How to pronounce "contraceptive"

Chris Anderson: So, this is an interview with a difference.

On the basis that a picture is worth a thousand words,

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 so many kids around the world,

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, lots of countries in Africa,

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 about childhood vaccines,

and they would bring the conversation around to

"But what about the shot I get?"

which is an injection they were getting called Depo-Provera,

which is a contraceptive.

And I would come back and talk to global health experts,

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 my husband knowing it,

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 here in the United States,

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 women in the United States

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 we can perform a miracle.

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

in its continuous learning journey,

and we don't travel together as much

for the foundation, actually, as we used to

when Bill was working at Microsoft.

We have more trips where we're traveling separately,

but I always know when I come home,

Bill's going to be interested in what I learned,

whether it's about women or girls

or something new about the vaccine delivery chain,

or this person that is a great leader.

He's going to listen and be really interested.

And he knows when he comes home,

even if it's to talk about the speech he did

or the data or what he's learned,

I'm really interested,

and I think we have a really collaborative relationship.

But we don't every minute together, that's for sure.

(Laughter)

CA: But now you are, and we're very happy that you are.

Melinda, early on, you were basically

largely running the show.

Six years ago, I guess,

Bill came on full time, so moved from Microsoft

and became full time.

That must have been hard,

adjusting to that. No?

MG: Yeah. I think actually,

for the foundation employees,

there was way more angst for them

than there was for me about Bill coming.

I was actually really excited.

I mean, Bill made this decision

even obviously before it got announced in 2006,

and it was really his decision,

but again, it was a beach vacation

where we were walking on the beach

and he was starting to think of this idea.

And for me, the excitement of Bill

putting his brain and his heart

against these huge global problems,

these inequities, to me that was exciting.

Yes, the foundation employees had angst about that.

(Applause)

CA: That's cool.

MG: But that went away within three months,

once he was there.

BG: Including some of the employees.

MG: That's what I said, the employees,

it went away for them three months after you were there.

BG: No, I'm kidding. MG: Oh, you mean, the employees didn't go away.

BG: A few of them did, but —

(Laughter)

CA: So what do you guys argue about?

Sunday, 11 o'clock,

you're away from work,

what comes up? What's the argument?

BG: Because we built this thing

together from the beginning,

it's this great partnership.

I had that with Paul Allen

in the early days of Microsoft.

I had it with Steve Ballmer as Microsoft got bigger,

and now Melinda, and in even stronger,

equal ways, is the partner,

so we talk a lot about

which things should we give more to,

which groups are working well?

She's got a lot of insight.

She'll sit down with the employees a lot.

We'll take the different trips she described.

So there's a lot of collaboration.

I can't think of anything where one of us

had a super strong opinion

about one thing or another?

CA: How about you, Melinda, though? Can you? (Laughter)

You never know.

MG: Well, here's the thing.

We come at things from different angles,

and I actually think that's really good.

So Bill can look at the big data

and say, "I want to act based on these global statistics."

For me, I come at it from intuition.

I meet with lots of people on the ground

and Bill's taught me to take that

and read up to the global data and see if they match,

and I think what I've taught him

is to take that data

and meet with people on the ground to understand,

can you actually deliver that vaccine?

Can you get a woman to accept those polio drops

in her child's mouth?

Because the delivery piece

is every bit as important as the science.

So I think it's been more a coming to over time

towards each other's point of view,

and quite frankly, the work is better because of it.

CA: So, in vaccines and polio and so forth,

you've had some amazing successes.

What about failure, though?

Can you talk about a failure

and maybe what you've learned from it?

BG: Yeah. Fortunately, we can afford a few failures,

because we've certainly had them.

We do a lot of drug work or vaccine work

that you know you're going to have different failures.

Like, we put out, one that got a lot of publicity

was asking for a better condom.

Well, we got hundreds of ideas.

Maybe a few of those will work out.

We were very naïve, certainly I was, about a drug

for a disease in India, visceral leishmaniasis,

that I thought, once I got this drug,

we can just go wipe out the disease.

Well, turns out it took an injection

every day for 10 days.

It took three more years to get it than we expected,

and then there was no way

it was going to get out there.

Fortunately, we found out

that if you go kill the sand flies,

you probably can have success there,

but we spent five years,

you could say wasted five years,

and about 60 million,

on a path that turned out to have

very modest benefit when we got there.

CA: You're spending, like, a billion dollars a year

in education, I think, something like that.

Is anything, the story of what's gone right there

is quite a long and complex one.

Are there any failures that you can talk about?

MG: Well, I would say a huge lesson for us

out of the early work is we thought

that these small schools were the answer,

and small schools definitely help.

They bring down the dropout rate.

They have less violence and crime in those schools.

But the thing that we learned from that work,

and what turned out to be the fundamental key,

is a great teacher in front of the classroom.

If you don't have an effective teacher

in the front of the classroom,

I don't care how big or small the building is,

you're not going to change the trajectory

of whether that student will be ready for college.

(Applause)

CA: So Melinda, this is you and

your eldest daughter, Jenn.

And just taken about three weeks ago, I think,

three or four weeks ago. Where was this?

MG: So we went to Tanzania.

Jenn's been to Tanzania.

All our kids have been to Africa quite a bit, actually.

And we did something very different,

which is, we decided to go spend

two nights and three days with a family.

Anna and Sanare are the parents.

They invited us to come and stay in their boma.

Actually, the goats had been there, I think,

living in that particular little hut

on their little compound before we got there.

And we stayed with their family,

and we really, really learned

what life is like in rural Tanzania.

And the difference between just going

and visiting for half a day

or three quarters of a day

versus staying overnight was profound,

and so let me just give you one explanation of that.

They had six children, and as I talked to Anna

in the kitchen, we cooked for about five hours

in the cooking hut that day,

and as I talked to her, she had absolutely planned

and spaced with her husband

the births of their children.

It was a very loving relationship.

This was a Maasai warrior and his wife,

but they had decided to get married,

they clearly had respect and love in the relationship.

Their children, their six children,

the two in the middle were twins, 13,

a boy, and a girl named Grace.

And when we'd go out to chop wood

and do all the things that Grace and her mother would do,

Grace was not a child, she was an adolescent,

but she wasn't an adult.

She was very, very shy.

So she kept wanting to talk to me and Jenn.

We kept trying to engage her, but she was shy.

And at night, though,

when all the lights went out in rural Tanzania,

and there was no moon that night,

the first night, and no stars,

and Jenn came out of our hut

with her REI little headlamp on,

Grace went immediately,

and got the translator,

came straight up to my Jenn and said,

"When you go home,

can I have your headlamp

so I can study at night?"

CA: Oh, wow.

MG: And her dad had told me

how afraid he was that unlike the son,

who had passed his secondary exams,

because of her chores,

she'd not done so well

and wasn't in the government school yet.

He said, "I don't know how I'm going to pay for her education.

I can't pay for private school,

and she may end up on this farm like my wife."

So they know the difference

that an education can make

in a huge, profound way.

CA: I mean, this is another pic

of your other two kids, Rory and Phoebe,

along with Paul Farmer.

Bringing up three children

when you're the world's richest family

seems like a social experiment

without much prior art.

How have you managed it?

What's been your approach?

BG: Well, I'd say overall

the kids get a great education,

but you've got to make sure

they have a sense of their own ability

and what they're going to go and do,

and our philosophy has been

to be very clear with them --

most of the money's going to the foundation --

and help them find something they're excited about.

We want to strike a balance where they have

the freedom to do anything

but not a lot of money showered on them

so they could go out and do nothing.

And so far, they're fairly diligent,

excited to pick their own direction.

CA: You've obviously guarded their privacy carefully for obvious reasons.

I'm curious why you've given me permission

to show this picture now here at TED.

MG: Well, it's interesting.

As they get older, they so know

that our family belief is about responsibility,

that we are in an unbelievable situation

just to live in the United States

and have a great education,

and we have a responsibility to give back to the world.

And so as they get older

and we are teaching them --

they have been to so many countries around the world —

they're saying,

we do want people to know that we believe

in what you're doing, Mom and Dad,

and it is okay to show us more.

So we have their permission to show this picture,

and I think Paul Farmer is probably going to put it

eventually in some of his work.

But they really care deeply

about the mission of the foundation, too.

CA: You've easily got enough money

despite your vast contributions to the foundation

to make them all billionaires.

Is that your plan for them?

BG: Nope. No. They won't have anything like that.

They need to have a sense

that their own work is meaningful and important.

We read an article long, actually, before we got married,

where Warren Buffett talked about that,

and we're quite convinced that it wasn't a favor

either to society or to the kids.

CA: Well, speaking of Warren Buffett,

something really amazing happened in 2006,

when somehow your only real rival

for richest person in America

suddenly turned around and agreed to give

80 percent of his fortune

to your foundation.

How on Earth did that happen?

I guess there's a long version and a short version of that.

We've got time for the short version.

BG: All right. Well, Warren was a close friend,

and he was going to have his wife Suzie

give it all away.

Tragically, she passed away before he did,

and he's big on delegation, and

— (Laughter) —

he said —

CA: Tweet that.

BG: If he's got somebody who is doing something well,

and is willing to do it at no charge,

maybe that's okay. But we were stunned.

MG: Totally stunned. BG: We had never expected it,

and it has been unbelievable.

It's allowed us to increase our ambition

in what the foundation can do quite dramatically.

Half the resources we have

come from Warren's mind-blowing generosity.

CA: And I think you've pledged that

by the time you're done,

more than, or 95 percent of your wealth,

will be given to the foundation.

BG: Yes.

CA: And since this relationship, it's amazing—

(Applause)

And recently, you and Warren

have been going around trying to persuade

other billionaires and successful people

to pledge to give, what,

more than half of their assets for philanthropy.

How is that going?

BG: Well, we've got about 120 people

who have now taken this giving pledge.

The thing that's great is that we get together

yearly and talk about, okay,

do you hire staff, what do you give to them?

We're not trying to homogenize it.

I mean, the beauty of philanthropy

is this mind-blowing diversity.

People give to some things.

We look and go, "Wow."

But that's great.

That's the role of philanthropy

is to pick different approaches,

including even in one space, like education.

We need more experimentation.

But it's been wonderful, meeting those people,

sharing their journey to philanthropy,

how they involve their kids,

where they're doing it differently,

and it's been way more successful than we expected.

Now it looks like it'll just keep growing in size

in the years ahead.

MG: And having people see that other people

are making change with philanthropy,

I mean, these are people who have

created their own businesses,

put their own ingenuity behind incredible ideas.

If they put their ideas and their brain

behind philanthropy, they can change the world.

And they start to see others doing it, and saying,

"Wow, I want to do that with my own money."

To me, that's the piece that's incredible.

CA: It seems to me, it's actually really hard

for some people to figure out

even how to remotely spend that much money

on something else.

There are probably some billionaires in the room

and certainly some successful people.

I'm curious, can you make the pitch?

What's the pitch?

BG: Well, it's the most fulfilling thing

we've ever done,

and you can't take it with you,

and if it's not good for your kids,

let's get together and brainstorm

about what we can be done.

The world is a far better place

because of the philanthropists of the past,

and the U.S. tradition here, which is the strongest,

is the envy of the world.

And part of the reason I'm so optimistic

is because I do think philanthropy

is going to grow

and take some of these things

government's not just good at working on and discovering

and shine some light in the right direction.

CA: The world's got this terrible inequality,

growing inequality problem

that seems structural.

It does seem to me that if more of your peers

took the approach that you two have made,

it would make a dent

both in that problem and certainly

in the perception of that problem.

Is that a fair comment?

BG: Oh yeah. If you take from the most wealthy

and give to the least wealthy, it's good.

It tries to balance out, and that's just.

MG: But you change systems.

In the U.S., we're trying to change the education system

so it's just for everybody

and it works for all students.

That, to me, really changes

the inequality balance.

BG: That's the most important.

(Applause)

CA: Well, I really think that most people here

and many millions around the world

are just in awe of the trajectory

your lives have taken

and the spectacular degree to which

you have shaped the future.

Thank you so much for coming to TED

and for sharing with us and for all you do.

BG: Thank you. MG: Thank you.

(Applause)

BG: Thank you. MG: Thank you very much.

BG: All right, good job. (Applause)