Scaling a business in the US can feel like a maze.
Each state has its own payroll benefits and compliance rules, pulling your focus away from growth, which is why founders use DEAL.
DEAL is the Professional Employer Organization, or PEO, that gives you a dedicated HR expert plus Fortune 500 level benefits for your team.
The National Association of PEOs says businesses can grow twice as fast if they use one.
So if you're scaling, make it simple with Deal.
Go to deel.com slash MOS and get up to three months free.
Your company's data is everywhere, in systems, in silos, and across teams.
But if your AI can't reach it, then that data isn't working for you.
Every business has unique data.
What really makes a difference is how you use it.
IBM helps your AI access your data wherever it lives to change how you do business.
Let's create smarter business.
IBM.
Hi, listeners.
It's your host, Reid Hoffman.
Welcome back to part two of our landmark episode with Bill Gates on how to accelerate history.
In part one, we heard how Bill scaled Microsoft.
In this episode, we turn our attention to the Bill and Melinda Gates Foundation.
I believe this episode includes the greatest success story ever told on the show.
All that is ahead.
We'll start, as always, with a story.
There's a piece of technology we all use every day but barely notice it.
This technology has been around in some form or another since the dawn of civilization.
The ancient Romans, Chinese, and the Abbasid Caliphate all used it.
But product development plateaued over the years.
And billions of potential users aren't served by its current design.
That is what I call a neglected opportunity.
And a legendary tech founder stepped in.
We got universities involved.
We did prototypes.
Now we're getting big companies drawn in.
That's Bill Gates.
In recent years, he's taken on an audacious goal to completely reinvent a ubiquitous tool.
Most people turn up their nose at this essential invention if they notice it at all.
Through the centuries, this item has acquired a multitude of names.
The Dunny.
The Privy.
The Chamber of Commerce.
The Thunderdome.
That's right.
We're talking about the Toilet.
And if you're not familiar with its history, you're not alone.
But its origins are fascinating.
The modern lavatory was born in England in 1596 when John Harrington presented Queen Elizabeth with his invention a flush toilet, a bowl fed with water from a cistern that banished the royal business out of sight.
Flush 4 to 1866.
London is suffering from the Great Stink, a putrid smell that overwhelmed the city.
Its cause?
The use of the Thames River as an open latrine.
The solution?
Master engineer Joseph Bazalgette creates London's first sewer, an underground system of pipes that clears the air and drastically reduces deaths from cholera.
From that point on, sewer-based sanitation becomes a norm worldwide.
And the toilet innovation pipeline stops flowing.
Cities throughout the developing world still lack sewers.
Huge swaths of humanity are stuck with a great stink.
It's one of these things that you're never exposed to until you really are going out there.
And as you're touring those slums, it feels implied to bring it up, but it doesn't smell very good.
This isn't down to a lack of know-how.
It's down to a lack of engineering solutions appropriate to the geography and income of these cities.
The problem isn't just unpleasant.
It causes the deaths of a million children every year.
And yet, progress has stalled.
And so, unless there's some breakthrough, you're going to literally be living in human feces, with the unpleasantness and disease impacts that implies.
We expect consistent upward progress in tech.
But there are areas the market doesn't fund, where inflection points cease to come.
The toilet is one.
And Bill is asking...
Why can't we build a better one?
On paper, it looks very solvable.
It looks solvable, but no one was trying to solve it.
So in 2011, the foundation launched the Reinvent the Toilet Challenge.
They hold expos, they court research partners from universities and corporations and they fund promising ideas.
A solar-powered toilet.
A toilet that uses worms to break down waste.
A nanomembrane toilet that burns waste to ash.
We're still not there, but it did take some audacity to say let's bootstrap a completely different approach, because it wasn't going to happen otherwise.
It wasn't going to happen otherwise.
Bill Gates' career is a testament to what happens when the right person has the right idea at the right time.
And they do everything they can to accelerate history.
Change comes about differently in the nonprofit world than the commercial world.
But Bill's work with the Bill and Melinda Gates Foundation shows clear parallels.
I believe it's not enough to just take advantage of inflection points in history.
You have to accelerate those inflections if you want to achieve huge scale.
You've got to have incredible talent at every position.
There are fires burning when you're going home.
Can you believe it?
Such an idiot.
And then you go back to, this is totally going to be amazing.
There are so many easy ways.
I have no idea what to do.
Sorry, we made a mistake.
But you have to time it right.
Oops.
Working out of a three-bedroom apartment.
Stuff that just seems absolutely nut balls.
Ten years later, we're like, well, that's just how you do it.
We haven't made it just how you do it.
This is Masters of Scale.
I'm Reid Hoffman, co-founder of LinkedIn, partner at Greylock and your host.
And I believe it's not enough just to take advantage of inflection points in history.
You have to accelerate those inflections if you want to achieve huge scale.
In part one of this two-part episode, we saw how Bill Gates took Microsoft to massive scale by spotting and accelerating a string of inflection points in technology.
And the same kind of remarkable effort has driven their success at the Bill and Melinda Gates Foundation.
But in philanthropy, it's not enough to just spot an inflection point.
You may have to will them into existence with persistence, partnerships, innovation, and yes, money.
I should probably mention that the foundation has become the world's single largest private philanthropy, handing out more than 50 billion in grants.
But it's one thing to give money away and quite another to have impact with it.
So I want to start with a success story.
I'd argue it's the biggest success story we've ever told on Masters of Scale.
And to be clear, it's not Bill Gates' success.
It's humanity's success.
And the foundation played a pivotal role accelerating it.
Now, normally on Masters of Scale, we reveal the success story slowly over the course of the episode, knowing that you already kind of know how the story turns out.
But despite the magnitude of this global success, there's a good chance you've never heard about it.
Here it is.
In the past two decades we reduced childhood deaths by 50, from 10 million to just over 5 million deaths annually.
What does that mean?
It means that this year, four and a half million children who would have died before the age of five of something completely preventable are still alive.
It's an achievement that ranks among humanity's best work.
In this episode, we'll focus on the story of this one extraordinary inflection point.
It's the perfect illustration of the playbook that allows the gates foundation to accelerate history.
And we'll start at the beginning.
The Bill and Melinda Gates Foundation launched in 2000, combining two older foundations.
What inspired them was a shocking article they both read about children dying by the millions of preventable diseases.
I asked Bill about it.
What was the opening theory of this is how we're going to do something different than anyone's done with foundations before.
Well, our big theory was that there were innovations that the market wasn't funding.
As I'd learned about why, at that time, 10 million children die every year, and then looked into how many resources were going to fix those problems malaria diarrhea, pneumonia I was completely shocked.
When you have a disease that only poor people have, the market doesn't have an incentive to come up with drugs and vaccines for those diseases.
The lack of attention to fatal childhood diseases would be the first of many jarring discoveries.
But at first, the challenge seems straightforward to Bill.
There were diseases that needed cures.
So we would go in and solve that.
This wasn't arrogance.
It's more a testament to Bill's optimistic belief that technology can overcome almost any problem.
And that's natural for me, because Microsoft created a software economy by hiring top engineers and riding the wave of more powerful microprocessors to create software and software platforms.
Bill wasn't underestimating the problems.
He was remembering what worked for him in the early days of Microsoft.
Then he leaned into the inflection point around newer, faster microchips.
Here, he was eyeing another inflection point, this time biotechnology.
The tools were emerging.
They just weren't being used to solve the challenge of childhood disease.
Here you had biological science moving ahead DNA sequencing, stem cells, all sorts of deep knowledge.
But then applying that knowledge to create actual tools and making sure they could get out to all the children in the world.
There was this stunning vacuum which was, in a way, tragic.
But it excited me because I thought okay, that plays to my strengths, plays to the values Melinda and I have.
Let's go build a team to do that.
Let's go baby Let's go build a team to do that.
Bill was ready to solve.
He saw a challenge, childhood deaths in developing countries.
And he saw a tool set in biotech that would enable new vaccines and drugs.
Now he just needed to know which problem to solve first.
For this, he needed data.
And Bill found himself foiled from the start.
My assumption was that the same type of measurement and celebration of great successes and discussions of great failures would exist in this global health community that existed in private markets.
In fact, the underinvestment in knowing how many children died and what they died of was unbelievable.
It was a riddle at a global scale.
And Untangling how Bill and the Foundation found a meaningful way to make a difference here is like following a detective story from an especially convoluted case.
At each twist in the tale, just as Bill thinks a solution is in sight and the riddle is solved, another thorny issue stalls progress.
But the story begins with their search for answers and partners.
You'd think that the pride and the energy and visibility of that work would draw in more and more people and a lot of top talent.
In fact, it was truly obscure.
When the United Nations issued its Millennium Development Goals in 2000, Bill and Melinda latched onto them as the kind of clear, measurable goals they could get behind.
Among the eight Millennium Development Goals, there were targets like eradicate extreme poverty and hunger, achieve universal primary education and reduce child mortality.
We got involved in the Millennium Development Goals and that was the first time there was something that brought that through in a crisp way, that the world does have a report card that is not just increased global GDP, that deaths and hunger and malnutrition, or responding to crises like the HIV epidemic, even though the market system alone isn't going to solve those problems.
We should think of that as being part of our report card.
Here's the first lesson of accelerating any historical inflection point.
Don't go it alone, even when you're Bill Gates and you funded the world's largest private philanthropy.
Don't go it alone.
Bill and Melinda immediately saw that the Millennium Development Goal number four reduce child mortality was the inflection point they were looking for.
And the foundation would ultimately become the largest philanthropic contributor to the goals by far, contributing 179 billion.
But it's one thing to write a check, and quite another to solve a problem.
The Foundation was determined to do both.
And for that, they needed to understand why, exactly, so many kids were dying.
Remember what Bill said earlier.
The underinvestment in knowing how many children died and what they died of was unbelievable.
Everyone knew the number of child deaths was staggering, but no one knew exactly what they were dying from.
It turns out that causes of death were often not recorded, and when they were, they were often vague.
For example, two of the most common listed causes of childhood death were pneumonia and diarrhea.
And that didn't add up.
Even the term diarrhea is a symptom.
It's actually not a cause.
There's one thing rotavirus that was causing over half of those, but the balance wasn't understood.
Likewise, pneumonia, again, there was pneumococcus was about 40%, but the balance wasn't understood.
And so the idea that nobody was funding that data infrastructure which would guide your innovation, your delivery, that actually was pretty shocking.
This is a great example of the problem-solving required to achieve scale on social issues.
You have to dig beyond what's visible to the underlying cultural roots.
As Bill dug deeper into what was known about childhood deaths, he realized the lack of data wasn't due to a lack of interest, but rather a set of complicated cultural and economic factors.
Here's one example, the lack of autopsies in developing countries.
Well, an autopsy is a super expensive thing.
The skill and cost isn't in this world at all.
And it's very disfiguring to the body.
You have many reasons why only rich people do we actually know what they die of.
Bill had discovered two factors that were limiting the data.
Autopsies are expensive.
They're also invasive, and that makes them unacceptable in many cultures.
He and his team went looking for a solution rooted in innovation.
So then we found somebody who invented this thing called minimally invasive autopsy, where you take a few samples that don't disfigure you know the puncture wound you can't see.
You take two lung samples, two gut samples.
The tech already existed.
Now the challenge was getting families who had suffered the loss of a child to agree to the autopsies.
So the foundation funded an ongoing effort to work with affected families and respectfully secure the data.
They helped create an independent organization called CHAMPS Child Health and Mortality Prevention Surveillance.
We're now out and actually getting permission from 80 of the mothers as we explain.
This will help us.
You know, your death is tragic, but if you agree, this will help.
More autopsies would mean more data about the causes behind child mortality.
But that data would only be worthwhile if there were reliable standardized collection efforts worldwide.
As Bill looked around, he found those efforts noticeably, even bizarrely, absent.
The idea that nobody was funding that data infrastructure which would guide your innovation, your delivery.
That actually was pretty shocking.
Bill's quest for reliable data led him to global health researcher Chris Murray.
When I first met Chris Murray, he actually worked in Geneva for the World Health Organization, and he said, look, there's a basic paradox that WHO isn't allowed to write documents saying that countries are all messed up because that's our managers are from those countries.
A sort of dispassionate look at those numbers needs an independent institution.
An independent institution could cut through the politics that kept data in the shadows.
Chris made that case.
And in 2007, the foundation helped establish the Institute for Health Metrics and Evaluation, which Chris leads to this day at the University of Washington.
It wasn't a one-time donation but an ongoing commitment to drive inflection points in global health.
That aspiration.
Hey, we better know what's killing all these kids.
What's killing them with the diarrhea?
What's killing them with pneumonia?
We've spent hundreds of millions of dollars and had to get smarter and smarter and created institutions.
The creation of independent institutions has become a hallmark of how the foundation gets work done in the world.
But as they started out in 2000, holistic solutions were elusive.
Let's go back with Bill to the beginning.
In the early days, you'll remember that Bill was eager to innovate, developing a new product and bringing it to market.
That was something he knew how to do.
But as it turns out, the problem wasn't just the lack of cures.
It was the lack of access.
In Microsoft, the market invention is straightforward in one sense, which is here's an amazing product that you should buy.
But here we actually have to change the market.
So what does the tool set look like for changing the market?
Yeah, in the case of Microsoft, the evolution of the hardware technologies, including the chip and the storage and the connectivity, came together with the software.
And partly we saw that we could bet on really powerful hardware because it wouldn't be too expensive.
In the case of global health, I thought that the research piece and the breakthrough say new vaccines or drugs was the only missing piece.
Sadly, the delivery mechanism in many of these countries, the primary health care system, was also very, very poor.
And it was kind of shocking that for that diarrheal disease rotavirus, we found out that the rich world had a vaccine.
And it wasn't getting out to the kids who needed it most.
So that's this deep irony that the kids who are least at risk of dying are getting the vaccine and the kids who most are not.
And I admit, for a year or two I thought gosh isn't someone else going to solve this financing and quality of delivery problem.
And eventually got convinced that, no, it wouldn't be solved.
And so it would be almost pyrrhic to invent more new vaccines that wouldn't get financed and wouldn't actually get delivered.
This realization marked a key pivot for Bill and the foundation.
It's one that will be familiar to any founder trying to bring about a change, whether commercial or nonprofit.
Often the problem you set out to solve has to wait until you solve a whole lot of other problems first.
In Bill's case, he couldn't just focus on vaccines.
He also had to solve what he calls the delivery problem.
Why was it that vaccines and drugs could be effectively delivered in some regions and not others?
It comes down to government.
Yeah, governments in rich countries, even now in middle-income countries, are pretty amazing.
We kind of take for granted that the water system, electricity system, education system, justice system, these things work pretty darn well.
As you get into very poor countries, the fact that salaries don't get paid and even vaccines that are lifesaving the funds don't get allocated.
They can even be stolen.
It's pretty shocking how bad government can get.
In his years at Microsoft, the government was, at times, more an adversary than an ally.
But at the foundation, Bill had to rethink this relationship.
The foundation may have contributed billions to the Millennium Development Goals, but governments contributed hundreds of billions.
They needed each other.
Microsoft didn't need government intervention to build and sell products or get them involved.
Matter of fact, it was kind of more challenging the other way.
But the question about saying all right, in order to fix these problems, we actually, in fact, have to get on side with governments.
If you could call through time and call the younger Bill Gates and say here's how you should start dealing with governments at the beginning.
This is what you should do.
What was the learning curve there?
You always have to decide, are you going to get the government to step up to its role there?
Are you going to try to go around it and eventually realize we have to get governments to step up?
It's the only long-term solution.
So there have been a huge learning curve on the delivery side.
There are huge learning curves on delivery and also huge differences between countries.
On one end of the spectrum, there are governments that prove to be exceptional partners, like Ethiopia.
One of the greatest experiences we had is that the prime minister of Ethiopia wanted to have a good health service.
And so the relationship on building up their health system and even improving their agriculture system.
We got to do that in partnership.
That became an example for us.
Found a willing government that was allocating its money the right way, was willing to put a measurement system in place and when the figures said things were going poorly, they didn't try and reject the data, that they were in it for the long run.
That was pretty fantastic for us.
But not every country partnership works out this well.
A case in point is Nigeria, which once accounted for half of the world's polio cases, largely because vaccines weren't reliably delivered, especially in the troubled north of the country.
The foundation backed an effort that went around the government.
200,000 volunteers immunized 45 million children.
Nigeria hasn't recorded a new case of polio for three years.
But it's an ongoing effort to maintain the partnerships that ensure vaccines get to those who need them.
We did a much better job getting new vaccines introduced in all countries than we did improving the coverage.
The coverage thing, even today in northern Nigeria, I spend a ton of time on it.
I do conferences multiple times a year with these governors of the states in the north.
So we're hopeful.
But that has proven to be tough.
But even the toughest efforts have long-term payoffs, Bill says.
In parallel, the biological sciences that give us new ways of inventing vaccines.
That's gone super well.
Even though there's some miracles that haven't emerged yet an HIV vaccine, a TB vaccine.
You know, over the next 10 to 15 years we are going to have those.
And so it's well worth thinking making sure that the delivery system is going to be there, not only for what we have today, but for these things that are so exciting, that are coming down the pipeline.
To paraphrase the ancient Greek inventor Archimedes, with a long enough lever and a fulcrum on which to place it, you can move the world.
The challenge is finding that lever and convincing enough people to grasp it with you.
After the break I'll share the most telling moments from my conversation with Bill on the comparisons between scaling a global company and a global philanthropy.
These were the questions I couldn't wait to ask him.
Real leaders don't back down when the stakes are high.
They innovate, they push forward, and then they take the stage at the Masters of Scale Summit.
Join us in San Francisco October 7th to 9th to hear from the CEO of The New York Times scientists using cutting-edge technology to find cures, the leader of crypto powerhouse Coinbase, a retired four-star general and many, many more more.
Apply now at mastersofscale.com slash apply25.
That's mastersofscale.com slash apply25.
If you're ready to take your startup from idea to impact, then AWS is your launchpad.
From data storage to machine learning to secure app hosting, AWS gives you the tech trusted by the world's fastest scaling startups.
And here's the best part.
Join AWS.
Activate today and you could score up to 100000 in AWS credits, tailored to your stage and network.
Go to awsamazoncom slash, activate and start building.
Expanding your business in the US can feel like a maze.
Every state has its own payroll benefits and compliance rules, which can pull your focus away from growth.
That's why founders use Deal.
Deal is the professional employer organization, or PEO, that gives you a dedicated HR expert plus Fortune 500 level benefits for your team.
The National Association of PEOs says businesses can grow twice as fast if they use one.
So if you're scaling, make it simple with Deal.
Go to deel.com slash MOS and get up to three months free.
As I mentioned in part one, when you think of the people who've achieved huge scale in both a global business and a global philanthropy, the intersection is literally one person Bill Gates.
This is what interested me most when I sat down with Bill.
I'm fascinated with how he reflects on both those similarities and differences between Microsoft and the Gates Foundation.
I asked him about this from a number of different angles when we talked, and I started with the idea of a co-founder.
Bill's first co-founder, Paul Allen, came along early in Bill's life and Bill is clear about Paul's importance.
Well, Paul was totally critical to there being a Microsoft at all.
The foundation was also explicitly launched with a co-founder.
It's called, after all, the Bill and Melinda Gates Foundation.
I was really curious how this experience of co-founding compared.
So how did you and Melinda meet?
Melinda was an employee at Microsoft.
She went to Duke and got both her undergrad and MBA there in five years.
She and I ended up sitting next to each other at this big dinner in New York and talking to each other.
And a few weeks later, I asked her out.
And for five years we were kind of off and on, getting to the point where we decided to get married.
So obviously it's something of a challenge in the intensity of founding a new organization and co-founding to do it.
You know husband and wife adds an extra.
Both probably delight, but also some stresses.
What was that like?
Well, I'm sure that if I tried to partner with my spouse in my 20s, or even my 30s, I couldn't have achieved it.
I'm a lot more mellow.
Melinda's just very mature and thoughtful.
The fact that I was used to being a CEO did require some adjustment.
That okay, she sees things that I don't see.
We need to have a common view of things.
And so you know, in our case it's been fantastic that we get her skills and my skills going together.
Leaving aside the complexity of working with your spouse, this partnership with Melinda would be quite different than the partnerships he had with Microsoft co-founder Paul Allen and eventual CEO, Steve Ballmer.
It was always a challenge that I managed Paul and pushed him to work super hard.
Steve and I, it was a little complicated.
Steve worked for me, and then he became CEO.
And the whole thing of who was leading, who was following during that period, wasn't that black and white?
But it all had a happy ending.
And so what did that initial team look like?
Because obviously at Microsoft, it was engineers, but it was more focused on biology.
What would you say was like the okay, these are the people we must have, and this is how we start building this new kind of foundation.
Yeah, the mix of deep skills you need in an organization is always a question.
And how do you get those people mixing together?
Here understanding how to work in poor countries and get things delivered.
That hadn't been an area of specialization at Microsoft.
Hiring smart engineers was, but this was more biology-focused than software-focused.
So I had to really study the pharmaceutical companies, which were doing a mixed job.
Try to figure out who's doing it best in terms of both design and going in and drawing some of the very best people out of pharma.
Because, in a virtual way, we needed to become a pharmaceutical company and actually create more successful products than any pharmaceutical company was.
So that first group was there to help us sort of bootstrap.
We had an amazing person, Patty Stonecipher who, in partnership with my dad, were the first executives.
And so they looked around and said, okay, how do we go down this science path?
And with a little bit of part-time help from me.
And so...
When did you start thinking that actually, in fact, there were more interesting parallels between the business innovation of creating these markets and the foundational work than might have first appeared?
Let's metricize what saving a human life is worth, and then let's drive that metric across all of the innovations.
It was one of the earliest things I remember hearing the Gates Foundation talking about.
It wasn't so much that I thought I was bringing my business approach.
It was that I was shocked that those foundational elements really weren't present.
And you know it's partly lack of attention, lack of funding, and bringing that type of business thinking in was actually fairly new.
Because one of the parallels that I recall –
From when you were kind of building Microsoft from a small organization to a global organization, was this notion of being very customer-focused, find the most challenging customers that were important and surprise and delight them.
And that created a whole market.
Did you find a similar pattern going on with the foundation?
Is that a pattern that also kind of is figuring out like well, how do we actually in fact have the right purchasers of these new kinds of drugs, the right understanding of how we're trying to save children's lives?
Yeah, there have been sort of two miracles in global health in the last 50 years.
There was the smallpox eradication.
And so looking at the great people who did that and how that worked.
And then Jim Grant, who ran UNICEF in the 1970s, had gotten a focus on getting vaccines out to lots of children.
Now, it was a very small set of vaccines, but he got the coverage up dramatically by celebrating the countries that were doing it well and, to some degree, shaming the countries that were not doing it well.
Part of the good news was that when I looked at child survival versus GDP, It wasn't a perfect correlation.
If you have to wait for the GDP of a country to grow before you can get the death rate down, that's definitely worth doing.
But the fact that countries like Tanzania Rwanda, Senegal had a third of the childhood deaths of other countries who had the same or more GDP.
That suggested that they were getting the tools out and managing their system the primary health care delivery system in a way that was affordable and impactful.
So telling the stories of the heroes individually and the systems approach, which is less exciting but also important, that was key to us.
And so I really dove into the historical exemplars like Costa Rica, Sri Lanka, and the contemporary ones, including some of these African countries.
Part of scaling Microsoft when you were leading it from its startup to global transformation.
It's always hard work and a bunch of lessons learned about how to scale an organization, because it's how the rule changes when you're 100 people, 200 people, 500 people, 1000 people.
All of a sudden, the organizations get large.
Has the pattern been the same with building the foundation, in terms of what the scaling of the organization had been?
Yeah, so geographic scaling is very different than engineering scaling.
Geographic scaling, you can have the central assumption that your activities in each of the countries are going to be 90 similar.
Understanding what that 10% should be, what does Japan really need that's different?
What does South Africa need that's different?
That's a fun, interesting problem.
But the basic approach you use is going to be the same.
The engineering piece where you're adding more products for Microsoft.
That was fundamental.
That most of our competitors were single product companies.
Microsoft knew that we wanted to be a very multi-product company and we wanted to be way more international than the other guys.
So we wanted to own all our subsidiaries, do direct distribution everywhere in the world.
And we wanted to understand how we avoided top management not being a bottleneck so that we could just keep adding product groups.
For the foundation.
We like that same sort of engineering, scaling so that we created budgets for each of the program groups.
So the malaria group, the tuberculosis group, the HIV group.
The thing I underestimated is that in drug creation there are a lot of horizontal skills about manufacturing and regulatory approval.
And so until we hired the current head of our global health group, Trevor Mundell, we thought we tried too much to have those engineering groups, science groups, be too independent of each other.
We didn't have a central manufacturing expertise, central regulatory expertise.
Trevor came in and said, no, you need to have both.
So our engineering design is actually somewhat more complex at the foundation.
Yes, at Microsoft there's a central engineering group about tools and training, but that's like 5 of the headcount.
In the case of the foundation, we have over 30 of the headcount and budget is in these horizontal things.
That's a management challenge because you have the two different groups, but the nature of the problem demands that you do it that way.
And so when did you start also figuring out how to deploy technological innovation, not just of the biological sort, but of the kind of more wide ranging?
You know, here I'm gesturing at the grand prize technological challenges with the toilet and so on.
But when did that start factoring in and how did that start saying okay.
Technology also gives us unique leverage here.
Well, we mimicked the thing that Hilbert did in terms of the great unsolved problems.
He did that for mathematics around the turn of the century.
And so very early on, we did that for global health.
And as we look back on it, we... didn't pick exactly the right 10 things.
And yet, by putting money behind those things and creating visibility for the field, you'd think that in the process of cutting childhood deaths from 10 million a year to 5 million a year, the pride and the energy and visibility of that work would draw in more and more people and a lot of top talent.
In fact, it was truly obscure.
And so when did the technological elements come in?
The fact that you've built two amazing, huge scale organizations is that there's parallels in business models, there's parallels in organization.
There's also parallels in technology.
And like the toilet was one of the ones we've talked about before.
Well, the toilet's an example where trickle-down doesn't work.
Where you get a failure of trickle-down to work is when you have things like a sewer-based sanitation system where you have to build all that piping and those processing plants.
And the cost gets stuck at a level that's barely affordable by middle income.
And in these big African cities, it'll just never happen.
And this brings us back to the top of the episode, an inflection point.
That will never happen unless the right people and organizations and nations get together to make it so.
So the engineering craziness to say that you could do the toilet as this self-contained filter.
Could you get down to five cents a day?
And can you make it so that it matches the gold standard that is the rich world flush toilet?
And we, on paper, looks very solvable.
For Bill Gates, solvable problems start with technology.
For you, they may start somewhere else.
But with a powerful combination of people, partners and persistence, you can accelerate history and even will a new inflection point into place.
I'm Reid Hoffman.
Thank you for listening.
The inspiration.
It was born from the desire to create a space that felt like home, where we can connect community culture, good food and come together as family and friends.
That's how we birthed aunts and uncles.
Nicole and her husband Mike were fulfilling their dream of bringing people together out of their home kitchen.
But they soon learned that the demand for community was greater than they knew.
It became overwhelming and we were like, we need home, but not in our actual home.
We realized that there was also a need in our community for something bigger in our neighborhood.
So we had to find a place.
Moving from a home operation into a storefront was a huge next step.
But Nicole and Mike were able to take it on with the help of Capital One Business, not for the week as a small business.
Finding resources is super important because that's the way you'll be able to manage and scale.
We would have never done that without having Capital One to be able to help us along the way.
The cashback rewards are very helpful.
You know, it just gave us that runway to be able to breathe a little bit.
Then you get to focus on the cooking of the food and making the experience great.
To learn more, go to CapitalOne.com slash business cards.
If you're in private capital, you understand that your next great deal starts with who you know.
That's why over 3000 firms trust Affinity, the CRM platform purpose-built for private capital.
Affinity's relationship intelligence reveals your team's strongest paths to founders, investors and decision makers, using insights hidden in emails, calendars and meetings.
With powerful AI tools like Affinity Notetaker and Deal Assist, you'll spend less time managing data and more time closing the right deals.
Learn more at affinity.co slash marketplace.
AI agents can make your teams more productive, but if they aren't connected to other agents or your data or your existing workflows, they can only take you so far.
Any business can add AI agents, but IBM connects your agents across your company to change how you do business.
Let's create smarter business.
IBM.
Masters of Scale is a Waitwater original.
The show is recorded on-site in California and produced at the studio inside SY Partners in New York.
Our executive producers are June Cohen and Darren Triff.
Our producers are Chris McLeod, Adam Skuse, Jenny Cataldo, Jordan McLeod, Catherine Clark-Gray, Hallie Bondy and Ben Manilla.
Our supervising producer is Jay Punjabi.
Music and sound design by Ryan Holiday and Daniel Nissenbaum.
Mixing and mastering by Brian Pugh.
Special thanks to Chris Yeh, Elisa Schreiber, David Sanford, Saida Sapieva, Bob Safian, Christina Gonzalez and Sarah Sandman.
Visit mastersofscalecom to find the transcript for this episode, and be sure to subscribe to our email newsletter.
Bye.