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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 tothe Internet today, if he has the curiosity

and an Internet connection, is as [empow380

ered] 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 dramaticallychange 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 refrigera

tion, 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.

"We're trying to accomplish two things with this program," explained Rick Klausner,

a former head of the National Cancer Institute who now runs the global health programs

for the Gates Foundation. "The first is [to make] a moral appeal to the scientific

imagination, [pointing out] that there are great problems to be solved that we, the

scientific community, have ignored, even though we pride ourselves in how

international weare. We have not taken our responsibilities as globalproblem solvers

as seriously as our self-identity as an international community. We wanted the Grand

Challenges to say these are the most exciting, sexy, scientific things that anyone

in the world could work on right now . . . The idea was to fire the imagination. The

second thing is to actually direct some of the foundation's resources to see if we

could do it."

Given the phenomenal advances in technology in the last twenty years, it is easy to

assume that we already have all the tools to address some of these challenges and

that the only thing lacking is money. I wish that were the case. But it is not. In

the instance of malaria, for example, it isn't just the drugs that are missing. As

anyone who has visited Africa or rural India knows, the health-care systems in these

areas are often broken or functioning at a very low level. So the Gates Foundation

is trying to stimulate the development of drugs and delivery systems that presume

a broken health-care system and therefore can be safely self-administered by ordinary

people in the field. That may be the grandest challenge of all: to use the tools of

the flat world to design tools that work in an unflat world. "The most important

health-care system in the world is a mother,"

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said Klausner. "How do you get things in her hands that she understands and can afford

and can use?"

The tragedy of all these people is really a dual tragedy, added Klausner. There is

the individual tragedy of facing a death sentence from disease or a life sentence

of broken families and limited expectations. And there is the tragedy for the world

because of the incredible lost contribution that all these people still outside the

flat world could be making. In a flat world, where we are connecting all the knowledge

pools together, imagine what knowledge those people could bring to science or

education. In a flat world, where innovation can come from anywhere, we are letting

a huge pool of potential contributors and collaborators slip under the waves. There

is no question that poverty causes ill health, but ill health also traps people in

poverty, which in turn weakens them and keeps them from grasping the first rung of

the ladder to middle-class hope. Until and unless we can meet some of these grand

challenges, much of that 50 percent of the world that is still not flat will stay

that way-no matter how flat the other 50 percent gets.

TOO DlSEMPOWERED

There's not just the flat world and the unflat world. Many people live in the twilight

zone between the two. Among these are the people I call the too disempowered. They

are a large group of people who have not been fully encompassed by the flattening

of the world. Unlike the too sick, who have yet even to get a chance to step onto

the flat world, the too disempowered are people who you might say are half flat. They

are healthy people who live in countries with significant areas that have been

flattened but who don't have the tools or the skills or the infrastructure to

participate in any meaningful or sustained way. They have just enough information

to know that the world is flattening around them and that they aren't really getting

any of the benefits. Being flat is good but full of pressure, being unflat is awful

and full of pain, but being half flat has its own special anxiety. As exciting and

as visible as the flat

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Indian high-tech sector is, have no illusions: It accounts for 0.2 percent of

employment in India. Add those Indians involved in manufacturing for export, and you

get a total of 2 percent of employment in India.

The half flat are all those other hundreds of millions of people, particularly in

rural India, rural China, and rural Eastern Europe, who are close enough to see, touch,

and occasionally benefit from the flat world but who are not really living inside

it themselves. We saw how big and how angry this group can be in the spring of 2004

Indian national elections, in which the ruling BJP was surprisingly tossed out of

office-despite having overseen a surge in India's growth rate-largely because of the

discontent of rural Indian voters with the slow pace of globalization outside the

giant cities. These voters were not saying, "Stop the globalization train, we want

to get off." They were saying, "Stop the globalization train, we want to get on, but

someone needs to help us by building a better stepstool."

These rural voters-peasants and farmers, who form the bulk of India's population

just had to spend a day in any nearby big city to see the benefits of the flat world:

the cars, the houses, the educational opportunities. "Every time a villager watches

the community TV and sees an ad for soap or shampoo, what they notice are not the

soap and shampoo but the lifestyle of the people using them-the kind of motorbikes

they ride, their dress, and their homes," explained Indian-born Nayan Chanda, editor

of YaleGlobal Online. "They see a world they want access to. This election was about

envy and anger. It was a classic case of revolutions happening when things are getting

better but not fast enough for many people."

At the same time, these rural Indians understood, at gut level, exactly why it was

not happening for them: because local governments in India have become so eaten away

by corruption and mismanagement that they cannot deliver to the poor the schools and

infrastructure they need to get a fair share of the pie. As some of these millions

of Indians on the outside of the gated communities looking in lose hope, "they become

more religious, more tied to their caste/subcaste, more radical in their thinking,

more willing to snatch than create, [and] view dirty politics as being the only way

to get mobility, since economic mobility is stalled," said Vivek

Paul of Wipro. India can have the smartest high-tech vanguard in the world, but if

it does not find a way to bring along more of those who are unable, disabled,

undereducated, and underserved, it will be like a rocket that takes off but quickly

falls back to earth for lack of sustained thrust.

The Congress Party got the message, which was why as soon as it took office it chose

as its prime minister not some antiglobalizer but Manmohan Singh, the former Indian

finance minister, who in 1991 first opened the Indian economy to globalization,

placing an emphasis on exports and trade and reform wholesale. And Singh, in turn,

pledged himself to vastly increase government investments in rural infrastructure

and to bring more reform retail to rural government.

How can outsiders collaborate in this process? I think, first and foremost, they can

redefine the meaning of global populism. If populists really want to help the rural

poor, the way to do it is not by burning down McDonald's and shutting down the IMF

and trying to put up protectionist barriers that will unflatten the world. That will

help the rural poor not one iota. It has to be by refocusing the energies of the global

populist movement on how to improve local government, infrastructure, and education

in places like rural India and China, so the populations there can acquire the tools

to collaborate and participate in the flat world. Theglobal populist movement, better

known as the antiglobalization movement, has a great deal of energy, but up to now

it has been too divided and confused to effectively help the poor in any meaningful

or sustained manner. It needs a policy lobotomy. The world's poor do not resent the

rich anywhere nearly as much as the left-wing parties in the developed world imagine.

What they resent is not having any pathway to get rich and to join the flat world

and cross that line into the middle class that Jerry Yang spoke about.

Let's pause for a minute here and trace how the antiglobalization movement lost touch

with the true aspirations of the world's poor. The antiglobalization movement emerged

at the World Trade Organization conference in Seattle in 1999 and then spread around

the world in subsequent years, usually gathering to attack meetings of the World Bank,

the IMF, and the G-8 industrialized nations. From its origins, the movement that

emerged in Seattle was a primarily Western-driven phenome385

non, which was why you saw so few people of color in the crowds. It was driven by

five disparate forces. One was upper-middle-class American liberal guilt at the

incredible wealth and power that America had amassed in the wake of the fall of the

Berlin Wall and the dot-com boom. At the peak of the stock market boom,lots of pampered

American college kids, wearing their branded clothing, began to get interested in

sweatshops as a way of expiating their guilt. The second force driving it was a

rear-guard push by the Old Left-socialists, anarchists, and Trotskyites-in alliance

with protectionist trade unions. Their strategy was to piggyback on rising concerns

about globalization to bring back some form of socialism, even though these ideas

had been rejected as bankrupt by the very people in the former Soviet Empire and China

who had lived under them longest. (Now you know why there was no antiglobalization

movement tospeak of in Russia, China, or Eastern Europe.) These Old Left forces wanted

to spark a debate about whether we globalize. They claimed to speak in the name of

the Third World poor, but the bankrupt economic policies they advocated made them,