When You Have $24 Billion...

What would a charity look like if it took Microsoft's hard-driving formula for success and applied it to giving away money? Well, a lot like the Bill and Melinda Gates Foundation. Patty Stonesifer, who was the top female executive at Microsoft before she got into the check-writing business, is the first to admit her approach to philanthropy combines a desire to help the needy with a geek's approach to problem solving. "Hey, we come out of the math-camp world," she says. So when Stonesifer, who chairs the foundation with Bill Gates Sr., the First Dad of Microsoft, talks about how she plucks winning grant applications from the thousands that pour into her Seattle offices, she can sound as if she's solving for x. "There's an analysis to be done," she explains. "Where are the biggest inequities? Where is the avoidable mortality and avoidable morbidity?"

One of the Gates' biggest goals is policy change, particularly in health and education. To that end, Stonesifer, whose foundation has more than $24 billion in the bank, likes to fund medical projects when the science has progressed to the stage that it can improve people's lives. And she tries to make grants that leverage rather than replace government dollars and encourage coalitions among public and private forces.

Stonesifer gets some advice on funding decisions from Bill Jr. and his wife Melinda. She is quick to deny one criticism: that their philanthropy is designed in part to generate good press for Microsoft and counter the perception that it's a big, bad monopolist. Bill Gates comes from a family with a long philanthropic tradition, she says, and when he was growing up, charity was "kitchen-table stuff."

Stonesifer's guiding principle is one echoed by the foundation's co-founder, who just happens to be the world's richest man: Where is the highest return on investment? Right now it's in medical research, education and libraries. Stonesifer, who has already doled out or committed $4.9 billion, has spent heavily on malaria prevention and research for an AIDS vaccine. Other favorite causes: wiring U.S. libraries for Internet access and bankrolling college scholarships for minority students. But what really moves Stonesifer is when there's a sense that it all makes a difference. As she puts it, it's about "seeing mothers in the worst neighborhoods of India, with children on their hips, bringing them in for a polio vaccination." That's a blue-chip investment of a higher order.