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This quote from Bill Gates refers to his view that money spent on international aid and health interventions can very effectively save human lives at a relatively low cost. By “well-spent aid money,” Gates seems to mean funding for programs and initiatives that directly improve people’s health, such as vaccines, disease treatment, and medical resources.
The quote suggests that when aid money is targeted toward life-saving health interventions, the cost per life saved is often only a few thousand dollars. So Gates appears to be arguing that international aid for health is a worthwhile investment that can have a high return in terms of human lives improved and extended.