盖茨夫妇如何改变数十亿人的生活？

2018年3月，比尔·盖茨又一次站在讲台前。过去几个月里他发表了一场又一场演讲，在旧金山敦促制药商关注影响穷人和富人的疾病；在印度安得拉邦宣扬小农场的价值；在阿布扎比建议王储和太子党继续支持全球医疗行动；在克利夫兰建议投资建更好的学校。

此刻，这位排名全世界第二的富豪，也是最积极为穷人争取利益的盖茨身处尼日利亚阿布贾，演讲的主题也一以贯之：投资“人力资本”的必要性。会议中心位于总统府附近，在场者包括尼日利亚总统穆罕默杜·布哈里，政府部门也几乎全员出席，从立法官员到各州领导再到商界领袖。大家都准备好聆听这位通过名下基金会向尼日利亚慷慨捐助16亿美元的人演讲。

两个月前，比尔和梅林达盖茨基金会走了非同寻常的一步，决定帮尼日利亚偿还欠日本的7600万美元债务，尼日利亚借该笔资金是为了消灭脊髓灰质炎。进展十分惊人。2012年，该国的骨髓灰质炎导致瘫痪病例占全世界一半以上，之后该数字已降至零。

但盖茨的演讲内容并非关于“继续做好工作”。相反，他告诉尼日利亚，虽然该国在非洲最富有，人口也最多，但仍有1.9亿人生活在危险边缘。盖茨表示，尼日利亚正面临“慢性的营养不良流行病”，尼日利亚儿童有三分之一长期营养不良，而且产妇死亡率排名全球第四高，也由此成为“世界上生孩子最危险的地区之一”。尼日利亚超过一半的农村儿童读写能力欠缺。基层医疗系统“千疮百孔”。

盖茨的话还没完。他表示，从人均国内生产总值来看，石油资源丰富的尼日利亚“正迅速接近中上收入水平，如巴西、中国和墨西哥”。但从有意义的衡量标准来看仍然更像贫穷国家，人均寿命仅有53岁，比隔壁收入更低的撒哈拉以南非洲国家还低9岁。尼日利亚正走向危险的未来，除非改变路线，开始为提升人民健康、教育和经济机会大笔投资。

“你们一直对我很客气，这么直言不讳也许不太礼貌。”盖茨向听众表示，他将事先准备好的演讲稿稍微改动了一点。但他解释说这从尼日利亚商人和亿万富翁阿利科·丹格特身上“吸取的教训”。丹格特曾告诉他：“‘我获得成功可不是因为假装销售我并没有的水泥。’我深以为然，礼貌可能更容易，但面对现实也很重要，这样才能进步。”

第二天的头条新闻显示，该演讲让政府“震动”。全球疫苗免疫联盟（GAVI）主席，曾担任两届尼日利亚财政部长的恩戈齐·奥孔约·伊维拉说，可能也只有比尔·盖茨才能做到。几年前，盖茨还在微软担任首席执行官时，就曾直言不讳地挑战政府领导人，例如上世纪90年代美国政府针对微软的反托拉斯案中。1975年，盖茨与保罗·艾伦共同创立微软公司。

如今盖茨已远离微软时代，但仍然坚持坦诚风格。“他在尼日利亚这次就是，还是直言不讳的风格，” 奥孔约·伊维拉说，不过现在坦率的态度中融入了别的东西，一种明确目的驱动的感觉，相对温柔的热情。

近来人们说起63岁的比尔·盖茨，热情一词频频出现。就在上世纪后几十年，他还经常被嘲笑是个傲慢又没有灵魂的企业掠夺者。

It was March 2018, and once more Bill Gates found himself behind a podium. In the previous few months, he had given one keynote address after another—in San Francisco, he’d urged drugmakers to focus on diseases that affect the poor as well as the rich; in Andhra Pradesh, India, he had preached the value of smallholder farms; in Abu Dhabi, he’d enjoined the Crown Prince and other princelings to continue their financial support for global health initiatives; in Cleveland, he’d promoted investment in better schools.

Now the world’s second-richest man and foremost itinerant advocate for the poor was in Abuja, Nigeria, talking about the same theme that had underlain all of these speeches: the need to invest in “human capital.” Among those gathered at the conference center, in the shadow of the Aso Rock Presidential Villa, was the Nigerian President himself, Muhammadu Buhari, and what seemed like the entire seat of government, from legislative mandarins to a full house of governors and business leaders—all primed to hear from a man who had, so far, lavished the country with $1.6 billion in grants through his eponymous foundation.

Two months earlier, the Bill & Melinda Gates Foundation had taken the unusual step of absorbing a $76 million IOU Nigeria owed to Japan, for money Nigeria had borrowed to fund a polio eradication effort. The progress there had been striking. In 2012 the country had more than half of the worldwide cases of this paralyzing disease; that number had since been cut to zero.

But Gates wasn’t there to deliver a keep-up-the-good-work speech. He was there to say the opposite: to tell his hosts that their nation—Africa’s richest and most populous, with 190 million residents—was on a knife’s edge. The country was facing an “epidemic of chronic malnutrition,” with one in three Nigerian children chronically malnourished, Gates told his audience. Nigeria had the fourth-worst maternal mortality rate on the planet, making it “one of the most dangerous places in the world to give birth.” More than half of rural Nigerian children could not adequately read or write. The primary health care system was “broken.”

The harsh litany went on. On the basis of per capita GDP, oil-rich Nigeria was “rapidly approaching upper-middle-income status, like Brazil, China, and Mexico,” Gates said. But by every meaningful measure, it still resembled an impoverished nation: Life expectancy was a meager 53 years—nine years lower, on average, than its low-income neighbors in sub-Saharan Africa. Nigeria was headed for a perilous future—unless it changed course, that is, and began to substantially invest in the health, education, and economic opportunity of its people.

“It may not be polite to speak so bluntly when you’ve always been so gracious to me,” Gates told the gathering, veering a bit from his prepared remarks. But, he explained, he was “applying a lesson” he’d learned from Nigerian businessman and fellow billionaire Aliko Dangote, who told him: “ ‘I didn’t get successful by pretending to sell bags of cement I didn’t have.’ I took from that, that while it may be easier to be polite, it’s important to face facts so that you can make progress.”

It was a speech that “rattled” the government, according to the next day’s headlines. And it could have been given only by Bill Gates, says Ngozi Okonjo-Iweala, chair of GAVI, the international vaccine alliance, who twice served as Nigeria’s finance minister. Years earlier, when Gates was CEO of Microsoft, the company he cofounded with Paul Allen in 1975, he’d had no trouble speaking bluntly to government leaders—vigorously challenging, for one notable example, the U.S. government’s antitrust case against the company during the 1990s.

The post-Microsoft Gates was still unabashedly candid—“He did that in Nigeria, and he didn’t mince words,” says Okonjo-Iweala—but the frankness was now infused with something else: a driving sense of purpose. A more tender kind of, well, passion.

That’s a word that’s used quite a bit these days to describe Bill Gates, 63, who in the waning decades of the 20th century was often pilloried as a brash—and sometimes soulless—corporate predator.

雷·钱伯斯是一位很有影响力的美国慈善家，现在担任世界卫生组织全球战略大使，也曾担任联合国秘书长疟疾问题特使数年。他说，盖茨对全球医疗领域不管什么“问题的热情”，以及“对病患的同情”都很强烈。医生海琳·盖尔曾在盖茨基金会工作五年，负责艾滋病、结核病和生殖健康计划，现任芝加哥社区信托公司首席执行官。她特别指出“坚定”一词，认为“该描述并不准确，太缺乏想象力。实际上应该是介于坚定和热情之间。盖茨这个人肩负使命，而且‘无所畏惧’”。

如果你想知道如此长久的热情动力何在，主要原因其实藏在基金会的名字里，不过是除了盖茨的另一部分：梅琳达·盖茨。

如果说比尔的超能力是敢于向强权说真话，梅琳达的超能力可能倾听弱者的心声，而且能消化并分享秘密，往往都是残酷压抑的智慧。她语气温和，却又如教堂钟声一样振聋发聩。了解她的人都说她真正不可思议的本领其实是倾听的能力。

梅琳达今年54岁，曾在盖茨基金会工作的盖尔回忆起2000年代初与梅琳达前往印度，会见了受到艾滋病毒影响严重的群体，都是从事性交易的女性。梅琳达像往常一样，坐在地板上倾听。“他们当中许多人常年受周围人们轻视和羞辱，”盖尔回忆说，“她静静听在场女性讲述自己的故事，了解她们的生活，为什么沦落到用性换取基本的生存，还有外界人的倾听，听她们的故事，愿意拥抱她们，按照正常人的尊严平等对待她们意味着什么，当时的场景非常非常感人，”她说。

在莫桑比克情况也一样。盖茨夫妇前往偏远的农村地区，听当地妇女谈论对子女的期望，“以及对无法供养照顾子女的担忧，” 盖尔说。“梅琳达会坐在地上，跟女性谈论母亲关心的事情。她就是有跟每个人联系起来的超凡能力。”

洛克菲勒基金会的首席执行官拉吉·沙赫也曾在盖茨基金会工作，经常与创始人一起旅行，但有一次比较特别：2005年12月前往孟加拉。政府竭尽所能欢迎这对著名的夫妇到访达卡，还把巨大的两人头像贴在机场路边广告牌上。然而，盖茨夫妇只想参观著名的国际腹泻病研究中心，或者人们常说的“霍乱医院”。

该医院成立于20世纪60年代，在帮助腹泻儿童生存的研究方面成果颇丰。“当时，”沙赫回忆说，“爆发了霍乱，我们也正好路过。不知道你见没见过霍乱病床，都比较高，中间有个洞，上面有蓝色的防水布，原因很明显。”每张小床上睡一个孩子。“孩子们不停腹泻，”沙赫说。“病床下放着水桶接排泄物。母亲坐在孩子旁边，不停地喂口服液，一般是加盐和其他电解质的纯净水。”这种叫ORS的口服液可以防止孩子在腹泻期间脱水甚至死亡。

梅琳达坐在一位母亲旁边，帮忙用勺子喂孩子。这两位女性一个出生在达卡，另一个出生在达拉斯的中产阶级家庭，通过翻译谈论晚饭吃的东西。就在那一刻，沙赫意识到梅琳达真的能做到跟任何人建立联系。他在谈话中停顿了片刻：“我记得可能不够准确。但我只记得她说：‘哦，我家里人也吃了米饭和豆子！’她就是这样，人们能以很特别的方式跟她产生联系。”

Ray Chambers, an influential American philanthropist who is now the World Health Organization’s Ambassador for Global Strategy and who for several years served as a UN Secretary-General’s Special Envoy for Malaria, says Gates’ “passion for the subject”—whatever that might be in global health—“and his compassion for the victim” are equally striking. Physician Helene Gayle, who spent five years with the Gates Foundation, overseeing its HIV, TB, and reproductive health programs and who is now CEO of The Chicago Community Trust, singles out the word “determined” before saying, “that’s not quite right—that’s too pedestrian. It’s somewhere between determined and passionate. I mean this guy is on a mission, and he is—the word is ‘undeterred.’ ”

And if you’re wondering what drives this perpetually refueling zeal, a big part of the answer can be found on the other side of the ampersand in his foundation’s name: ¬Melinda Gates.

If Bill’s superpower is speaking truth to the mighty, Melinda’s may well be hearing the truth of the unmighty—and then internalizing and sharing that secret, often brutally repressed wisdom. For a generally soft-toned speaker, her voice has the command of a church bell. But those who know her say her truly uncanny talent is simply the ability to listen.

Gayle recalls one trip with Melinda, now 54, and Bill in the early 2000s to India, meeting with a group that was particularly hard-hit by HIV, women in the commercial sex industry. Melinda—as was often the case—sat on the floor with the women and listened. “Many of them were despised and stigmatized in their own communities,” recalls Gayle, “and having her listen to these women’s stories and hear the lives that they led—why they ended up having to trade sex for basically survival, and what it meant to them to have people from outside come and listen to them, listen to their stories, be willing to hug and embrace them, and treat them like human beings with equal value—was a very, very moving moment,” she says.

In Mozambique, it was the same. The ¬Gateses would travel to a remote rural area, talking with women about their desires for their children—“and their fears that they wouldn’t be able to provide for their children and care for them,” says Gayle. “And Melinda would sit on the ground, talking woman to woman about the things that mothers care about. She has this remarkable ability to connect with everybody.”

Raj Shah, the CEO of the Rockefeller Foundation, has likewise worked at the Gates Foundation and traveled frequently with its founders, but there is one trip that stands out: Bangladesh, December 2005. The government had pulled out all the stops in welcoming the famous couple to Dhaka, putting their giant faces on billboards lining the highway from the airport. The Gateses, however, just wanted to visit the famous International Center on Diarrheal Disease Research—or, as everyone called it, the “Cholera Hospital.”

Established in the 1960s, the hospital had long been a pinnacle of research on ways to help children with diarrhea survive. “At the time,” recalls Shah, “there was a cholera outbreak, and we were walking through. And I don’t know if you’ve ever seen a cholera cot, but basically it’s a raised cot with a hole in the middle, and they have a blue tarp over it, for obvious reasons.” On each cot was a child. “And the kids just have constant diarrhea,” says Shah. “There are buckets under the cot to capture all that. And the mothers sit next to their kids and constantly give them a combination of oral rehydration, salts mixed with purified water and some other electrolytes.” That ORS, as it’s called, keeps the child from dehydrating and dying during the diarrheal episode.

Melinda sat down beside one mother and began helping to spoon-feed her child, as the two women—one born in Dhaka; the other, in a middle-class home in Dallas—talked through a translator about what they ate for dinner. It was a moment when Shah realized that Melinda could bond with anyone. He pauses for a moment in the conversation: “I could be wrong in all my recollections. But I just remember her saying that ‘Oh, my family ate rice and beans also!’ It’s just who she is: People connect with her in a very special way.”