<i>By decreasing the amount of wealth that is necessary for a human person to remain alive - for example by introducing a new vaccine that allows a large (5+) family in unsanitary conditions to have all of their children reach adulthood - these sorts of programs in undeveloped countries actually create more poverty then they solve. There is not a cheap-manual labor shortage in these countries. There is however an acute shortage of well-paying jobs that don't involve corruption. By allowing the supply of just-surviving people to increase, you are putting even more downward pressure on the wages of unskilled labor (they are caught in the Iron Law of wages).</i><p>I refuse to believe that the loss of life is perferable than the preservation of life.  And quite frankly, arguments from classical economics seem rather cold given the subject matter.<p>The heart of your argument suggests that the political issues in these countries are the root of the problem.  This is correct.  However,  history shows us that the amount of money spent on politically bankrupt states has little or no impact on making them politically sound.  Gates money is useless on the third world political playing field; instead, Gates is choosing to spend it in an area which he can actually have an impact.<p>As far as domestic politics go, the positions you suggest that Gates take on "farm subsidies, fossil fuel subsidies, and the recreational diamond market" are all politically untenable at the moment.  It's not clear Gates could have an impact there either.