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Bill Gates announces the Gates Foundation will spend all its funds over the next 20 years, committing over $200 billion to global health and education. This historic philanthropic effort aims to save millions of lives and address critical global challenges.
Published May 9, 2025
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Bill Gates
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Interviewer: What are you announcing today?
Interviewee: Well, in celebrating 25 years of incredible progress at the Gates Foundation, I'm committing that my money and the money in the foundation will all be spent over the next 20 years to the causes that we work on. Global health being the biggest, education being the second biggest, and basically things that we treat lives as having equal value. And I'm super excited that that'll be over 200 billion that we'll give away during that time period and that we'll be able to save tens of millions of lives.
Interviewer: And you're not going to miss it?
Interviewee: No, I won't. I hope I'm still alive when we finish the 20 years, but I'll save a little bit to be able to buy hamburgers as much as I need.
Interviewer: Has any organization in the history of humanity ever given anywhere near $300 billion away?
Interviewee: No, this will be for a foundation and a large amount of research, definitely more than ever before. You could say so.
Interviewer: Why are you doing it now?
Interviewee: Well, I think it's important to double down on the great success we've had. You know, I didn't know when we got started how much progress we'd make. I saw the tragedy of over 10 million children dying every year. I saw that the vaccines that could save those lives were being given to rich kids who were not at risk and not to the kids in other countries. And so we've been able to make sure that vaccines that stop you dying of diarrhea or pneumonia and other diseases are now getting out to almost all of those kids. And that's why we've gone from 10 million children dying every year to under 5 million children dying every year. And, you know, we can do more.
Interviewer: But why double down now? I know you say you're optimistic about the future, but one could look at this change in your approach and think, is he worried? Is he panicked?
Interviewee: Well, whenever you create a foundation, you can decide that it should last forever. But then saying, okay, who's in charge? And, you know, will it stay true to the things I want it to focus on? By deciding to spend all this money in the next 20 years, we can get a lot more done. And after that, you know, there'll be other very wealthy people who can understand what the problems are, what's still left over. So we're getting a lot of certainty and doubling down because of the success. In a way, it's wild that somebody can have as much money as I do. It is wild. And, you know, so I'm lucky to say, okay, you know, let's make sure those who are the poorest are the most in need, you know, kind of an equity value driven approach that I got from my parents, that that's, I'll be able to watch over making sure that money is very well spent. So I guess what I was driving at is there's no
Interviewer: Particular worry or fear or concern of yours right now that's leading to this decision?
Interviewee: Well, I'm sad that 5 million children die every year. I'm sad that some of the causes like helping to buy vaccines for children. Now, it looks like we'll be able to raise less money now than we did in the past because the US at least is tentatively not supporting buying those vaccines. And other countries in Europe that have always been substantially more generous are also cutting back as they have budget tightness. I will say, um, despite the challenges we have right now, which are huge and surprising, I'm very optimistic about the progress we can make over the next 20 years. The next five, there will be setbacks because of these, these, uh, uh, cutbacks, but, you know, we'll get, and so the number of 5 million might go up for a bit, um, which shouldn't happen. It's terrible. Uh, but over time we'll get that number down even below, uh, 3 million.
Interviewer: But I heard something in the middle of that answer, which it sounds like in part you're doing this because you're looking at the world and you're looking at this country and they're doing less. So the Gates Foundation and other foundations need to do more.
Interviewee: Well, you always want more money going into these things where you're saving lives for a few thousand dollars. I mean, if people could actually visit and go to a malaria ward and see those children, they would buy bed nets. If you saw a hospital like one in a part of Mozambique called Gaza, you know, the money that stopped mothers from giving, uh, HIV to babies was cut off, uh, because of some confusion there. And, you know, that's just an incredible tragedy. Uh, so I'd be doing this even if others were being generous. You know, I, I want to make sure, uh, the money is spent as soon as possible. I view these things as urgent. In parallel with that, I'll always be an advocate, uh, that governments should, uh, you know, we're, we never asked for more than one percent, uh, to go to helping, uh, the poorest. Um, and, you know, I, I think, you know, cutting, when you're well below that one percent cutting that, I, I think is, you know, doesn't reflect the values I think we should, uh, stand for.
Interviewer: So you think America doesn't currently reflect the values it should be standing for?
Interviewee: No, I think the U S, uh, shouldn't be cutting the money for vaccines or HIV medicines. And I'll be an advocate, uh, that, uh, you know, what was done, uh, now over 20 years ago when President Bush created a lot of these programs, uh, for HIV, malaria, and some other things, uh, that, you know, that, that should be maintained.
Interviewer: What's it been like working with the Trump administration? I know you recently had dinner with the president. Did anything come out of that?
Interviewee: Yeah. So I talked to him about, uh, work on HIV and the great innovations and, uh, encouraged him the same way he had helped the COVID vaccine get done quickly. I said, Hey, let's work together to get, uh, what's called an HIV cure, uh, done sooner. I talked about polio or close, uh, that, uh, we, we stay committed. Uh, we could get that done in the next four or five years. So, uh, you know, it was a great discussion. Since then, some of the programs, uh, have been cut off and I, you know, I'm hoping both with the president or the Congress, uh, to get them to restore, uh, some of the, those aid activities.
Interviewer: If they don't, is the Gates Foundation large enough to take the place of what the government had been doing?
Interviewee: No, the, the government money here is, is, uh, over four times, even now at this high level where we're spending down over the 20 years, they, the government, the U S government's very big, bigger than one individual. So their money for global health, uh, was four times, uh, what,
Interviewer: What the Gates Foundation. So if this money goes away and you were talking about millions of lives saved, can you put a number on the lives potentially lost?
Interviewee: Yeah, absolutely. So we should be going from 5 million children dying a year over the next five years to 4 million. And now with these cuts, if they're, if they're not reversed, we'll go to over 6 million dying. So instead of going down, we'll go back up. Wow. So it's a difference of 2 million lives. Absolutely. These vaccines, the HIV medicines, preventing mothers from infecting their babies. Uh, the impact of this money has been miraculous. And the good news of going from the 10 million to 5 million, it's, you know, it's too bad people don't realize that, uh, in the US their government's generosity in Europe, their government's generosity, uh, partnering with us and others has been why we have a greater reduction in childhood death than ever in history of the world was this magic time period.
Interviewer: So why don't you think more people know this or, and are not right now calling their congressperson, writing letters to the White House and saying, please help?
Interviewee: Well, over time, I think they will. I mean, we have partners like Rotary who help with polio eradication. I don't think they'll, uh, stand still while that money and those people have been let go. You know, we want to not let polio spread back to where it's paralyzing hundreds of thousands of children a year. And that's, you know, hangs in the balance. So I, a lot of it is that you don't see it. You know, if you go visit, then you can't turn away from it. Uh, you, you will be drawn into the helping these children. And as you make these children healthier, uh, then they can be educated. They can uplift their economies. You know, the recipients like Indonesia and Vietnam, who got a lot of this global health money are now have graduated and they fund it entirely with their own resources. And so we get to focus in on the countries that are in the most need and help them lift themselves up.
Interviewer: I want to ask about focus, where to put one's attention because people hearing you talk right now, it's not that they want millions of children overseas to die of preventable illnesses. They don't know. No one's rooting for that. But at the same time, they're thinking the money that we have to give the money that Bill Gates has to give, why not spend it here in America where we have plenty of problems of our own?
Interviewee: So the, the plea here would be to say that for 1% of the budget, we're not touching the 99%. For 1%, if you can save lives for a thousand times less than we save lives here. And if that creates stability in those countries, so they're thriving countries that will participate in the global economy and we don't have to intervene with our military or anything. And the strategic relationship with them where they see that we've helped them, uh, advance, uh, and that that money is why you'll be able to see a future pandemic early and stop it from spreading like COVID did all the way to the United States. So there's a lot of benefits, uh, that come from what is a quite in the scope of the US government of a very modest amount of money.
Interviewer: And yet here we are with reports out there that the Trump administration may by executive order, make it illegal for charities like yours to send money overseas and still get a tax benefit. If that were to come to pass, well, just first off, what's your reaction to that possibility?
Interviewee: Yeah, I hope they don't do that. Um, I think that, you know, if you, uh, are successful and you care about children dying, you, you should be able to, uh, uh, give, uh, you know, all of these programs, buying vaccines, buying HIV medicines so that mothers don't infect children, buying bed nets. These are things that the US government was giving more than I am, uh, to these things. Now that is up for question. Uh, but I'd be surprised if they actually said the freedom to help those children is taken away.
Interviewer: Okay. You are turning 70 this year. Microsoft is turning 50. The foundation is turning 25. A lot going on. Uh, what are you doing to celebrate?
Interviewee: Um, you know, I'm stunned that, you know, I'm 70, uh, cause when I was young and you know, I thought, hey, those old people don't, uh, they're not very up to date on, you know, what's changing, what's important. And, you know, so here I am, uh, obviously now rather than, you know, write code myself or do it hands on, I'm supporting great young people, you know, scientists who are coming up with new vaccines. Like we're funding a TB vaccine and an HIV vaccine, and we're coming up with new, uh, uh, seeds that allow farmers to be more productive, even if the weather's, uh, getting more difficult for them. So it's, it's equally fun, uh, to be supporting, you know, very young, innovative people and, and heroes who are out in the field delivering these innovations. But the question was about celebration. Oh, okay. Uh, you know, I, I still like to work hard, but, uh, you know, when my birthday comes in late October, I'll, you know, gather hundreds of my friends and, you know, maybe they'll roast me or just, uh, you know, stay up late. Um, no, it's, it's incredible that, uh, you know, I'm, I'm very lucky to have these resources. I love doing the work. Um, you know, I get to travel and see the impact. Um, and I'm not working in my twenties. All I did was work. Uh, those Microsoft days were very intense. Now I'm, you know, more normal. I, I do take time off. I play tennis. I play pickleball. I get to read and, um, you know, so I'm, I'm not all, all work.
Interviewer: But while you are retirement age and you take a little more time for fun, you're definitely not retired.
Interviewee: No, I'm, I work full time. You know, I go to Africa and India and, you know, go to the labs where these scientists are doing the work. I like to really understand, okay, what's going well, what's not going well.
Interviewer: Um, what, what was it like in the note accompanying this announcement today, you write that you're beginning the last chapter of your career, just typing those words last chapter. What's that feel like?
Interviewee: Well, I wish I had, you know, even more time and, you know, I hope I'm lucky enough that during the 20 years that we spend, uh, all of these resources that I'll be able to both help guide it somewhat and, you know, see the work, uh, and make sure that others, you know, are going to step in to pick up where whatever doesn't get done, uh, during these next 20 years. Uh, no, I, I don't feel like a 70 year old that always kind of was like, wow, uh, how did that happen? Uh, but you know, I have to say, okay, this, this is, uh, you know, the last part of my life and I'm a steward of, of these resources. I should make sure that it's well spent, you know, Warren Buffett's generosity. That's always, I've felt a huge responsibility to make sure his generosity is, uh, highly impactful. And, and now, uh, you know, this is the last stage of all that.
Interviewer: I, um, I once sat down with Dolly Parton in an interview like this and I asked her, what does she hope the world says about her a hundred years from now? And she said, I hope they say, doesn't she look good for her age? But it does raise the question, Bill, what do you hope the world says about you a hundred years from now?
Interviewee: Well, I have no interest, you know, in that, you know, if I cared about that, maybe I'd make the foundation of, uh, a foundation that lasts forever. And I, you know, other people choose to do that. That's fine. I don't think that's the way to have the most impact. Most of the things I work on will no longer be problems. You know, TB should be eradicated. Measles should be eradicated. Malaria. And so, you know, people might be puzzled. What were these things? Uh, you know, just like smallpox, uh, has been eradicated. Nobody has to worry about that now.
Interviewer: What an amazing thing to say. The problems that you're working on now and taking on in the next 20 years, you think a hundred years from now will feel like distant memories.
Interviewee: Yeah. I think we'll treat all children's lives as having value, um, because the world will be rich enough and the innovative tools to let you do that will be so strong. You know, the, the childhood death number, you know, should be very small and not different between different countries.
Interviewer: You know, there's another big milestone in the year ahead, just about a year, the 250th anniversary of the birth of America, the declaration of independence. You're born here. You built your company here. As Barack Obama used to say, only in America is your story even possible. Do you think America 250 years in, or better question, do you think the world world is better off today because of America and its people than it otherwise would be?
Interviewee: Well, certainly the fact that both people born here and people who come here are working on the latest medical understanding and willing to share that knowledge, including some funding, uh, for it, uh, the U S has been fantastic. You know, the PEPFAR program, uh, that goes back to, uh, President Bush, that was so generous, you know, literally saved millions of lives. Uh, you know, the U S has a lot to be proud of. It's a model for research. It's a model for the amount of philanthropic giving people do where they can pick, you know, a huge range of causes from art to cancer, to, uh, education and do great work. No, this, this country's made gigantic contributions.
Interviewer: And yet, and I've covered this when I talk to young people, poll after poll shows that most young people don't believe, or at least don't have a positive view of capitalism. And many of them don't have a positive view of America. What are they missing?
Interviewee: You know, I, I, I think you're, you must be misreading those numbers. I'm definitely not misleading the capitalism number.
Interviewer: Uh, only 40% of people under the age of 29 young people have a positive view of capitalism, according to Gallup.
Interviewee: Well, I wonder what, you know, their, their thinking is the alternative to that. I mean, certainly, you know, we've seen where you have East, East Germany versus Western Germany, you have North Korea versus South Korea, you have societies that are culturally identical at the start, and one runs a more capitalistic system than the other. You see the outcomes in terms of education, life expectancy, freedom. Uh, now capitalism covers such a range of things. You know, should taxes on rich people be higher? That's within capitalism. Sure. Uh, you know, should companies be held to a higher standard? That's within it. But this is the system that organizes human activity that led to, you know, we, people now live over twice as long as they did a hundred years ago. You know, people are largely literate. Whereas if you go back a hundred years ago, the majority were not. So this system, it's very imperfect, but the arc of time is that it's worked very well.
Interviewer: Yeah, I mean, I think when you ask a young person, what do you think of capitalism? They're thinking, how's their life going and how do they think their future is going to go? And it does seem that from your generation to a younger generation, even younger than me, a lot of pessimism has snuck in.
Interviewee: And that's very complicated because, you know, what are they comparing to? They wouldn't want to have been born 50 years ago. Uh, honestly, if they think so, they're, you know, that's a, one of those factual, uh, difficulty problems. You know, we are far, far better off today. Um, but this is fascinating because 50 years ago, they would have said, uh, I could, I could have a high school degree, still have a job where I can save a little money, take a vacation, own a car, own a home, retire with dignity and hope my children are better off and expect that my children will be better off than me. People today don't even want to have kids in larger numbers than we've seen before.
Interviewee: Uh, well, the U S birth rate is down somewhat, all rich countries, uh, over time, you actually have, have some reduction there. This is the best time to be alive. You know, if you get cancer today, it's better than 50 years ago. If you're, uh, a woman, if you're a gay person, if you want to learn a variety of things. Uh, yes, there are problems. We need to solve Alzheimer's. We need to get rid of polio. Uh, but you know, now we have the tools that, you know, it's within our reach to make those advances.
Interviewer: Let's go back to the three big goals for the future of the Gates Foundation. One being eliminating childhood deaths, infant deaths and deaths of mothers in, in childbirth, the elimination of infectious disease. Before I get to the third, which is about prosperity, and I think it's a longer conversation. What are you most excited about technologically that's going to help you accomplish those, those goals?
Interviewee: Dr. Well, the, uh, you know, malaria is this terrible disease that was in America, but uh, got eradicated. You know, we have tools now that give us a chance to completely get rid of that. Uh, malnutrition is a terrible thing. You know, most kids in Africa don't ever develop their brain or their body because their diet isn't quite right. And that's just a huge tragedy. Uh, HIV, you know, we have 40 million people in the world living with HIV and, uh, they don't live their full lifespan, even if they're taking their medicine. And so we need a tool that actually does a real HIV cure. You know, in every one of those areas, the Gates Foundation is funding brilliant scientists. We have trials underway. And so even in this 20 years, I'd expect, uh, to, to have advanced each of those problems.
Interviewer: On that third area, putting people on a path to prosperity, education is a big part of it. You write about that. AI is a part of education. I've asked the heads of some of the major AI companies, the following question. And I'll ask you, what do you think a seven year old, a first grader needs to know today to be ready for the world that AI is creating?
Interviewee: Well, in a certain sense, it's going to be so novel that none of us are ready for it. But some of the aspects of it are incredibly positive. I mean, we're already creating these AI tutors. You know, so I went to New Jersey to see how a form of AI called Khan Amigo from Khan Academy was being used by the math teachers there. And it was great to see the kid who was way behind. It was helping him. The kid who was way ahead, it was helping him. The promise in areas like health and education of AI improving the world is phenomenal. Um, you know, kids will choose what they're interested in. They don't all have to be AI scientists that we only need a small portion, uh, to go and do that. But for any young person now, AI can, uh, foster their curiosity, help them learn new things. So it's a very empowering tool.
Interviewer: It is an empowering tool, but what I'm driving at is if AI can do most everything the human brain can do in the near future, what do we need to prepare the human brain for? What do we get up in the morning and contribute to the world if AI can do everything?
Interviewee: Well, that's, you know, that's called the embarrassment of riches problem that, you know, you won't have to work the long hours that you work today. You won't, uh, have a shortage of doctors and huge waiting lists. You know, if a kid in the inner city feels like, God, math's not for me. I'm confused. You know, they'll be able to seek encouragement and get things that motivate them, uh, to learn those things. And so it's true that if you solve so many of society's problems, society will get to decide how do you spend time and how quickly that comes, uh, you'd get pretty broad disagreement, but in general, that's where we're headed. Uh, and so that, you know, we'll, we'll have more freedom. It's a lot better than, than, you know, things going backwards where we don't, particularly if you look at a place like Africa, you know, millions die because there's not enough doctors and we'll use AI to provide medical advice, that will, will eliminate that tragedy.
Interviewer: So what do you teach a first grader to be ready for the world ahead?
Interviewee: I don't think you would change what you're doing today. You know, if they, they encourage them in the subjects they like over the next few years, the AI tutors will come in and, and help teachers, help them, uh, engage their students and motivate their students. But it's not like there's some new curriculum that we need to adopt.
Interviewer: All right. That's interesting. You mentioned Alzheimer's. Your father died with Alzheimer's. My grandfather died with a rarer, similar disorder called super nuclear palsy. And every day I think about it. I'm sure you think about it too. Where are we with understanding the brain and how to prevent illnesses like this?
Interviewee: Well, there's a lot of resources being put into Alzheimer's research.
Interviewer: Your father died with Alzheimer's. My grandfather died with a rarer, similar disorder called super nuclear palsy. And every day I think about it. I'm sure you think about it too. Where are we with understanding the brain and how to prevent illnesses like this?
Interviewee: Well, there's a lot of resources being put into Alzheimer's research.
Interviewer: I've funded some things. Can I ask you before you, do you worry? Cause I, I worry with my grandfather. Do you worry about the path your father went down and whether these next 20 years you could follow?
Interviewee: Well, certainly, you know, once you get to your eighties and nineties, your risk of all kinds of diseases as very high, you know, and we'll all, you know, eventually succumb to these things. I'm not somebody who's, I'm not putting my money into my longevity or the medical risks that I have. You know, most of my money goes, um, for, you know, deaths that are, are very cheap to avoid. I did pick Alzheimer's cause I met some of the researchers there and we now have a blood test where you can see what your amyloid levels are. Um, there's a lot of work going on with drugs. People like Eli Lilly have trials out that maybe if you're accumulating amyloid, you can use an antibody drug, uh, to get rid of that and prevent or reduce the chance of getting Alzheimer's. So I'd say this field over the next 10 years will be very different. Uh, you know, that's why I, I fund some of that work. I stay up to date on it. We're gathering data about all the people who have Alzheimer's so scientists can try out different ideas.
Interviewer: They all want me to ask you about measles. I find measles to be something hard to keep covering because the avail, the knowledge is available if people want to utilize it, get a vaccine, your risk goes way down. People don't seem to want to utilize it. And you and I having a conversation about it or scolding somebody or telling me what's telling them what they need to do, a conversation about it doesn't seem to help. In fact, on some level, it seems to hurt. People are offended to be told what to do.
Interviewee: Well, the number of measles deaths in the U.S. won't be large. It'll be a lot larger than it should be because of the, uh, skepticism from people in positions of leadership about the vaccine. It'll cause more deaths outside the United States because whenever, and there, you know, it's over 300,000 deaths a year. Uh, and so, you know, that, that to me is, is deeply unfortunate. Uh, you know, I've seen, uh, children who have measles, who are dying of measles. It's horrific. Uh, you know, the U.S. is lucky, uh, that we don't have much of that. We had a, uh, a thing in Samoa where they stopped using the vaccine and, uh, pretty quickly they had a lot of deaths, uh, from measles because of that. So, um, you know, it's a medical miracle and, uh, I wish we were using any, uh, influence, uh, to encourage people to vaccinate.
Interviewer: But it seems like the more you push vaccines, the more some people are resistant to the push. That's the trap that I struggle to get out of. I don't know how anyone does.
Interviewee: Well, you know, we're working to take vaccines and instead of having a needle, uh, it's just a little patch you put on your arm. You know, we don't know that might help improve the uptake. We're combining a lot of the vaccines together so that there's not as many, uh, shots involved. Um, you know, we've shown that the, uh, HPV vaccine, uh, in a lot of countries, they've taken our data and they, they see you only have to get it once, uh, to be fully protected. So that's saving a lot of money and helping us cover a lot more girls to prevent cervical cancer. So, you know, the vaccine story, we will have a TB vaccine. We'll have an HIV vaccine. Those are super important tools for the future of our health.
Interviewer: Hmm. Um, you mentioned Andrew Carnegie in the beginning of your essay, your note today, and Andrew Carnegie said in his memoirs that he doesn't believe in a personal God that cares about the affairs of man, but he does believe in a God. Is that where you are on the subject?
Interviewee: Yeah, I don't think I, I have definitive knowledge in this area.
Interviewer: But you seem excited about what you might learn in the next 20 years about this subject.
Interviewee: But I think the basic idea of the golden rule that, you know, we should help other humans, uh, you know, that pervades all religions. Uh, and, you know, my parents inculcated that mean, uh, you know, so that's guides the work I do.
Interviewer: But you've said you're more or less an atheist.
Interviewee: I don't have a particular knowledge of, uh, you know, what rituals God wants us to engage in, but my values are very similar to people who are deeply religious.
Interviewer: Interesting. Maybe God will hold a press conference one of these days. Help us out.
Interviewee: He could clear up a lot in 15 minutes.
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