3 tough questions we get asked

A decade ago, we started a new annual tradition: sitting down to write a letter about our work in philanthropy. We got the idea from our dear friend Warren Buffett, who’s been writing brilliant reports to the shareholders of Berkshire Hathaway for more than half a century.

This year we’re marking our 10^th letter by answering 10 tough questions about our work that people often ask us. Here are excerpts from three of them. You can read the rest at gatesletter.com.

Why do you work with corporations?

Melinda: We work with companies like GSK and Johnson & Johnson because they can do things no one else can.

Take the example of developing new diagnostics, drugs, and vaccines for diseases of poverty. The basic science that underlies product development happens at research centers and universities. But when the goal is to build upon basic science, translate it into products that save lives, get those products tested and approved, and then manufacture those products, biotechnology and pharmaceutical companies have the vast majority of the necessary expertise. Every partner we work with is required to make products developed with foundation funding widely available at an affordable price.

Bill: So far, the best examples of our work with private companies are in global health. We’re funding research on new drugs and vaccines, including two early-stage companies that are working on ways to use messenger RNA to teach your body how to produce its own vaccines. It could lead to breakthroughs in HIV and malaria—as well as flu and even cancer.

We’re also working with the private sector to make existing drugs and vaccines available to people in poor countries. For example, donors can remove some of the risk for companies by guaranteeing them that they will either get a certain price for their product or sell a certain volume of it. We are one of several donors that created a price guarantee to scale up the delivery of a vaccine for pneumococcal disease, an infection that kills nearly half a million children every year. Poor children in 57 countries now get this vaccine, and it could save 1.5 million lives by 2020.

We’re also working with the private sector in other areas, especially agriculture and financial services. Those efforts aren’t as far along, but we’re optimistic that they’ll have just as much impact.

Are you imposing your values on other cultures?

Bill: On one level, I think the answer is obviously no. The idea that children shouldn’t die of malaria or be malnourished is not just our value. It’s a human value. Parents in every culture want their children to survive and thrive.

Sometimes, though, the person asking this question is raising a deeper issue. It’s not so much a question about what we do, but how we do it. Do we really understand people’s needs? Are we working with people on the ground?

Melinda: We’re acutely aware that some development programs in the past were led by people who assumed they knew better than the people they were trying to help. We’ve learned over the years that listening and understanding people’s needs from their perspective is not only more respectful—it’s also more effective.

Our foundation is designed with this principle in mind. When we say “we” work on a certain issue, we don’t mean that Bill or I or the foundation’s employees are delivering treatments for river blindness or training farmers to rotate their crops. What we mean is that we fund organizations with years and sometimes decades of local experience that do those things. These organizations, our thousands of partners, keep us connected to the people we’re trying to help.

We also have a strong conviction about the importance of empowerment. We aren’t interested in making choices for anyone. We invest in family planning, for example, not because we have a vision of what other people’s families should look like but because parents around the world have told us they want the tools to make their vision of their own family come to fruition. In all our work, we are interested in making sure people have the knowledge and power to make the best choices for themselves.

What happens when the two of you disagree?

Melinda: Bill almost never gets this question. I get it all the time.

We have two things going in our favor. First, we agree on basic values. Second, Bill is very open-minded, which isn’t necessarily how people perceive him.

When Bill first came over to the foundation from Microsoft, he was used to being in charge. I’d stayed home with our kids, so I was restarting my career. There were times I felt that disparity—in meetings when I was reticent and he was voluble, or when the person we were meeting with looked toward Bill and not me. It’s always been important to us that we are equal partners in our foundation’s work. We’ve learned over time to give each other feedback at home about times in the office when we didn’t meet that goal. 

This is a balance that married couples, and co-workers, all over the world are always trying to strike. One of the reasons this work has been so fun for me is that we’ve been on this journey together.

Bill: Because I've been a public figure longer, and because I’m a man, some people assume I am making the big decisions. That's never been the case. 

Some people see Melinda as the heart of our foundation, the emotional core. But just as she knows I’m more emotional than people realize, I know she’s more analytical than people realize. When I get really enthusiastic about something, I count on her to make sure I’m being realistic. I also love watching her bring together just the right mix of people to solve a problem.

We are partners in both senses that people use the word these days: at home and at work.

Read our full letter at gatesletter.com.