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  • Chris Anderson: So, this is an

  • On the basis that a picture

  • what I did was, I asked Bill and Melinda

  • to dig out from their archive

  • some images that would help explain

  • some of what they've done,

  • and do a few things that way.

  • So, we're going to start here.

  • Melinda, when and where was this,

  • and who is that handsome man next to you?

  • Melinda Gates: With those big glasses, huh?

  • This is in Africa, our very first trip,

  • the first time either of us had ever been to Africa,

  • in the fall of 1993.

  • We were already engaged to be married.

  • We married a few months later,

  • and this was the trip where we really went to see

  • the animals and to see the savanna.

  • It was incredible. Bill had never taken that much time

  • off from work.

  • But what really touched us, actually, were the people,

  • and the extreme poverty.

  • We started asking ourselves questions.

  • Does it have to be like this?

  • And at the end of the trip,

  • we went out to Zanzibar,

  • and took some time to walk on the beach,

  • which is something we had done a lot

  • while we were dating.

  • And we'd already been talking about during that time

  • that the wealth that had come from Microsoft

  • would be given back to society,

  • but it was really on that beach walk

  • that we started to talk about, well,

  • what might we do and how might we go about it?

  • CA: So, given that this vacation

  • led to the creation of

  • the world's biggest private foundation,

  • it's pretty expensive as vacations go. (Laughter)

  • MG: I guess so. We enjoyed it.

  • CA: Which of you was the key instigator here,

  • or was it symmetrical?

  • Bill Gates: Well, I think we were excited

  • that there'd be a phase of our life

  • where we'd get to work together

  • and figure out how to give this money back.

  • At this stage, we were talking about the poorest,

  • and could you have a big impact on them?

  • Were there things that weren't being done?

  • There was a lot we didn't know.

  • Our naïveté is pretty incredible,

  • when we look back on it.

  • But we had a certain enthusiasm

  • that that would be the phase,

  • the post-Microsoft phase

  • would be our philanthropy.

  • MG: Which Bill always thought was going to come

  • after he was 60,

  • so he hasn't quite hit 60 yet,

  • so some things change along the way.

  • CA: So it started there, but it got accelerated.

  • So that was '93, and it was '97, really,

  • before the foundation itself started.

  • MA: Yeah, in '97, we read an article

  • about diarrheal diseases killing

  • and we kept saying to ourselves,

  • "Well that can't be.

  • In the U.S., you just go down to the drug store."

  • And so we started gathering scientists

  • and started learning about population,

  • learning about vaccines,

  • learning about what had worked and what had failed,

  • and that's really when we got going,

  • was in late 1998, 1999.

  • CA: So, you've got a big pot of money

  • and a world full of so many different issues.

  • How on Earth do you decide what to focus on?

  • BG: Well, we decided that we'd pick two causes,

  • whatever the biggest inequity was globally,

  • and there we looked at children dying,

  • children not having enough nutrition to ever develop,

  • and countries that were really stuck,

  • because with that level of death,

  • and parents would have so many kids

  • that they'd get huge population growth,

  • and that the kids were so sick

  • that they really couldn't be educated

  • and lift themselves up.

  • So that was our global thing,

  • and then in the U.S.,

  • both of us have had amazing educations,

  • and we saw that as the way that the U.S.

  • could live up to its promise of equal opportunity

  • is by having a phenomenal education system,

  • and the more we learned, the more we realized

  • we're not really fulfilling that promise.

  • And so we picked those two things,

  • and everything the foundation does

  • is focused there.

  • CA: So, I asked each of you to pick an image

  • that you like that illustrates your work,

  • and Melinda, this is what you picked.

  • What's this about?

  • MG: So I, one of the things I love to do when I travel

  • is to go out to the rural areas and talk to the women,

  • whether it's Bangladesh, India,

  • and I go in as a Western woman without a name.

  • I don't tell them who I am. Pair of khakis.

  • And I kept hearing from women,

  • over and over and over, the more I traveled,

  • "I want to be able to use this shot."

  • I would be there to talk to them

  • and they would bring the conversation around to

  • "But what about the shot I get?"

  • which is an injection they were

  • which is a contraceptive.

  • And I would come back and

  • and they'd say, "Oh no, contraceptives

  • are stocked in in the developing world."

  • Well, you had to dig deeper into the reports,

  • and this is what the team came to me with,

  • which is, to have the number one thing

  • that women tell you in Africa they want to use

  • stocked out more than 200 days a year

  • explains why women were saying to me,

  • "I walked 10 kilometers without

  • and I got to the clinic, and there was nothing there."

  • And so condoms were stocked in in Africa

  • because of all the AIDS work that the U.S.

  • and others supported.

  • But women will tell you over and over again,

  • "I can't negotiate a condom with my husband.

  • I'm either suggesting he has AIDS or I have AIDS,

  • and I need that tool because then I can space

  • the births of my children, and I can feed them

  • and have a chance of educating them."

  • CA: Melinda, you're Roman Catholic,

  • and you've often been embroiled

  • in controversy over this issue,

  • and on the abortion question,

  • on both sides, really.

  • How do you navigate that?

  • MG: Yeah, so I think that's a really important point,

  • which is, we had backed away from contraceptives

  • as a global community.

  • We knew that 210 million women

  • were saying they wanted access to contraceptives,

  • even the contraceptives we have

  • and we weren't providing them

  • because of the political controversy in our country,

  • and to me that was just a crime,

  • and I kept looking around trying to find the person

  • that would get this back on the global stage,

  • and I finally realized I just had to do it.

  • And even though I'm Catholic,

  • I believe in contraceptives

  • just like most of the Catholic

  • who report using contraceptives,

  • and I shouldn't let that controversy

  • be the thing that holds us back.

  • We used to have consensus in the United States

  • around contraceptives,

  • and so we got back to that global consensus,

  • and actually raised 2.6 billion dollars

  • around exactly this issue for women.

  • (Applause)

  • CA: Bill, this is your graph. What's this about?

  • BG: Well, my graph has numbers on it.

  • (Laughter)

  • I really like this graph.

  • This is the number of children

  • who die before the age of five every year.

  • And what you find is really

  • a phenomenal success story

  • which is not widely known,

  • that we are making incredible progress.

  • We go from 20 million

  • not long after I was born

  • to now we're down to about six million.

  • So this is a story

  • largely of vaccines.

  • Smallpox was killing a couple million kids a year.

  • That was eradicated, so that got down to zero.

  • Measles was killing a couple million a year.

  • That's down to a few hundred thousand.

  • Anyway, this is a chart

  • where you want to get that number to continue,

  • and it's going to be possible,

  • using the science of new vaccines,

  • getting the vaccines out to kids.

  • We can actually accelerate the progress.

  • The last decade,

  • that number has dropped faster

  • than ever in history,

  • and so I just love the fact that

  • you can say, okay, if we can invent new vaccines,

  • we can get them out there,

  • use the very latest understanding of these things,

  • and get the delivery right, that

  • CA: I mean, you do the math on this,

  • and it works out, I think, literally

  • to thousands of kids' lives saved every day

  • compared to the prior year.

  • It's not reported.

  • An airliner with 200-plus deaths

  • is a far, far bigger story than that.

  • Does that drive you crazy?

  • BG: Yeah, because it's a silent thing going on.

  • It's a kid, one kid at a time.

  • Ninety-eight percent of this

  • has nothing to do with natural disasters,

  • and yet, people's charity,

  • when they see a natural disaster, are wonderful.

  • It's incredible how people think, okay,

  • that could be me, and the money flows.

  • These causes have been a bit invisible.

  • Now that the Millennium Development Goals

  • and various things are getting out there,

  • we are seeing some increased generosity,

  • so the goal is to get this well below a million,

  • which should be possible in our lifetime.

  • CA: Maybe it needed someone

  • who is turned on by numbers and graphs

  • rather than just the big, sad face

  • to get engaged.

  • I mean, you've used it in your letter this year,

  • you used basically this argument to say that aid,

  • contrary to the current meme

  • that aid is kind of worthless and broken,

  • that actually it has been effective.

  • BG: Yeah, well people can take,

  • there is some aid that was well-meaning

  • and didn't go well.

  • There's some venture capital investments

  • that were well-meaning and didn't go well.

  • You shouldn't just say, okay, because of that,

  • because we don't have a perfect record,

  • this is a bad endeavor.

  • You should look at, what was your goal?

  • How are you trying to uplift nutrition

  • and survival and literacy

  • so these countries can take care of themselves,

  • and say wow, this is going well,

  • and be smarter.

  • We can spend aid smarter.

  • It is not all a panacea.

  • We can do better than venture capital, I think,

  • including big hits like this.

  • CA: Traditional wisdom is that

  • it's pretty hard for married couples to work together.

  • How have you guys managed it?

  • MG: Yeah, I've had a lot of women say to me,

  • "I really don't think I could work with my husband.

  • That just wouldn't work out."

  • You know, we enjoy it, and we don't --

  • this foundation has been a coming to for both of us