Melinda Gates, along with her husband, Microsoft founder Bill Gates, chairs the world’s largest philanthropic organization. Founded 14 years ago, The Bill and Melinda Gates Foundation has given away more than $27 billion. They believe efforts like theirs are making a difference: people around the world are living longer and healthier lives, poverty has been cut in half in the last 25 years and child mortality rates are falling. Melinda Gates joins Diane to talk about the work and priorities of the Gates Foundation, why she believes support for women and girls can make a critical difference and the role of philanthropist in improving lives around the world.

Guests

  • Melinda Gates co-founder and co-chair, The Bill and Melinda Gates Foundation.

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Transcript

  • 11:06:54

    MS. DIANE REHMThanks for joining us. I'm Diane Rehm. By 2035, there will be almost no poor countries left in the world. This prediction, made my Melinda and Bill Gates, who direct the largest private foundation in the world, with assets of more than 38 billion dollars. Melinda Gates joins me in the studio to talk about progress against poverty and infectious disease worldwide. And why she passionately believes support for women and girls is the key to future success. Throughout the hour, we'll welcome your questions, comments.

  • 11:07:35

    MS. DIANE REHMJoin us at 800-433-8850. Send us your email to drshow@wamu.org. Follow us on Facebook or send us a tweet. Melinda Gates, welcome to "The Diane Rehm Show."

  • 11:07:53

    MS. MELINDA GATESThank you for having me, Diane.

  • 11:07:54

    REHMSo glad you're here. Talk about that letter that you and your husband, Bill, wrote, saying that by 2035, there will be almost no poor countries left. How can you make that prediction?

  • 11:08:14

    GATESWell, let me step back a little bit to say why we even wrote the annual letter. Bill and I have been at this foundation work now for, you know, over, well over two -- almost two decades now. And what we see is incredible progress around the world. We see it when we're on the ground traveling in Africa, which we do many times a year. We see it in northern India. But yet, we come home, the papers write about all the disasters, because those are the headlines.

  • 11:08:43

    GATESAnd so what we wanted to point out is that these myths that exist, where people think that poor countries will stay poor, are just not true. And if we believe those myths, it will hold us back from making the progress that we see that's happening around the world, that's absolutely incredible.

  • 11:08:57

    REHMBut you call them myths, and yet, we see every day, children dying of hunger, children dying of disease, women not being allowed to use birth control because of their village rules. I mean, there is another attitude presented.

  • 11:09:23

    GATESWell, there are absolutely places where progress still needs to be made. But, if you look back at around the time I was born, the early 1960s, 20 million children used to die every single year. 20 million children. Today, we're down to less than 7 million children dying. That is enormous progress, and it's because even if you look back at the United States, what has allowed children here to grow up healthy? Well, vaccinations. In the last 50 years, 50 years ago, we really invested in a vaccine system.

  • 11:09:57

    GATESAnd we got the basic immunizations out to children that we take for granted as parents. If you get a tool like that, a vaccine out, the key vaccines out to children in Africa and northern India, you will save so many more lives. And that's why the under five death rate has come down so significantly.

  • 11:10:16

    REHMAnd that is what you and Bill have participated in?

  • 11:10:22

    GATESWe have. With many, many others on the ground, is making sure that that vaccine system works around the world, making sure we get out the great vaccines from the US to the developing world. But also making sure that we create new tools, new vaccines, new innovations for diseases that still exist in Africa, like Malaria, that we don't have in the United States. But when you see what's going on to get basic health started, and then families lifting themselves up out of poverty, and education that's starting in Africa, you see a whole host of countries that have now gone from what we used to consider low income countries to middle income countries.

  • 11:10:59

    GATESChina, Brazil, Mexico, Morocco. You know half of the people who used to live in extreme poverty, 25 years ago, do not today.

  • 11:11:09

    REHMAnd how has that growth in self sufficiency occurred?

  • 11:11:15

    GATESWell, you have to start this basic, what we call virtuous cycle. That is, you have to allow a child to have the basic things to grow up healthy. That is to not have some of the diseases that you might get in childhood. Things that we don't get today. Tetanus, Diphtheria. Let them grow up and live a healthy life. Get them started on the right cycle, and then give people a tool to make sure that they have the means of production. So, predominantly, in Africa, people are farmers. Men and women.

  • 11:11:45

    GATESIf they have the right seeds that will grow with the environment changes. The drought resistant seeds that don't take very many pesticides or fertilizers, and they can grow three times as much on their farms, like we do in the United States. We grow so much more food than we used to on our farms, because we have great seeds. If you make sure they have great seeds on their farm, they can not only feed their family a nutritious meal, they can put some of their crop on market and get that income, and then educate their children.

  • 11:12:15

    GATESAnd that starts a virtuous cycle, where they lift themselves out of poverty.

  • 11:12:18

    GATESWhy do you think these myths, as you and your husband call them, about poor countries staying poor, why do they persist?

  • 11:12:32

    GATESWell, I think because the things that make news are the headlines. The famines that happen around the world. The airplane crashes that happen. There are places where people don't see things getting better. We talk about the smog that's happening -- that is happening in a lot of large cities, but we don't look back at history to say, look at the smog that used to persist in Mexico before, versus what that city looks like now. Look at Nairobi, what it looked like 20 years ago versus today.

  • 11:12:58

    GATESI think we don't, sometimes, talk about the good news of progress. And we need to do more of that to show that progress is possible. And the American people are generous, and with just a little bit of generosity, the government's generosity that we give, we start that virtuous cycle, and then those countries do lift themselves up.

  • 11:13:18

    REHMWhen you encounter people who are throwing up their hands and saying, you know, no matter how much the Bill and Melinda Gates Foundation puts in to 12 countries, there's still gonna be poor. What do you say?

  • 11:13:39

    GATESWe say no. You can start people on that cycle of change. You can make sure that they have innovations that we have in the United States. That if you take those innovations to those places, that they will start on that cycle of being able to change their economy. But it's not just -- and it's not just philanthropy. It's not just our foundation. It's taking some of the innovations that we can take risks on those innovations. We can try certain things out, like new vaccines.

  • 11:14:07

    GATESSome of which might come to market, some of which might fail on their way to market. But get the one that makes a difference, and then it takes government money to scale that up. And so, the US government budget, that goes around foreign aid, you know, there's a myth in the United States. People, if you ask them in the US, how much do you think our foreign aid budget -- how much of the US government budget is spent on foreign aid? People in the US will say 25 percent.

  • 11:14:29

    REHMExactly.

  • 11:14:30

    GATESWell, that's crazy. We spend about one percent on foreign aid.

  • 11:14:33

    REHMOr even less.

  • 11:14:34

    GATESIt's about -- yes. It's less than one percent, and yet those dollars start unbelievable things that let a country lift itself out of poverty. South Korea used to receive aid. It doesn't anymore. We actually go to South Korea now to get aid for other countries. Brazil no longer takes aid. Mexico doesn't take aid. So when you see what's changed around the world, you see that that aid makes a difference, and then countries lift themselves up.

  • 11:15:02

    REHMMelinda Gates. She and her husband have co-founded the Bill and Melinda Gates Foundation. It is the world's largest philanthropic organization. You can join us. 800-433-8850. One aspect of education, especially for young people, and young girls, may be the resistance of that country's culture toward educating girls. How is the Gates Foundation working to try to educate the people who had the right to make those decisions?

  • 11:15:55

    GATESAgain, in countries in Africa, we're seeing much more, thank goodness, in the last 15 years, a focus on getting girls and boys educated at that primary level. So, school rates are up for girls and boys. When I'm out in villages, I was just out in November, in a northern village in Ethiopia, the girls will tell you how much they want to stay in school. And what we know is that if a girl stays in school, she's twice as likely to keep her kids in school when she becomes a mother.

  • 11:16:27

    GATESAnd so those girls are saying, I'm not ready to get married. I want to be older before I get married. I want to be older before I have children, because I know that I don't want to live like my parents did, and my ticket out is to get a great education. So, girls are starting to demand education, as well. And we're seeing more and more government policies that allow girls to be in school. Now, they need to keep investing in those schools, not just at the primary level, but at that secondary level as well.

  • 11:16:52

    GATESBut that is starting to happen.

  • 11:16:54

    REHMHow do you do the research that then leads to a decision to go into a particular country with a particular plan?

  • 11:17:07

    GATESWell, we first look at the global statistics to see where the need is, so for instance, in childhood deaths, we look at which countries have the most childhood deaths. We look at countries to see, OK, a country is now a middle income country, what did they do when they were a low income country to improve childhood deaths? How do we take those learnings then to the countries in Africa where there are still lots of childhood death, and are the policies right that that government is investing in itself to build out their healthcare system?

  • 11:17:36

    GATESSo, a prime example is Ethiopia. They have invested their own money, but lots of foreign aid dollars to fix their primary healthcare system, so that it reaches a tiny, tiny little clinic that's the size of a very small room, out in a village. They've invested in 10,000 of those out in the countryside. They staff them with trained healthcare workers, 30,000 women. And so what that means is that vaccines get out to children. Women start to get contraceptives. Women get educated about the importance of keeping your daughter in school.

  • 11:18:07

    GATESAnd it's making profound effects in India. It's why their childhood death rate is down significantly in the last decade.

  • 11:18:14

    REHMMelinda Gates. And we will take just a short break here. When we come back, we'll talk more, take your calls. I look forward to speaking with you.

  • 11:20:00

    REHMWelcome back. Melinda Gates is here with me. She and her husband are cofounders of the Bill and Melinda Gates Foundation. Along with her husband she shapes the foundation strategies, reviews results and sets the overall direction of the organization. Here's our first email from Susan. "Could Melinda comment on the value of single sex education for girls and how her high school experience had an impact on her world view."

  • 11:20:45

    GATESSure. Thanks. I'm a big believer in single sex education. I think for many girls that's the right choice. For some others, another choice is fine too. I will just say for me, my parents' choice to put me in an all-girls high school was phenomenal. I learned to be a leader there. I learned to have my voice. I learned that girls could do anything. We could be great in math and science. I went on from there to pursue a computer science degree, which was pretty rare back in the 1980s. And I think it's a phenomenal opportunity if you can take it.

  • 11:21:16

    REHMHow did you and Bill Gates meet?

  • 11:21:20

    GATESWell, we actually met at a dinner in New York that was a Microsoft dinner. And it was only about a month after I had started at the company. And I came in late to a dinner. It was before a convention that Microsoft was attending. I was there for a different set of meetings for Microsoft. I came in late because my set of meetings ran late into the evening. I took the second to last chair and the person who came in even 20 minutes later was Bill and he sat down next to me. So that's how we first met.

  • 11:21:46

    REHMAnd how long before he asked you out?

  • 11:21:51

    GATESOh, it took him a few months, and I certainly didn't think that he would. That's actually kind of a sweet story. The first time he asked me out he was incredibly busy as the CEO of the company. And it was a Saturday and I think he said to me, can you go out two weeks from this Saturday night? And I said, I have no idea what I'm doing two weeks from Saturday night. Call me closer to the date, which he eventually did.

  • 11:22:11

    REHMAnd what did your mother say about all this?

  • 11:22:15

    GATESShe didn't think it was a great idea to be dating the CEO of the company. But after she met him and saw what his values were like, she and my dad, she thought he was a pretty neat person.

  • 11:22:27

    REHMAnd how long before you were married?

  • 11:22:30

    GATESAbout five-and-a-half years.

  • 11:22:32

    REHMReally?

  • 11:22:33

    GATESYeah, so we had a great dating experience. And actually it was during that time that we decided after we got engaged, but we'd already been talking about it, that the resources that had come from Microsoft, we made that decision as a couple that those would go back to society. And in fact, the very first time Bill or I was ever in Africa was together.

  • 11:22:52

    GATESAnd it was after we'd been engaged in 1994, we went for a Safari. And it was on that trip that we started to ask ourselves a series of questions about, well what's really going on with the people that we meet here? Why is it so different than the United States, and is there something that a philanthropy could actually do about it? So that started us on our learning journey.

  • 11:23:12

    REHMNow, there might be some people listening to you and hearing about the work that the two of you are doing around the world and beginning to say, what about right here at home? What do you see happening here at home? We hear about a growing population who are hungry. We hear about a growing number of young children who are neither vaccinated nor have good health care. Might you think of turning your eyes homeward?

  • 11:23:57

    GATESWell, we do have a substantial portion of the resources of the foundation that are invested in the United States. And what Bill and I have chosen to focus on there is the U.S. education system. We think the basic -- the thing that people need here the most to lift up their life is a great education. And to use it's a crime that the U.S. public school system only prepares a third of children who are ready to go to college. Two-thirds graduate but only a third are actually prepared to go to college. And we feel like something should be done about that. And so we focus on that as a foundation.

  • 11:24:31

    REHMDo you have any thoughts about public schools versus say charter schools? Some people are concerned that government involvement in public education is diminishing.

  • 11:24:50

    GATESWell, we believe in charter schools because we believe that there are lights of innovation. You can try things in charter schools and then take those to the public school system. And so you're seeing New Orleans after Hurricane Katrina, the difference that charter schools have made there. You see charter schools helping in the Los Angeles school district. But what we need to do is take those learnings and make sure they get poured back into the main public education system, because that's where the vast majority of students are still educated. Charter schools are only a tiny fraction of students, less than 5 percent, in all the United States.

  • 11:25:22

    REHMBut what about the public school system? Lots of people are concerned about deterioration.

  • 11:25:32

    GATESAbsolutely and it needs to be fixed. And what we -- I think that we're seeing in places like Memphis, Tenn. and others is that you can take a child from any zip code. And if you have the right set of teaching that goes on in the classroom, they really can learn. They can learn, you know, incredible algebra, incredible English language arts. We have to hold them to a high standard and we have to make sure that teachers are prepared in the right way to teach subjects to students.

  • 11:25:57

    GATESBill and I have incredible respect for teachers and how difficult the circumstances are in those U.S. school systems today. But it is possible and the charter schools actually show that it's possible.

  • 11:26:09

    REHMHere's an email from Karen in St. Louis who says, "I'd never suggest that helping children survive or lifting people out of poverty is a bad thing, but how can the planet possibly continue to provide even basic needs for so many people? We've seen what's happening in China, the increased demand for resources, increased pollution. How does Mrs. Gates believe we can reconcile limited resources of the planet with the growing population of the planet?"

  • 11:26:52

    GATESI love this question. In fact, this is the question -- this is the part of the annual letter that I wrote, which was a third myth, which is, aren't we going to overpopulate the planet? If we save more children's lives, fewer children are dying won't we overpopulate the planet? People wonder about that and they should wonder about that. But thank goodness the converse is true. That is, as a family stays healthier, as societies around the world stay healthier, women naturally bring down the number of children that they have.

  • 11:27:21

    GATESThat's been true in Germany and France and the United States, Italy, Peru, Brazil. It happens all over the world but you have to give women the family-planning tools that they would like to have. So the basic tools that women use in the United States, contraceptives, they're not available in many countries around the world. And we know that 200 million women would like to have access to contraceptives and cannot get them today.

  • 11:27:47

    GATESAnd when I am out in places like Niger and Senegal in Ethiopia, the women will tell me, I walk ten kilometers to get the shot -- they use a kind of a shot in Africa, Depo-Provera -- I walk ten kilometers and it's not there. What am I going to do? I already have three children. I don't want more. I want to wait until I have more but I need to have that tool. And so I am very passionate about making sure we get -- give women basic access to contraceptives like we use here in the U.S.

  • 11:28:15

    REHMAnd what about those countries where males may determine whether a woman has access?

  • 11:28:25

    GATESAbsolutely. There are definitely countries like that. And what you need to do is talk to the men first. So, for instance, in Niger, the first thing they do is set up a husband school. And they teach the men about reproductive health. They teach men about why having fewer children allows them to feed those children and educate them. And these families are about educating their children. They see the difference. So you start with the men first and then you talk to the women about contraceptives and what's available and what can be available.

  • 11:28:56

    REHMIt's interesting. Here is a note from Dr. Philip. I won't give his last name, in Greenbelt who says, "I'm a former Gates Cambridge scholar matriculation 2008. I want to thank Bill and Melinda Gates for giving me the opportunity to complete my PhD in astrophysics at Cambridge University. I'm now a postdoctoral researcher at NASA Goddard. The foundation does amazing work to help the poor and give promising individuals opportunities to excel. So there's clearly a scholarship program at work as well.

  • 11:29:46

    GATESYes. We have Gates scholars around the globe both here in the United States and, as you hear, at Cambridge and other places who we allow to study through the scholarship program. And again, I think it gives people an access to college and beyond, graduate school and PhD if they want. And in fact, the Cambridge program is really about getting scholars who are focused on global health and focused on Africa. In the U.S., it's all kinds of scholarships for students to help -- you know, will eventually help 10,000 students get scholarships in the United States to go to college.

  • 11:30:20

    REHMMelinda, how do you and Bill live? You have a great deal of money that you could spend on yourselves. I realize you give away a huge amount. But how do you live? How do you enjoy what you have for yourselves?

  • 11:30:41

    GATESYou know, I think we enjoy a lot of the basic things that other families enjoy. Bill and I say that one of our favorite weekends is when we look ahead at the schedule and we say, oh my gosh, Friday night is family movie night. We're all going to plop in a DVD. We agree on it ahead of time, put our pajamas one, get our dogs and have some popcorn and watch a movie. That's a great weekend.

  • 11:30:59

    REHMHow many children are there?

  • 11:31:01

    GATESWe have three children. So we have Jen who's 17 and a son who is 14 and then our daughter Phoebe, who's 11.

  • 11:31:09

    REHMSo what are your surroundings like?

  • 11:31:14

    GATESWell, we have a large home on the lake in Seattle. And we enjoy that a lot. I would say as a family we travel probably maybe more than other families. And I think one of the great privileges is that we can travel to the developing world as a family. So next week is our kid's school holiday. And besides being at a nice beach location, the kids have actually asked us to go to Haiti because we're not that far away. And they've traveled enough to Africa that they're interested in going and seeing the developing world.

  • 11:31:43

    GATESAnd so we'll go spend a little bit more than a day in Haiti on that trip. But they've all been all over Africa, not just on a safari but also to see what happens in real life.

  • 11:31:52

    REHMMelinda Gates and you're listening to "The Diane Rehm Show." I'm going to open the phones now, 800-433-8850. Let's go first to Rockford, Mich. Hi there, Brian, you're on the air.

  • 11:32:13

    BRIANYeah, thanks for taking my call. I love your show. I was a white boy in Africa in the '70s, Rhodesia, and also Zimbabwe. And my parents were also in Rwanda so I've got a little bit of background of Africa. But my last trip was Xai Xai Mozambique. And I asked about the Africans, why they were poor in poverty. And two theories came up with one of these missionaries (unintelligible) on their third generation. He mentioned it would be communal.

  • 11:32:40

    BRIANSo you get a tribe and a person wants to like say make doors. The other tribesmen, because it's communal or communism, they kind of shun him getting better. That's one theory. Second theory would be maybe ancestral worship. You know, maybe God kind of like curses that in that whole continent. So I wanted to throw out those two thoughts to you and to Mrs. Gates. And I appreciate all the work she does over there too 'cause it's good stuff.

  • 11:33:07

    REHMAll right. Thanks, Brian.

  • 11:33:10

    GATESWell, you know, it's interesting. It sounds like you spend a lot of time in Africa, which is fantastic. You know, you have to go country by country because there are different beliefs, different structures that they've grown up in. But what I'm seeing is that as people get more and more educated, just like in the U.S., those beliefs change.

  • 11:33:28

    GATESAnd so even -- I was just recently in Tanzania -- even there where they came out of a system where there weren't many land rights, the farms were all opened -- owned by the government, the government sort of gave people most of the basic services, there is now in Tanzania a sense of entrepreneurism. And so people are starting to say, what can I do for myself? Yes, I rely on the governments for schools but how do I lift my own family up?

  • 11:33:52

    GATESAnd when I go to places like Senegal and we talk about educating people on cultural practices to bring women into clinic because it will save their lives and babies' lives, literally the villagers say, wow, we didn't know that. Now that we know that, of course we're going to do that. So basic education on all kinds of things, health-related, farm-related in school really does change practice for people. And I think that's happening across the face of Africa.

  • 11:34:18

    REHMNow, what about attempting to educate women in regard to contraception? Do you ever run into roadblocks or even criticism?

  • 11:34:33

    GATESSure, we run into both. And I think you have to take both individually and separately. So working with women on the ground in villages -- first of all, I'm struck by how much they know actually about contraceptives, how much they want them. But they will even tell you sometimes what the power structures are around them that hold them back. So for instance, in Senegal, some of the moms at the village level don't believe that the Quran allows for family planning, when in fact the converse is true.

  • 11:35:00

    GATESSo when you meet with the high level people in the Islamic faith in Senegal they say, no, the Quran allows for family planning. We have to get that message all the way down to the village level. And they're doing it. And one of the ways they're doing it is a lot of the men who are part of that structure, if you say to them, do you know a woman that died in childbirth, they'll say, yes my sister or my wife or my daughter. We want to change that and we know that family planning allows people to space the births of their children.

  • 11:35:29

    GATESAnd so the women are healthier and it saves their lives and the babies' lives. That's just one example of how you change that culture of belief and that structure that it's around women.

  • 11:35:38

    REHMAll right. To Barry in St. Louis, Mo. You're on the air.

  • 11:35:44

    BARRYThanks, Diane. I love your show. I'm a huge fan. Melinda, I'm also a huge fan of you and Bill and the work you guys are doing. Thank you so much for the philanthropy and the work. I hear the passion in your voice and it's wonderful. Actually, you guys represent the vision that I have for myself in my life. I have a startup I'm trying to get off the ground called Nova Innovations. And I've heard you mention the word innovations many times in your talk so far this morning. And that really is at the root of what causes human progress obviously.

  • 11:36:22

    BARRYI wanted to ask you about several things. One is, I know that you and Bill are very passionate about the work you're doing in Africa. One of the things that I'm very passionate about, one of my whys, for example, is to help Native Americans. They have such a horrendous plight right here in this country. And they're like the great overlooked ethnicity. It's like they're invisible. Nobody thinks about Native Americans. They're like out of sight, out of mind.

  • 11:36:53

    REHMAll right. Barry, unfortunately we're almost out of time in this segment. Can you talk briefly about Native Americans, Melinda?

  • 11:37:02

    GATESYes. We have quite a few Native Americans, as you can imagine, in the Pacific Northwest. And I think one of the greatest things you can do for them is help get them into the education system and give them a great education.

  • 11:37:13

    REHMMelinda Gates is here. And we'll take just a short break here. When we come back, more of your calls, your email. I look forward to speaking with you.

  • 11:39:59

    REHMAnd welcome back. Melinda Gates is here with me. She and her husband, Bill Gates, direct the largest private foundation in the world with assets of more than $38 billion. And here is an email from Bill in Winston-Salem. "How did you ever know how to start the foundation? You obviously had the funding, but how did you acquire the expertise, the staff? Had you two already had experience with foundations and learned what to do in that way?"

  • 11:40:45

    GATESWell, thanks for that question, Bill. You know, once we decided what we wanted our foundation to stand for, and that is that all lives have equal value. Bill and I really believe that, that all lives no matter where you live on the plant have equal values. Then it was easy for us to say, okay, what do we want to invest in? What is it that keeps people from having an equal life? And in a lot of places in Africa or Northern India, it's they don't have basic health. And so we literally looked at the list of diseases and said, well, which ones are the biggest killers, and which one could a private philanthropy do something about?

  • 11:41:21

    GATESAnd from there we gathered scientists around us to really inform us and educate us, not just in a couple of meetings here and there, but over a series of years. And Bill and I would travel to these places and learn from locals on the ground. What was actually possible? What was -- what needed to be culturally sensitive to do our work? And in the United States we thought the thing that kept people from living equal lives was a great education, so we started to invest there. And it's been from that a learning journey over time in lots of these different areas that we focus on.

  • 11:41:52

    REHMAnd of course here in this country there's been a fair amount of attention paid to both Alzheimer's and Parkinson's. Do you see the Gates' Foundation moving into areas of interest like that?

  • 11:42:12

    GATESWell, in the United States those things are actually quite well funded because of private money that already goes there, but also the National Institutes of Health which our government funds and needs to keep funding. We're making progress on those diseases. So what Bill and I have chosen to do with our resources is to focus on diseases that people don't want to spend money on, things like malaria that cause a million deaths a year, things like pneumonia that we -- a child here gets pneumonia and you hospitalize them, you take care of it. In Africa that child dies.

  • 11:42:41

    GATESAnd yet if we come up with a vaccine which we have done with our partners and other scientists, you can save those babies' lives, so we're focused on the poorest where research is not done.

  • 11:42:53

    REHMAnd here's an email from Sarah. She's just curious if you've had any interaction with the Roman Catholic Church in regard to their opposition to birth control.

  • 11:43:09

    GATESWell, we have had discussions with the Church. I didn't want to surprise the church about what we were doing. We share a very common mission around social justice. And so even though we have different beliefs about contraceptives, I am still a Catholic, and so I've been very upfront that I use contraceptives. I have friends that use them. But that I believe this is what's right for poor women around the world, to have the same access that we have here in the United States. So we didn't surprise the Catholic Church. We still work together. We do a lot of work with Catholic Relief Services, so we have respect for one another's opinions on this issue, and we move forward with our work.

  • 11:43:46

    REHMAnd finally another email, "We fear much of our foreign aid is lost to corruption." This is Steve writing this. "How do you guard against your funds being wasted?"

  • 11:44:04

    GATESI think this is a really good question because -- and this is one of the myths that we tackle, the second myth in the annual letter, which is foreign aid needs to be spent well. And we should ask our government, is the money being spent well? You know, there's always going to be a tiny bit around the edges where you're going to have to worry about, you know, is some of it being, you know, we're buying bed nets, and did we really buy 9 or did we buy 10? But the thing that Bill and I do is anywhere that we invest our own money we go back and measure on the backend, did it work? We're invested with the U.S. government things like the Global Fund that delivers malaria bed nets, over 300 million of them around the world.

  • 11:44:43

    GATESGlobal Fund itself has its own mechanism for measuring corruption. And if they find it in a country, they hold that country accountable. To Bill and me, that's exactly the kind of measurement you want to have built into foreign aid so it's effective. And we feel it is, so we keep investing.

  • 11:45:00

    REHMAll right. Let's go now to Jim. He's in Arlington, Va. You're on the air.

  • 11:45:10

    JIMYes. Hi. I just want to say that I appreciate all that you do, your foundation does for the D.C. area schools. And I was wondering if there's a component of your program here that tries to get kids ready to benefit from all the work you do to provide good schools. That would be improving the family life, improving nutrition and making sure their homes are lead-free and the water that they drink is lead-free, so that they're ready to take advantage of what you do for D.C.

  • 11:45:42

    GATESYeah, thanks for that question, Jim. So in the Pacific Northwest where we live, we do a whole set of poverty grants in that region. Around the United States we've decided to fundamentally invest in the U.S. education system. We don't do the pre-work all around the U.S. Again, Bill and I believe to get results we have to focus, so we're still learning in the Pacific Northwest what we think might actually work, and then to eventually scale up some of those things.

  • 11:46:10

    REHMWhat do you splurge on for yourself?

  • 11:46:15

    GATESOh, a massage every now and then, a nice vacation. Those to me would be splurges, or, you know, a gift for my kids at Christmastime. For me that's actually a lot of fun.

  • 11:46:25

    REHMAnd what about vacations? What would you regard as the perfect vacation?

  • 11:46:32

    GATESWhen you can go to the beach with a whole tote bag of books and have five days to read, for me that is just a little piece of heaven.

  • 11:46:41

    REHMDo you like fiction?

  • 11:46:42

    GATESI love fiction. I love cultural fiction where I'm learning something about a region and its people, while it's a great piece of fiction.

  • 11:46:50

    REHMSo what about historical fiction?

  • 11:46:53

    GATESI do still read historical fiction and I enjoy that. And every now and then, of course, I throw in a global health book here or there.

  • 11:47:00

    REHMYeah, I guess you can't get away from that.

  • 11:47:02

    GATESWell, particularly if it's by one of my heroes like Paul Farmer who works in the field. I love a lot of his writings.

  • 11:47:08

    REHMTo Marylou in Petoskey, Mich. You're on the air.

  • 11:47:14

    MARYLOUHello, Diane. And thank you, Melinda, for your hard work, yours and Bills. I have a question about momentum. We were friends with Garrett Hardin who is a biologist on the west coast. And he used to -- he has a trilogy that said, "You can't do just one thing." And the second part of it was, "And then what?" And then the third part was, "We tend to be literate, but not numerate." So my question is, are you working with demographers on the whole momentum issue? Stopping, you know, the death of so many infants is so admirable, but the growth momentum, I think, might exceed our capacity to sustain the people that would be born in the meantime.

  • 11:48:06

    REHMAll right. Thanks for your call, Marylou.

  • 11:48:10

    GATESYes. Again, I love this question, because this was one of the questions that Bill and I asked ourselves when we first started the foundation, which is what if we are successful? What if we save children's lives with vaccines? Aren't we going to overpopulate the planet? And thank goodness we talked to demographers and learned that the converse is true, and that country after country around the world, as countries are and people are healthier in those countries, they naturally bring down the number of children. When they know a few of them will survive, they have fewer children, because then they can feed and educate their children.

  • 11:48:44

    GATESThat is true throughout the history of time, so that we know as we keep more children alive in Africa, families will bring down the number of children they have, and we need to give women the tools, contraceptives so they have options about how to plan and space those births.

  • 11:49:00

    REHMAnd now to Nandani in Sugarland, Texas. You're on the air.

  • 11:49:08

    NANDANIHi, Diane. I'm just so incredibly honored to be on your show and I think it's the most informative show on any -- across any broadcast media, so thank you for the...

  • 11:49:18

    REHMThank you.

  • 11:49:18

    NANDANI...for the service that you do. I had a question. The question that I had for Ms. Gates is, I am a business professional. I went to the same business school as Ms. Gates did. I've been working for about 15 years. And as I've been going through my career, I've been finding that a lot of my friends and colleagues are very motivated to, you know, contribute to the causes, international development, and especially in my case, to the cause of women and girls, particularly, again, in my case in India.

  • 11:49:49

    NANDANIAnd we want to work in a professional capacity, not just volunteer. But we do not live -- you know, a lot of us don't live in Seattle or D.C. or cities where there is a lot of NGO or development work. So how best -- or, you know, what are the -- what are the different avenues we can take to, again, not just, you know, work on a volunteer basis, but actually act in a professional capacity and contribute our skills and hopefully make a difference?

  • 11:50:14

    REHMAnd before she answers, let me just remind you, you're listening to "The Diane Rehm Show." Melinda.

  • 11:50:24

    GATESYes, Nandani, thanks for that question. I think it's fantastic if you want to give your professional services to a developing world. There are a whole host of NGOs who love to have trained medical doctors and nurses come and do meaningful work in the developing world. As you know you need to be there for quite some time to actually make a difference. And particularly when you're on the ground, if you can train other doctors or healthcare professionals or nurses in a particular field, then you leave something behind besides the great work that you do. Partners In Health is but one of those organizations.

  • 11:50:56

    GATESI think if you go up on our website you can find others. But believe me, your skills could be well used in a developing world, so it would be great to see you do that.

  • 11:51:06

    REHMAnd to Carlisle, Ind. Hi there, Bob.

  • 11:51:11

    BOBHi, Diane. Keep up doing the good work, huh?

  • 11:51:15

    REHMThanks.

  • 11:51:16

    BOBI have two questions for Mrs. Gates. One is, sometimes when I take my sabbatical, I'm fortunate enough to be able to do that, I try to listen to different missionary groups to get an understanding of how to be sensitive to what we see and what we're trying to learn about other people. And I was wondering, do you see any future with a group like Peace Corp.? Or maybe a list of dos and don'ts for people that are visiting different countries so that we can learn better and more. That's my first question.

  • 11:51:56

    BOBThe second is cities to visit. Cities that you might recommend where -- all cities can teach us and we can learn, but what cities fascinate you that they deserve more attention and more visiting to understand some of the great stuff they're doing.

  • 11:52:15

    REHMThanks for calling, Bob.

  • 11:52:18

    GATESSo to your first question, I would say I think the Peace Corp. has made a huge difference around the world in the work that it does. And what I come across is, you know, 10, 15, 20 years later, people who were involved in the Peace Corp. go on to their own career and then come back to do work in global development. And they are some of the most committed on the ground. And because they lived there before, they know how to do that work in a culturally sensitive way. And then in terms of other cities to learn from, you know, I think going to Ethiopia, Addis Ababa and seeing how it's changing and what it's learning, it's unbelievably different. Going to Arusha, Tanzania, those would be two of the top on my list.

  • 11:52:58

    REHMAnd, Melinda, describe the efforts of the Dreamers.

  • 11:53:05

    GATESThe Dreamers, well, that's really to help lift D.C. students up, To make sure that all students have a great education, and some need scholarships to be able to do that, and so making sure that no matter what your zip code or what your background is, you can get a great education going through D.C. school system and then on into college.

  • 11:53:23

    REHMAnd I gather that was created with Donny Graham.

  • 11:53:27

    GATESIt was. He's been a fantastic leader in that space. He sees the needs that have, you know, a student goes through the U.S. education system and they're not from our country, they actually need to still be able to go on and get a great education. And so he's the one that really inspired us to make sure that we would invest in that program with him.

  • 11:53:44

    REHMAnd thinking now about, pardon me, the next 10 years, what do you see the foundation doing?

  • 11:53:51

    GATESI see us continuing to invest where we are currently investing, and doing more of it. So I want to see fewer women dying in the developing world in child birth. I want to see fewer babies dying every year. I want to see more girls lifted up and staying into school. Not being married as young, having access to contraceptives so they can wait and have children, and staying in school so they can learn and participate in the economy and lift their own families up. I think you're going to see the foundation working in all those spaces with all kinds of partners.

  • 11:54:22

    GATESWhile we may not do some of the work directly, for instance, in girls' education, we'll support a whole host of partners who are doing that kind of work, because it supports the whole chain of lifting people out of poverty.

  • 11:54:31

    REHMI wonder whether you think that foundations like Bill and Melinda Gates Foundation can actually do more than governments can do, because there's a certain trust factor at work.

  • 11:54:49

    GATESWell, I think we can sometimes take the risk out of the equation. We can do innovations that a government might not take on because it feels too risky. We can try five vaccine candidates knowing that maybe only two will make it to third stage development. But, you know, as long as there's one or two and we get a real one out there, Bill and I are willing to make investments like a venture capital and see which ones can work. But then it takes governments to scale those vaccines up.

  • 11:55:12

    GATESWe could spend all the money of the foundation scaling up one vaccine. So we try to point lights of where you can go, and then we try to measure on the backend what actually worked, so governments can say, the thing we invested in makes a difference and it's efficient, and we should invest more money in it.

  • 11:55:28

    REHMWhat is the core staff of the foundation? And then broadly, how many people report to the foundation?

  • 11:55:40

    GATESWe have almost 1,200 people today. And our primary office is in Seattle, but we also have small offices in Beijing, D.C., London and now a few small offices where we do work on the ground in Africa, such as South Africa, Nigeria and Ethiopia.

  • 11:55:56

    REHMDo you see that staff growing?

  • 11:55:58

    GATESI think it'll grow some, but I think the extension of our staff is the -- are the incredible scientists that inform us and help us with our work, and the incredible partners on the ground, the reach that they have in these countries, we work through those partners on the ground. So I don't see our staff scaling hugely over the next few years. I think we'll just continue with the deep partnerships that we have and continue to deepen those and bring more people in the umbrella that help.

  • 11:56:23

    REHMYou're clearly so excited about the work you're doing.

  • 11:56:28

    GATESI love it. I absolutely love it. My best days are the days that I'm on the ground talking to women in villages in Africa. When I can spend a day with women, understanding what their lives are like, understanding the length that they're going to educate their sons and their daughters, and what, you know, a simple intervention or a simple tool from the U.S. might mean to help them lift themselves up, that's a great day.

  • 11:56:55

    REHMMelinda Gates, she and her husband, Bill Gates, direct the largest private foundation in the world. Thank you so much for being here.

  • 11:57:10

    GATESThank you, Diane.

  • 11:57:10

    REHMGreat to talk with you. Thanks for listening all. I'm Diane Rehm.

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