February 14, 2020
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‘India Did Not Get Anything Wrong’

His calling card reads ‘Co-Chair, Bill & Melinda Gates Foundation’; his mindset is still of ‘Chairman, Microsoft’.

‘India Did Not Get Anything Wrong’
Narendra Bisht
‘India Did Not Get Anything Wrong’
outlookindia.com
-0001-11-30T00:00:00+0553

If philanthropy sounds like a nice, leisurely post-retirement activity to be squeezed in between morning golf and afternoon siesta, the sight of the world’s richest man zipping into and out of cities, countries and continents disabuses you of the notion. With a war chest in excess of $36 billion (approximately Rs 20,200 crore) and a statutory requirement that he must donate five per cent of it each year to remain a charity, William Henry Gates III doles out his millions with the same maniacal zeal that he sold software. His calling card reads ‘Co-Chair, Bill & Melinda Gates Foundation’; his mindset is still of ‘Chairman, Microsoft’.

So, he schmoozes with the Australian prime minister on Tuesday, tucks into chicken tikka masala and paneer mattar with the Indian health minister in Delhi on Wednesday, drops in on Hyderabad and Mumbai along the way before flying back to Seattle for the weekend. In between, the 58-year-old squeezes in visits to locations where his foundation operates, and happily does interviews and photoshoots because he sees them as a “break”. “The dumbest question I am asked is, ‘What does it mean to be rich?’” he tells Krishna Prasad. Excerpts from an interview:

How different are the Foundation trips to India from the time you ran Microsoft?

When you come on business you don’t spend time in the slums running things; you don’t go up to Bihar all that much. So, I’m seeing more of India, the real India, in this job than I ever did in the other job. I remember once saying that all these cities have big slums, and the Microsoft guy sitting next to me in the plane said, ‘No, no, no, Bangalore doesn’t have slums.’ When we flew over, there was this huge slum. I said, ‘OK, what’s that?’ He said, ‘Oh, maybe it does.’ So it is easy to be a bit naïve, which is fine. But what we are doing now, is very real.

Does this suggest to you that corporates and business houses have a rose-tinted view of India?

The people who are well off, even if you live in the same place, you have a way of not rubbing your nose in it all the time. When people first come to India, they are amazed that all these levels of income are so intermixed with each other. But you [Indians] are used to it; you are not going, ‘This is unusual’. Definitely, because better-off people are clustered together, whether in the US or better parts of India, there’s never the depth of awareness of what people are going through. Activating them, making them aware of it, is key to getting people engaged in reducing these inequities.

You once courted countries to sell your products. Now countries court you for your money. You almost seem like a head of state who can fly in and meet the biggest, most powerful people at a whim.

If you are CEO of Microsoft, you can fly into a country and meet with all those same people, but yes the nature of the trip, the meaning, is very different now. Back then I was trying to explain to them how the magical software could be useful to run government better. My interest and theirs was aligned. I was potentially a tool to help achieve their goals. Now when I come in as a Foundation and say ‘Hey, let’s have fewer children die in India’, my goals and theirs overlap very strongly. They have a broader set of goals but some of the key goals are the one of the Foundation has adopted. So they can think of it as more of a partnership discussion and in a sense we are partners. That’s a word that gets overused, but in this case it is true.

So, do you find yourself more loved and less threatening than before?

At Microsoft, people always wanted to come and chat up. There was lots of positive energy towards the magic of software, the American dream. I am not going to downsize that! Even in that role the interest levels were very high, but now it’s different, with different people. I spend most of the time with the ministry of health. I was with the IT guy discussing IT stuff. Now I do bring the desired measure of things that governments always want to bring. I do bring a strong sense of the money and want to be used for the best purpose, which comes from the private sector background that I have. When you look at government with private sector training, you can see things that should be done better. That’s kind of common sense. And fact that it is my own money I am putting against these things means, I am not joking around. I am not asking anyone to give me money at all, so it makes the conversation a little simpler.

Do you see your Foundation work as some kind of penance for your Microsoft work?

Not at all. I loved my Microsoft job. I feel it was fun for me. I think it was great for the world. In my 20s, 30s and 40s, that was the perfect job for me. Now in my 50s and 60s, partnered with my wife Melinda, this is the perfect job for me. Both the jobs let me learn a lot, let me feel like I could have an impact, let me take on things. Like Polio eradication, I have been raising money, telling people, but now we have violence in Pakistan. It’s not guaranteed work. We have to get clever, get smart about all these things. We are going through the whole statistics of UP and Bihar, there are a lot of shortcomings, how do we help? How do we make these things sustainable? So there are similarities in terms of finding innovators, hiring good people, taking on ambitious goals. What I did at Microsoft, once I moved past writing code myself, I was the manager, orchestrating things. My own powers have surprising amount of similarities.

Could this philanthro-capitalism become a little too big for comfort? Might people fear the Foundation like they did Microsoft, because it is so big?

I don’t understand the fear of Microsoft. What were they afraid of? That Google wouldn’t come along? That Apple wouldn’t come along? I don’t know what they mean by fear. Microsoft built products and they built great products in a hyper-competitive market. How big were they? They employed 100th of the world’s biggest companies. The turnover was a 50th of the biggest companies. In the size of companies that wasn’t very big. The Foundation is about reducing childhood deaths. If people are afraid we will move fast, so quickly and that we are so ambitious in reducing childhood death, they should be in great fear, great fear.


Safe keeping A vaccination programme

What’s the key mistake countries and governments made vis-à-vis what you are doing in public health.

Governments are never perfect. Their ability to measure things, their ability to find innovations and their need to use innovations isn’t as strong as the private sector. So their idea was to draw the scientists in and saying, ‘Let’s make a Malaria vaccine’. Nobody was funding the Malaria vaccine. Was that a mistake? Yes. While there were many projects the world was working on which were not as important as funding the Malaria vaccine. And which government in the world was supposed to do that? Companies won’t to do it because there was no market, because it’s poor people who have the malaria. They are not going to get paid back for the work. So yes, there was an opportunity to make things better.

But are there nights when you feel governments like India’s, are receding from public life, public health, public education and outsourcing the things that the state ought to be doing to private partners?

I don’t know what you are talking about. Have you looked at the health budget recently? The number of public health employees in India is going up every year. NRHM (National Rural Health Mission), all those people, all those salaries. I don’t think it is shrinking. The question is, are they trained properly, are they measured properly? The size of government is not going down. All the countries we were working in, it’s about growing government in the best way possible. There is no shrinking of government in any country we are working. We need more primary health care, we need more people to deliver facilities.

You met Rahul Gandhi in Delhi. His father said of every rupee spent in India, only 15 paise reaches people. That’s the kind of pilferage you seen in government funding in this country. Are you seeing better results with your money?

I am not that cynical. I guess I am more of an idealist than whoever that person was. When we buy a vaccine we contract the vaccine. When we buy, say, 10 vaccines, it’s not the case that only one vaccine gets to the child. It may not be 10, we are getting about 9. It’s important that the people not be cynical about the government. Government, yes, it needs to be tuned up, yes, it’s imperfect, but for certain of these functions it’s absolutely necessary. That’s why we are here to help, to measure, to deliver.

So, you are saying that a technocratic kind of approach towards public health is for the public good.

Yeah, we are technocrats trying to help the technocrats do a better job. We are trying to help support units at the end of mainstream. Look at immunisation coverage. Avahan is a great example because it’s a system that involved a lot of measurement and thinking, but it also involved one of the more social constructs of all time, which is community of people who trust each other together and work together. Avahan is an overwhelming success at convincing people to insist on safe practice and therefore reduce the HIV epidemic. It also improved community credit savings but its primary aim was HIV prevention, it is a runway success. So that’s a good example of combination of things— and not just technocratic. But to come up with it, to execute it, to keep it on track required a technocratic strength which actually the government has picked up and done a quite a good job maintaining.

Was there a reason why you chose HIV and Polio as your priority areas when it’s actually tuberculosis that kills more people in this country?

Well, we are very involved in TB. We have had a worldwide TB programme for over a decade. Our top TB person two years ago chose to step down from his top and to come and live in India and work on TB. Yes, TB in India is not a great situation. There is no Avahan of TB at this point, and because it is diffused in the community, the tactics of combating it have to be a bit different. In HIV, there was a group of commercial sex workers of various types, there was a risk of the disease, and if there was going to be a general epidemic it was going to be coming through them. India was potentially on the verge of an AIDS epidemic. In places like Mumbai it had gone up by 70 or 80%. You were about to see exactly the same thing that had happened in some African countries where commercial sex workers were the key factor. You will have to get in early to these areas from where it spreads.

Of all the countries you now personally visit, where do you place India in terms of ranking?

Well the majority of unvaccinated children in the world are in India. The most kids who die of measles are in India. The majority of vaccines are manufactured in India. India is so unique. If you take Africa as a continent, we do a little bit more than we do in India. But we do way more in India than in any single country. But in India we have unique partnerships like we have for Bihar, the work we are trying to do in UP. Then we have our programmes in sanitation, agriculture.

As someone who set up this giant corporation and made it so successful, when you see India grappling with problems like this, what do you think India got wrong?

India didn’t get anything wrong. India every year gets better. Understand the childhood death rate. In this country, three million children were dying, now it’s 1.7 million. So every year is a year of progress and so we don’t step back and think about what if the British had never come or something like that. We look at the practical situation. The government has made this huge investment in NRHM, which is a great thing, but is the country getting as much out of that as it should? Our grants and our ground people help people to make it work and make it sustainable. All good news, so we don’t say why is government so imperfect? We wake up and try to help that stuff work to be perfect. It’s never going to be perfect, but within India you have places like Kerala that do a very good job on this stuff. So our job is pretty simple, we were trying to make UP as good as Kerala. If we get to that point, all of us will feel like, wow, all of us will feel super-good but it’s complex: hiring, monitoring, training, check lists.

Do you get the feeling that people like you in this country, the billionaires and trillionaires, are doing enough in terms of charity? Should they be doing more?

No, no. There is no ‘should’ in philanthropy. The question is, can we expose them to how much fun it is to do this work, and how much impact it can have. We cannot shame people into being more philanthropic. It will be up to them to find something they are passionate about. I am part of a dialogue with successful Indians: we talk about where we made mistakes, where we found success. I do think philanthropy is growing in India. It will become positive and fast forward. Now compare the business in the private sector, philanthropy is a tiny little piece. When we get someone like Azim Premji saying I am going to show how education could be done better, not only are you affecting the kids who are directly in his programme but it wholly takes on government. Government learns and sees that. I think it is a fantastic thing. Groups like Pratham go around helping schools get better. Actually it’s the lot of Indians in the US who founded that. So there are some great shining lights in the philanthropic activity independent of us.

But there’s much resistance from India’s rich to pay more taxes, something you advocated in Australia.

I am not an expert on the tax laws in India. I have no statements to make on Indian tax laws because I don’t know them very well. In the US, there is a budget deficit and I advocated that the rich should pay more taxes. But that is all about changing the law, that’s politics and I have no statements to make about taxes in India. Maybe there is something to be done with taxes to encourage people to be more philanthropic. That may be good thing, to make people more philanthropic. The US does that very well. The rich must follow the laws, if not they should pay the price for it.

At the end of the day, when you look at your CV will Microsoft seem bigger for you or the Foundation?

That is really hard to answer. I worked 20 hours a day, I was not married, I was fanatical. I was about the magic of software from age 17 and into my 40s and I got a lot done. I hired some great people, added to personal computing, I travelled the world, I learnt how to do business worldwide. That was amazing and you look at people using these tools, having been part of that, it means something to me. That digital revolution continues. I needed all that training and the resources I got from Microsoft enable me to do the Foundation work. The Foundation work is helping the poorest in the world and in that sense it’s kind-of got this most romantic justice to it. In that, you have somebody who has a huge amount of wealth who is taking and making all that wealth have the most impact as possible for the poorest.

If, at the end of all these efforts, would you be disappointed if a Nobel Prize does not come your way?

No, my goal is poverty eradication. My goal is bringing Indian childhood deaths below a million. There is no prize in the world as exciting as getting Indian childhood deaths down from 1.7 million to 1 million. And if we get these new vaccines rolled out, if we get the coverage, there is a path to achieve that. Going to the event where we celebrate the eradication of polio will be more fun than any other Prize. Because that’s a prize we can imagine.


A shorter version of this appears in print

 

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