In that time, the foundation paid out $45.5 billion in grants as she met with people in need, as well as health care and aid workers, local and government officials, doctors, scientists, economists and others on the front lines.
One thing stood out to her, though, which eventually compelled her to write her first book. That issue was the. Journeying through Africa, India, China, Europe and the Middle East led to her to conclude that not factoring gender -- the role of women -- into the foundation's problem-solving was their "big missed idea."
It also led her to a pretty stark conclusion about the status of women in the US.
"We're a long way from equality in this country," Gates said in a May 7 interview in San Francisco as part of a tour to promote her New York Times bestselling book, The Moment of Lift: How Empowering Women Changes the World.
"Less than 25% of Congress is women," she adds, gesturing to express her chagrin at the slow rate of progress in the US. "Less than 5% of Fortune 500 CEO companies are run by one and only 2% of women get venture capital."
In her book, which is dedicated to her two daughters and son, she writes about growing up in Texas, watching space launches that her aerospace engineer father worked on for NASA and being inspired by one of her teachers at her all-girls Catholic high school to work on early Apple computers. She ended up at Microsoft, where she met Bill, and acknowledges that the "abrasive" culture" almost wore her down. Instead, she pushed against the predominantly male setting and stayed for nine years.
Gates says she supports Microsoft CEO Satya Nadella, who continues to face challenges over diversity and equality as he works to change that culture at the world's largest software company. "I do know Satya and I know Kathleen Hogan, who runs HR -- I'm incredibly impressed with what they are doing. They're taking it very seriously."
Today, her foundation has become the world's largest private charitable organization and has helped Gates became one of the most influential women on the planet. In 2015, she started Pivotal Ventures, an investment firm, focused on supporting women and families in the US.
She's direct when she talks about Silicon Valley's poor track record when it comes to funding women, which has convinced her to turn her investment attention to other areas of the country including Chicago. We need to, she says, "leave Silicon Valley behind."
Here's an edited transcript of our conversation:
Q: The original charter of the Bill & Melinda Gates Foundation was to see how science and tech could be used for the greater good, but you write in your book that's not where change starts. Instead, you admit there was a failure to understand how women factored into the solutions you were working on. What did you learn?
Gates: Bill and I started the foundation with the premise that all lives have equal value. And we absolutely started with a science focus. Bill and I totally believe in the power of innovation to change things, whether that's biotechnology or tech like our cellphones.
However, when we started looking at all these disease areas and vaccines, it became clear very quickly that you can have the best science in the world, but if you don't have a health system that will deliver those things, then they never reach moms and dads and kids.
If a mother or father won't accept or doesn't want that new technology, you're not going to create change. And so we have to look at the science, the delivery and then what I call the gender pieces -- because the gender pieces were our big missed idea. Because if you don't focus on that, you aren't being as effective, you aren't actually creating as much change. So it is a lot of gender and behavior change. But we have to do these pieces our partners do -- everything we do we do through partnership, science delivery, the behavior change pieces -- but you have to do it or you will actually not be as effective with your money or create as much change in the world.
Give me an example of a gender miss.
Gates: We had a great new seed coming out that is pest-resistant or drought-resistant or flood-resistant ... and when they would come out, we would get them out through the agri-dealers into various countries in Africa. But we were completely missing the women, because 50% of the farmers in the developing world are women ... It's the women who feed the kids.
All over the world, women predominantly cook the food. And so if she's already spending five hours a day preparing meals, chopping the firewood, making the fire, getting the clean water, preparing the meal, and all of a sudden this new seed, this new potato or whatever, is going to take longer to cook ... she won't plant it.
Because she'll say, "Look, I don't have another hour in the day ... Every hour, 30 minutes or 10 minutes I put into one of my tasks means I don't have time for something else."
And so that piece, the gender piece, was our big missed idea. Now we take women's input into crops, and they give us fabulous input about how to create things their children will actually eat.
You're a smart woman. How did you miss that gender piece?
Gates: You can come with a science focus and come with a delivery focus. But unless you say, let's look at gender, people just kind of make these false assumptions.
It's funny, I had one of the most hardcore scientists at the foundation, who just recently retired, and he said, "Melinda, when you first started talking about gender, I just did not get it. I totally thought it was BS. Now I 100% get it. I get why my science would not have benefited kids in the developing world. I get it, if we didn't think about the women's piece of it."
Sometimes I think we miss issues because it is a world often run by men. The other thing about this particular man's life is he has two daughters, now who are in their twenties. He felt like he was supportive of them through their education and through college, but then he saw them go out in the workforce, and all of a sudden, he saw all these barriers his daughters were up against. So then he said, "Melinda you're right. These barriers for women in the developing world are real."
And that's why I try in the book to bring up barrier after barrier after barrier that we often just don't see as a society. It's why I talk about unpaid labor so much in the book.
Most working moms will agree with you that the unpaid labor they do at home isn't factored into a lot of thinking.
Gates: It's been one of the most surprising things. I've had so many men say, "I just never really thought about it."
If you went back in the world and defined productive labor, why don't we define the things that are done in the home as productive labor? Who put that label on? Well, the label was done by economists and they'll tell you what was the easiest thing for us to measure.
No -- you can measure how much time a woman spends at the stove or doing the groceries, going and getting them.
I want society to look at it because I think in the United States, we often have this myth that we think women are equal. And it wasn't until I traveled all these countries, and it was just so clear where the women weren't equal.
In the US, we have a distance still to go in this unpaid labor. The 90 minutes more a day a woman does in her home, it takes away from other things she might want to do, other productive things she may want to do -- take care of her health, right? Some of it is things we want to do -- taking care of loved ones. But a lot of it is chores.
How far behind do you think we are here in the US?
Gates: I just go big industry by big industry. So Congress -- part of the reason I did this book was because I feel with the #MeToo movement and then the number of women running for Congress, the window's open. But we've got to take advantage of it. But less than 25% of Congress is women. And we know that when women are in Congress, they bring up different issues. And so we're all excited about that progress. We should be. But at this rate, it will take us 60 years [to reach parity.]
Less than 5% of Fortune 500 CEO companies are run by women and 2% of women get venture capital. So I would say we're a long way from equality in this country.
This issue of equality in tech has been a big topic of conversation for several years now, but every time diversity reports are released we see little progress.
Gates: I agree the needle is moving slowly. But I do think the momentum is starting to happen. Go back before the Ellen Pao trial, whatever you think of that. ... All of a sudden, people started to be willing to speak out more and then the press started to put pressure on companies to be more transparent -- how many women are in tech roles, how many women are in managerial roles? Then you get a company like Salesforce where they decide, we're actually going to look at our pay and say, oops, we do have gaps.
I feel like we're gathering some momentum. It's going slowly, but the ball is starting to roll. And the fact that you have more women who just don't want to be in the current venture capital firms, they're actually losing partners. Women now have the credibility and are going on building their own venture funds.
Eventually, the guys will realize they're leaving money on the table. They just don't get it right now.
But we also need, in a certain way, to ... leave Silicon Valley behind. I'm much more interested in Chicago. Their venture capital community is climbing. They have incubators for women. It's becoming a larger percentage of their economy. So let's just go do that in five or six other places.
Microsoft CEO Satya Nadella has talked extensively about his mistake a few years back in saying that women should just wait for "karma" to reward them when he was asked what advice he had for women. What's your advice?
Gates: I would say just women banding together and going to senior leadership in droves with their stories and their experiences.
Look what happened at Nike. I know some of the women who were behind the scenes in that at Nike and who were trying to figure out what to do, because they had individual stories. But it wasn't until they banded together that then they take it to senior management and you can't turn [them] away. And that's why the self-help groups that I've seen in India and all over the world -- when women band together, all of a sudden, people can't say, "Oh, it's just her, that's a one off."
We know that behavior change only happens when there's full transparency. It takes men and women -- what I call enlightened men -- to say something is not okay.
You'll have a village that will say, okay, we care about our women not dying in childbirth. We know we need to take them to the clinic. Then they'll problem-solve and they'll say, OK, how do we do that? Sometimes we don't have the money for transport. How do we have a community fund for transport? Or oh, in the rainy season, we can't cross the river. Oh, how do we build a bridge?
Eventually the community will say, some of our women don't go to clinic because they're abused in their homes. And so eventually the community will say, we need to stop the abuse. Who can stop abuse? Men. So the men have to say, "When we hear that man beating up his wife, we're going to go knock on the door and call them out."
And so that's what I would say inside of companies. It takes men and women naming the truth and committing it together, and then actually taking action.
I will say about Satya -- I do know Satya and I know Kathleen Hogan, who runs HR -- I'm incredibly impressed with what they are doing. They're taking it very seriously.
You write as a Catholic about reconciling your beliefs with the need for contraception and family planning. There is movement in this country to turn back the clock on family planning issues. Are you optimistic we can continue to make progress on this front in the US?
Gates: I am optimistic that we will uphold what we have.
Certain steps will be taken to try to roll things back [but] I don't think women will let that happen.
The saddest thing about some of the proposed changes to Title 10, as an example, is who does that target? That targets low-income single moms in our country. That is just sad.
You mentioned the role of enlightened men.
Gates: We absolutely need men. Sometimes it sounds like small things. But it's not. It's literally a man saying in a business meeting when a woman gets interrupted, "Don't interrupt her." Or if somebody re-explains her point, "Don't re-explain her point. She said it." It takes men to do that.
It just seems to be taking a long time.
Gates: Yeah, I'm impatient.
With reporting by CNET's Ian Sherr.