Enterprise Seattle Economic Forecast Conference

January 17, 2007
Cheryl Scott, Senior Advisor, Global Health Program

Thank you for that kind introduction. I’m pleased to be here this afternoon.

At the Bill & Melinda Gates Foundation, we are always reminding ourselves who we’re really working for. Around the office, we talk constantly about this child, known affectionately as “the kid in the bucket.”

Bill and Melinda started the foundation because they believe that every person has equal worth. The kid in the bucket is just as precious as your children or mine, and it is way past time to give the hundreds of millions of kids in buckets the chance to live a healthy, productive life.

Warren Buffett believes that too, and that’s why he made his amazing gift to the foundation last year. Warren’s unprecedented contribution will allow us to double our grantmaking starting in the year 2009—to about $3 billion per year.

The reason Warren decided to support the foundation, and the reason Bill and Melinda have been putting more of their energy into it, is that they believe we are living in a unique moment in history.

This is a time when advances in fields as diverse as telecommunications, biotechnology, finance, and education are making it possible to solve big problems like never before. If these advances are focused on the problems of people with the most pressing needs and the fewest champions, then within this century billions of people will be healthier, get a better education, and have the power to lift themselves out of poverty.

These additional resources and our heightened sense of urgency provide amazing opportunities, but they also pose a technical challenge: As an organization, we have to learn how to be effective at a much bigger scale. And we have to do it fast.

That’s a big part of my job—to help figure out how we grow smart so we can live up to this challenge. That’s what I want to talk about today. But first let me explain a bit about what we do.

Around the world, we are committed to improving the health of millions of people who are sick and dying from diseases that we don’t even have in the United States.

Today, 1,000 kids will die of measles—measles!—even though there is a 15-cent vaccine that has been available for four—count them, four—decades. So we try to help people in the developing world get access to the treatments that already exist, and we support research into new, lifesaving solutions.

Of course, we know it doesn’t do much good to save a child from measles if she is destined to die of malnutrition a few years later. So we also focus on fighting poverty and hunger in developing countries.

Sixteen of the 18 most undernourished countries in the world are packed together in sub-Saharan Africa, and yet few people are looking for ways to make that continent’s staple crops higher-yielding and more nutritious. Instead, the crop with the fastest growing research budget in the world is golf grass!

These international programs are evidence of a philosophy that’s very important to us—that in our world, borders matter less and less, because advances in technology are bringing us all closer together.

On the Web, we can see pictures of Africa or Asia just minutes after they’re taken. We can email, text message, talk on the phone, or videoconference with virtually anyone in the world. And we can fly anywhere in just a few hours.

And yet, even in a borderless society, we all need a home base that keeps us grounded. The foundation’s home is the great Pacific Northwest, and a lot of our values are home-grown: commitment, optimism, resilience. As most of you know, the Pacific Northwest is my home, too. I was born here, and I grew up with the people who live here.

Because we love our home—and because we have a responsibility to be good neighbors—we’re dedicated to making sure that all children in Washington state have the opportunity to make the most of their lives.

If we can’t do it here, in one of the best economies in the world, in one of the most generous communities in the world, then how can we do it anywhere?

To that end, we have supported more than 600 community organizations in Washington state and the Greater Portland area that are working to improve the lives of vulnerable children and families. Organizations like the YWCA, Hopelink, and the Technology Access Foundation.

One of our biggest initiatives here in the Pacific Northwest is aimed at ending family homelessness in the Puget Sound. Right here in our community there are thousands of parents and young children who don’t have a safe place to sleep at night.

In 2000, with assistance from many government partners, we launched the Sound Families Initiative, which gives homeless families a place to live, plus the social services they need to get back on their feet. Those services include domestic-abuse counseling, alcohol or drug treatment, job training, child care, and much more.

Sound Families is working. Most parents who leave the program get jobs and increase their incomes. But you know how expensive it is to live here, and as hard as these folks are working, they still aren’t earning enough to make ends meet without additional help.

It’s a challenge for the business community to make sure that economic growth reaches everybody. And you’ve made a great start. The Committee to End Homelessness in King County is implementing a 10-year plan, and business played a key role in developing that plan.

From the kid in the bucket in Africa to the kid on the streets in Pioneer Square, our foundation has an incredibly diverse mission and the opportunity to make a real impact. So how are we going to use our resources to get all this work done most effectively?

The foundation is still a relatively new organization, so we’re already learning as we go. And yet we have plans to grow quickly in the next three years.

When I started, we had about 250 employees; by 2010, when we move to our new campus near Seattle Center, we’ll have a whole lot more. If we don’t get our growth right, we will find ourselves running too hard just to keep everything moving in the right direction.

I would say that the organization I joined six months ago is a well-run organization on every score. However, what we have done in the past is no guarantee that we will continue to have the right infrastructure and platform for growth.

Remember when you were a kid and you’d go on a trip with your mom and dad and your brothers and sisters, and everybody gets in the station wagon and you load all the stuff in the back and on the roof. And the dogs and cats are sticking their heads out the windows. And you leave the driveway and the chassis starts to drag on the pavement? Sparks are flying, kids are yelling, parents are ready to scream.

As we go move into the future, we are taking steps to make sure that doesn’t happen to us. We’re getting ready for a big journey, and we’ve got to make sure the chassis can handle the load.

So we’ve launched something called the chassis project to make sure we grow wisely. And we’re looking at three areas in particular. First, how do we get the right people? Second, how do we get the right business processes and technology? And third, how do we make sure our culture adapts to the changes or change adapts to our culture? How do we orient people to a new way of doing things while keeping the great aspects of the old way?

First, the people. In terms of hiring, we face a unique challenge: For about half the positions we have to fill, we have to do what amounts to an executive level search. We can’t recruit 100 program officers in one fell swoop. We want to recruit the best candidates with very specialized areas of expertise.

I mentioned all the work we do in the Pacific Northwest. Well, that’s just one of 22 portfolios we have. You might call them product lines. How many 300-person organizations do you know with 22 product lines?

Our searches need to target an expert in, say, clean water in India. That person is not the same as our program officer who knows everything there is to know about microbicide trials in Botswana. Or our go-to person on college scholarships in the United States. Or our advocacy officers who understand the nuances of policy questions in one or more of 22 fields of interest.

To handle that work, we’re beefing up our recruiting team. Last year it had three people. This year it’s eight and it will go to 16 next year.

So we even have to tackle our problem in miniature. How do you recruit 13 recruiters who can learn about the areas we work in, and then how do you get them up to speed so they can bring in the right people and eventually get them up to speed?

What we’ve found is that it’s going to be critical for us to use the experts we already have to help us find the experts we need. We need to turn our organization into a 300-person recruiting organization, which means we need to build stronger relationships between the people who manage our grants and our human resources team. They need to know each other well, and they need to learn this issue together.

Second, the processes and the technology: You all know that when you’re a start-up, when you’re small, you can make do with that technology that you’ve got. If there are problems with it, you can work around them, and you can do your work just fine. But once you try to scale up, you’ve got to tailor your technology to your needs. It becomes a key business imperative.

Let me give you an example. For the past seven years, we’ve been using a software package to manage our grants. About six months ago, it became clear that we will need to upgrade and potentially change application. But now that we’re developing new strategies and initiatives, it’s a challenge because the software that works for the Education team won’t work for the Global Health team. Not to mention that the Global Development team has an entirely different way of doing things.

It’s counter-cultural for us, but we’ve realized that in some ways, the processes we build will have to follow on the great technologies available to us. We can’t always make the technologies follow all of our unique ways of working. So the Education and Global Health teams may need to adjust the way they function so it fits the technology at our disposal. That’s new for us, and it’s not easy.

Third, our culture. Our culture is everything to us for many, many reasons. One reason is that we don’t really have a market to tell us how we’re doing. You know, we’re putting hundreds of millions of dollars into an HIV vaccine, and we’re not going to know how that turns out for another 15 years at least.

There aren’t any competitors who might beat us to market, or set their prices lower. So our feedback and our motivation have to come from within. They have to be a part of our culture.

And our culture works very well now. Our people are passionate. They believe the problems they’re going after can be solved, and they believe they can be solved now. There’s an urgency—even an impatience—in our office, because we feel that it’s just plain wrong to waste even a minute.

But how do you take that intensity and scale it up? So we have just redesigned our orientation program for new employees. Now, it involves immersion in foundation-wide culture, which we need because many of our new employees have never worked in philanthropy before. It also entails intensive orientation to the workings of each program, so as each team grows it can keep its sense of identity.

Our culture has evolved organically over the last several years, and now we’re codifying it and translating it for new arrivals.

In closing, I have an overall reflection about our work.

The problems of scale can be addressed by great people, technologies, and culture.

The inequities of our world cannot. For that, we need something very, very different. And that is where we all come in. While our resources are vast, they’re nothing compared to the scope of the problems we’re dealing with. We need businesses—and governments, and non-profit groups, and heroes on the ground in slums and villages around the world—to work together. It’s a team sport—a team sport all the way. And it’s a terrible waste for anybody to sit on the bench.

So that’s how I would like to conclude today. I know so many of you already are, but I would ask that we all get in the game. I hope each of you will think about how you can tackle some of these pressing issues. Maybe you’ve got a passion for helping sick children in Africa. Or perhaps it’s homeless families right here in Seattle that move you. At the end of the day, we can’t solve any of these problems until each and every one of us decides they’re our own personal responsibility.

But once we do make that decision, we will solve them. The philosopher Peter Singer recently wrote a piece in the New York Times Magazine in which he proved that—without suffering significant hardship—the richest 10 percent of people in the world’s richest nations could afford to virtually eliminate global inequities six times over. It’s not that we don’t have the resources. It just a question of what we do with them.

So the facts are in. It’s time to move. With your help, we can create a world where my boss, the kid in the bucket, has every opportunity that she deserves.