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In 2003 President George W. Bush announced a five-year, $15 billion HIV/AIDS treatment and prevention initiative, the largest commitment ever by a single nation to an international health effort. "It would have been outlandish to even consider that the U.S. government would do something like that before," Kim says. This year European nations pledged an astonishing $4 billion over 10 years to immunize children in poor countries--dwarfing the Gateses' $1.5 billion contribution. "When the history of global health is written," says Dr. William Foege, a former head of the Centers for Disease Control and Prevention (CDC) who now advises the foundation, "the tipping point will be two people: Bill and Melinda Gates."
Both Gatses guard their privacy closely, barring reporters from their plane and their home in Seattle. Melinda, in particular, has resisted the attention that comes with their wealth. For the first nine years of their marriage, she declined almost all media interviews. She quit her job at Microsoft after she had their first child in 1996. "I wanted to have some privacy in our community," she says. "When I took the kids to a preschool event, a mommy-and-toddler event, say, I could be like all the other moms."
Only after their youngest child, Phoebe, turned 1 did Melinda begin to go public. "Bill and I both felt it was important that people know we're both behind the foundation," she says. And the more she traveled in the developing world, the harder it was to keep quiet. "I was very moved. I felt that I had a role to give some voice to the voiceless."
Their friends and the staff at the Gates Foundation go to great lengths to emphasize that Melinda and Bill are equals. "She is not a junior partner in any way, shape or form. Bill likes that," says Warren Buffett, a close friend (and the second richest man in the world, for those who are counting). Says Sylvia Mathews, the foundation's chief operating officer: "We joke and say Bill and Melinda have 21/2 degrees: she has two; he has a half." (Melinda, 41, has a bachelor's degree in computer science and economics and a master's in business from Duke University. Bill, 50, dropped out of Harvard at the end of his sophomore year to run Microsoft.)
But despite what anyone says, it's clear that the big decisions still get made by Bill Gates. At a quarterly review of grants at the offices in Seattle, he sits at the head of the table, with Melinda on his left and his father on his right. Nervous staff members direct their presentations to him, not Melinda--who drinks a Snapple and seems like the most relaxed person in the room. Bill flings out questions in his trademark squeaky voice, with an expression on his face that suggests more curiosity than concern. "How are they going to prioritize?" he asks about a potential grantee. "Are they going to have a theme? Are they heart, lung, cancer, infections--what are they?" he asks, his voice arcing higher with each question.