One of the most fascinating profiles I've read this year is the Melinda Gates cover story from Fortune. She's here at Walt and Kara's All Things D Conference to talk about The Bill and Melinda Gates Foundation, where Bill will be directing most of his energy come July. Although this is not directly gadget related, I'm excited to hear how Microsofties make philanthropy happen in their own way.


Mossberg asks what's the difference between your work here and at Microsoft?
Melinda says that there's a lot of crossover because of advances in tech that aren't available to the developing worlds. The skill set is very transferable.
Mossberg: What's the difference between your Foundation and others like it? More money?
Melinda Gates: We can take risks. There's a market failure for malaria vaccines, so no one's done anything on this in a while. (There's a traveler's market only.) But we can take on some of that risk and work with the pharmaceutical companies and then distribute through government. We can show them that there is a market.

Melinda says they could tap their entire budget by attempting to fix the problems in the education system alone. Their mission is more to help take on that risk that governments can't in fixing problems.

Mossberg: How do you work with countries with governments that are more part of the problem (corrupt, poor) than part of the solution?

Mossberg: Are you applying business principles? More organized than others?
Melinda Gates: We take a very economic and business approach, which doesn't mean we don't pay attention to the social issues.


(Bill and Melinda go through a list of diseases and evaluate where they can be most effective.)

Mossberg: Do people tell you how to spend the money?
Bill carried around a letter in his briefcase for a month about a kid who needed a new liver. It's hard, but we try to treat all lives with equal value. And the world does not do that. So with that in mind, it's easier to focus on that.


Melinda: Why does it take 25 years to put a vaccine's technology in Bangladesh compared to here, today?
There's no world fund for getting doses to the developing world. There's a lot of infrastructure problems. And we've been adding new vaccines like tetanus and hepatitis. Several million kids die from measles a year, and now it's less than 300k. (From the vaccines they've helped get out there.)


Bill and Melinda don't want to do the day-to-day stuff, but they've had a lot of help from people like Bill Gates Senior. She spends a lot of time setting strategy with Bill Junior.

Mossberg: Will having Bill around in 30 days full-time be annoying? (Jokingly.)
Melinda: I knew that Bill wouldn't wear a tool belt around the house when he retired. He'll take a sabbatical this summer, he'll spend a day on special projects at Microsoft that Ballmer wants him to work on and 2-3 days at the foundation a week. And some time being curious and learning about science, education, etc. We love working on the foundation together and not many days go by at home that we don't talk about this. Vacations are huge for talking about the foundation, too.


Re: education, the US loses a million or so as drop-outs. The foundation worked on data measurement. For example, that million only counts senior-year drop-outs, while it should be measured from freshman year. The other problem is that many graduates aren't ready for college.

Walt sends his kids to public school. It's fine, but maybe that's because of the affluent area.


Melinda: The top 10% of the kids do well in whatever school. The schools track them into their own curriculum. Those parents fight the change and ignore the remainder of the kids. There are parents who demand a better system, but they get no traction because the money is going in the wrong direction. One of the things they learned is that you can't just get a good urban school started without working with the city, district and state because the system will just pull it back down. (You can see how these successful people in tech have started applying similarly huge scale system thinking to the education and healthcare system problems —B.L.)

They are focusing in NY with Bloomberg and Joe Klein (who formerly led the case against Microsoft as a monopoly, I believe). Because they're willing to be bold and think of things in a business-minded way and shut down schools that don't work and rethink labor incentives. The best teachers are currently not treated well in the current school system.


They can't change the minds here and make it change long term. They focus on changing the system, so the negotiation can't happen at the labor level, but has to be at the district level.

Question from the crowd: What's the time frame?
Melinda: We take this lesson from Microsoft: a long-term approach. We're saving lives today, but we have a long horizon. Once we get an HIV vaccine, we'll try to distribute. Why not a 200-year perspective on helping the world? They believe that the wealth Bill and Melinda have will be gone in 50 years or so. And Warren Buffet stipulates in his will that 10 years after his death his money needs to be spent out. That's so that they can give back to people now.

We're working on banking for people who live on less than $2 a day. As tech goes cheaper, this stuff will make a huge difference in the world.


Question from the crowd: How do you deal with violence in schools going from students to teachers?
Melinda says that comes from facelessness in big schools. She's seen schools with three cop cars in front and two metal detectors. You can see the gangs going through schools and once the teachers recognize the kids, the kids act a lot better. Once the teachers know the kids' names, these things fall into place. She's seen schools that have fixed this in NY be able to lose their metal detectors, and graduation rates go up profoundly (up to 78%).

[All Things D]


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