It was March 2018, and once more Bill Gates found himself behind a podium. In the previous few months, he had given one keynote address after another—in San Francisco, he’d urged drugmakers to focus on diseases that affect the poor as well as the rich; in Andhra Pradesh, India, he had preached the value of smallholder farms; in Abu Dhabi, he’d enjoined the Crown Prince and other princelings to continue their financial support for global health initiatives; in Cleveland, he’d promoted investment in better schools.
Now the world’s second-richest man and foremost itinerant advocate for the poor was in Abuja, Nigeria, talking about the same theme that had underlain all of these speeches: the need to invest in “human capital.” Among those gathered at the conference center, in the shadow of the Aso Rock Presidential Villa, was the Nigerian President himself, Muhammadu Buhari, and what seemed like the entire seat of government, from legislative mandarins to a full house of governors and business leaders—all primed to hear from a man who had, so far, lavished the country with $1.6 billion in grants through his eponymous foundation.
Two months earlier, the Bill & Melinda Gates Foundation had taken the unusual step of absorbing a $76 million IOU Nigeria owed to Japan, for money Nigeria had borrowed to fund a polio eradication effort. The progress there had been striking. In 2012 the country had more than half of the worldwide cases of this paralyzing disease; that number had since been cut to zero.
But Gates wasn’t there to deliver a keep-up-the-good-work speech. He was there to say the opposite: to tell his hosts that their nation—Africa’s richest and most populous, with 190 million residents—was on a knife’s edge. The country was facing an “epidemic of chronic malnutrition,” with one in three Nigerian children chronically malnourished, Gates told his audience. Nigeria had the fourth-worst maternal mortality rate on the planet, making it “one of the most dangerous places in the world to give birth.” More than half of rural Nigerian children could not adequately read or write. The primary health care system was “broken.”
The harsh litany went on. On the basis of per capita GDP, oil-rich Nigeria was “rapidly approaching upper-middle-income status, like Brazil, China, and Mexico,” Gates said. But by every meaningful measure, it still resembled an impoverished nation: Life expectancy was a meager 53 years—nine years lower, on average, than its low-income neighbors in sub-Saharan Africa. Nigeria was headed for a perilous future—unless it changed course, that is, and began to substantially invest in the health, education, and economic opportunity of its people.
“It may not be polite to speak so bluntly when you’ve always been so gracious to me,” Gates told the gathering, veering a bit from his prepared remarks. But, he explained, he was “applying a lesson” he’d learned from Nigerian businessman and fellow billionaire Aliko Dangote, who told him: “ ‘I didn’t get successful by pretending to sell bags of cement I didn’t have.’ I took from that, that while it may be easier to be polite, it’s important to face facts so that you can make progress.”
It was a speech that “rattled” the government, according to the next day’s headlines. And it could have been given only by Bill Gates, says Ngozi Okonjo-Iweala, chair of GAVI, the international vaccine alliance, who twice served as Nigeria’s finance minister. Years earlier, when Gates was CEO of Microsoft, the company he cofounded with Paul Allen in 1975, he’d had no trouble speaking bluntly to government leaders—vigorously challenging, for one notable example, the U.S. government’s antitrust case against the company during the 1990s.
The post-Microsoft Gates was still unabashedly candid—“He did that in Nigeria, and he didn’t mince words,” says Okonjo-Iweala—but the frankness was now infused with something else: a driving sense of purpose. A more tender kind of, well, passion.
That’s a word that’s used quite a bit these days to describe Bill Gates, 63, who in the waning decades of the 20th century was often pilloried as a brash—and sometimes soulless—corporate predator.
Ray Chambers, an influential American philanthropist who is now the World Health Organization’s Ambassador for Global Strategy and who for several years served as a UN Secretary-General’s Special Envoy for Malaria, says Gates’ “passion for the subject”—whatever that might be in global health—“and his compassion for the victim” are equally striking. Physician Helene Gayle, who spent five years with the Gates Foundation, overseeing its HIV, TB, and reproductive health programs and who is now CEO of The Chicago Community Trust, singles out the word “determined” before saying, “that’s not quite right—that’s too pedestrian. It’s somewhere between determined and passionate. I mean this guy is on a mission, and he is—the word is ‘undeterred.’ ”
And if you’re wondering what drives this perpetually refueling zeal, a big part of the answer can be found on the other side of the ampersand in his foundation’s name: ¬Melinda Gates.
If Bill’s superpower is speaking truth to the mighty, Melinda’s may well be hearing the truth of the unmighty—and then internalizing and sharing that secret, often brutally repressed wisdom. For a generally soft-toned speaker, her voice has the command of a church bell. But those who know her say her truly uncanny talent is simply the ability to listen.
Gayle recalls one trip with Melinda, now 54, and Bill in the early 2000s to India, meeting with a group that was particularly hard-hit by HIV, women in the commercial sex industry. Melinda—as was often the case—sat on the floor with the women and listened. “Many of them were despised and stigmatized in their own communities,” recalls Gayle, “and having her listen to these women’s stories and hear the lives that they led—why they ended up having to trade sex for basically survival, and what it meant to them to have people from outside come and listen to them, listen to their stories, be willing to hug and embrace them, and treat them like human beings with equal value—was a very, very moving moment,” she says.
In Mozambique, it was the same. The ¬Gateses would travel to a remote rural area, talking with women about their desires for their children—“and their fears that they wouldn’t be able to provide for their children and care for them,” says Gayle. “And Melinda would sit on the ground, talking woman to woman about the things that mothers care about. She has this remarkable ability to connect with everybody.”
Raj Shah, the CEO of the Rockefeller Foundation, has likewise worked at the Gates Foundation and traveled frequently with its founders, but there is one trip that stands out: Bangladesh, December 2005. The government had pulled out all the stops in welcoming the famous couple to Dhaka, putting their giant faces on billboards lining the highway from the airport. The Gateses, however, just wanted to visit the famous International Center on Diarrheal Disease Research—or, as everyone called it, the “Cholera Hospital.”
Established in the 1960s, the hospital had long been a pinnacle of research on ways to help children with diarrhea survive. “At the time,” recalls Shah, “there was a cholera outbreak, and we were walking through. And I don’t know if you’ve ever seen a cholera cot, but basically it’s a raised cot with a hole in the middle, and they have a blue tarp over it, for obvious reasons.” On each cot was a child. “And the kids just have constant diarrhea,” says Shah. “There are buckets under the cot to capture all that. And the mothers sit next to their kids and constantly give them a combination of oral rehydration, salts mixed with purified water and some other electrolytes.” That ORS, as it’s called, keeps the child from dehydrating and dying during the diarrheal episode.
Melinda sat down beside one mother and began helping to spoon-feed her child, as the two women—one born in Dhaka; the other, in a middle-class home in Dallas—talked through a translator about what they ate for dinner. It was a moment when Shah realized that Melinda could bond with anyone. He pauses for a moment in the conversation: “I could be wrong in all my recollections. But I just remember her saying that ‘Oh, my family ate rice and beans also!’ It’s just who she is: People connect with her in a very special way.”