/ 31 July 2006

Opening the relief gates in SA

A family live in a corrugated iron shack with no sanitation, among thousands of other brightly painted corrugated iron shacks in Khayelitsha on the outskirts of Cape Town. Ten people, five of them children, share three dark rooms and nobody earns any money. They are among the poorest people on the planet. Recently, the richest man in the world walked in through their door.

Bill and Melinda Gates, with an air of slight embarrassment, sat on a low wooden bench in the middle of the dark room, surreally reminiscent of nervous interviewees on a breakfast TV sofa. Before their arrival, the 60-year-old head of the family known only as Nkosepaca had hauled himself across the floor and into a makeshift wheelchair at one end of the bench. He lost both legs above the knee when he fell off a crowded train a couple of years ago, and the stumps were tied up with filthy rags. Gates, whose personal wealth exceeds $40-billion, sat next to him, hands in his lap, eyes lowered below his baseball cap and feet wedged behind one of the chair’s wheels, which might once have belonged to a bicycle.

How were they to make conversation? Bill and Melinda Gates, whose charitable foundation takes as its premise that all lives have equal value, struggled to connect. They were there to talk about tuberculosis, because the foundation is putting millions into research to replace the ancient and inadequate BCG vaccine and find new drugs to shorten the six-month treatment time. Nkosepaca has had tuberculosis (TB) four times, infected by different strains of the bacterium — something which it later appeared had fascinated Bill Gates, who was to raise it with scientists again and again, asking what the implications were for a vaccine.

But faced with the man, he was silent and it was his wife Melinda who tried politely to engage Nkosepaca about his health, and who lit up with real warmth as she caught the eye of a wild-haired, fidgety granddaughter or a big-eyed baby. When his turn came to ask a question, Gates, looking less than comfortable, resorted to numbers.

”How many people live here?” he asked in that staccato voice that carries all the feeling of a computer chip, followed by: ”How long have you had electricity?”

The Gateses were on their first tour in South Africa since Bill announced he would step aside from Microsoft in 2008 and the billionaire financier Warren Buffet announced he would give the $30-billion foundation most of his fortune — effectively doubling it in size.

The family had no idea of the vast wealth at Gates’s disposal. ”Do you know who he is?” I asked them. They shook their heads. ”Or why he has come?” No clue. But as most destitute Africans reasonably do, faced with a white, well-fed foreigner, Nkosepaca asked him for help. ”He asks if anybody can help us because the money we’re getting is too little to sustain a family,” translated a young man from the Desmond Tutu TB Centre at Stellenbosch University, which had arranged the visit. Later, one of the daughters spoke up. ”I just want to know whether you can help our father,” said 25-year-old Kutala quietly in English from the back of the room.

”We came for a visit,” answered Melinda. ”We certainly will do something to help your family because you have been so hospitable today.

”We do a special gift for the houses that we go into, but that’s more out of courtesy. It isn’t how you can change the basic phenomenon that we’ve got here.”

Melinda adds, with an emotional underlay: ”I don’t think you ever go into a place like this and leave without thinking about the individual. I’ve gone into some of the orphanages where you’d like to take all the children home with you. But then you have to always try and upscale from there and say, ‘OK, if I help just that one child, what am I doing for the entire cause?”’

Gates has the ability to ring-fence a problem and focus his formidable mental energies on solving it. He moves it into a detached dimension, where he can be scientifically rational. Emotion does not get in the way. He prefers philanthropy performed with technical discipline; altruism run like a multibillion-dollar business. It will probably get results — perhaps spectacular results — but Gates is never going to be a crowd-pleaser.

Two days later, the relatively modest Gates entourage is swallowed by a whale. Bill and Melinda’s fact-finding trip links up with Bill Clinton’s Africa tour in Lesotho.

Clinton is doing five countries in seven days. There are three huge private jets on the Maseru airstrip — probably more planes than have ever been there at one time before.

Ex-presidential philanthropy looks different from that of software billionaires. Gates has his own private plane, naturally, but Clinton has two bigger ones, loaned by people richer than himself. And his millionaire backers come along for the ride, bewitched by the Clinton charisma, but with nobody much to talk to.

German media mogul Karl Heinz Korgel’s pilot needs some sleep, so the 15 or more journalists and camera crews following Clinton, together with a more modest four writers accompanying Gates, are temporarily on a plane leased from the president of Djibouti. It has a double-bed at the back and sofas with seatbelts that are mostly ignored. As we take off, Ira Magaziner, who runs the global health side of the Clinton Foundation, is perched on the side of an armchair. We sit on the table or floor to hear his briefing and catch cans of cold Coke before they slide away. There is something of a party atmosphere.

Lesotho has one of the highest rates of HIV infection in the world, at somewhere between 23% and 31% of young adults. We are headed for an Aids clinic which, with Clinton Foundation backing, is now offering drug treatment not just to adults, but also to children. Few disagree that Clinton has already made a significant difference to Aids treatment, using his name and standing and the expertise he can command to force down the price of drugs.

And suddenly there is the former United States president, in the middle of a crowded courtyard at Mafeteng hospital. Clinton has emerged from a private meeting with a small girl twisting and spinning from his hands. Arriet (6), is the first child to receive anti-retroviral drugs here. She has been on them for eight months, is clearly very well and Clinton knows exactly how to handle her. She does not want to talk, but gets interested in my camera, so I let her look through the viewfinder and then take her picture, while Clinton bends down to get in the shot. I show it to her and she laughs.

It is very well done. Even his security guards, the bristling, dark-suited heavies with earpieces who talk into their sleeves, melt away around the former president so you are left as if alone with him. Clinton is relaxed and warm. He seems to have a genuine liking for people.

Gates now shares platforms with world leaders, but you sense he talks numbers with them. So many lives potentially saveable. So many millions for a vaccine. He does not do human and he does not want to do politics.

”Politics is a dangerous word,” he says. ”We’re involved in working with governments to talk to them about how rich governments can make their aid money be used more effectively, and encourage them to do more aid. We’re involved with developing-world governments in terms of trying pilot programmes and, when something works, encouraging them to replicate that. I make a distinction between that and politics.”

Some might argue for a moral imperative to get into the political argument in South Africa, where the health minister supports lemon and garlic as a cure for Aids and millions are set to die while the treatment plan is slowly, grudgingly rolled out. Gates says what has been achieved so far is due to the activists and the press. But he is meeting the deputy president privately later that day and is waiting to hear whether he will be talking to President Thabo Mbeki in person or on the phone.

Privacy matters to the Gateses. They will do what they have to do on the public stage to advance Microsoft or the foundation, but beyond that they do not seek attention. Their philanthropy is a family ideal, handed on from their parents. They intend that their own children should understand what it means to be less equal. Their two older children were in South Africa with them, hidden from the press. On the day after the visit to the Khayelitsha family, the Gateses took 10-year-old Jennifer and seven-year-old Rory to see the crowded corrugated iron homes of Khayelitsha for themselves. ”We talk at the dinner table about these issues. We think as a family we have a responsibility to give back to the world,” says Melinda.

Gates is excited, energised, by the ideas of brilliant scientists who must think him a 21st-century messiah. Who else is going to fund their money-losing, world-saving ideas? Gates says what would be unthinkable at Microsoft. ”We can afford to have a lot of failures. We’re going to have a lot of failures. I will not stop working on malaria, TB or Aids because of failures.”

Extraordinarily, he is capable of counting the pennies one moment and throwing vast sums at unpredictable prospects the next. But on arguably the hardest scientific challenge in medicine today, which could easily cost him billions, he says: ”We’re not going to give up working on an Aids vaccine. Not in my lifetime.” And when I ask if he could reach a point when he will decide that too much money has been spent with nothing to show for it, he answers with what passes for a laugh: ”Ask me in 30 years’ time.”

Regardless of anyone’s views on Microsoft’s business practices, it is an attitude that has to command respect. As he says himself, no government facing election every four years would take such risks. He is not standing in for rich governments — he is doing what they do not dare to do. If this is what philanthropy is about in our times, perhaps we should just be glad. — Â