Bill Gates reveals how he decides where to spend his billions

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REUTERS/Rick Wilking

  • Bill Gates has sunk billions of dollars into vaccinations and therapies for the world’s deadliest diseases.
  • At a recent conference, he explained how he goes after low-hanging fruit that few people have thought to grab.

Bill Gates has invested billions of dollars into solutions for the world’s deadliest and most common diseases, such as malaria, tuberculosis, and HIV. His efforts have helped cut rates of child mortality, maternal mortality, hunger, and overall prevalence of such ailments.

At the recent JP Morgan Healthcare Conference, the billionaire philanthropist shared with moderator Dr. Sanjay Gupta some of the specific strategies he uses to make these world-changing investments.

“If you’re smart,” Gates said, “you find the thing that is risky and hopefully before you do a phase I or phase II test” – two stages of the clinical trials that are used to assess drugs – “you have an understanding of what’s going to to work. We’re no different than anyone else.”

Gates and his wife Melinda are cochairs of the Bill and Melinda Gates Foundation. The organization funds and coordinates research efforts to develop and deliver medicine to needy populations, typically those in developing countries.

Gates said one of his biggest strategies is to find ways to make big dents in infectious disease. He said there’s “lots of low-hanging fruit out there,” for which “there just hasn’t been that much work done.”

When it comes to malaria, for example, he told Gupta the current process is to run in-house human challenge trials. That means people can volunteer to take an intervention, typically some kind of tablet or pill, get bitten by a mosquito with malaria, and see if they get infected.

“If we can get the latest tools involved we can have a good chance at success,” Gates said, referring to creating effective disease interventions. The Gates Foundation has committed hundreds of millions of dollars to groups like the PATH Malaria Vaccine Initiative and the Medicines for Malaria Venture to develop solutions.

The method tracks with much of Gates’ past investments, in that he has gone after diseases that afflict millions – sometimes billions – with the hope of saving the most lives possible with a single, targeted approach. Since 2000, malaria death rates in Africa have fallen by 57%, something Gates has called “one of the greatest success stories in the history of global health.”

The Gates Foundation has invested in a host of companies that target malaria and other diseases afflicting the poorest parts of the world. At the JP Morgan Healthcare Conference, Gates pointed to CureVac and Moderna, two companies that use RNA molecules to develop cancer therapies.

“This approach is also intriguing as a potential immunological intervention for HIV, malaria, flu, and the Zika virus,” Gates said in his address at the conference. He went on to discuss possible interventions in neonatal mortality, which affects nearly 5 million kids annually.

Over time, Gates’ strategy has remained mostly the same: Pick a disease that robs millions of people of their lives or livelihoods, and if a given intervention can go a long way toward reducing that suffering, chances are Gates classifies it as “promising.”