Bill and Melinda Gates reveal what surprised them in annual letter

Since the Gates Foundation was formed back in 2000 by Microsoft co-founder Bill Gates and his wife Melinda, it has paid more than 45 billion dollars in grants supporting work in more than 130 countries. Their work addresses issues like vaccine delivery, family planning, and emergency response. First on CBS this morning, they're revealing their 11th annual letter highlighting, they call it, nine things they didn't see coming. Bill and Melinda Gates are co-chairs and trustees of the Gates Foundation, and we're happy to say they're joining us at table. Good to see you both. Thanks for having us. So let's start with this guys, because you've been wealthy for a very long time. Whenever they say Bill Gates and Melinda Gates, they say the world's richest people. I wonder if that moniker ever gets old, but when did you decide that, listen, we have all this money, we want to do something with it, Melinda? Well, we were engaged to be married, and after we'd taken our first trip to Africa, actually a vacation, we were walking on the beach, and we committed at that point that we were going to give the vast majority of the resources for Microsoft back to society. Just, it was the right thing for us to do. Bill, you felt that too? Yeah, we were exploring it, and we've gotten more and more engaged in it. Now it's our full-time work. So we were naive about how to do it and how to have a big impact, but we knew that, you know, it was amazing we had this fortune. It was gigantic. We didn't think it would be great to give lots of it to our children, and so, and it became something that, you know, we get to do together. We're, you know, partners in crime. And you're working very hard. I want people to know you're not sitting home. Both of you are doing a lot of traveling. You just came back from Ethiopia, Bill, but I thought the letter was so fascinating. The thing that stuck out to me was about data, the importance of data. I never thought about that. Explain why that's so important. We were surprised when we got into this work, having both come from the tax sector, that there was so little data around philanthropy. And we kept thinking, if we're going to put another thousand dollars into a project, we have to know whether the first one's worked, whether that project's worked, and if we go call in another government. And data can be sexist. And data became very important, but that was the thing we learned, was that data, that while we think it's objective, it's actually sexist. We don't actually collect that much data about women around the world, and so we don't know how to make great investments on behalf of women. And so we've really highlighted that issue in the last three years, and are working with our partners to collect great data. Well, Africa's already come up twice in this conversation, Bill. You just came back from Africa. You talk about it being the youngest continent and the real growth potential there. The median age is 18. In North America, it is 35. Why is there potential that maybe the rest of the world is not seeing in investing in Africa, and why is that so important right now? Well, today, Africa's only about 14% of the world population, but that's where there's a large population growth. And so almost half the kids in the world will be born there by the end of the century. And so it's a very young continent. And the question of whether those kids grow up with decent health and decent education will determine whether there's a lot of innovation, and they're stable, and participating in the world economy, or if it's a source of great instability and pandemics. And so investments we make now to partner with Africa to help them out, I think, can make a big difference. And Melinda, let me piggyback on that. One of the things you argue in your letter is that globalism can be a nationalist idea. Explain that for people. Sure. We know that when you invest in people's health, and they start out healthy, and they go on to get a great education where they live, they'll grow up and thrive, and they'll participate in their own economy. And so there's huge potential there. But conversely, if you don't, they don't thrive, and then you get more instability in the world, less security. Disease, we know, crosses borders. We saw it with Ebola. So we need to be making those investments so people can thrive where they are. And Bill, let me ask you a question about the domestic U.S. You learned something about anger by going to prison. Tell us that story. Well, first explain how Bill and Melinda Gates are sitting at prison, what that was like. I was fascinated by that, too, John. Well, of course, the U.S. has more people in prison than any other country. And understanding the stories of those people and thinking about that in our poverty work, we visited Georgia prison. That was so touching. Then later, I got a chance to, in Chicago, meet with some young black men who were in a counseling thing called Becoming a Man. And they were super nice to me, included me in the session. And it was a discussion about anger. And when's the last time you got anger? And how do you channel that anger? Are there times you don't do that well? I thought it was brilliant. And I was amazed how much that counseling session was going to help put those boys on the right track. What was your answer, both of you, to when was the last time you became angry? Well, I didn't come up. I was talking about how there's been more polio cases than we hoped for this last year. I'll bet they didn't think that. I'm mad that made me. That wasn't on the top of their list. Yeah, none of them had that exact experience. The last time for me was, I would have said, was when I was an African. I saw a baby literally dying needlessly on a warmer because the mother hadn't made it to the health clinic in time to give birth. The village didn't think she needed to go until too late. That made me angry because that was a life we could save. Race and sex play a big role in this list, in this letter this year. You talk about the mystery behind premature births, in particular among African-American women in this country. African-American women are 49 percent more likely to deliver their babies preterm than white women. One of the factors could be racism. Explain that. Yes, we don't know all the factors, but that is on the rise, as is maternal mortality in the United States, particularly for African-American women. We need to look at all the factors. Is it the health system? Is it the way they're received there? Is it the stress in their community is how we treat them? Is it genetic? We talk about selenium in here. We just don't know the answer, but we need to focus on that, both in the U.S. and around the world. Around the world, 10 percent of babies are born prematurely. Is there something in these puzzles you've tried to solve over the last many years that you've seen from outside the United States that you think, hmm, if we did things that way in the United States in solving these big, seemingly insoluble problems, we might make some progress? Well, the U.S. has by far the world's most expensive health care system, and there are ways that we could get better outcomes and be more efficient. When we're working in Africa, the total resources are like one percent per person of what they are here in the U.S. And by focusing on vaccination, using primary health care workers that don't have to be doctors, it's amazing what can be done. So that idea of task shifting, focusing on preventative disease, that could work even in the U.S. And the thing that struck me, guys, was in the letter you mentioned toilets. You said, not sexy, but toilets can save lives. I'm going to leave that as a tease and say people have to go to get the letter to find out. As I said, as you point out, Bill, they haven't changed in a century and we all need one. Thank you, Bill and Melinda Gates. Good to have you here.