Bill Gates Addresses 'Tough Questions' On Poverty And Power

This year, Bill and Melinda Gates are doing something a little different with their annual letter. They are answering what they call some of the "toughest questions" from their foundation's critics.

On the list: Is it fair that you have the influence you do? Why don't you give more to the United States? Why do you give your money away?

Since its inception, the Gates Foundation has given $41.3 billion in grants, including a grant to NPR.

After the letter was published on Tuesday, Bill Gates joined Ari Shapiro of NPR's All Things Considered to answer a few more tough questions. These responses have been condensed and edited.

Ari Shapiro: You have greater spending power than many countries. Unlike a government, you don't have checks and balances or the same level of transparency. How do you respond to that criticism?

Bill Gates: We're fascinated to know what alternate priorities are being suggested. We want to make sure we're being smart about which things we pick. In health, we look at what's causing deaths. We've also made sure that data is being collected in a better way.

In a world where people have private wealth, you could just spend money on yourself. We've chosen to go after malaria and HIV as our priorities. Our money will be spent on those causes. [By listening to] constructive criticism, that's the way the world moves forward.

You acknowledge in your letter that some of your critics [whose work is funded by the Gates Foundation] don't speak up because they don't want to risk losing money. How do you fix that problem?

Academic communities are usually pretty vocal, so even in the tuberculosis or HIV communities where we provide a lot of funding, people are saying, "Hey there's a new path you're not funding," or "the path you're on right now looks like a dead end."

This online world lets people give us a lot of feedback. But we're not wedded to any particular program. We want to improve human health and education. Surprisingly, there's more agreement about what to do for health than, say, U.S. education.

One of the big themes in your letter is investment in the United States. You traveled this year throughout the American South looking at poverty. Can you describe something you saw that will shape your giving in the years ahead?

The complexity of how a poor person has to deal with housing, health and education authorities, filling out different forms, is very complicated. So understanding how those programs could be more holistic or simpler for the people involved. These systems are well-meaning, but it's hard for people, particularly when they're facing a crisis, to get what's needed.

That sounds intriguing and also very different from the work that your foundation has done in the past. Are you talking about redefining the American bureaucracy?

Everybody who works on poverty has seen that just having vertical approaches is falling short in terms of effectiveness and efficiency.

We gathered a panel of 25 experts — one expert on eviction, one expert on economic mobility, and so on — to look at poverty, and they went out to those communities and created a report on what kinds of jobs and programs would be helpful.

Our foundation alone can't fund all those initiatives, but I think it's brought a lot of philanthropists together to think how [we] could be more coordinated to have significant impact.

You formed this foundation in the year 2000 with your wife Melinda. Virtually every year since then, you've argued that this is a better time to be alive than it has ever been. You make that argument again in this letter. I wonder whether you think people remain unconvinced. If so, why?

Oh absolutely, people are exposed to the setbacks, the natural disasters... When you say, hey, the murder rate in the country is less than half of what it was, they're kind of surprised. They think it must be the most violent time both globally and domestically.

That's a bit of a problem if you want to look at why we've made progress. If you're blind to it you're both depressed and not getting the benefit of where things really went well.

So we can be outraged about the things we haven't fixed yet, while actually recognizing that we've made a lot of progress. That should inspire us and educate us.

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