From Riches to Rags

At least once a year, Bill and Melinda Gates like to take what they call a "learning tour" of the places that civilization has largely forgotten. On Dec. 6 in India, on the most recent of such visits, they left the five-star Taj Mahal Hotel in New Delhi, to which they had flown on their private jet the night before, and took a 20-minute drive to a slum colony in an area called Meera Bagh.

On the way there, through rickshaw traffic jams and past lumbering cows, a local doctor briefed them on the slum's 9,000 residents and five health-care workers. Melinda listened intently with her eyebrows raised, as she almost always does, while Bill interrupted to ask the kinds of questions you would expect from a capitalist billionaire. "Who owns the land?" (The doctor wasn't sure, but probably the government.) "How much do the health-care workers earn?" (Ten dollars a month.) "Is that a full-time job?" (No.)

Once they arrived, they strolled through the narrow alleys lined with staring children. Bill, in a black fleece pullover and khaki pants, stuck his hands in his pockets and squinted into the sunlight, not unlike a man walking down the fairway at Augusta. Several times they stopped to talk with families. In unit No. 774, they found Sushila and Suraj Naik, who live in the windowless space with their daughter Puja, 3, and a tiny new baby called Liza. The Naiks welcomed them, offering them the only seat in the unit—on the double bed that took up almost the entire room. The space was lit by a single bare lightbulb. Through an interpreter, the Naiks patiently answered all the Gateses' questions.

Sushila, dressed in a red sari, smiled broadly the whole time, showing improbably white teeth. Yes, her daughter Liza was born here in this room a month ago. Her husband is a carpenter. They pay $13 a month in rent. Melinda held Liza for a few minutes, and then she and Bill got up to go. "Very impressive," said Bill, using his default version of thank you. "Namaste (goodbye)," said Melinda, holding her palms together and bowing slightly. After the Gateses returned to the hotel, I went back to Meera Bagh to talk to Sushila. She was giving her children a bath, but she stopped to play hostess to yet another foreign inquisitor. I sat on the bed, and she stood beside it, discreetly breast-feeding Liza while Puja, the toddler, hid under her sari. I asked Sushila whether she knew the names of the people who had visited that morning. She said that she did not but that they were very nice. I told her the man in the khaki pants was the richest man in the world. Sushila smiled and said it didn't matter that he was the richest. All foreigners were rich compared with her, she said.

There are many places the Gateses could go together for an adventure. That they chose to come to India and Bangladesh to sit on concrete floors and talk about tuberculosis and diarrhea sets them apart from most globe-trotting billionaires. But their relationship with the developing world is even more complicated than that. As they tour hospitals and huts, they seem to delight in these escapades, not just because they are intellectually captivated by the scientific challenge of treating the diseases of the poor but also because they are convinced that they are living through a historic inflection point when medical breakthroughs could save the lives of millions. They see the Bill & Melinda Gates Foundation not as a solution but as a catalyst for this progress: pumping resources and rigor into the fight just when scientists are inventing new tools that could change everything. "This is a magic time in terms of the momentum we can get going," Bill says later from his hotel suite.

And beneath all those grand ambitions, there is another force at work: they get a kick out of sharing these pilgrimages as a couple—talking with transgendered sex workers in India or women who start businesses with micro loans in Bangladesh. In these situations, they prefer it if people don't know who they are. "We're just people from the moon, as far as they know," says Bill. Later, they spend hours talking about everything they've seen. Says Melinda: "That's a huge side benefit. We love doing this together."

in its six-year existence, the Gates Foundation has accomplished a fraction of what it aims to do. But already it has helped save at least 700,000 lives in poor countries through its investments in vaccinations. In the U.S., its library project has brought computers and Internet access to 11,000 libraries. And it has sponsored the biggest privately funded scholarship program in history, sending 9,048 high-achieving minority students to college. It is the largest foundation in the world, with an endowment of $29 billion. Each year it spends almost the same amount as the World Health Organization (who). In public health in particular, to which the foundation devotes 60% of its funds, "it's the most important organization in the world," says former President Jimmy Carter. The Carter Center, which has been working to eradicate guinea worm disease since 1986, received a pledge of $25 million from the foundation this year. "We've been intimately acquainted with their method of operation, the thorough investigation they do before they make a decision, their willingness to take a chance, their willingness to stick to something once it's begun and the extremely high competence of their top people," says Carter. "They know what they're doing."

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