‘Philanthropy does not work in isolation’

On the occasion of the release of the 10th annual letter from his wife Melinda Gates and him on the working of the Bill and Melinda Gates Foundation, the co-chairman of the foundation, Bill Gates, in a phone interview, spoke to Hindustan Times on the state of philanthropy, the big challenges of our times, working with governments, and the foundation’s achievements in India. Edited excerpts :

Your work over these last 10 years seems to be on the basis of understanding that philanthropy can be a powerful tool to solve some of the world’s big problems. Would that be an accurate way of putting it, and if so, how do you go about identifying areas where you have most impact?

I’m a huge fan of philanthropy, and I’m excited that philanthropy throughout the world, including the US and India, will get even larger. There are tons of things that philanthropy alone can’t solve, so the basic provision of justice and roads and education, and funding primary healthcare — those are government functions. As the world gets wealthier, governments get more capable of stepping up to that.

But if you have an idea about a new type of school or inventing a new vaccine that would help poor people, or a way of using digital tools to manage primary healthcare, philanthropy can bring in talented people and development capital, and then work in partnership to do pilots of new things.

Probably the biggest single thing philanthropy has done in its history was in the 1960s and ’70s when the Green Revolution, that is high-productive maize, rice, and wheat varieties were created through funding that came from the Ford and Rockefeller foundations. Those things took what at the time was predicted to be extreme famine in India and Pakistan, and actually allowed calories per person to go up. So even though philanthropy at that time was not at the scale it is today, and the understanding of the science was not anywhere near where it is today, it was a phenomenal contribution. And it wasn’t philanthropy alone. The government had to get the seed market to work and the fertiliser market to work and get the roads so that everything could work and it wasn’t perfectly executed, but it made a huge difference. Now we have similar things as we create new vaccines. Philanthropy is important, but it’s only 2% of the economy, even in the United States. And it doesn’t ever work in isolation of the private and government sectors.

You spoke of working with governments as well as others in the private sector. Partnerships are key to getting the model to work, and increasingly we’re seeing philanthropy coming from big business. How does that fit in?

In the US, philanthropy is mostly at the individual level. But all the big companies have some type of corporate social responsibility budget, which, yeah, if you use the broad term of “philanthropy”, that would be encompassed.

India is fairly unique in having created a requirement that corporations spend a percentage of their profits on philanthropic-type activities.

The corporations do have skill sets that we want to engage with. So getting the mobile phone companies to do, say, mobile money not just for urban dwellers, but to really get the penetration out in the far reaches of Bihar, that is a service to the citizens, and we can partner with the mobile companies to make sure that happens. We can partner with vaccine makers where we commit — whether it’s Bio-e or Bharat Biotech or Serum Institute, we can commit huge volumes to buy their vaccines and help with their development programmes, or give grants.

And so those are private-sector activities that can have huge positive impacts. The blend of where it’s voluntary versus mandatory and when it’s from the corporation itself versus the large shareholders individually spending their wealth, that varies by country. India has a unique mix of those things.

From your experience, how do you build trust of stakeholders like the government?

I’ll use examples from India. The very first thing we did was this partnership called Avahan. The foundation worked to create communities of commercial sex workers so that they could come and help each other and deal with violence. The key goal was to have them teach each other about safe practices so that HIV was not spreading throughout that community, and from that community to the public at large.

That was a partnership with the government where we funded a lot of it at the start, and over time, they took over some responsibility. Things like vaccination programmes — we’re pleased that the federal level is looking at new vaccines to see what the benefits would be, say for the rotavirus vaccine or the pneumococcus vaccine or pentavalent vaccine. And when PM (Narendra) Modi came into office, he pretty quickly decided that the vaccine was a good thing, and that’s been rolled out since then. So, we often provide a technical team that can help do just analysis.

The government decides what goals it wants to achieve, like cutting death rates or cutting malnutrition rates or, you know, adding toilets. Once the government picks those priorities, we have a lot of expertise in toilets and mobile money and vaccines and how primary healthcare can be improved.

As we see that agenda, we find ways to work either through grants or what we sometimes call a technical consulting unit to. And we do that at both the federal and the state level. Our statelevel work has been primarily, although not entirely, in UP and Bihar.

In general, and also specifically with reference to India, how easy is it to work with the government?

Well, it’s critical to work with governments, so there’s really no choice, whether it’s donor governments that have resources or developing country governments. Working with government requires special skills. We hire people who help manage those relationships for us. So I’d never say it was easy. They’re setting the agenda.

If you get a new, say, chief minister, he may decide that primary healthcare or reproductive health or agricultural productivity or sanitation aren’t in his set of priorities. He decides the priorities of the government, we’re just there when there’s an alignment. As you get into Africa and the governments are often less capable, that can be challenging. I spent three hours today on video conferences with state governors in Nigeria talking through the improvement in their primary healthcare system. They’re well behind the least developed parts of India, and yet it’s very important.

We’ve had to learn a lot. There’s no similarity — well, they’re very different. If you learn how to work in Japan or China, that won’t necessarily tell you how to work in India.

Based on the experience you’ve had running the foundation, if someone is just starting out in philanthropy and giving money away, what are the two or three things that person should focus on?

As I go around the world, I have a lot of dinners where people who have been successful come, and we just chat about philanthropy. We have, in India, on a yearly basis, something that I’ve gone to a number of times, the so-called India Philanthropy Initiative, IPI. So in a lot of contexts, I’m talking with philanthropists. In terms of what they choose to give to will often come from some passion — that they’ve seen the schools aren’t good enough or their relative had a particular disease or their community doesn’t have good sanitation.

We invite them to come to our foundation and see if there’s anything they can learn, even if they’re going to work in different areas. That’s been very fruitful. And, of course, there are different styles. Our foundation has a scale where it’s highly staffed. We have 1,500 people. We’re giving $5 billion a year away, and most foundations, the real question people ask is, should they just be hands-on without full-time staff, or would it make sense to get staff? And if so, how do they make sure that somebody who’s good at it doesn’t just have their own agenda?

I am trying to encourage people to do it at a younger age and to bring their business skills and very talented people in, and think about innovation and measurement in a deeper way.

In India, over the period that you’ve been here, what are some of the most significant achievements to your mind?

Well, certainly our participation, along with GAVI, working with the government to introduce new vaccines for all the children of India and working to get the coverage rates so they really get out even in the poorest areas — those are probably our biggest achievements. We have other achievements like Avahan, which helped avoid the HIV epidemic getting super

How’s the quest to fight malaria going?

On malaria, the case count was over a million children dying a year in 2000, and we’re below 500,000. So that’s a huge progress which has to do with bed nets and artemisinin-based medicines and spraying — indoor residual spraying. Now, we’re starting to see some drug resistance and insecticide resistance, so we have to keep innovating and get new bed nets out — they wear out over time. We have to work hard to make sure those case counts don’t go back up and then invent even better tools to get the case counts down.

We expect over the next 10 years to get the case count down, cut it more than half, and have some countries — Sri Lanka recently was declared malaria free, but to have a lot more countries, including south-east Asia, declared free of malaria. Eventually, if you look at a 20-year time frame, we want to go for eradication... We don’t have the tools yet, but we’re getting smarter .

You set a trend, you started convincing more people to pledge their money to philanthropy. Do you think that when you travel around the world on these pledge meetings, you see more people coming forward wanting to give at least some of their money away to address problems?

I really do see it growing in India -both from people involved in the tech sector, and people involved in other sectors. I do see it growing in China.

The goal, of course, is not just the very wealthy, but everyone, including volunteering their time and their voice. And it helps a lot if those who’ve done the best are setting an example, both in how they’re being smart about it and generous about it.

I hadn’t anticipated we’d get so many members of The Giving Pledge. So, yes, I’m pretty pleased that we’ll have a big increase in philanthropy, which plays this great role of trying out new ideas.