0
$1 BILLION
$2 BILLION
$3 BILLION
BILL & MELINDA GATES FOUNDATION
ANNUAL GRANT DISBURSEMENTS
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
U.S. PROGRAM
Includes K-12 education, poverty
research, and family
homelessness campaigns.The
World’s 50
Greatest
Leaders
The List48
FORTUNE.COM // MAY.1.19
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.”FOR EVIDENCE OF WHAT HAPPENS when an un-
stoppable force meets a profoundly movable
human being, one has simply to measure the
impact of the Bill & Melinda Gates Foundation.
From January 1995 through the end of
2017, their namesake philanthropy (along with
earlier Gates family foundations that were
merged into the Bill & Melinda Gates Founda-
tion in 2000) has deployed an extraordinary,
barely countable $45.5 billion. (When I asked
the foundation, partly as a hypothetical, if they
could send me an accounting of every single
grant they’d doled out since inception, I got
back a spreadsheet with 41,487 line items.)
That $45 billion has launched, and then
continually supported, what global health
experts widely acknowledge to be two of the
most successful international, private-public
partnerships ever formed. The first is the
aforementioned GAVI, which has helped
developing countries immunize 700 million
children against preventable diseases. The
second is The Global Fund to Fight AIDS, Tu-
berculosis and Malaria. The fund, through its
own community partnerships, has put more
than 17 million people on retroviral therapy
for HIV, cared for 5 million people with TB,and treated more than 100 million cases of
malaria in 2017 alone—even as it helped
prevent an untold number of infections in all
three diseases. (Apart from national govern-
ments, the foundation is also the largest donor
to the World Health Organization.)
The Gates money, put to work through the
Global Polio Eradication Initiative, has helped
bring that horrific paralyzing disease to the
brink of elimination, leaving only two places
on the earth, Afghanistan and Pakistan, where
the wild poliovirus remains active. In 1998,
the disease could be found in 125 countries.
The eradication quest is, as nearly all
foundation efforts are, sophisticated and data-
driven. Gates-funded disease hunters have
plumbed sewage systems in hotspot regions to
check for lurking poliovirus and used digital
satellite data to understand how many kids
were in a given area—and, therefore, how
many houses inoculation teams needed to visit.
The foundation has spent more than a bil-
lion dollars to date to reduce the burden of
ancient, and long neglected, tropical diseases
(NTDs) that can cause everything from blind-
ness to anemia to an elephantine swelling of
limbs—and that, despite the progress made,
continue to debilitate one-seventh of the earth’s
population. It has fortified health systems in
developing countries and brought new innova-
tions to agriculture. (As Bill begins one of his
wonkily upbeat GatesNotes blogs, “I’ve never
been shy about my passion for fertilizer.”)
The foundation jump-started a national1 - Bill and Melinda GatesGFT.W.05.01.19.XMIT.indd 48 4/17/19 6:00 PM