Gates Foundation to be remain ‘engaged deeply' in India: CEO Mark Suzman to HT

Hindustan Times

09-05-2025

Microsoft founder Bill Gates on Thursday pledged to donate almost all his wealth over the next two decades, including around $200 billion, through his foundation, the Bill Gates Foundation, which he plans to close by December 31, 2045. That commitment to the foundation is around twice what he ploughed into it in its first 25 years of existence. The foundation has been very active in India and in the context of the announcement, Gates Foundation CEO Mark Suzman spoke to HT's editor-in-chief R Sukumar. Edited excerpts:
Apart from the fact that this is 25 years of the Gates Foundation, you were also an early entrant into India. India was probably the first overseas operation for the Gates Foundation, 2003. And back then, the Indian philanthropy sector was pretty much in its infancy. Sure, there were always people who were giving, but I don't think it was formalised. I don't think people were looking at the outcomes. Can you tell us a bit about how you see the space having changed in this period, and also the role that the Gates Foundation has played as a catalyst in facilitating this change?
Yes. India was the first country where we established an office outside the United States in the early 2000s, initially working on HIV/AIDS, and then broadening into the full range of work we do across health and agricultural development, financial inclusion, sanitation, a wide range of priorities, all very aligned with the government's priorities. And also, India was one of the earliest places where Bill and Melinda started focusing very much on, how can we help support and build a stronger domestic philanthropic sector?
And you're right, there were long traditions of philanthropy that the Tatas, in particular, have long established history of philanthropic leadership in India. But I think what the Gates Foundation and Bill and Melinda, personally, were able to help provide was catalysing more of a dialogue among many of the wealthy in India about their wider philanthropic opportunities and ways in which they could work together.
And that's certainly been one of the signature things that we've observed in India over the last 20 years now, is a significant expansion in the philanthropic sector, and an energy and attention and great leadership, a number of people joining the Giving Pledge, including Nandan Nilekani, Azim Premji, others who have become truly global leaders and global examples of how to do effective and smart philanthropy. And that's something we're continuing to build on.
We're working on a couple of exciting new partnerships, which we hope to be able to announce in the near future that are philanthropic partnerships. And we've developed strong partnerships with other groups, like the Piramal Foundation. We work extensively in Bihar, specifically, but also a range of other districts where we've been working with – directed by NITI Aayog, many of the poorer and most destitute districts in the tribal areas and elsewhere.
And so, India has been a great example and a model of how philanthropy can work closely with government and generate and support the private sector and deliver outcomes. And in fact, India overall has been an amazing model over the past 25 years of how it can successfully look at the needs of its citizens in areas like health and agricultural development. It's an amazing story.
What are the really big successes that you think you've managed to achieve in this period, two or three things that really stand out?
Well, first, I just want to emphasize that we don't do anything on our own as the Gates Foundation. All our successes – are very much done in partnership with the government, with other philanthropists, with private sector partners.
But in a number of areas, India's successes that we've helped contribute to include your massive scale up and improvement in Indian vaccination and the reduction in child mortality across India. We helped work and develop new vaccines, like the rotavirus vaccine that was developed with Indian expertise and Indian knowledge. And that's a vaccine which is also now being used globally by the GAVI vaccine alliance that helps bring down childhood deaths from diarrhoea. We helped expand access to a range of other vaccines as well.
We worked with Prime Minister Modi when he made a signature commitment around the Swachh Bharat program. I think the sanitation work that we've done together – we awarded the Prime Minister a Goalkeepers Award several years ago at the United Nations – has been an area where India has really shown massive global leadership, and we've been proud to contribute to.
More recently, there's been some really good work being done in agricultural development. There's the work we've been doing with the government of Odisha, now the government of Bihar about developing, pioneering new AI-enabled apps that are helping small holder farmer development, helping them get access to prices, to understand what services they can get from the government, to figure out, get real-time analysis, satellite data on weather forecasts, their soil, what they can be used for fertilizer. Those are pioneering activities that India is now leading the world on.
And the other area, big area has been the whole expansion of digital public infrastructure and inclusive financial services, where India, with the universal ID system, that's now become a global model. Again, we've helped provide some technical support, but the real leadership's come from India, first from Nandan Nilekani and then with the government.
Those are a number of the areas that I think we're very proud of having helped contribute to, and we can see the results in the massive improvements that India has had, in more than halving preventable child mortality over that period, and significant reductions of maternal mortality and huge reductions in extreme poverty.
At the time we started the Foundation, India and South Asia actually had the largest number of extreme poor in the world, and that is no longer the case.
And so, it's been a remarkable quarter century in Indian development, and it's part of what's made us excited about what's possible, and it's helped inspire both our work elsewhere in the world, elsewhere in Asia and in Africa. And as we think about the next 20 years with the announcement we're making, the model of India is very much one we have in mind that we hope some of those successes can be replicated elsewhere.
When you speak about these successes, and I guess what you were referring to is the fact that if something works well here, you could take the model elsewhere in the world, and see whether it works there, what are some of the things that have worked in India which you've managed to take out and use in other parts of the world?
Initially, we were very focused on what we could do within India, and now that shift in the last five to 10 years has really been shifting into where are some of those lessons? Some of them have happened just…well, I would say naturally, because we've helped engage, but that India has already provided global public goods, and that is in the area of vaccine manufacturing.
We did a lot of the original partnerships, both through ourselves, through the GAVI Vaccine Alliance, which we helped form, and our major funders of, with the original contracts with companies like Serum Institute and Bharat Biotech and others in the sector, who are now the largest global vaccine manufacturers and the largest supplier of vaccines all across the world. India has shown it can be a global leader in a space, and we fully expect that to continue.
A lot of what we were looking at in our recent trip was in areas like diagnostics now. Low-cost diagnostics for diseases like tuberculosis, or new tools that are actually able to monitor pregnant mothers. We have a fetal monitoring system that's quite robust, but technically accurate and informed by AI that's being piloted in India.
And the key thing with the Indian innovations, and one of the reasons why they are so rapid, is they're actually – the phrase we like to use is frugal innovation. India is a place where we've been able to drive down the cost and make these cost effective, because there are lots of interventions we know are successful on their own, but are just far too expensive to be scaled up across low and middle income countries.
But the Indian models are really about how you do this in a high quality, but very cost effective way, that that's where they led the way in vaccines.
And then, above all, the most important area where India is truly a global leader, is around the digital public infrastructure agenda. We've already worked and we helped cofound the institute called MOSIP, which I also visited when I was in Bangalore. MOSIP now helps provide, I think it's over 20 countries with their own digital identity systems building on the Aadhaar system, or the model of the Aadhaar system.
And now there's other partnerships, like the Co-Develop partnership that we're also partnering with Nandan Nilekani on, that are helping with a wide range of additional tools. And this was a priority of the Indian G20 where we help provide some support to the government on shaping that agenda, and that's been taken up through subsequent G20s, both the Brazilian G20 last year and the South African G20 this year. And there'll actually be a major event on digital public infrastructure in Cape Town later this year, which is very much building on that Indian model. And that's the area we're very excited about, going forward.
In the context of the announcement on doubling the investment that you've made so far and the Foundation, as you go forward, are there any new focus areas that are going to come in India, because you spoke about agriculture, and I know you've been doing some work there? One area which I think would be of special interest to India is climate adaptability, given the fact that we are already seeing some of the impacts of the climate crisis play out in various parts of the country. Could you just tell us a little bit of what the Foundation is doing in that area?
Effectively, in our first 25 years, we've spent $100 billion and the commitment now is over what will be our final 20 years as a foundation, we will spend on the order of an additional $200 billion. And the intent is, we do not intend to focus on new areas. It's very much going to be focused on the existing areas that we've been prioritizing, helping drive preventable child mortality as close to zero as possible, helping really eradicate or control the world's deadliest infectious diseases, like polio.
Actually, I forgot to cite that. India's great success on polio eradication, which came in 2011, which we helped support, it's the biggest milestone in polio eradication. We always thought India would likely be the last country to eradicate polio. And in fact, it's now still endemic in Pakistan and Afghanistan, where it's well over a decade since India successful eradicated polio. We hope we can eradicate malaria. Add malaria to that list and bring HIV and tuberculosis fully under control. And both of those are core priorities for Prime Minister Modi as well and the Indian government.
And then the third category is helping ensure that those are able to thrive, and that is continuing to focus in the key areas of digital public infrastructure and agricultural development, with a strong focus on gender equality and women's economic empowerment. And that definitely does include climate adaptation.
Our big focus on climate adaptation is really how you do more effective agricultural use? We do that in a couple of ways. One is in research and development, and we are working with ICAR, the Indian Center for Agricultural Research, which we also visited when we were in India recently, in a number of areas, including more resilient crops and livestock that can help withstand floods and droughts and more frequent weather events.
And we've had some success in India over the last decade or two, in particular, a breed of rice that can stay fertile when it's submerged after flood waters for twice as long as regular rice. And so, we'll keep doing those investments and scaling them.
The app I mentioned, the AI app that helps smallholder farmers, actually also works with climate adaptation by allowing much more targeted use of fertilizer and irrigation, because it's able to use these advanced technologies to both do digital soil health mapping. Climate adaptation will remain a high priority for us going forward, but very much with a focus on the agricultural development space, because that's such a critical engine for both poverty reduction, but also, more broadly, economic growth.
The one point I wanted to make on that was just our, now, date of ending the Foundation, which is the end of 2045, is pretty close to the 2047 Viksit Bharat, a date that the Prime Minister and the government has set for India becoming a middle income nation. And so, certainly, our intention is to stay engaged deeply in India for our entire lifetime as a foundation. We're very proud of the work we've done. We look forward to doing a lot more work together, going forward. And we hope that the work we're doing together with the philanthropic sector, with the government, with our private sector partners, will make a critical contribution to the Viksit Bharat goal, going forward.