The Gift that Keeps on Giving

This past week I had time to reflect on the passing of a great man: Bill Gates Sr.

While many are writing about his countless accomplishments, I’d like to talk about the Bill Sr. I knew.  

More than 20 years ago – before the Bill & Melinda Gates Foundation was even born – I was working at Johns Hopkins University of a center I helped found – the Center for Communication Programs – a world leader in the field of behavior change in public health. Bill Sr. had reluctantly agreed to visit Hopkins upon the invitation of his friends, Dean Al Sommer and Professors Laurie Zabin and Henry Mosley. He made it clear that he wanted to keep his visit low key. I was designated to pick him at the airport. It turned out that he didn’t want to be picked up after all because he wanted to rent a car to try out the then-new GPS navigation system. And he was really excited to experience this new technology.

Bill Senior’s reluctance to visit Hopkins stemmed from his impression that his son Bill Jr. and his wife Melinda were not interested in funding universities. However, during his visit he said he was “blown away” by the caliber of the students he’d met from the developing world. He repeated those words to me and many others… “blown away,” and cut a check to Hopkins for $2.3 million the very next week.  Bill Sr. told me then that his philosophy was to give funding to the best institutions and trust them to do the job well. He was later quoted in a 1999 Wired magazine article titled Philanthropy Pop-- Bill Sr., the man giving away Trey’s billions as saying: “We feel really good about the overseas education work that Johns Hopkins University is doing in family planning and the outfit that’s trying to find a vaccine for AIDS.”

That seed grant and subsequent gifts laid the foundation for the establishment of the Bill & Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health. His generosity led to thousands of young and mid-career professionals in the developing world being trained in public and reproductive health leadership - and Centers of Excellence being established in universities in 10 countries. These in turn accelerated the identification and training of more leaders through formal degrees, seminars, and workshops. 

In hindsight, one can only marvel at the extraordinary vision of Bill Sr. in making these early investments. He saw the need to reinvigorate the field of family planning and bring it to the forefront once again after being left off the global agenda for 15 years. He understood that making family planning exciting would attract the best and the brightest to it and to the broader public health field. He saw the need for long-term investments, not just the transactional quick-fix kind so common today. He may not have foreseen the specifics of the birth of the Family Planning 2020 movement, but he knew there were no easy ways to jumpstart a global movement. Moving from good to great can only be achieved when you have a critical mass of highly self-motivated people worldwide committed to excellence with a passion for a common goal. By 2012, thousands of these leaders were ready and in place around the world to shepherd what became known as FP2020.

In 2007, I was ready to retire early from Hopkins. But I received an invitation from the Bill & Melinda Gates Foundation to help revitalize the global family planning agenda, and it was too good an opportunity to pass up.  My professional career began with family planning and reproductive health, and it would be fitting and fulfilling to end on this note.  

My path once again crossed that of Bill Sr. when I joined the Gates Foundation to lead the policy and advocacy portfolio for family planning, maternal and neonatal health and nutrition. When I saw him the first time at the foundation, I asked if he still believed in the idea of finding the best institutions and trusting them to do a good job. He smiled and said that while that was his philosophy when he was operating from the basement of his house, now grants had to be based on portfolio strategies, proposals, reviews, performance appraisals…. We both had a good laugh about that.

But it was during my first holiday party at the foundation that I discovered more about Bill Sr.’s essence as a human being. My wife and I arrived a bit late to the party and thought we were lucky to find a table still vacant at the front of the hall.  We took the two seats around the table. A few minutes later, Bill Sr. and his wife Mimi arrived, looked around and asked if it was OK for them to join our table. Of course, I then realized that the table I had staked a claim to most likely had been reserved for Bill Sr., as he was the main speaker that night! Bill joked with my wife and said I that I had the most difficult job in the foundation because I had to discourage people from having sex.  We had another good laugh though, because at the time, I was known by my colleagues as the person who wanted to make the topic of sex more “sexy” and was subsequently given the “wall of fame” award by my peers for bringing “sexy back to sex (family planning).”

His towering humility is what endeared Bill Sr. to so many people, especially the foundation staff. He was as humble as he was physically tall, and he was dearly beloved. He often had lunch in the staff cafeteria, and he was delighted to have people join him, as I happily did on several occasions.

In 2010, Bill and Melinda Gates won the United Nations Population Award but could not attend due to a scheduling conflict. Bill Sr. agreed to receive the award on their behalf. But he told his assistant that he would not do it until I briefed him about the progress of our family planning work and the full significance of the award.  I wound up being invited to accompany him to New York for the award ceremony at the UN to ensure everything ran smoothly, help him with his acceptance speech, and provide anything else he might need. However, his kind nature made me feel like he was taking care of me. He was solicitous, asking me more than once if I was okay and if everything was alright. That was Bill Sr.; he made everyone feel important. It just came naturally for him. 

One day, his assistant called and told me Bill Sr. was visiting Asia and he wanted to know if I had any recommendations on who and what to visit. I suggested that if he had time, he should visit Mechai Viravaidya in Thailand. Known as Mr. Cabbages and Condoms, Mechai was and still is a pioneer in the fields of family planning, HIV/AIDS prevention and micro-enterprises.  He is the founder of the Bamboo School (a winner of the Gates Foundation-supported $1M global health award given by the Global Health Council). He owns Cabbages and Condoms restaurants and a Cabbages and Condoms resort in Pattaya – with the profits used for many programs run by his NGO. As you can see from these pictures, it was a successful visit, as Mechai and Bill Sr. connected in many ways. When he returned from his trip, Bill Sr. asked me if I thought it was a good idea for Mechai to be invited as the keynote speaker at the foundation’s annual staff meeting, and I wholeheartedly agreed. Mechai gave one of the most memorable and humorous presentations we had ever heard.

After I returned to Hopkins in 2013 to join the Gates Institute, we invited Bill Sr. to deliver the keynote address at our 15thanniversary celebration, which he graciously accepted. After he arrived, his assistant called to say that Bill Sr. wanted to see where he was going to deliver his address. I told his assistant that everything was all set for the next day and he should rest because it was already 7 p.m. But Bill Sr. insisted. When he came to the auditorium, he smiled and said he wanted to make sure the podium would work for his six-foot-six-inch tall frame to ensure he could read his speech.  Unfortunately, when it did not meet his needs, he said that this situation had happened to him twice before, and he was determined that it would not happen again!  So, we quickly located a broken music stand backstage and duct taped it to the podium at a height he found comfortable. He gave me a quizzical look and then smiled at the improvised contraption. I said, “Don’t worry, Bill, this will look awesome tomorrow and not at all like a broken music stand that was duct taped.” Again, we had a good laugh.

Bill’s vision in establishing the Gates Institute at Hopkins has been a gift that keeps on giving. It has enabled the Institute to create sustainable platforms to train thousands of leaders of today and tomorrow in research, policy and advocacy, breakthrough innovations in the use of smart phones for performance monitoring, and demonstrating scalable, high impact, low cost, business-unusual programming for sustainable programs addressing the needs of urban slum residents. It has enabled the Institute to steward and leverage up to four times every dollar invested, by bringing other partners on board.

All that the Gates Institute has done and will do in the future with all of its partners worldwide is the result of Bill Sr.’s visionary legacy. His gift’s benefits will continue to amplify for years to come. 

But the reason I wanted to recall my personal encounters with him is because, above all, his simply “showing up,” as he would like to say, illustrates to me his enduring values – humility, concern for others, a sense of humor (including the ability to laugh at oneself), and a sense of purpose. He knew that more than material resources, non-material ones are the most important – trust, confidence, respect and integrity – because they are hard to earn back once lost. He lived that way throughout his long life.

Bill Sr. was not just a great man to me. I agree with his son’s very apt description, he was incredible.

Jose “Oying” Rimon II
Bill & Melinda Gates Institute for Population and Reproductive Health
Senior Scientist
Population Family and Reproductive Health
Johns Hopkins Bloomberg School of Public Health

Amy Tsui
Director from 2002 to 2013

Laurie Schwab Zabin
Founding Director