Q&A with Bill Gates: The optimist
As he begins to wind down his foundation, Gates makes his biggest plans yet
In May, Bill Gates gave himself a bold new challenge and a tough deadline: to give away virtually all his wealth in the next 20 years and close up his long-running philanthropic enterprise. The Gates Foundation, one of Rotary’s partners in the Global Polio Eradication Initiative, has already given away more than $100 billion in its first 25 years. But for the foundation to wind down fully it first needs to ramp up — in order to spend more than twice that amount before it closes its doors on 31 December 2045.
Polio remains a priority. At the 2025 Rotary International Convention in Calgary, Alberta, Rotary and the Gates Foundation announced a joint commitment to direct up to $450 million over the next three years to support polio eradication, a renewal of their long-standing partnership. Rotary will continue to raise $50 million per year, with every dollar matched with two additional dollars from the Gates Foundation.
In June, Bill Gates dedicated an award he received from the Nigerian president to Chief Ayuba Gufwan. Paralyzed by polio at age 5, Gufwan serves as the executive secretary of Nigeria’s National Commission for Persons with Disabilities and CEO of Wheelchairs for Nigeria.
Courtesy of the Gates Foundation
To learn more about his decision, how he views the foundation’s legacy, and what lies ahead, the magazine posed some questions to Gates, who turns 70 this month. These are the responses he sent in their entirety.
As the Gates Foundation celebrates its 25th anniversary, what are you most proud of?
Over the past 25 years, we’ve witnessed and contributed to more progress than we ever thought possible.
I’m proud of the partnerships that have contributed to saving lives — not only the Global Polio Eradication Initiative but also the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Gavi, the Vaccine Alliance. Thanks to these programs, the price of lifesaving health care innovations — vaccines, treatments, bed nets, and diagnostics — has dropped dramatically.
The impact is mind-blowing: Thus far, these collaborations have reached 1.1 billion children with lifesaving vaccines, helped cut global child mortality in half, and saved more than 80 million lives. Hundreds of millions of people have risen out of poverty and into better lives.
As you wind down your foundation over the next 20 years, where do you think your money will make the biggest impact? What headwinds do you anticipate?
In spite of all of the progress I’ve just described, we are seeing the toughest headwinds in the history of our foundation. Countries are slashing tens of billions of dollars in global development funding, and the consequences will be deadly. In fact, this will be the first year in the new millennium when the number of kids dying around the world goes up instead of down — an unthinkable tragedy.
Illustration by Uli Knörzer
We need people who are committed to progress — like Rotarians — to stand against these deadly cuts and help us get back on a path to progress.
For our part, we will be accelerating our work over the next 20 years to solve urgent problems and save and improve more lives. We remain steadfastly focused on where we can have the most impact: 1) reducing child mortality, 2) eradicating or eliminating infectious diseases, and 3) lifting millions more people out of poverty and onto a path to prosperity.
We’re placing our bet on human ingenuity — on the scientists, health workers, educators, and farmers whose tireless work has already delivered some of the most dramatic gains in human history. They haven’t given up, and neither will we.
How do you ensure sustainability?
Our goal at the Gates Foundation has always been to solve problems, not manage them in perpetuity. That means helping communities build capacity to take on the challenges they face. That will be our priority for the next 20 years, and we hope it will be the priority for the next generation of catalytic philanthropists who will take up the challenges of their time.
New innovations will continue to give these communities better tools than ever before to invest in their own health and prosperity. So, despite the challenges we face, I’m optimistic. The past 25 years was one of the greatest periods of human progress in history, and I believe that we can make the next 20 years even more transformative.
Wild poliovirus case counts rose in 2024. What makes you optimistic polio eradication is still possible?
I am as confident as ever that the global polio program will end polio for good.
What keeps me optimistic, despite some challenges, are the innovation, frontline workers, and global commitment driving this effort forward. The next-generation polio vaccine, nOPV2, is helping to stop outbreaks, protecting children in under-immunized communities from paralysis. More than 1.6 billion doses have been administered as of July 2025 — that is an incredible number of children protected from this devastating disease. And we now have enough supply of this new vaccine to protect children wherever it emerges.
In the countries where wild polio remains endemic, Afghanistan and Pakistan, the program is working closely with local authorities to tackle obstacles, improving cross-border coordination and strengthening community trust to reach all children with vaccines.
Despite the recent uptick in cases, we shouldn’t lose sight of the broader progress, which really is remarkable: the Global Polio Eradication Initiative has eliminated wild poliovirus in almost every country in the world, reducing the number of polio cases by over 99 percent. With continued commitment and collaboration, including from Rotarians around the globe, I am confident we can finish the job.
How is the polio program pivoting given the current political and economic volatility? Is there any change to how your foundation is doing its work toward ending polio?
The polio program has a long history of adapting to stop polio in some of the world’s most complex settings — working closely with governments and communities to protect routine immunization progress and stay focused on eradication.
Take Pakistan as an example. Security forces sometimes provide support in conflict areas so that vaccinators can do their jobs safely. But in areas of the Khyber Pakhtunkhwa province where conflict has been on the rise, the presence of those security forces was actually keeping families from feeling safe enough to go get vaccinated. So local influencers stepped in to keep vaccinators safe without having to involve security forces at all. The approach has been working well, with a reported 80 percent of children being reached. It will be critical that the program independently monitor these areas so we can be confident in the results.
Today, amid competing health priorities and growing political and financial pressures, we know tough challenges lie ahead. Some major donors are reducing support for global health, but new donors are also coming in with contributions, which is so critical at this time. And we are continuing to adapt as we do best, staying laser-focused on what works and using financial and human resources where they will have the greatest impact to end polio for good.
What’s the biggest lesson you’ve learned in your time working on polio eradication?
Progress depends on relentless collaboration. Success is only possible when polio workers, government officials, partners, and donors — including Rotary — all work together to reach children with life-saving vaccines, even in the world’s hardest-to-access areas.
We observed the power of this kind of collaboration recently in Madagascar during an outbreak of variant poliovirus. The government came in with strong political leadership to halt the spread; community partners worked quickly to strengthen vaccination campaigns; and international partners like UNICEF and the World Health Organization surged support to bolster those efforts. Everyone worked to protect children with vaccines in some of the most distant and isolated regions of the country, and they succeeded in stopping the outbreak.
Ending polio for good will require more collaboration like this whenever and wherever the disease continues to emerge. Rotary members’ roles as global advocates and civic leaders are critical to ensure polio eradication remains a top global priority.
This September 2000 photo captures Gates giving the polio vaccine to a child in India, an illustration of his long-standing commitment to ending the disease.
Image credit: Getty images
The Gates Foundation has funded technical innovations in polio vaccines for two decades, including the development and rollout of nOPV2. What most excites you about what’s in the research and development pipeline now?
Sustained investment in innovation is as critical as ever. As I mentioned, nOPV2 is already helping close outbreaks, and we continue to invest in more genetically stable vaccines to keep future generations safe from variant polioviruses. These advances are helping us stop transmission faster and protect more children with greater precision.
We’re also excited about the hexavalent vaccine, which combines protection for children into a single shot against six diseases: diphtheria, pertussis, tetanus, Haemophilus influenzae type B, and hepatitis B, along with polio. This simplifies immunization schedules and strengthens early protection for children, especially in regions that have limited health care resources. In fact, in July, Senegal and Mauritania became the first countries to introduce this vaccine with support from Gavi, the Vaccine Alliance.
These innovative vaccines are giving frontline health care workers better tools to reach every child and stop transmission of all forms of polio for good.
Why did you choose to have the Gates Foundation partner with Rotary? What does Rotary bring to the table?
Rotary was the first organization to envision a world without polio, and members’ leadership has been essential in driving this global effort for over four decades.
As a founding partner of the GPEI, Rotary has helped vaccinate nearly 3 billion children across hundreds of countries since 1985. Rotary members have contributed numerous volunteer hours and significant funding, and their advocacy has helped secure billions more from governments to support eradication efforts. Their global network allows them to deliver vaccines and engage communities in the toughest settings, from India to the Philippines to Ukraine.
Because of Rotary’s leadership, we are closer than ever to our shared goal of ensuring that families will never have to fear this disease again.
Why are you extending the Gates Foundation’s 2-to-1 funding match with Rotary?
Together, we hope to mobilize up to $450 million in new funding over the next three years. These funds will be used to support vaccine delivery, outbreak response, community engagement, and implementation and maintenance of polio eradication programs in affected regions.
This extension comes at a critical time. Over the past year, we have seen wild polio case numbers rise in the last endemic countries, Afghanistan and Pakistan. And the detection of polio in places that were previously polio-free is a stark reminder that polio anywhere is a threat to people everywhere. While transmission overall remains low, our hard-won progress is at risk. Reductions in global aid, vaccine misinformation, and rising conflict and political instability are all contributing to polio’s continued spread.
Continuing our partnership with Rotary will allow us to address these challenges and reach children around the world with lifesaving vaccines.
It is critical that we finish the job on polio. Eradication is the only way to make sure that continuing challenges don’t mean an ongoing risk for children today and for generations to come.
In 2009, your father, Bill Gates Sr., suggested to Seattle Rotarians that they work on malaria eradication. Over the years, their work has grown into the Rotary Healthy Communities Challenge, which the Gates Foundation supports through a $13 million donation and technical assistance and guidance. How does this project fit into your overall strategy for malaria eradication and preventing childhood deaths?
Our long-standing partnership with Rotarians has been critical to the progress we’ve seen against malaria in recent decades — and it’s more important today than ever, in the face of shifting agendas and uncertain financing that are putting this progress at risk.
Over the past 25 years, 2.2 billion cases of malaria and 12.7 million deaths have been averted — thanks to innovation, generous aid, and political commitment. For the first time, eradication is within our view, and the pipeline of next-generation tools to bring that vision to reality has never been stronger.
Rotary’s work is essential to building the networks of community health workers who will bring these tools to the people who need them. Through the Healthy Communities Challenge, Rotary is helping to train thousands of community health workers across the Democratic Republic of Congo, Mozambique, Nigeria, and Zambia who are treating malaria, pneumonia, and diarrhea in their own communities. These community health workers know their communities in ways no one else could. They’re the ones who will get us across the finish line in beating malaria in the toughest places — and in the process, they’ll build the foundation for healthier, more resilient communities that can face multiple health challenges.
How will AI impact development? Paint us a picture of what health care, agriculture, education, etc. might look like in 20 years.
Artificial intelligence has the potential to help solve some of the world’s toughest challenges. One of the key ways AI is helping to shape the future is by providing critical support to frontline workers — including community health workers, farmers, and teachers — who are using AI to reach people more efficiently and effectively.
In global health, AI-powered tools could significantly reduce pressure on overburdened health care systems by supporting frontline workers in diagnosing health problems and delivering better, more effective care. Imagine a nurse in a rural clinic using an AI tool to analyze a patient’s symptoms, flag high-risk cases, and provide accurate diagnoses and treatment suggestions. This kind of real-time clinical support could improve both accuracy and access, bridging long-standing gaps in care and bringing lifesaving capabilities to those who need them most.
And this is just the beginning. In agriculture, AI is delivering tailored advice to smallholder farmers to increase agricultural production. In classrooms, AI-powered tools are helping teachers personalize lessons for students and improve learning outcomes. f the world continues to prioritize equity and access at the forefront, AI can be a powerful force multiplier for development — expanding opportunity, reducing inequality, and improving millions of lives.
Rotary has been increasingly emphasizing measurable impact in its projects. As someone who has long been focused on data collection, can you give our members any advice?
Quality, timely data is critical for everything from development of AI-backed tools to vaccine delivery to advocacy. Through advances in how researchers collect and analyze global health data, we now know much more about what kills children, where these deaths occur, and why some kids are more vulnerable than others. By putting those insights to work, we’ve been able to make incredible progress over the last 25 years, reducing child mortality and saving lives. Over time, better data has revolutionized how we understand health challenges, target resources, and measure impact — and remains one of the most powerful tools we have to drive future progress.
Investing in data is a smart, cost-effective way to create impact. Continuing to improve data-gathering and to invest in the collection of quality data will give us a fuller picture of where our investments and programs will have the greatest impact and help us build solutions to some of the world’s toughest health challenges. Measuring impact and starting with quality data to design programs will make Rotary initiatives even more effective.
What message do you have for Rotary members?
Most importantly, thank you for your unwavering support to eradicating polio. Rotary’s leadership, advocacy, and sustained commitment have brought the world to the brink of eradication — something once thought to be impossible.
To Rotarians everywhere: Thank you for decades of dedication and partnership. Because of your efforts, we will one day live in a world where all children are safe from this disease. We look forward to leaving polio behind long before our foundation closes its doors in 2045.
This story originally appeared in the October 2025 issue of Rotary magazine.