For evidence of what happens when an unstoppable force meets a profoundly movable human being, one has simply to measure the impact of the Bill & Melinda Gates Foundation.
From January 1995 through the end of 2017, their namesake philanthropy (along with earlier Gates family foundations that were merged into the Bill & Melinda Gates Foundation in 2000) has deployed an extraordinary, barely countable $45.5 billion. (When I asked the foundation, partly as a hypothetical, if they could send me an accounting of every single grant they’d doled out since inception, I got back a spreadsheet with 41,487 line items.)
That $45 billion has launched, and then continually supported, what global health experts widely acknowledge to be two of the most successful international, private-public partnerships ever formed. The first is the aforementioned GAVI, which has helped developing countries immunize 700 million children against preventable diseases. The second is The Global Fund to Fight AIDS, Tuberculosis and Malaria. The fund, through its own community partnerships, has put more than 17 million people on retroviral therapy for HIV, cared for 5 million people with TB, and treated more than 100 million cases of malaria in 2017 alone—even as it helped prevent an untold number of infections in all three diseases. (Apart from national governments, the foundation is also the largest donor to the World Health Organization.)
The Gates money, put to work through the Global Polio Eradication Initiative, has helped bring that horrific paralyzing disease to the brink of elimination, leaving only two places on the earth, Afghanistan and Pakistan, where the wild poliovirus remains active. In 1988, the disease could be found in 125 countries.
The eradication quest is, as nearly all foundation efforts are, sophisticated and data-driven. Gates-funded disease hunters have plumbed sewage systems in hotspot regions to check for lurking poliovirus and used digital satellite data to understand how many kids were in a given area—and, therefore, how many houses inoculation teams needed to visit.
The foundation has spent more than a billion dollars to date to reduce the burden of ancient, and long neglected, tropical diseases (NTDs) that can cause everything from blindness to anemia to an elephantine swelling of limbs—and that, despite the progress made, continue to debilitate one-seventh of the earth’s population. It has fortified health systems in developing countries and brought new innovations to agriculture. (As Bill begins one of his wonkily upbeat GatesNotes blogs, “I’ve never been shy about my passion for fertilizer.”)
The foundation jump-started a national conversation in the U.S. on education reform: one backed by data, as well as dollars—though there have been many of those, too. (It spends $300 million annually on K-12 learning, and on learning about learning.) The Gateses have even changed the nature and scale of family philanthropy—partnering with Warren Buffett in 2010 to convince other billionaires to give half or more of their money away during their lifetime or in their will. Today, nearly 200 families have joined the aptly named “Giving Pledge.”
“Every one of their actions has a multiplier effect,” says Warren Buffett in a phone interview about the pair, with whom he has been close friends for decades. His own fortune became part of that multiplication as well, when he donated 500,000 Berkshire Hathaway B shares to the Gates Foundation—a gift then worth about $1.6 billion.
“Every one of their actions has a multiplier effect. They act with a unity of purpose.” – Warren Buffett, Chairman and CEO, Berkshire Hathaway
But the impact of Bill and Melinda Gates is due to more than money. Buffett returns to his earlier thought: “The two of them have a multiplier effect—the two of them together. They act with a unity of purpose and with a difference of style,” he says, chuckling at the truth of his own line: “That just came to me—and it’s really true.”
“They are so results-orientated that most people have no idea all the things that would not be happening without them,” says Bono, who, like the Gateses, has been a tireless champion for global health, and whose own (RED) and ONE campaigns have received funding from the couple. “For as long as I’ve known them, their only interest in their income is the outcomes it can generate for others in terms of changing lives,” he adds. “They don’t ask for acknowledgment; they just get on with it. They set up the scene, hire the photographer, but are so focused on results, they sometimes forget to be in their own photograph.”
Their work over the past 20 years has helped transform the lives of hundreds of millions of people—and will surely affect billions more if the research they’re funding now helps prevent and cure AIDS, multidrug-resistant TB, malaria, neglected tropical diseases, and the flu. It will help immeasurably more if the work they’re doing now to empower women, provide sanitation, boost agriculture, and improve education (as well access to education) comes to full fruition.
For all that, Fortune has chosen Bill and Melinda Gates as our 2019 World’s Greatest Leader. The pick, pointedly, is a singular one; the power of their leadership is definitely double-barreled.