To make real progress on the problems of the poorest, you need at least two ingredients: a deep understanding of the problems, and the technical ability to solve them.
In the United States, we have amazing technical capacity. We have the world’s top universities and great companies where researchers are working on new drugs and vaccines, new seeds, and other innovations. But we don’t have everyday experience with the problems of the poorest. We don’t see people living in extreme poverty next door or pass by them in a slum down the street.