In the context of the Trolley Problem, one option is the reality of the present (X amount of lives saved due Gates' success / the foundation), the other option

In the context of the Trolley Problem, one option is the reality of the present (X amount of lives saved due Gates' success / the foundation), the other option is unknown - it may be Y lives saved. It is possible that this alternate reality might have a better outcome than the present. Can't say with any certainty but it is tempting to guess that X > Y