There is an aerial sculpture called the Impatient Optimist on the campus of the Gates Foundation. Built out of clear, lightweight fibers, it is strung between the foundation’s two boomerang-shaped buildings like a net and hangs 55 feet above the ground. During the day, its gigantic folds sway as gently as a baby’s cradle if the wind is mellow, and billow like curtains in a more insistent wind. The fibers capture the changing moods of Seattle’s daylight. At night, the sculpture resembles an upturned, undulating jellyfish, almost bioluminescent from the LED lighting sequences that the artist, Janet Echelman, programmed so that they change color when the sun rises in the different countries where the foundation has global offices. Echelman, one of the country’s most well-known visual artists, took the sky as her inspiration to communicate boundless optimism. Knots in the netting represent our interconnected world.
The phrase “impatient optimist” was dear to both Gates and French Gates; it’s how they described themselves as philanthropists at the foundation. The term, which they began using regularly after the foundation’s media team, back in 2009, found that it resonated with audiences, was meant to communicate their unshakeable belief that the goals they set for themselves were achievable, no matter the setbacks, and their impatience to get to a better world was what kept them going. Like the determinedly cheerful whistle of a military officer lifting his troops’ morale, Gates strikes a note of optimism wherever he can—in letters, blog posts, and interviews and on social media forums. The word “optimistic” shows up frequently in the annual letters he pens for the foundation. The foundation’s weekly newsletter, in which it shares updates about its work, is called “The Optimist.” When Gates assesses the foundation’s work, acknowledging that there is still far to go, he insists on hope. Every uptick on a curve showing improved crop yields, every breakthrough in the mechanism for vaccine delivery, every data point about a death averted, is a victory. It is proof that the foundation’s work has value, and that there is reason to keep going. After all, to de-emphasize optimism is to give up, shut down, and go home.
Gates came to philanthropy with a fix-it approach, starting out with the ambition and naïveté of a newbie and the arrogance of a software king confident that by directing his fortune toward technological innovation in global health and development, his foundation could solve—or at least come close to solving—specific but seemingly intractable problems within decades. He has shared many aspects of his philanthropic journey, including his learnings and experiences, and the challenges and wins. But perhaps the one overarching lesson that Gates has learned is that progress is finicky and nonlinear, and its pace is sometimes so slow that a watched pot will boil over, and a snail will have reached its destination. Complicated as it is by underfunding, changing political affiliations, conflict, droughts, floods, cultural mores, conspiracy theories, and chaos, the story of global public health and development is a story of missed targets and abandoned strategies, of real-time adjustments and wasted opportunities. Is it better to direct efforts to prevent a disease or focus on its treatment? What good is a vaccine if it remains out of reach for the poorest communities? The ideal is constantly accommodating the real. For a man inclined to see the world as a series of solvable challenges, it has been a long and humbling test of patience, an unending game of Whac-A-Mole.
The Gates Foundation’s work has had enormous impact in many regions of the world, particularly in sub-Saharan Africa and South Asia. Trends in global morbidity and mortality rates provide one way to gauge the foundation’s success given the broad and deep nature of its involvement in global health. For the two-decade period ending in 2020, the maternal mortality rate—the number of women who die at childbirth—fell by 34 percent. For children under five years old, who are most susceptible to death from disease and undernutrition, the rate fell by 60 percent.1 In its annual report for 2022, the WHO credits “major investments and improvements in communicable disease programs, such as those dedicated to human immunodeficiency virus (HIV), tuberculosis (TB) and malaria” for declines in the prevalence of those diseases and the number of deaths caused by them, although challenges stemming from the pandemic have caused recent setbacks.
Still, despite the decades of efforts and billions of dollars spent by multilateral organizations, nonprofits, and governments, diseases like malaria and polio are yet to be eradicated. The WHO began trying to eradicate malaria—a key focus of the Gates Foundation—in 1955. There are victories: The total number of estimated deaths has fallen in recent decades, and the incidence of new malaria cases fell between 2000 and 2019. But they rose again in 2020 and 2021, largely in African countries, as pandemic-related disruptions prevented treatments from reaching those regions.2 At the same time, malaria-carrying mosquitoes are developing resistance to the pesticides sprayed on bed nets that the foundation and other health agencies distribute, creating new challenges even as the existing ones evade conquest.
Polio, another big priority for the Gates Foundation, too has proved impossible to uproot. The highly infectious and crippling disease cannot be cured, but multiple vaccinations can prevent it. In 1988, the nonprofit Rotary International started the Global Polio Eradication Initiative (GPEI). The foundation, which has made $5 billion in total grants to end polio, is a primary partner to Rotary, supporting its efforts to administer vaccines. The vaccine alliance GAVI, also backed by the foundation, is another big supporter of the Rotary initiative. In 2011, Gates proclaimed that polio can be eradicated with enough financial support. Three years later, the WHO declared polio a global health emergency, and the health community promised to eradicate it by 2018. India, which once accounted for the largest number of polio cases, was declared free of the wild poliovirus in 2014—a victory of immense significance made possible by the work of multiple organizations including the Gates Foundation, as well as the Indian government. Emboldened by that success, Gates predicted in 2017 that the end of polio worldwide was near.3 The global health community came close to fulfilling that prediction, but the 2019 coronavirus was a huge setback, and polio still exists in countries such as Afghanistan and Pakistan.4 At the same time, a strain of virus mutated from the oral polio vaccine itself has led to new cases. In the spring of 2023, a New York man was found to have polio. The polio eradication initiative has now set 2026 as a new target. “To be blunt, we are also closer than ever to losing the gains we have fought so hard for [if] GPEI doesn’t identify substantial new resources soon,” Gates said at the launch of the new strategic plan, calling for more resources.5
The world has missed other global health and development targets. In 2000, the same year that the Gates Foundation got going, the United Nations announced its Millennium Development Goals, a series of eight targets that its member states agreed to try to meet by 2015. The foundation used those goals as a roadmap to set its own priorities, focusing on improvements in public health and vaccinations. Then 2015 came and went. Progress was uneven, and the world fell short of many of the millennium goals. The United Nations next formulated the set of targets called the Sustainable Development Goals that it hoped to meet by 2030. In addition to the traditional goals of achieving gender equality, ending poverty and hunger, and improving access to education, the revised document established new and pressing targets: reducing economic disparity, combating climate change, and promoting sustainable growth. The goals have also shaped the recent priorities of the Gates Foundation, but it’s already clear that the world is unlikely to fulfill them by 2030. The pandemic had created massive roadblocks, choking off access to vaccines because supply chains broke down and healthcare systems were too overwhelmed to administer routine immunizations. In April 2023, as the pandemic ebbed, the Gates Foundation, along with global agencies like the WHO and UNICEF, announced an urgent vaccination campaign called “The Big Catch-Up.” With more than 25 million children not fully vaccinated during the pandemic, preventable diseases such as measles and yellow fever were on the rise, according to the foundation. Two devastating wars have taken a fresh toll on humanity. Since Russia invaded Ukraine in February 2022, tens of thousands of Ukrainians have died or been injured; amputees await prosthetic limbs, war widows grieve as they await aid. In October 2023, Hamas attacked Israel, triggering a destructive counterattack that bombarded hospitals, schools, and shelters, and killed more than 30,000 people within months, leaving survivors desperate for help and humanitarian organizations racing to provide relief. In 2022, Gates said that the pandemic and the war in Ukraine had created enough new challenges for the world that there was even more of a need for philanthropy. He said he would transfer $20 billion of his fortune to the foundation’s endowment, including $15 billion that he had pledged in 2021, adding to the nearly $70 billion in assets it currently holds.6
In recent years, Gates has picked climate change as his next big focus, directing his energy and resources toward fighting the effects of warming weather in the same determined way that he sought to eradicate certain diseases and solve specific problems in areas such as nutrition and vaccination. In his 2021 book How to Avoid a Climate Disaster, Gates explains the breakthroughs the world needs to avert calamity and lays out the steps needed to get there. In a video advertising the book, he draws a line from his earliest days at Microsoft, referring to the “wild idea” that made him rich and famous: “What could we do if there was a computer on every desk?” His latest wild idea, he says in the video, is to get emissions down to zero by 2050 while meeting the planet’s basic needs. Averting a climate disaster will be even greater than landing on the moon, eradicating smallpox, or putting a computer on every desk, he says. Innovation, he insists with an almost childlike optimism, will get us all out of this mess. “It’s our power to invent that makes me hopeful.” He told Wired magazine that his optimism about beating climate change reflected his success in general. “It’s a characteristic of someone who drops out of school thinking they can create a software company and hires a lot of people and then it actually works.” Furthermore, he told the magazine, it’s the huge successes of the foundation “that pushes you into the wow-what-can-I-do category.”7
In the book, however, he sidesteps the most important, and most obvious, point about climate change: With competing national agendas, fractured domestic politics, apathetic corporations, and investors who settle for dutiful gestures, even the wisest strategies and smartest innovations will make little difference. Without buy-in from the rest of the world, the arsenal of a single man—even if it contains the smartest minds, billions of dollars, a bottomless reservoir of determination, relentless hope, and the shrillest of alarms—can only go so far in defeating the foul gathering clouds of wildfires, hurricanes, melting ice caps, and raging temperatures. Gates is hardly blind to that criticism, but he argues that investing in the right technologies now will prepare the world for when there is no time for innovation or politicking left.
With the additional funds from Gates, the foundation will have to give out $9 billion annually by 2026 to keep its tax-deductible status as a nonprofit. “I will move down and eventually off of the list of the world’s richest people,” the billionaire wrote in a blog post.8 His giving has already pushed him down the list of billionaires, although the nature of wealth invested in the markets is such that it can rise and fall. In 2018, Forbes estimated his net worth at $90 billion. By 2022, it had risen to $129 billion, even after the separation of assets with French Gates, making him the world’s fifth richest individual. At the same time, the Gates Foundation is structured as a spend-down entity, which means that it intends to deplete its resources steadily and fold when it has bequeathed its last dollar. Unlike the Rockefeller Foundation, which has a perpetual endowment that allows it to continue its philanthropy more than nearly 90 years after its founder’s passing, the Gates Foundation is expected to wind down within the next 25 years. The governing documents can be modified, but unless they are, the foundation is likely to disappear sometime within the twenty-first century.
One goal of a spend-down foundation is to ensure that the intention of the founders remains intact, and that it doesn’t become a source of employment for future generations or executives who run the entity. In this case, though, it is driven more by the foundation’s urgency. “The decision to use all of the foundation’s resources in this century underscores our optimism for progress and determination to do as much as possible, as soon as possible, to address the comparatively narrow set of issues we’ve chosen to focus on,” according to a statement on the foundation’s website.
What, then, is the long-term impact of a spend-down foundation through which a hubristic billionaire technologist pursued his dream of fighting some of humanity’s most stubborn problems—problems that predated him and will outlast him, even as new ones arise? Any optimist will tell you that history is not a reason to give up on the future. But money, ambition, and optimism are modest beacons that can guide us only so far through the unmapped caverns of a troublesome world. What Gates will leave behind, in the end, is a palimpsest, a document of ambition upon which future generations of billionaires and philanthropists can scribble their own dreams and goals, effacing, rebuilding, and reimagining the Sisyphean task of improving our lot.
In The Great Gatsby, the narrator, Nick Carraway, reflects on the nature of Gatsby’s love for Daisy Buchanan, and the desperate lengths to which he went to rekindle their romance. “He had come a long way to this blue lawn, and his dream must have seemed so close that he could hardly fail to grasp it,” Carraway writes—the line that Gates and French Gates loved so much they had it painted on the ceiling of the library in the home they formerly shared. But in Fitzgerald’s slim Jazz Age novel, Carraway’s last words are hauntingly sad, evoking not only that which was gone but that which had never been attainable in the first place: “He did not know that it was already behind him, somewhere back in that vast obscurity beyond the city, where the dark fields of the republic rolled on under the night.”