be famous in my mind, but is not Barack Obama or Hillary Clinton or Melinda Gates. People like Molly are the real heroes in the book.
Doug: You’ve touched on a few of the lessons from the book Thinking Big, The Big Aspirational Goal, while asking the simple pointed question again and again, obviously working in partnership. What are some other important takeaways from the book?
Raj: Well, one of the big lessons in my mind is called “keep experimenting.” I wrote about it in the context of the 2014 response to the Ebola crisis because during that crisis, the Centers for Disease Control had estimated that 1.6 million people would get Ebola and that it would spread widely around the world.
President Obama made a big bet to deploy—for the first time in America’s history—our troops into West Africa to help create conditions so that humanitarian actors could enter and together we could resolve Ebola in that setting. Over time, there were only 30,000 cases; 11,000 deaths; and only 2 cases in the United States, but neither resulted from transmission within our nation.
That was a big bet that worked. But when the president made that judgment that he was going to deploy our troops, we actually didn’t know exactly which interventions would stop transmission of this horrific disease. Ebola is a hemorrhagic fever. People would bleed to death in front of others in their communities, on the streets. It was really unimaginable. At the time of our deployment, the mortality rate was 70%, so if you got Ebola, there was a 70% chance you were going to die, which is extraordinary.
In that setting, the thing the troops were actually sent to do was to build these big Ebola treatment units. It turned out people wouldn’t go to them because if you went into one of those units, you never came out, your possessions never came out, your ashes didn’t even come out. Naturally, people wouldn’t go.
Instead, what we learned was that local communities had constructed a solution, which was removing the bodies of deceased family members using a World Health Organization protocol, without washing and redressing and honoring those individuals, which had been the custom. The burial teams that we created, based on that insight, ultimately reduced more than 70% of the transmission much faster than anyone expected. I write in the book about how you keep an open mind and put a data infrastructure in place so that you can experiment even in the midst of a really intense crisis and always search for better solutions to problems, more innovation and more solutions, so you can have a better outcome.
Doug: That was a great example of a big bet’s preventing a big problem. What’s another example from the book that really inspires you and provides another lesson?
Raj: Well, so one of those examples is how big bets start with fresh, innovative solutions like those burial teams, in that case in rural Liberia. But they also require truly unlikely partners to come together, hold hands, and do extraordinary things. I write in the book about building that unlikely partnership between Democrats and very conservative Republicans in our fight to expand the global fight against hunger during the Obama Administration.
I talk in the book about a lesson that I call “make it personal” because I learned the hard way that just having data, information, numbers, and spreadsheets might be compelling to some types of people—and I’m one of them—but it wasn’t really compelling to everybody. I had actually gone up to Capitol Hill and testified about the impact of a Republican budget on our global health programs.
I said 70,000 kids would die as a result of these draconian Republican budget cuts. While I was congratulated by some on the Left, I quickly got a phone call that informed me that Speaker Boehner, at the time the Speaker of the House, was upset with my language. He felt it was disrespectful and asked to see me.
I went, and I saw the speaker, and I apologized. He gave me a list of Republicans to see and get to know. The message was, if you get to know these people personally, and you understand their values, more of them will support this global humanitarian mission than you think is true right now. That proved to be correct. There’s a strong faith-based, conservative Republican support for America’s global humanitarian activities.
I met senators, and I prayed with them. We talked about our families. We traveled together. Those personal relationships at the end of the day really helped codify the Global Food Security Act into law. I think it saved a lot of lives, and even more important, it’s maintained America’s role long after I left government and long after President Obama left government, as the world’s humanitarian leader.
Doug: When we started talking, you mentioned you wrote the book because people hear so much about the problems in the world that they are demotivated to address them. We also hear so much about the divisions, which are real, obviously, in our politics, but that doesn’t mean they can’t be transcended to get things done.
Raj: Unfortunately, bipartisan consensus doesn’t really make news in the same way. But to me, that’s inspiring. But it’s exciting. It shows that people can come together and solve problems even when it’s tough. I think that’s true even today with our really deeply fractured politics.
Doug: What’s a big bet you’re working on now that has inspired you?
Raj: Well, our biggest bet is an effort to use the renewable energy technology sector to help both fight climate change and address global poverty. In addition to the reality that almost a billion people live in energy poverty, the other fact most people don’t know is that within two decades, 75% of all greenhouse gasses will come from what we today call developing and emerging economies.
Those 80 countries are today receiving almost no meaningful financing to support a meaningful strategy of reducing their carbon emissions, while in richer countries like the United States, and in China and Europe, we’re pouring trillions of dollars into reshaping and greening our economies.
Our effort is to make sure that those 80 countries can access the batteries, the solar panels, the micro-hydro technologies, and someday the small modular nuclear technologies that will be a big part of ensuring that we have a truly green global economy. If we can achieve that together, we’ll transform the fight against climate change, we’ll move hundreds of millions of people out of poverty, and it would be an extraordinary big bet and success story.
Doug: Yeah, that’s an exciting one. Let’s unpack your method from the book, some of the lessons and methods through this example. You have an ambitious, audacious, inspiring goal.
Raj: Yeah, that’s where it starts. Then we spent years and years seeing if there were new solutions to old problems. The traditional way of bringing electricity to communities that didn’t have it was to build big coal plants, connect it to grids, let the governments run those grids through public utilities, and see how you do.
The truth is, in most developing economies, that strategy has been a terrible one at providing reliable, low-cost power and at reaching low-income communities, whether they’re in urban slums or rural areas. It was really the work we did over years creating these new solar mini-grids using artificial intelligence to manage battery management, and energy management systems from afar, so you had fewer personnel costs baked into the research. It was through inventing with partners these smart meters that allowed customers to pay for only the power they used and to do it on their mobile phones, and then looking at new battery technologies to figure out what would most durably reduce the cost.
We got the costs down from around $1.20 a kilowatt per hour to just under 20 cents a kilowatt per hour, at which price point this is the best, least-cost electrification strategy for hundreds of millions of people who live in the dark.
That’s step one. Step two was finding partners that could help us scale. In our case, that started with a major public-private partnership between the Rockefeller Foundation and Tata Power, India’s largest power company. They are now building out 10,000 of these mini-grids to reach 25 million people. But it’s expanded with all these other company and public-private partnerships.
In Goma, in Eastern Congo, we just announced efforts to build out electrification there. In Nigeria, they’re building 10,000 of these grids. In Ethiopia, they’re connecting the grids to irrigation to improve agricultural production and food availability. It’s very exciting. But those partnerships are what makes it go.
Then the final component of a big bet is being able to measure results and be true to whether you’re succeeding or not. Something like electricity can be measured because you can track how much power a community consumes. You can evaluate how many customers you’re reaching. You can survey customers and find out whether their incomes are going up, they’re creating jobs, and their families are moving up or whether it’s not such a good deal for them. What we found is, almost without fail, when these systems roll out in communities, girls are studying at night in schools that stay open later than they otherwise would.
Families are using it for agricultural processing equipment and post-harvest processing. The women buy sewing machines and start small tailoring businesses, and all of that results in more income, more empowerment for girls, more safety with public lighting, and a better trajectory forward for an entire community.
Doug: Well, you make it sound doable. I love the way you talk about these complex problems. You’re breaking down the complex problems, which can be daunting, into their solvable components.
Raj: Yeah, and look, they’re still complex. In the book, I come back to the idea that it’s not that the problems are not complex. But if we fixate on the complexity, we end up in the aspiration trap, and we believe that we can’t solve these problems. Instead, if we focus on the solutions, over time, you can see a path forward.
There are plenty of super complex issues with our energy effort, including how you structure a financial solution to shut down a coal plant and invest in solar on that site to transition the source of generated electricity. That’s actually a deeply complicated thing to do. But we did it once in South Africa, now we’re doing it again in Indonesia, and we’ll do it again in Vietnam. Once people see that solutions exist, they believe big bets are possible, and they, in their hearts, believe that it’s realistic to be optimistic about solving these problems.
Doug: That’s awesome. Let’s close on a word of advice you might have for somebody who’s been reading. What would be a word of advice to get them going? What might be a first step they could take?
Raj: I’d say two things. The first is, I do think anyone can contribute to this type of work and this mission. It starts with just learning about these issues. Whatever area you’re passionate about. It could be fighting climate change. It could be addressing inequality. It could be working on racial injustice. Learning enough to be able to know how to use this methodology in that case is a big part of success. That’s one answer to that question.
The second is perhaps more fun, which is, I benefited a lot because I got to work with people I learned from all along the way. I think finding—as you make decisions about your career and the projects you take on—thinking hard about the people you’re going to work with and whether you’re going to learn from them ways that expand your thinking, that grow your leadership, and that give you more confidence to be someone who can make big bets, that’s been very important to me.
I wish someone had told me a long time ago that decades into your career, it’s like, that’s the thing you’ll cherish most, is the people you got to work with and the people you were able to learn from. That would have been helpful to know earlier. I would share that as well.
Doug: Absolutely, and I can recommend that folks pick up the book, Big Bets, full of insights, inspiration, practical tips. Raj Shah, thanks for all the great work you do. Thanks for joining us.
Raj: Thank you, Doug. Great to be here, and thanks for all you’re doing.
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