washingtonpost.com
Gates's New Frontier

By Sebastian Mallaby
Monday, May 3, 2004

SEATTLE -- As a high-school hacker in the early 1970s, Bill Gates could see that technological advances would yield the first personal computer. When that computer materialized, in the form of the Altair 8800, Gates and his buddy Paul Allen were the first to write an operating system for it, and they founded a company called Microsoft to market the program. In the three decades since then, Gates has surfed the PC wave to unimaginable riches. The ride has imbued him with a sunny techno-optimism, a belief that large dollops of human intelligence can conjure up extraordinary progress.

The Altair 8800 appeared on the cover of Popular Electronics in its January 1975 issue. Eighteen years later, another publication heralded a different kind of intellectual breakthrough -- one that has also had a dramatic impact on Gates's career. In 1993, the World Bank released a report on health in developing countries, calculating the toll from diseases such as malaria in terms of disability-adjusted life years, a composite measure of the shortening of life and the lowering of its quality. When Gates read the report a few years later, it was an "Aha!" moment. He had passed his 40th birthday, but he had never before grasped the medical oppression of poor countries. He sent out copies of the study to dozens of associates, and he now gives nearly $600 million annually to improve world health.

Some of the mythology about Gates seems a bit outdated. The profiles of the past portray him as combatively disheveled, his hair chaotic and his glasses filthy. They describe him, alternatively, as a sort of disembodied intelligence: thin and pale almost to the point of weightlessness and colorlessness, not unlike software. But Gates appeared for an interview last week with a healthy buzz about him; he wore color-coordinated slacks and sweater; he was engagingly intelligent rather than arrogant or sinister. In his business career, Gates has been called the Prince of Darkness, Godzilla, the Dorsal Fin. But he has also created the largest philanthropic foundation in the world.

The one thing about Gates that fits with the old stereotypes is his belief in the power of intelligence. It's a natural faith for a programmer: In the world of software there's no filter between the engineer's inspiration and the result that he or she is seeking -- a program that works. In the computer world, moreover, intelligence has wrought such continuously marvelous change that techies speak as though some law ordains it: Moore's law, named for Gordon Moore of Intel, lays down that technological advance will double the power of microprocessors every 18 months or so without adding to their cost.

At Microsoft, faith in brain-power drives everything. "We come from a philosophy where there's generally a right answer and a wrong answer," Gates told the Post's Mark Leibovich four years ago. "And if you explore it enough, everybody will just agree there's a right answer and a wrong answer." Gates feels the same way about his battle against disease in the poor world. Just as computing was on the verge of a breakthrough when he wrote his first programs, so medicine is about to reap the benefits of biotechnology and genomics. "You will see a Moore's law-type improvement in the fight against cancer," Gates predicts confidently, because pharmaceutical companies will translate advances in the basic science into marketable products. The challenge for his philanthropy is to turn biological advance into equally wonderful progress against diseases from which rich countries don't suffer, so that the world gets a vaccination for AIDS as well as treatments for erectile dysfunction.

Of course, you can be skeptical. There is no Moore's law for the problems of poor countries: Much of the developing world has gone sideways over the past two decades, and many medical technologies (malaria-preventing bed nets, or oral rehydration therapy for diarrhea) are not effectively deployed. Unlike software engineers, development experts face a thicket of filters between their good ideas and results: To implement an AIDS program, for example, you must contend with sexual taboo, social stigma and gender inequality. In the Microsoft culture, it's a put-down to accuse someone of being "random." In development, random stuff happens all the time.

And yet Gates's optimism is infectious. Technological advance does have the potential to cut through the frustrations of development. If we had an AIDS vaccine, for example, we could bypass the difficult fight against taboo and stigma. If we had a way to preserve vaccines without refrigerating them, we would not have to organize cold chains to get medicines out to villages. It's hard to get parents to deploy malaria bed nets consistently. But if there were a one-shot malaria vaccine, the problem would be solved.

More than that, Gates's techno-optimism might even dent the strange lethargy toward global poverty that affects the public -- the oddity that American high-schoolers are more likely to worry about the erosion of the rain forests than the fact that, every year, 10 million children die before their fifth birthdays. If Americans get the idea that, with enough scientific effort, nearly all those deaths could be averted, they might break out of the pessimism that crushes the impulse to demand action. From Kennedy's moon shot to Google's share offering, technological triumph has fired the public imagination. Married to the cause of fighting poverty, it packs a moral oomph as well.

mallabys@washpost.com

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