Rajiv Shah

"Before that trip, it had never occurred to me that people could live in such destitute circumstances," Shah said in 2008.

After graduating in 1995, Shah went on to the University of Pennsylvania, where he earned a degrees in medicine and business.

He took time off from his studies to move to Nashville and advise 2000 presidential candidate Al Gore on health-care policy. Shah told the Penn Gazette that he "fell in love" with politics (along with his wife) during those 16-hour days on the campaign.

Shah later proposed to his wife by flying to India for a day to propose to her at the Taj Mahal.

Bill and Melinda Gates Foundation

After graduating in 2002, a former colleague with the Gore campaign encouraged him to take a temporary position with the Bill and Melinda Gates Foundation.

That interim job led a to full-time stint as deputy director of policy and finance for the foundation's global-health program. In that position, Shah helped raise over $5 billion for the Global Alliance for Vaccines and Immunizations (GAVI), an initiative that funds childhood-immunization programs.

Shah eventually pushed the organization in a new direction by lobbying to lead a division on agriculture, particularly in Africa. The foundation agreed, and Shah took over that portfolio. "When we started, developing-world agriculture seemed very much out of fashion," Shah told the New York Times in October 2008.

But the Gates Foundation was a leader in changing that perception. It invested serious money in trying to reduce food shortages and redevelop agricultural markets.

Obama Administration

Still, the lure of politics was too strong. In May 2009, Shah joined the Obama administration as undersecretary of agriculture for research, education and economics and cjhief scientist. To prepare for the gig, Shah told the Seattle Post Intelligencer that he read Team of Rivals, a history book on Abraham Lincoln's cabinet.

At the USDA, Shah worked on everything from food safety to sustainable agriculture. He also emphasized explaining the results of his research to the public. "Americans are willing to support public actions, and public institutions, but they expect results."

Just a few months later, Shah was tapped to run USAID. Shah's confirmation came after nearly a year of false starts and stalls by the White House, which initially intended to tap Paul Farmer. Farmer withdrew his name in summer 2009 because of the intrustive vetting process.

The delay drew criticism from several foreign policy hands, who said that Obama's vision of "smart power diplomacy" could only be realized with a strong head of USAID.

In his first months in office, Shah outlined the four "core areas" USAID will address during his term - recommitting USAID to the Millennium Development Goals, investing in country-owned models of growth and development success, developing and delivering scientific and technological breakthroughs, and utilizing USAID expertise in conflict settings.

"Most of all, we need to change internally," Shah said. "We need to reform or eliminate processes that inhibit our success, and truly treat development as a discipline. We need to take risks, acknowledge mistakes, and harness the passion that brought us to this field."

He also relaunched the policy planning shop.

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