ARI SHAPIRO, HOST:
Bill Gates marked the 25th anniversary of the Gates Foundation by announcing its final chapter. Over the next 20 years, the foundation will spend down more than $200 billion, all the accumulated wealth of the man who was once the richest person in the world. Gates says the goal is to save and improve as many lives as possible in that time, to, quote, "end preventable deaths of moms and babies" and "lift millions out of poverty." Bill Gates is with us now to talk about his change of plans. Welcome back to ALL THINGS CONSIDERED.
BILL GATES: Thank you.
SHAPIRO: I'm going to begin by disclosing that the Gates Foundation is a supporter of NPR. When you started the foundation, the intention was to sunset it several decades after your death. So what made you change your mind and set this much tighter deadline?
GATES: Well, I've learned a lot in the last 25 years, including the incredible impact that these resources can have. And so, you know, I know there'll be lots of rich people in the future, and the needs are very urgent today. I, you know, want to spend at an even higher level than we are right now because I see the pipeline of innovations. Some are, you know, pretty straightforward, like vitamins for pregnant women, or things that are complicated, like AI health delivery or gene editing to cure HIV. So with that in mind, you know, I'd like to make sure we do as much as we can in these 20 years. And I built a strong organization. Hopefully, I'll be able to help guide it during all of those 20 years. But if not, it's got a strong culture, and I'm sure it'll do well.
SHAPIRO: The amount of money we're talking about can be hard to imagine. So can you give us an example of what specifically you'll be able to do in the next couple decades with $200 billion-plus that you would not have been able to do with the mere tens of billions of dollars...
GATES: Yeah.
SHAPIRO: ...That you had been planning to spend over that next 20 years?
GATES: Well, one of the areas we work in is agriculture. It's - you know, health is by far biggest, about 70%, and then education is about 15. But agriculture, some people are surprised that we can do incredible things to improve seeds and educate farmers so that even in Africa, where today the productivity is the lowest, and they face climate change and population growth, we want to get kids even more nutrition despite all of that. So we do better seeds, better chickens, better cows, and that's an area we're growing our spending a lot.
This idea of curing HIV, you know, curing sickle cell - a few kids have been cured of sickle cell, but it costs millions of dollars for each case. And we want to do that for less than $100. So it's very advanced science, and it'll take us, even spending full speed, maybe eight to 10 years to get that done. But I'm able to say to those scientists, who are incredible, please go full speed ahead.
SHAPIRO: You've mentioned some ambitious goals, like curing HIV. But less ambitious goals, like treating HIV, have seen dramatic cuts since the Trump administration has ended many of its foreign aid programs, like USAID. So does your announcement have anything to do with the government pulling back on foreign aid spending? Are you trying to fill that gap?
GATES: No, my decision came after thinking about this for several years, and it's really timed with the year I turn 70 and our 25th anniversary. And so it's kind of strange that here we are in the middle of a global health emergency, where the U.S. made gigantic, abrupt cuts, and some of the European countries are also making cuts 'cause of the demands to raise their defense spending. And so, you know, I can't overstate how awful it is to be in a period where the number of children who die is going to go back up. You know, it went down from 10 million to 5 million. We cut it in half, and it was supposed to keep...
SHAPIRO: Since the year 2000, right?
GATES: Since the year 2000, exactly - and it was supposed to keep going down. But with these cuts, millions will die. So I'm going to try and make the case that a lot of this money should be restored. There's a lot of benefits that have come from this less than 1% of the U.S. budget.
SHAPIRO: On vaccines specifically, a lot of your work has been about getting these lifesaving vaccines into developing countries. And the last time you were on this program back in February, you told my cohost Scott Detrow that you were hoping to meet with Health Secretary Robert F. Kennedy Jr., who has questioned the science around vaccine safety and effectiveness. You said you were optimistic and hopeful about finding common ground. Have you been able to meet? Were you able to find common ground?
GATES: No, I'm still hoping to get that meeting. You know, since then, there have been some headcount cuts, so I'm worried. You know, the U.S. medical research has been hugely beneficial to the world. So, you know, I, you know, think the U.S. commitment to medical research is great, and we've got to make sure it continues. And we'll try and influence it in the right direction.
SHAPIRO: You recently told The New York Times, the world's richest man has been involved in the deaths of the world's poorest children. That's a reference to Elon Musk leading the effort to defund USAID. Have you spoken with him about that?
GATES: No. And although he's a genius and, you know, expert in a lot of things, you know, I've been out and met these people. I've been to Nigeria and seen their great work. I've been to the Democratic Republic of Congo. And so this is one where I think he made a mistake.
SHAPIRO: What responsibility do you believe comes with enormous wealth?
GATES: Well, trying to avoid killing children, maybe (laughter). So I've been involved in what's called The Giving Pledge, that Warren Buffett and Melinda and I created, to get philanthropists to share their thoughts to encourage better giving, more giving. And, you know, philanthropy is on the increase, not just in the United States. You know, I'm trying to set an example by giving 98% of the money I have. Warren Buffett's been an inspiration to me. He - even before I met him, he'd written an article about how, you know, giving too much money to your children isn't necessarily good for them or society as well.
SHAPIRO: You're a notorious optimist. And sometimes, when people who listen to the news every day ask me about the state of the world, I say, well, there's, you know, the Bill Gates view, which is that more people have access to clean water and education and fewer children are dying, and more people, etc., etc., etc. You've in this very conversation said millions more children are going to die in the coming years than otherwise would have. And so how do the cuts of the last few months shape your outlook on the state of the world?
GATES: Yeah, I think the tragedy that this so - is so far away means that people don't feel it. And, you know, I think the basic religious principle of treating other people well still applies. So you're going to see me speaking out a lot about these budget things. But no, I'm not pessimistic because I think the case is so strong that we can get the money back and then take advantage of pipeline of innovation, including a lot driven by advances in AI.
SHAPIRO: Microsoft founder and global health philanthropist Bill Gates, thank you so much for speaking with us today.
GATES: Thank you.
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